Nigeria bears the world’s highest burden of schistosomiasis, with school-aged children and adolescents experiencing particularly high prevalence and infection intensity. In Zaria metropolis, the abundance of water bodies and frequent water-contact activities, including irrigation farming and swimming, may increase the risk of transmission. This study aimed to determine the prevalence of schistosomiasis and identify its associated risk factors among school-aged children and adolescents in Zaria metropolis. A community-based cross-sectional study was conducted among individuals aged 6–19 years using a multistage sampling technique to select communities, clusters, and households. Stool and urine samples were collected from eligible participants and examined for ova of Schistosoma species using standard laboratory techniques. Demographic characteristics and potential risk factors were assessed using a structured questionnaire, and the data were analysed using SPSS version 26. A total of 423 participants were recruited from the Biye, Bomo, Wuchichiri, and Kufena communities. The overall prevalence of schistosomiasis was 10.6% (45/423), comprising 9.5% (40/423) urinary schistosomiasis caused by Schistosoma haematobium and 1.2% (5/423) intestinal schistosomiasis caused by Schistosoma mansoni. Frequent water contact through swimming and irrigation farming was significantly associated with increased odds of infection (adjusted odds ratio [AOR] = 2.688, 95% confidence interval [CI]: 1.341–5.386, p = .005), while geographical location was also independently associated with schistosomiasis (AOR = 0.275, 95% CI: 0.102–0.740, p = .011). These findings indicate a high prevalence of schistosomiasis among school-aged children and adolescents in Zaria metropolis and demonstrate the importance of water-contact behaviour and geographical context in sustaining transmission. The study provides epidemiological evidence to support geographically targeted interventions, health education, reduced exposure to infested water bodies, and strengthened schistosomiasis prevention and control programmes.

Multidrug-resistant organisms (MDROs) are important in clinical practice worldwide. As whole genome sequencing (WGS) technologies are adopted, it is key to understand the nature of MDROs before the introduction of WGS in resource-poor settings. A hospital-based surveillance study was conducted in the largest referral health facility in northern Nigeria. A rectal swab sample was collected from each patient and samples were investigated for extended spectrum beta-lactamases and carbapenemase-resistant Enterobacterales (i.e. ESBL-PE and CRE, respectively). These MDROs were subjected to antimicrobial susceptibility testing and multiplex PCR. Statistical analyses were used to identify any associations between MDROs and selected antibiotics. The prevalence of MDROs among participants (N=168) was 87.5% (n=147) for ESBL-PE and 4.2% (n=7) for CRE. All isolates were resistant to tetracycline and co-trimoxazole; however, most MDROs were susceptible to meropenem, ceftazidime-avibactam and fosfomycin (≥70%). blaSHV (33.3%; n=49) was the predominant ESBL gene carried by the isolates, followed by combinations of blaSHV, blaCTX and blaTEM. Although no carbapenemase genes were found, all CRE isolates had the blaOXA-48 gene, which may not be associated with phenotypic carbapenem resistance observed (χ2=0.056, p=0.81). Research utilising WGS and bioinformatics will elucidate more of the molecular landscape of MDROs in resource-poor settings.

BACKGROUND:It is well documented that inappropriate use of antimicrobials is the major driver of antimicrobial resistance. To combat this, antibiotic stewardship has been demonstrated to reduce antibiotic usage, decrease the prevalence of resistance, lead to significant economic gains and better patients' outcomes. In Nigeria, antimicrobial guidelines for critically ill patients in intensive care units (ICUs), with infections are scarce. We set out to develop antimicrobial guidelines for this category of patients.METHODS:A committee of 12 experts, consisting of Clinical Microbiologists, Intensivists, Infectious Disease Physicians, Surgeons, and Anesthesiologists, collaborated to develop guidelines for managing infections in critically ill patients in Nigerian ICUs. The guidelines were based on evidence from published data and local prospective antibiograms from three ICUs in Lagos, Nigeria. The committee considered the availability of appropriate antimicrobial drugs in hospital formularies. Proposed recommendations were approved by consensus agreement among committee members.RESULTS:Candida albicans and Pseudomonas aeruginosa were the most common microorganisms isolated from the 3 ICUs, followed by Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli. Targeted therapy is recognized as the best approach in patient management. Based on various antibiograms and publications from different hospitals across the country, amikacin is recommended as the most effective empiric antibiotic against Enterobacterales and A. baumannii, while colistin and polymixin B showed high efficacy against all bacteria. Amoxicillin-clavulanate or ceftriaxone was recommended as the first-choice drug for community-acquired (CA) CA-pneumonia while piperacillin-tazobactam + amikacin was recommended as first choice for the treatment of healthcare-associated (HA) HA-pneumonia. For ventilatorassociated pneumonia (VAP), the consensus for the drug of first choice was agreed as meropenem. Amoxycillin-clavulanate +clindamycin was the consensus choice for CAskin and soft tissue infection (SSIS) and piperacillin-tazobactam + metronidazole ±vancomycin for HA-SSIS. Ceftriaxone-tazobactam or piperacillin-tazobactam + gentamicin was consensus for CA-blood stream infections (BSI) with first choice+regimen for HA-BSI being meropenem/piperacillin-tazobactam +amikacin +fluconazole. For community-acquired urinary tract infection (UTI), first choice antibiotic was ciprofloxacin or ceftriaxone with a catheter-associated UTI (CAUTI) regimen of first choice being meropenem + fluconazole.CONCLUSION:Data from a multicenter three ICU surveillance and antibiograms and publications from different hospitals in the country was used to produce this evidence-based Nigerian-specific antimicrobial treatment guidelines of critically ill patients in ICUs by a group of experts from different specialties in Nigeria. The implementation of this guideline will facilitate learning, continuous improvement of stewardship activities and provide a baseline for updating of guidelines to reflect evolving antibiotic needs.

Gonorrhoea is a sexually transmitted infection (STI) that increases the risk of infection with human immunodeficiency virus (HIV) and causes infertility and urethral stricture. We describe three cases of sexually active men, otherwise stable, who presented with a history of painful micturition and creamy white, urethral discharge. A clinical diagnosis of gonococcal urethritis was made and confirmed by microscopy, culture and 16SrRNA. Antimicrobial susceptibility revealed resistance to all the antimicrobial agents tested including ceftriaxone. A dual therapy was initiated using ceftriaxone and azithromycin, but at a higher dose for the patient with multi-drug resistant (MDR) Neisseria gonorrhoeae. Patients did well and were followed up for 5 months. Contact tracing was done for their sexual partners. While it is also important for healthcare workers to familiarize themselves with current treatment guidelines for gonococcal urethritis, the place of clinical laboratory in the management of STIs, with molecular techniques and the need for surveillance for MDR Neisseria gonorrhoeae cannot be overemphasized.

INTRODUCTION:Kaduna State is among the three States with the highest number of confirmed COVID-19 cases. The objective of this study was to assess the knowledge, risk perception and practices of staff towards prevention and control of COVID-19 infection in schools to provide policy makers, education and health managers required information to manage the epidemic as the schools prepare to re-open. METHODS:This was a school-based survey conducted using purposive sampling of 55 schools located in nine LGAs with the highest number of reported COVID-19 cases as at October 2020. Five schools with the highest students'/pupils' enrollment in each of the LGA were selected and all staff were interviewed. Information on knowledge, risk perception and practices of prevention was collected. Descriptive statistics were generated using Stata v14 software. RESULTS:A total of 1065 staff in 55 schools completed the interview. Major sources of information are television (73%), radio (61%), and social media (57%); and 76% indicated that a virus is the causative agent of COVID-19. Overall, 70%, 19%, 7%, 9.3% and 0% respectively had adequate knowledge of cause, preventive measures, respiratory hygiene, modes of transmission and symptoms of COVID-19; however only 14% ever attended a workshop on COVID-19. Eighty-two percent and 89% respectively believed in the efficacy of face masks and handwashing as means of prevention; 39% thought that they are likely to contract COVID-19. Ninety-nine percent and 90% have ever used face mask and hand sanitizer to prevent COVID-19; 96% and 85% respectively have use these methods in previous 24hours. Between 42% and 73% of schools needed additional commodities/requirements/supplies to comply fully with COVID-19 prevention protocols. CONCLUSION:While knowledge of COVID-19 is suboptimal, perception is positive and practice is high. Thus, teachers need to be well informed and encouraged to sustain current levels of preventive measures. Government needs to provide schools with adequate preventive commodities to ensure compliance.

Background: Hand hygiene is regarded as one of the most important and cheapest ways of preventing healthcare associated infections (HCAIs). Due to increasing incidence and effect of HCAIs, interest in hand hygiene is increasing among the managers of healthcare in various facilities globally. This study aimed at evaluating the level of knowledge and satisfaction with hand hygiene practices among Healthcare workers in emergency and intensive care units of a tertiary hospital In Nigeria.Methodology: A cross-sectional study was conducted using simple random sampling to select HCWs in the emergency and intensive care units of a tertiary healthcare facility. Data collection was done with self-administered structured questionnaires. The data obtained were analyzed with SPSS version 22.Results: Overall, 80 HCW were recruited. This study shows that majority of the staff had between moderate to good knowledge on hand hygiene. However, the overall correct responses regarding appropriate use of hand rub and hand washing was unsatisfactory and there were several gaps in staff knowledge with regard to the accurate procedure. More than two-third of the respondents (72.5%) revealed lack of training programme on hand hygiene by the hospital infection control unit and the management. Conclusion: The study shows the need for further improvement of the existing hand hygiene training programme to address the gaps in knowledge and also the need to upgrade hand hygiene facilities in our healthcare institution.

The Coronavirus disease 19 has gradually spread all over the world becoming a serious public health problem.The pandemic has virtually affected the economic systems of both the developing and developed world.Health workers are the front-liners of the covid-19 outbreak and are exposed to hazards that put them at risk of the infection.The major reason for health care workers infection is their lack of understanding of the disease, unavailability of personal protective equipment's (PPEs), psychological stress to mention but few.The aim of the study is to assess the exposure of healthcare workers to covid-19 and to improve Infection, prevention and control (IPC) practices at all level and contain the current covid-19 outbreak at Federal Medical Centre Katsina, Turai Maternal and Child Health and General AmadiRimi Specialist Hospital.There were 28 positive cases and 56 controls in ratio 2:1.Males were 63 while females were 15.The mean age was 36.Doctors were mostly affected.Those adequately trained for covid-19 IPC were 47%.Those who knew what risk assessment was 23%.Health Care Workers with community exposure were 60.3% and those with occupational exposure were 35.9%.High risk group in this study were use of N95 or its equivalent (54%), removal of PPE according to protocol (71%), hand hygiene after touching patients surrounding (58%).Decontamination of high surfaces (74%).Protection of health care workers should be made a priority by regularly training and retraining them, making PPEs available, ensuring HCWs get tested.

Background: To prevent discomfort from vulvovaginal complaints and as a way of maintaining personal hygiene, women use various cleaning agents for vulvovaginal care. Unfortunately, some of these agents are injurious to the vulvovaginal area. The muco-cutaneous inflammation, often caused by their use may cause further discomfort and increase the risk of acquisition of sexually transmitted infections like HIV. Aim: This study aimed at identifying agents women commonly used for vulvovaginal care with a view of generating public awareness and promoting correct practices thereby reducing risk of acquiring sexually transmitted infections such as HIV, genital chlamydial infection and gonorrhea. Methodology: It was a cross sectional study involving women who presented to the Special Treatment Clinic (STC) of a tertiary healthcare facility in Northwest Nigeria with vulvovaginal symptoms over a 6-month period were recruited. Structured questionnaire was used to collect data on their socio demographic and bio-medical characteristics, symptoms of vaginitis and various vaginal cleaning agents used. Data was analyzed using SPSS version 20.0 and descriptive statistics documented. Results: A total of 351 women attending STC were analyzed. Age range was 15- 65years, with mean age of 28.7±8.5. Majority 247(70.1%) were married, 229 (65.2%) were unemployed while 144(41%) had attained tertiary education. The commonest agent used for vulvovaginal care (52.4%) was water only. Other agents identified included antiseptic soap/solution (8.8%), mild toilet soap (8.5%), herbs (2.8%), local soap (2.3%) and 21.9% used a combination of various agents. Educational level was the only factor associated with type of agents used for cleaning (p=0.002).Conclusion: The high prevalence of use of other agents apart from water underscores the need for creating public awareness about proper vulvovaginal care among young girls and women.

Background: Lassa fever (LF) is endemic in Nigeria. Outbreaks usually begin in communities however, substandard Infection Prevention and Control (IPC) practices can cause secondary infection in Health Care Workers (HCW). We assessed the knowledge of LF among community members where 2 cases occurred and HCW at the facility where cases were managed to identify knowledge gaps. Methods and materials: During an outbreak response, a cross sectional study was conducted in the community among randomly selected residents aged ≥18 years, who had lived there for ≥ 6 months and all consenting HCW who managed the cases of LF. Respondents were interviewed with a structured interviewer administered questionnaire with sections on demography and knowledge of Lassa fever. Data was analysed using Epi Info version 7.1.06 Results: Overall, 98 community members and 123 HCW were recruited with mean ages 37 ± 10 and 37 ± 8 years respectively. More HCW were Nurses 65 (52.8%) and many community respondents had lived there for over 10 years 66 (67.3%). All respondents had heard of LF, the most common source of information was media among community respondents 82 (83.6%) and HCW 109 (88.6%) respectively. Many Community respondents 91 (92.8%) believed food contaminated with rat faeces is a source of infection however, 15 (15.4%) didn’t believe eating infected animals or unprotected contact 10 (10.3%) with infected persons could transmit disease and 20 (20.4%) practiced drying food in open spaces. HCWs 123 (100.0%) believed Lassa fever is preventable by IPC practice while 14 (11.4%) and 11 (8.9%) believe infection cannot occur in the lab and through contact with infected body secretions respectively. Conclusion: Knowledge of Lassa fever among respondents is good. Wrong perceptions on transmission may pose a risk for disease propagation during outbreaks. Community health education and re-training of HCW on IPC is recommended to help prevent future outbreaks of Lassa fever.

INTRODUCTION:it has been estimated that about 11.8% of the Nigerians suffer serious fungal infections annually. A high index of suspicion with early diagnosis and institution of appropriate therapy significantly impacts on the morbidity and mortality of invasive fungal infections (IFIs). METHODS:we conducted a cross-sectional multicentre survey across 7 tertiary hospitals in 5 geopolitical zones of Nigeria between June 2013 and March 2015. Knowledge, awareness and practice of Nigerian resident doctors about the diagnosis and management of invasive fungal infections were evaluated using a semi-structured, self-administered questionnaire. Assessment was categorized as poor, fair and good. RESULTS:834(79.7%) of the 1046 participants had some knowledge of IFIs, 338(32.3%) from undergraduate medical training and 191(18.3%) during post-graduate (specialty) residency training. Number of years spent in clinical practice was positively related to knowledge of management of IFIs, which was statistically significant (p < 0.001). Only 2 (0.002%) out of the 1046 respondents had a good level of awareness of IFIs. Only 4(0.4%) of respondents had seen > 10 cases of IFIs; while 10(1%) had seen between 5-10 cases, 180(17.2%) less than 5 cases and the rest had never seen or managed any cases of IFIs. There were statistically significant differences in knowledge about IFIs among the various cadres of doctors (p < 0.001) as level of knowledge increased with rank/seniority. CONCLUSION:knowledge gaps exist that could militate against optimal management of IFIs in Nigeria. Targeted continuing medical education (CME) programmes and a revision of the postgraduate medical education curriculum is recommended.

Background: Antimicrobials are nonreplaceable in the treatment of bacterial infections and thus should be used judiciously. In Nigeria, there is currently no restriction on the prescription and sale of antimicrobials. This study was conducted to assess the antimicrobial prescription pattern of physicians at a tertiary hospital in Northwestern Nigeria. Materials and Methods: A point prevalence survey was carried out among all inpatients at Ahmadu Bello University Teaching Hospital in June 2015. Those receiving an antimicrobial agent during the survey period were included in the study while patients admitted on the day of the survey were excluded from the study. Data were obtained using a structured interviewer-administered questionnaire and abstraction from patient records. Information obtained included demographic data, antimicrobial agents prescribed, indication for treatment, laboratory data, and stop/review dates of prescriptions. Data were analyzed using SPSS version 20.0. Results: Twenty-three wards with a total number of 318 inpatients were enlisted. Of these, 210 (66%) patients were on treatment with antimicrobials. Male: female ratio of patients on antimicrobials was 1.2:1, and age of respondents ranged from 1 day (0.0027 years) to 75 years. The overall antimicrobial prevalence rate was 210 (66%) with surgical prophylaxis 100 (47.6%) as the most common indication. Overall, 332 antimicrobials were prescribed with cephalosporins as the most common class prescribed 96 (28.9%). Majority of the prescriptions (328, 98.8%) were based on empirical treatment, 288 (86.7%) were open prescriptions, and only 4 (1.2%) were according to treatment guidelines. Conclusion: The high prevalence of antimicrobial use highlights the need for an antimicrobial stewardship program in this facility.

Background: Hepatitis B virus (HBV) infection is ranked among the top ten killers by the World Health Organisation. It is a public health problem, highly infectious and an occupational hazard for Health care workers. Nigeria is endemic for HBV with an estimated 20 million people infected. Though vaccine preventable, medical students are outside the age group which benefits from the introduction of HBV vaccine into the National immunization schedule and are a high risk group for HBV infection. We studied the HBV vaccination status of medical students who commenced clinical training to determine their risk of infection. Methods and materials: A cross sectional study was conducted among medical students who commenced clinical training at a tertiary institution in north-western Nigeria. All consenting students were recruited into the study. Those less than 18 years of age and students infected with HBV were excluded. Data was collected using a structured self-administered questionnaire with sections on demography, knowledge of HBV and HBV vaccination status. Data was analysed using Epi Info version 7.1.06. Results: Overall, 176 consenting students were recruited. Of these, 118 (67%) respondents were male, 172 (97.7%) were single and mean age of respondents was 22 ± 2 years. Most respondents, 172 (97.7%) had heard of HBV and common sources of information were lectures 146 (84.9%) and literature 51 (29.7%). Most respondents, 169 (96%) knew their training predisposed them to HBV infection though more than half, 94 (53.4%) were not vaccinated against HBV. The commonest reason for non-vaccination was lack of access 53 (56.4%). Of all respondents, majority, 142 (80.7%) had not received HBV vaccine before commencement of clinical training. Conclusion: Medical students in training at this institution are exposed to infection with HBV. We recommend the School authority develop policies on HBV vaccination for medical students before commencement of clinical training.

ObjectiveTo identify risk factors among contacts of Lassa fever cases which can predispose to disease spread and institute control measures.IntroductionContact tracing is an important strategy employed in surveillance to aid prompt detection of infectious disease and control outbreaks. It involves the identification of those who have come in contact with an infectious person and following them up for the duration of the incubation period of the disease to promptly detect symptoms and signs and institute treatment thus reducing chances of disease spread to other susceptible individuals. It is a primary means of disease prevention. The importance of cooperation from contacts being traced cannot be overemphasized as they are required to promptly report symptoms, avoid gatherings and travelling until they are cleared by the surveillance team. The follow-up should also link contacts who become symptomatic to designated care centers. In 2014, during the Ebola outbreak in Nigeria, the disease spread from Lagos to another State in the country by a contact who travelled out of Lagos to Rivers state.To identify risk factors among contacts of Lassa fever cases which can predispose to disease spread and institute control measures, we interviewed primary contacts of Lassa fever cases during an outbreak response in Kogi State Nigeria, 2016MethodsWe Identified contacts of Lassa fever cases (confirmed/suspected/probable) among family, friends, community members, co-workers and health care workers, followed up for 21 days during a Lassa fever outbreak which started in February 2016 at Kogi State Nigeria. Contacts were interviewed using a structured interviewer administered questionnaire with sections on demography, risk factors for infection and spread of Lassa fever, symptoms developed during the follow-up period and adherence to prorocol. Control measures were instituted to address identified gaps. We defined a contact as anyone irrespective of age, occupation or sex who came in contact with any of the cases of Lassa fever classified as either confirmed/suspected/probable and used standard IDSR case definitions for Suspected, Confirmed and Probable cases of Lassa fever. Data was analysed with Epi Info version 7ResultsOverall 149 contacts were interviewed, 79 (53.0%) were female, the mean age of respondents was 33.2 +-10.1 and many were health care workers 61(40.9%). Of the respondents, 18 (12.0%) live or work in areas infested with rodents, 21 (14.1%) ate bush meat, 2 (2.5%) of the females were pregnant and 20 (13.4%) of respondents travelled out of station with 1 (5%) contact crossing international borders. During the follow-up period, 14 (9.4%) developed symptoms suggestive of Lassa fever. Of these 12 (85.7%) sought treatment and the options were self-medication 3 (25.0%) and presenting at a health facility 9 (77.8%). The health facilities visited were mainly privately owned 7(77.9%) and only 1 (11.1) was a tertiary health care facility. We instituted the following interventions; Health education of contacts and linkage of symptomatic contacts to the designated treatment center where treatment commenced and samples were collected and sent to reference lab for diagnosis. All samples 14(100%) came back negative for Lassa fever.ConclusionsContact tracing is an important strategy in controlling outbreaks of infectious diseases. However, risk factors identified among contacts can hinder the effectiveness of this strategy and facilitate spread of the disease. We recommend training on health education and Lassa fever transmission for contacts of cases and the need to adhere to protocol so that the ultimate aim of interrupting transmission can be achieved.ReferencesNigeria Center for Disease Control.Viral Haemorrhagic Fevers,Preparedness and Response Plan.2017

Background: Malaria is the commonest cause of morbidity and mortality among displaced populations especially children in malaria endemic countries. Nigeria, an endemic country has poor under 5 indices and in the last 8 years, has had an increase in internally displaced persons (IDP) due to insurgency. We determined the prevalence and predictors of malaria parasitaemia among internally displaced children aged 6-59 months living at IDP camps in Abuja. Methods & Materials: A cross-sectional study of all children aged 6-59 months at the three IDP camps in Abuja was conducted. We collected information on sociodemographic characteristics, duration of displacement, household characteristics and risk factors for malaria using computer-aided interview. Finger prick blood samples were examined for malaria parasitaemia using Rapid Diagnostic Test (RDT) kits. Eligible children from whom blood samples could not be obtained and those with invalid test results were excluded from the analysis. Data was analysed using Epi info version7and statistical significance was determined with Chi-square and logistic regression at 5% level of significance. Results: Overall, 393 children from 242 households were enrolled with mean age of 33.3 ± 17.4 months, 51.6% were females, mean duration of stay in camp was 21.4 ± 11.5 months. The prevalence of malaria was 30.5%. Malaria parasitaemia was significantly higher in females (OR: 1.7, 95% CI: 1.1–2.6) associated with LLIN non-use (OR: 4.1, 95% CI: 2.3–7.5),LLIN ownership greater than 6 months duration (OR: 1.8, 95% CI: 1.1–3.3) and with large holes in LLIN (OR: 2.4; 95% CI: 1.1–5.7). Use of LLIN was protective against malaria parasitaemia (adjusted OR: 0.3, CI: 0.1–0.5). Conclusion: The prevalence of malaria among internally displaced children was high. The use of LLIN in good condition is important in protecting under five IDPs from malaria. We would recommend that the government provides LLIN to families with children at the IDP camps in Abuja.

Background: Candida is one of the most common opportunistic fungal pathogens and Candidaemia has become a public health problem due to the increase in populations at risk. Factors which predispose to candidaemia such as HIV/AIDS, TB, Cancer and indiscriminate use of antibiotics are rife in Nigeria. Anti-fungal drug resistance has been reported globally however, there is paucity of information on the situation in the country. This study was conducted to determine the epidemiology and antifungal sensitivity pattern of candida species causing blood stream infections. Methods & Materials: A hospital based cross-sectional study was conducted among patients at risk for invasive Candida infections. Those with signs and symptoms of sepsis were recruited. A sample size of 385 patients was calculated and eligible patients recruited consecutively. Blood samples were collected aseptically, cultured in brain heart infusion broth and sub-cultured onto Sabourauds dextrose and 7% sheep blood agar. Yeast isolates were identified using CHROMAgar Candida and antifungal susceptibility and minimum inhibitory concentration (MIC) was determined to antifungal agents indicated for treating candidaemia; Fluconazole, Caspofungin and Amphotericin B, using epsilometer test (E-test) strips. Data was analysed using statistical package for social sciences. Results: Overall, 390 patients were recruited. More patients, 70.5% (275) were adults and male 57.2% (223). Overall, five Candida species were isolated namely, C.parapsilosis (47.1%), C.glabrata(23.5%) C.tropicalis(17.6%), C.albicans(5.9%), and C.krusei(5.9%). All candida species isolated were sensitive to Amphotericin B with MICs which ranged from 0.064–1.0 μg/ml. Resistance was demonstrated in C.glabrata 50% (2) and C. Krusei 100% (1) to Caspofungin with MICs greater than 32 μg/ml and C.glabrata 50% (2), C. Krusei 100% (1) and C.albicans 100% (1) which were resistant to fluconazole with MICs greater than 256 μg/ml. Conclusion: There is a change in the epidemiology of candidaemia with non-albicans species occuring more commonly. Resistance to first line drugs in management of Candidaemia emphasise the need for susceptibility testing to guide patient management. We recommend multi-center studies and surveillance on the susceptibility profile of candida species causing blood stream infections to monitor drug resistance

Background: Infections with Streptococcus pneumoniae are endemic worldwide. It is a public health problem and responsible for 1.6 million of 8.8 million annual deaths of children under 5 years of age, with 50% occurring in sub-Saharan Africa. This descriptive study was done to determine the prevalent S. pneumoniae serotypes responsible for infections at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria. Materials and Methods: Clinical specimens of blood, cerebrospinal fluid, and aspirates from abscess, ear swab, throat swab, pus and sputa were collected over a period of 18 months from 420 patients with pneumonia, meningitis, septicemia, and otitis media. Specimens were cultured on 5% defibrinated sheep blood agar and chocolate agar. Incubation was done aerobically in a CO2-enriched atmosphere at 37°C for 18–24 h. Isolates of S. pneumoniae were identified by standard biochemical techniques using Gram reaction, catalase test, Optochin disc, and bile solubility tests. Antimicrobial susceptibility was determined by the modified Kirby–Bauer disc diffusion method with Mueller–Hinton agar supplemented with 5% sheep blood. Serotyping was done using the slide agglutination method (Denka Seiken Co. Ltd., Japan). The serotype final results were recorded as matching, discordant, or nontypeable. Results: A total of 420 patients participated in this study, in which 227 were males (54%) and 193 were females (46%). Participants' ages ranged from 2 days to 85 years. S. pneumoniae isolates were mainly from blood 12 (52.2%) and sputum 6 (26.1%). Samples with most isolates were from the pediatric age group of 15 years (65.2%). The serotypes identified were 6, 19, and 20 which were all from blood, as none of the strains from sputum was typeable. Conclusion: The major S. pneumoniae serotypes found in this study were 6, 19, and 20.

Healthcare-associated infections are among the major complications of modern medical treatment due to the increasing age and complexity of patients, increasing usage of invasive devices, and often inappropriate use of antimicrobial therapy. Acinetobacter species is associated with healthcare-associated infections due to its ability to survive for long periods of time on surfaces and its capacity to develop drug resistance. Multidrug-resistant (MDR) Acinetobacter is a challenge to manage clinically and is associated with mortality rates as high as 35%. We present a 25-year-old home maker with burns wound sepsis due to multidrug-resistant Acinetobacter baumannii which was successively managed with combination of drug regimen and institution of proper infection prevention control practices. We recommend minimization of invasive device in high dependency unit, scaling up of infection control practices, and further research into the efficacy of combination of ciprofloxacin, rifampicin, and amikacin in the treatment of MDR A. baumannii burns wound sepsis.

Gonorrhoea is an important sexually transmitted infection in both males and females which could consequently lead to different complications affecting both sexes. Despite availability of antimicrobials to treat the disease, transmission of the agent Neisseria gonorrheae (NG) is still prevalent. The ability of Neisseria gonorrhoeae to rapidly develop resistance to routinely used antimicrobials has made it a global public health challenge. We present a 26 year old single, male, professional who presented to our facility with a five weeks history of urethral discharge and painful micturition. He was initially managed at a private hospital with ciprofloxacin for 20 days with no improvement in symptoms. The patient then presented at our facility where he was diagnosed and managed for Neisseria gonorrhoeae urethritis after laboratory investigations. Susceptibility tests revealed penicillin and ciprofloxacin resistant NG. However, molecular characterization was not done as the stored isolate could not be reactivated for further analysis. We advocate for a review of the syndromic management of STIs in the country and a national surveillance on NG susceptibility profile. There is an urgent need to upgrade laboratory facilities to perform both cultural and molecular identification for sexually transmitted infections.

Introduction: Malaria is the commonest cause of morbidity and mortality among displaced populations especially children in endemic countries. Nigeria, an endemic country, has had increase in internally displaced persons (IDP) due to insurgency. utilization of long-lasting insecticidal nets (LLIN) is a key strategy employed to achieve global targets of malaria elimination and its effectiveness is determined by utilization, coverage and maintenance. We determined the coverage and utilization of LLIN among children aged 6-59 months at IDP camps and its predictors. Methods: A cross-sectional study was conducted among children aged 6-59 months at the three IDP camps in Abuja. We collected data on socio-demographic characteristics, LLIN ownership and utilization using computer-aided interview, complemented by direct observation of nets. We defined universal LLIN coverage as the proportion of households with one LLIN to two persons and utilization as an eligible child sleeping under the LLIN the night preceeding the survey. Bivariate analysis was done at p < 0.25 and logistic regression at 5% level of significance. Results: Overall, 393 children were enrolled with mean age of 33.3 +/- 17.4 months, 51.6% were female. Household LLIN ownership was 76.7.5%, universal coverage 11.2% and utilization 89.7%. Independent predictors of LLIN utilization were LLIN hung at sleeping area (adjusted OR: 99.9, CI: 22.7 +/- 438.8) and type of camp site (adjusted OR: 8.2, CI: 2.5 +/- 27.4). Conclusion: LLIN utilization was high in these IDP camps despite low coverage. LLIN distribution and hanging campaigns are recommended to reduce malaria transmission in the IDP camps.