scholarly journals Protracted cholera outbreak in the Central Region, Ghana, 2016

2020 ◽  
Vol 54 (2) ◽  
pp. 45-52
Author(s):  
Gyesi Issahaku ◽  
Franklin Asiedu-Bekoe ◽  
Samuel Kwashie ◽  
Francis Broni ◽  
Paul Boateng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vibrio Cholerae ◽  
Point Of Care ◽  
Contact Tracing ◽  
Treatment Center ◽  
Cholera Outbreak ◽  
Cape Coast ◽  
Point Of Care Test ◽  
Sanitation And Hygiene ◽  
Health Directorate

Objective: On 24th October 2016, the Central Regional Health Directorate received report of a suspected cholera outbreak in the Cape Coast Metropolis (CCM). We investigated to confirm the diagnosis, identify risk factors and implement control measures.Design: We used a descriptive study followed by 1:2 unmatched case-control study.Data source: We reviewed medical records, conducted active case search and contact tracing, interviewed case-patients and their contacts and conducted environmental assessment. Case-patients' stool samples were tested with point of care test kits (SD Bioline Cholera Ag 01/0139) and sent to the Cape Coast Teaching Hospital Laboratory for confirmation.Main outcomes: Cause of outbreak, risk factors associated with spread of outbreakResults: Vibrio cholerae serotype Ogawa caused the outbreak. There was no mortality. Of 704 case-patients, 371(52.7%) were males and 55(7.8%) were aged under-five years. The median age was 23 years (interquartile range: 16-32 years). About a third 248(35.2%) of the case patients were aged 15-24 years. The University of Cape Coast subdistrict was the epicenter with 341(48.44%) cases. Compared to controls, cholera case-patients were more likely to have visited Cholera Treatment Centers (CTC) (aOR=12.1, 95%CI: 1.5-101.3), drank pipe-borne water (aOR=11.7, 95%CI: 3.3-41.8), or drank street-vended sachet water (aOR=11.0, 95%CI: 3.7-32.9). Open defecation and broken sewage pipes were observed in the epicenter.Conclusion: Vibrio cholerae serotype Ogawa caused the CCM cholera outbreak mostly affecting the youth. Visiting CTC was a major risk factor. Prompt case-management, contact tracing, health education, restricting access to CTC and implementing water sanitation and hygiene activities helped in the control.Keywords: Cholera outbreak, Vibrio cholerae serotype Ogawa, Cholera treatment center, Water sanitation and hygiene, Cape Coast MetropolisFunding: This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana

Hypoglycemia screening of asymptomatic newborns on the 2nd day of life

2021 ◽  
pp. 1-6
Author(s):  
H. Karbalivand ◽  
A. Iyare ◽  
A. Aponte ◽  
X. Xianhong ◽  
M. Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Glucose Concentration ◽  
Prospective Observational Study ◽  
Point Of Care ◽  
Large For Gestational Age ◽  
Endocrine Society ◽  
Point Of Care Test ◽  
American Academy Of Pediatrics

BACKGROUND: Neonatal hypoglycemia management in the first 48 hours is guided by the American Academy of Pediatrics (AAP) and Pediatric Endocrine Society (PES) recommendations. Our aim was to determine the incidence of hypoglycemia via point of care test (POCT) on the 2nd day of life (DOL) among healthy, asymptomatic neonates regardless of risk factors. METHODS: In this prospective observational study, preprandial point of care glucose concentration was measured on the 2nd DOL in 150 healthy, asymptomatic neonates in the newborn nursery. We used 50 mg/dl (2.8 mmol/L) as the hypoglycemia threshold based on PES recommendations. RESULTS: The incidence of hypoglycemia on the second DOL was 10% among asymptomatic neonates (no risk factors = 8% ; late preterm birth (LPT) + small for gestational age (SGA) = 16% ; large for gestational age (LGA) + infant of diabetic mother (IDM) = 6%). SGA + LPT neonates accounted for the majority of the hypoglycemic cases (53.3%) and exhibited a trend towards the lowest glucose concentration (p = 0.09). CONCLUSION: The incidence of hypoglycemia on DOL 2 among asymptomatic neonates is high and of unclear significance in the absence of dedicated neurodevelopmental follow-up.

Auditing the use and assessing the clinical utility of microscopy as a point-of-care test for Neisseria gonorrhoeae in a Sexual Health clinic

2017 ◽  
Vol 29 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Sarah Mensforth ◽  
Nicola Thorley ◽  
Keith Radcliffe
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Clinical Utility ◽  
Point Of Care ◽  
Nucleic Acid Amplification ◽  
Contact Tracing ◽  
Health Clinic ◽  
Exact Test ◽  
Point Of Care Test ◽  
Sex With Men ◽  
Prompt Diagnosis

We assessed whether urethral microscopy was performed as per clinic protocol for male clinic attendees reporting contact with Neisseria gonorrhoeae (GC), urethral symptoms or given a diagnosis of epididymo-orchitis (EO) over a 12-month period (9732 patients). Prevalence of gonorrhoea in the contacts, urethral symptoms and EO groups was 50, 12.7 and 1.6%, respectively. Microscopy was performed reliably for contacts (96%), those with discharge/dysuria with evidence of urethritis on examination (98%), but not those with EO (43%). We explored the clinical utility of microscopy as a point-of-care test for identifying urethral GC in each subgroup, using the APTIMA Combo 2 CT/GC nucleic acid amplification test as the comparator (1710 patients). Sensitivity of microscopy for each subgroup was good; there was no statistical difference between subgroup sensitivity using Fisher’s exact test. Microscopy is valuable to ensure prompt diagnosis and contact tracing. All GC contacts were treated ‘epidemiologically’; however, half of GC contacts did not have GC. Microscopy identified the majority of GC cases, including amongst contacts (71% of heterosexual contacts, 66% of contacts reporting sex with men). We propose that epidemiological treatment for GC contacts should be reconsidered on the grounds of antibiotic stewardship, favouring use of microscopy to guide treatment decisions.

scholarly journals Refugee Settlements and Cholera Risks in Uganda, 2016–2019

2021 ◽  
Vol 104 (4) ◽  
pp. 1225-1231
Author(s):  
Godfrey Bwire ◽  
Christopher Garimoi Orach ◽  
Freda Loy Aceng ◽  
Sam Emmanuel Arianitwe ◽  
David Matseketse ◽  
...  
Keyword(s):  
Case Control ◽  
Host Population ◽  
Treatment Center ◽  
Prevention Measures ◽  
Case Control Studies ◽  
Cholera Outbreak ◽  
Registration Process ◽  
Standardized Protocol ◽  
Sanitation And Hygiene ◽  
Cholera Vaccination

ABSTRACTDuring 2016 to 2019, cholera outbreaks were reported commonly to the Ministry of Health from refugee settlements. To further understand the risks cholera posed to refugees, a review of surveillance data on cholera in Uganda for the period 2016–2019 was carried out. During this 4-year period, there were seven such outbreaks with 1,495 cases and 30 deaths in five refugee settlements and one refugee reception center. Most deaths occurred early in the outbreak, often in the settlements or before arrival at a treatment center rather than after arrival at a treatment center. During the different years, these outbreaks occurred during different times of the year but simultaneously in settlements that were geographically separated and affected all ages and genders. Some outbreaks spread to the local populations within Uganda. Cholera control prevention measures are currently being implemented; however, additional measures are needed to reduce the risk of cholera among refugees including oral cholera vaccination and a water, sanitation and hygiene package during the refugee registration process. A standardized protocol is needed to quickly conduct case–control studies to generate information to guide future cholera outbreak prevention in refugees and the host population.

scholarly journals Sero-prevalence and Risk Factors for Hepatitis A Virus Infection among Pregnant Women at the Samandin Medical Center, Ouagadougou, Burkina Faso

2019 ◽  
pp. 1-9
Author(s):  
Rouamba Poda Somda Hortense ◽  
Ouoba Jean Bienvenue ◽  
Traoré Kuan Abdoulaye ◽  
Ouoba Bruno Lalidia ◽  
Kagambéga Asséta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Burkina Faso ◽  
Pregnant Women ◽  
Hepatitis A Virus ◽  
Medical Center ◽  
Point Of Care ◽  
Epidemiological Survey ◽  
Elisa Test ◽  
Cross Sectional ◽  
Point Of Care Test

Aims: This study determined prevalence and possible risk factors associated with HAV infection and compared Immunochromatography (IgG) rapid point of care test with standard ELISA test for diagnosis. Study Design:  Cross sectional epidemiological survey. Place and duration of Study: The study was carried out at the Samandin Medical Center (Ouagadougou, Burkina Faso), from July 2017 to December 2017. Methodology: A total of 180 pregnant women were recruited at the Samandin Medical Center. Anti-HAV IgM and IgG detection tests were performed using AccuDiag™ HAV ELISA kit (Calabasas, CA, USA) and SD BIOLINE HAV IgG/IgM Rapid Diagnostic Test (Gyeonggi-do, Korea). Results: IgG anti-HAV antibodies (AccuDiag Elisa) were found with a prevalence of 88.9% (160/180) and Anti-HAV IgM were 1.1% (2/180). Of the 160 AccuDiag HAV IgG positive samples, 44.4% (80/180) tested positive using SD BIOLINE Diagnostics HAV IgG. Regarding risk factors, 86.9% (86/99) of the IgG positive women were illiterate; 90.7% (39/43) lived mostly in peripheral areas; 89.2% (74/83) were household workers and 88.6% (93/105) used fountain water. Conclusion: Our results demonstrated poor agreement between the assays tested, which are consistent with previous reports demonstrating significant variability between HAV ELISA and RDT HAV. Moreover, the detection of HAV specific IgM antibodies in two asymptomatic pregnant women signaled the current circulation of HAV in this area.

scholarly journals Multiple Drug-Resistant Vibrio Cholerae Responsible for Cholera Outbreak among Migrant Domestic Workers in Kerala, South India

Proceedings ◽  
2021 ◽  
Vol 66 (1) ◽  
pp. 26
Author(s):  
Kiran Krishna ◽  
Abdulaziz Anas ◽  
Sreelakshmi Parakkaparambil Kuttan ◽  
Syamkumar Vijayakumar ◽  
Jasmin Chekidhenkuzhiyil ◽  
...  
Keyword(s):  
Vibrio Cholerae ◽  
Migrant Workers ◽  
Pathogenic Bacteria ◽  
Multiple Drug ◽  
Cholera Outbreak ◽  
Pathogenic Vibrio ◽  
Sanitation And Hygiene ◽  
Multiple Drug Resistant ◽  
Clonal Origin ◽  
Repetitive Extragenic Palindromic Pcr

Cholera outbreaks are prevalent in countries with a low Human Development Index (HDI) where people have limited access to safe drinking water, sanitation and hygiene (WASH). Intriguingly, the state of Kerala which records the highest HDI in India is endemic to cholera. We discuss the epidemiology of a cholera outbreak reported among migrant workers of Kerala in 2017. Virulence genes of Vibrio cholerae, toxR and ctxA, were detected in the river and ground water samples collected from the outbreaks sites which indicates need of enhanced awareness on WASH practices among migrant workers. The pathogenic Vibrio cholerae isolated from four patients in two districts had a similar DNA band pattern when analysed using repetitive extragenic palindromic-PCR (BOX), which indicates their single clonal origin. The four isolates were serotyped as O1 Ogawa. These isolates were resistant to multiple antibiotics including the carbapenem like imipenem. Nevertheless, isolates of these pathogenic bacteria were susceptible to tetracycline, identical to clinical isolates of Vibrio cholera reported earlier from this region. The current study highlights the importance of generating awareness on WASH protocols among migrant workers to prevent the outbreaks and considers community-based data as socioeconomic variable to predict the incidence of cholera.

scholarly journals India and COVID-19: the task ahead

2020 ◽  
Vol 7 (10) ◽  
pp. 4199
Author(s):  
Madhulekha Bhattacharya ◽  
Madhumita Mukherjee ◽  
Shambhavi .
Keyword(s):  
Hot Spots ◽  
Point Of Care ◽  
Case Fatality ◽  
Contact Tracing ◽  
Young Population ◽  
Treatment Protocols ◽  
Remote Areas ◽  
Point Of Care Test ◽  
The Supreme Court ◽  
Testing Policies

COVID-19 pandemic has impacted countries across the globe causing unprecedented morbidity and mortality and weakening the economic fiber of each country. India too has to face this challenge by its strengths and manage the weaknesses to get over this COVID-19 disease, which is recording an average of 30 to 40000 positive cases per day in july2020 .The factors in favor of India are the epidemiological parameters such as low case fatality rate of 2.43%, recovery rate of 66% , the young population (67 % between 15 to 64 years), and only 7% (65 years plus) population. The guidelines issued by government of India regarding ban on travel, quarantine, isolation, treatment protocols, containment zones and testing policies steering the country with low death rates. The supreme court directive to increase testing facilities is being implemented with all medical colleges and private sector given permission for testing. The “point of care test” at hot spots will unearth asymptomatic and pre-symptomatic cases and prevent transmission from them. However, lack of concept of insurance and prevention in the community, misconceptions about quarantine, economic crisis and insufficient health infrastructure are hindrances in managing the current pandemic. The dictum of prevent, test, track and treat given by Indian council of medical research chief is the path to be followed. Aided by the various digital apps for contact tracing, tele medicine for managing cases in remote areas and provision of hospital facilities for moderate and severe cases till the indigenous vaccine arrives, should be the strategy adopted by India to get over the COVID-19 pandemic.

Testing for resistance: Point-of-care testing as a communicational tool in antibiotic prescribing

2018 ◽  
Vol 14 (3) ◽  
pp. 229-240
Author(s):  
Johanna Lindell
Keyword(s):  
Point Of Care ◽  
Rapid Test ◽  
Antibiotic Use ◽  
Treatment Recommendation ◽  
Antibiotic Prescribing ◽  
Communicative Practices ◽  
Effective Strategies ◽  
Reactive Protein ◽  
Point Of Care Test ◽  
Test Result

As antibiotic resistance becomes a growing health emergency, effective strategies are needed to reduce inappropriate antibiotic use. In this article, one such strategy – communicative practices associated with the C-reactive protein point-of care test – is investigated. Building on a collection of 31 videorecorded consultations from Danish primary care, and using conversation analysis, this study finds that the rapid test can be used throughout the consultation to incrementally build the case for a nonantibiotic treatment recommendation, both when the test result is forecast and reported. The study also finds that the format of reports of elevated results differs from that of ‘normal’ results, resulting in a subtle shift of authority from doctor to test.

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