Trends in Empirical Treatment of Hospitalized Children with Acute Gastroenteritis in Nigeria

Author(s):  
Ebuka E. David ◽  
Ikechuku O. Igwenyi ◽  
Ifeanyichukwu R. Iroha ◽  
Chidinma N. David ◽  
Precious C. Mbah ◽  
...  

Background: Acute gastroenteritis is a common infectious disease with a high rate of morbidity and mortality in children below five years of age. Appropriate empirical treatment is therefore vital for reducing the incidence of the disease. Objective: This study aimed at determining the trends in the empirical treatment of hospitalized children with acute gastroenteritis. Method: The study involved the data analysis of 88 medical folders of children who were diagnosed with gastroenteritis from January to February 2020 (a period of gastroenteritis yearly outbreak) in Mile 4 Hospital Abakaliki, Ebonyi State, Nigeria. Socio-demographic data and administered antibiotics data were collected. Result: Out of the 88 children, a total of 54 (61%) children were males, while 34 (39%) were females. The ages of the children ranged between 1-51 months, while the mean age was seen at 14 months. About 58 (66%) were diagnosed with acute gastroenteritis alone, with children aged 7-12 months recording higher numbers [25 (28%)]. Severe dehydration was seen as the most common morbidity of children with acute gastroenteritis. The guardians/parents of these children stayed at home for an average of 3 days (1-6 days) before visiting the hospital. The children were treated for an average of 5 days (2-9 days) in the hospital. The most singly used antibiotics was ciprofloxacin [31 (35%)] followed by a combination of ciprofloxacin and ceftriaxone [21 (24%)]. About 12 (14%) of the children were treated using a single dose of the antimalarial drug while 10 (11%) were treated in double combination therapy. The lowest duration in hospitalization (4 days) was seen in the use of a single dose regimen, while the highest hospitalization time (6 days) was seen in the use of a triple dose regimen. Conclusion: The best empirical treatment of acute gastroenteritis may involve the use of ciprofloxacin alone and its combination with ceftriaxone. The severity of gastroenteritis may also be exacerbated with malaria.

2019 ◽  
Author(s):  
Tegegne Eshetu ◽  
Mulugeta Aemero ◽  
Ayalew Jejaw

Abstract Background: The current control efforts against soil transmitted helminthic infection focused on reducing morbidity and transmission potential through periodic anthelminthic chemotherapy of single dose of mebendazole and albendazole regimen. Single dose mebendazole is one of extensively applicable drug regimen as a preventive chemotherapy in hookworm endemic areas. However, nowadays, studies reveal single dose treatment regimen has poor and unsatisfactory efficacy status against hookworm infection. We evaluated the efficacy status of single dose (500mg) versus triple dose (100mg) of mebendazole against hookworm infection among school aged children.Methods: This randomized, single-blinded clinical trial took place in a primary school on Burie and Debre Elias towns, Northwest Ethiopia among school-aged children (6-14). Using simple randomization, eligible hookworm positive children were randomly allocated (1:1) to either a single dose or triple dose of mebendazole arm. Stool samples were collected at baseline and follow-up period (14-21 days after treatment) for McMaster analysis. The primary and secondary outcome measures in this study were cure rate (CR) and egg reduction rate (ERR), respectively. Results were displayed using tables and figure. Independent t test was used to compare group means, logistic regression was used to calculate odds ratio (OR), and P-value < 0.05 at 95% CI was considered for statistical significance.Result: 109 children were allocated for each treatment arm and 103 children were completed the drug efficacy follow up study. Cure rate against hookworm was significantly higher in triple dose (96.1%) than in single dose (30.8%) with (OR=55.125; 95% CI: 11.92-254.9; P < 0.001). Egg reduction rate against hookworm infection in triple dose (99.5%) was also significantly higher than single dose (68.9%) with difference t (101) =5.38; 95% CI 230.95-505.36; P < 0.001.Conclusion: Single dose regimen of mebendazole for the treatment of hookworm infection showed poor efficacy, while triple dose revealed satisfactory efficacy. Therefore, we recommend for giving special emphasis on current deworming program which implemented through single dose mebendazole for hookworm endemic area.


2017 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
Rajni Suri ◽  
Anshu Suri ◽  
Neelam Kumari ◽  
Amool R. Singh ◽  
Manisha Kiran

The role of women is very crucial in our society. She cares for her parents, partner, children and other relatives. She performs all types of duties in family and also in the society without any expectations. Because of playing many roles, women often face many challenges in their life including both physical and mental. Mental health problems affect women and men equally, but some problems are more common among women including both physical and mental health problems. Aim of the study - The present study is aimed to describe and compare the clinical and socio-demographic correlates of female mentally ill patients. Methods and Materials: The study includes 180 female mentally ill patients based on cross sectional design and the sample for the study was drawn purposively. A semi structured socio-demographic data sheet was prepared to collect relevant information as per the need of the study. Result: The present study reveals that the socio-demographic factors contribute a vital role in mental illness. Findings also showed that majority of patients had mental problems in the age range of 20-30 have high rate. Illiterate and primary level of education and daily wage working women as well as low and middle socio-economic status women are more prone to have mental illness. Other factors like marital status, type of family and religion etc also important factors for mental illness. Keywords: Socio demographic profile, female, psychiatric patient


Author(s):  
Fang-Tzy Wu ◽  
Tomoichiro Oka ◽  
Ting-Yu Kuo ◽  
Yen Hai Doan ◽  
Luke Tzu-Chi Liu

2001 ◽  
Vol 39 (5) ◽  
pp. 1999-2001 ◽  
Author(s):  
I. T. Araujo ◽  
M. S. R. Ferreira ◽  
A. M. Fialho ◽  
R. M. Assis ◽  
C. M. Cruz ◽  
...  

Author(s):  
Abdulrahman Y. Al-Haifi ◽  
Abdul Salam Mohamed Al Makdad ◽  
Mohammed Kassim Salah ◽  
Hassan A. Al-Shamahy ◽  
Wadee Abdullah Abdulwahid Al Shehari

Objectives:  Lower respiratory infections (LRTIs) are the leading reason of death infectious diseases in the world and the fifth leading cause of death in general. The study aimed to identify the general characteristics of LRTI, the causative bacteria and the results of sensitivity to antibiotics. Subjects and methods:  A multicentre prospective study was performed at 3 University hospitals. The study included 555 clinical diagnostic cases as LRTI cases, 328 male and 227 female, aged 3 to 69 years. Clinical and demographic data were collected in the standard questionnaire, and samples included sputum or bronchial lavage (BAL) staining and culture. Samples were cultured in 3 different bacterial media, blood agar and LJ slope, chocolate agar with Co2; cultures were then examined for possible bacterial pathogens of LRTI. Possible bacterial pathogens were isolated and identified by standard laboratory techniques, and microbial sensitivity testing was carried out by disc diffusion method. Results:  LRTI was recorded among all age groups and with less frequency in children less than 16 years of age. A large number of LRTI (36.2%) was not diagnosed, most in CAP (52.4%), followed by HAP (33.9%) while unidentified cases were lower in AECOPD (22.8%). CAP isolates are K. pneumoniae (26.2%), S. pyogens (12.3%), and S. pneumoniae (9%); in HAP are MSSA (24%), E. Coli (12.9%), MRAS (11.1%), K. pneumoniae (10.5%) and P. aeruginosa (7%); and in AECOPD are M. catarrhalis (47.2%), K. pneumoniae (17.2%), H. influnzae (10.7%) and P. aeruginosa (2%). In Gram-positive bacteria, high resistance to ampicillin/sulbactam (100%) and amoxicillin/clavulanate (100%) was recorded, while moderate resistance to amikacin, vancomycin, cefepime and moxifloxacin was recorded. In Gram-negative bacteria, a high resistance to 3rd g Cephalosporin’s  (68.5%) was recorded, while a moderate sensitivity to the other antibiotics tested was recorded. Conclusion:  There is a high rate of undiagnosed LRTI in Yemen and this highlights the need for health authorities to develop strategies to diagnose most of the causes of LRTI, including Mycoplasma, Chlamydia, and viral causes. No antibiotics are completely effective in treating LRTI in our area and antibiotic sensitivity should be performed in all cases. Peer Review History: Received 22 April 2019; Revised 4 May; Accepted 9 May, Available online 15 May 2020 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Name: Dr. Michael Otakhor Erhunmwunse Affiliation: St. Philomena Catholic Hospital, Nigeria E-mail: [email protected]   Name: Dr. Amany Mohamed Alboghdadly Affiliation: Princess Nourah bint abdulrahman university, Riyadh E-mail: [email protected] Comments of reviewer(s): Similar Articles: BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN PREVALENCE, ANTIMICROBIAL SUSCEPTIBILITY PATTERN AND RISK FACTORS OF MRSA ISOLATED FROM CLINICAL SPECIMENS AMONG MILITARY PATIENTS AT 48 MEDICAL COMPOUND IN SANA'A CITY-YEMEN


2020 ◽  
Author(s):  
Tegegne Eshetu ◽  
Mulugeta Aemero ◽  
Ayalew Jejaw

Abstract Background: Despite the existence of a population-based control program using single dose albendazole or mebendazole as a preventive chemotherapy, hookworm transmission remains high. It causes a negative impact on the growth and school performance of children. In connection to this preventive chemotherapy, different studies produced conflicting results. This study aimed at evaluating the efficacy of single (500mg) versus multiple doses (100mg twice a day during three consecutive days) of mebendazole against hookworm infections among school-aged children. Methods: This randomized open-label clinical trial took place among school-aged children (6-14 years old) in Burie and Debre Elias towns, Northwest Ethiopia. Using simple randomization, eligible hookworm-positive children were allocated (1:1) to either a single or multiple dose treatment arms. Stool samples were collected and processed using McMaster method at baseline and follow-up period (14-21 days after treatment). Only laboratory technicians were blinded. The cure and egg reduction rates which were assessed after 14-21 days of treatment were the primary and secondary therapeutic outcome measures against hookworm infections, respectively. An independent t-test was used to compare group means, and logistic regression was used to calculate odds ratio (OR). P-value < 0.05 at 95% CI was considered statistically significant. Result: 108 children, 54 in each treatment arm had completed baseline data and received allocated treatment. 103 children had completed follow-up data records and included for the final efficacy analysis. Cure rate against hookworm was significantly higher in the multiple dose (96.1%) than in the single dose (30.8%) with OR=55.125; 95% CI: 11.92-254.9; P < 0.001. The egg reduction rate in the multiple dose treatment arm (99.5%) was also significantly higher than in the single dose arm (68.9%) with difference t (101) =5.38; 95% CI 230.95-505.36; P < 0.001. Conclusion: The single dose regimen of mebendazole for the treatment of hookworm infections showed poor cure and egg reduction rates, while the multiple dose revealed satisfactory. Although multiple dose regimen administration is a bit more complex than the single dose, we strongly encourage replacing it with multiple dose regimen during deworming programs in hookworm endemic areas. Trial registration: This trial is registered in www.pactr.org, # PACTR201911466695052.


2020 ◽  
Author(s):  
Tegegne Eshetu ◽  
Mulugeta Aemero ◽  
Ayalew Jejaw

Abstract Background : Despite the existence of population-based control program using single dose albendazole or mebendazole as a preventive chemotherapy, Hookworm disease transmissions remains high. It causes a negative impact on the growth and school performance of children. In connection to this preventive chemotherapy, different studies produced conflicting results. This study evaluated the efficacy of single (500mg) versus multiple doses (100mg twice a day during three consecutive days) of mebendazole against Hookworm infections among school aged children. Methods : This randomized single-blinded clinical trial took place among school-aged children (6-14 years old) in Burie and Debre Elias towns, Northwest Ethiopia. Using simple randomization, eligible Hookworm positive children were allocated (1:1) to either a single or multiple doses treatment arm. Stool samples were collected and processed using McMaster method at baseline and follow-up period (14-21 days after treatment). Main outcome measures : The cure rate against Hookworm and egg reduction rate for determining the changes in infection intensity were the main outcome measures after 14-21 days following dosing. An independent t-test was used to compare group means, and logistic regression was used to calculate odds ratio (OR). P-value < 0.05 at 95% CI was considered statistically significant. Result: 109 children were participated in both treatment arms. Cure rate against Hookworm was significantly higher in the multiple dose (96.1%) than in the single dose (30.8%) with (OR=55.125; 95% CI: 11.92-254.9; P < 0.001). The egg reduction rate in the multiple dose treatment arm (99.5%) was also significantly higher than in the single dose arm (68.9%) with difference (t (101) =5.38; 95% CI 230.95-505.36; P < 0.001). Conclusion : The single dose regimen of mebendazole for the treatment of Hookworm infection showed poor efficacy, while the multiple dose revealed satisfactory efficacy. Moreover, infection intensity reduction was not achieved following single dosing. Therefore, we strongly recommend replacing the single dose mebendazole regimen with multiple dose regimen during deworming program in hookworm endemic areas. Trial registration : This trial is registered in www.pactr.org , # PACTR201911466695052


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