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Biomedical subjects

H Nsanze

Publications and source records attributed to H Nsanze.

At least 19 recordsLinked to original sources

In vitro antibacterial activity of Omani and African honey.

The study aims to investigate the antibacterial activity of honey obtained from different parts of Oman and compare it with that of honey obtained from elsewhere in Africa. A total of 24 honey samples (16 from different parts of Oman and eight from elsewhere in Africa) were investigated for their antibacterial activity against Staphylococcus aureus (NCTC 6571), Escherichia coli (NCTC 10418) and Pseudomonas aeruginosa (NCTC 10662) using standard antimicrobial assays. Marked variations in the antibacterial activity of the different honey samples were observed. Fourteen of the 16 Omani samples and five of the eight African samples showed antibacterial activity ranked as either fair, good or excellent to at least one of the three bacterial strains tested. Both Omani and African honeys possess in vitro antibacterial activity against the three bacterial strains tested, with 25% of the samples showing excellent antibacterial activity.

Africa↗

Group A streptococcal throat colonization is a dynamic phenomenon.

In order to gain knowledge about the nature of group A streptococcal throat colonization of asymptomatic children, we studied a cohort of healthy children selected at random. Those with throat cultures positive for group A Streptococci (GAS) were followed for 5 weeks. Repeat throat swabs were obtained at weekly intervals for antigen detection and culture. GAS obtained were serotyped for T antigen. Twenty-two children were identified as having GAS and 50% had a positive antigen test and culture at least five times in 6 weeks. There was no consistent pattern in the typeable organisms. Most individuals had more than one T-type alternating with non-T-typeable organisms. We conclude that colonization may be a dynamic process involving numerous organism serotypes, which wax and wane.

Antigens, Bacterial↗

Systemic antibiotic prophylaxis in elective cesarean delivery.

OBJECTIVE: To test the value of using prophylactic antibiotics at elective cesarean delivery. METHOD: One-hundred and twenty women delivered by elective cesarean in the absence of labor and before the rupture of membranes were randomized to receive either 1.5 g of cefuroxime intravenously at cord clamping (n = 59) or no prophylaxis (control group, n = 61). RESULTS: Twelve women developed febrile morbidity (six study, six control, P = 0.09). Of these, five had endometritis (two study, three control, P = 0.09) and two had wound infection (one study, one control, P = 0.09). Ten more women had microbiological evidence of endometritis and wound infection (six study, four control, P = 0.08). There was no significant difference in the hospital stay (6.5 days study, 6.8 days control, P = 0.06). Staphylococcus aureus was the commonest pathogen accounting for 14 infection episodes. Amniotic fluid culture could not predict the development of infection. CONCLUSION: Administration of prophylactic antibiotics at elective cesarean deliveries was not associated with decreased postoperative morbidity.

Adult↗

Gonococcal scalp abscess in a neonate delivered by caesarean section.

Gonococcal infection in caesarean delivered babies is very rare and is usually limited to ophthalmia neonatorum. The mother had rupture of membranes 14 hours before the caesarean section. The infection was most likely introduced by the fetal scalp electrode probes applied 2 hours before delivery. This is the first reported of a neonatal gonococcal abscess in a caesarean delivered infant.

Abscess↗

Serotypes of group A streptococci isolated from healthy schoolchildren in the United Arab Emirates.

Group A streptococci (GAS) are the most frequent cause of pharyngitis in children and are a common cause of emergency room or paediatric clinic visits worldwide. This study determined the representative M and T types of GAS, and their distribution, among schoolchildren in the United Arab Emirates. Throat swabs were taken and cultured for GAS isolates during the winter of 1994-95 from 1000 children aged 5-7 years attending nine schools. Of the isolates obtained, 100 were serotyped using standard techniques. Nearly all these isolates (91%) were T typable, falling into 15 T types; the commonest being type 1 (n = 17), type 6 (n = 15), type 11 (n = 10), type 2 (n = 8), type 12 (n = 8), and type 28 (n = 8). A total of 76% of the isolates were typable for M protein, falling into 14 M types, with type 1 (n = 17), type 6 (n = 15), type 2 (n = 8), type 22 (n = 5), type 28 (n = 7), and type 75 (n = 5) predominating. Serotype clusters were found in certain classes or schools, although the number of isolates examined was too small to allow definitive epidemiological conclusions to be drawn. The ease of serotyping these isolates suggests that GAS strains in the United Arab Emirates are similar, but not necessarily related, to those commonly found in the USA and Europe, and that these may be the most prevalent strains worldwide. The relative prevalence of M type 1 is significant, as this GAS serotype is associated with serious diseases such as rheumatic heart disease, a recognized problem in the United Arab Emirates, and toxic shock syndrome, which has not yet been reported from this area. Knowledge of the prevalence of GAS serotypes, and further research on the epidemiology of streptococcal disease, will be useful should streptococcal vaccines become available.

Age Factors↗

Ophthalmia neonatorum in the United Arab Emirates.

Ophthalmia neonatorum in small babies is a common problem in neonatal units in Al Ain, but is infrequently associated with sexually transmitted disease agents. A study of 81 babies with ophthalmia neonatorum showed that 81.5% had bacterial or fungal infections. Staphylococcus aureus was the commonest causative organism followed by Escherichia coli and Pseudomonas aeruginosa while Chlamydia trachomatis and Neisseria gonorrhoeae were responsible for less than 5% of all cases. The disease was predominantly mild to moderately severe and easily treated with topical broad-spectrum antibiotic agents which are effective against Gram-positive and Gram-negative bacteria, including hospital-associated strains. The most effective antimicrobial agents were gentamicin topically or ceftriaxone systemically.

Anti-Bacterial Agents↗

The prevalence of group A streptococcal throat carriage in Al Ain, United Arab Emirates.

The aim of this study was to establish the carrier rate of group A beta haemolytic streptococci in school children in Al Ain, United Arab Emirates. One thousand and two randomly selected school children aged 5-7 years had their throats swabbed twice for both culture and direct antigen detection of group A streptococci. One hundred and fourteen children (11.3%) had both a positive antigen and culture test, while 216 (21.6%) had antigen-positive tests only and 16 (1.5%) had a positive culture only. Thus, the combination of culture and antigen detection revealed a carrier rate of 35.4% in the children examined. We conclude that in an affluent but isolated desert area on the Tropic of Cancer, group A streptococcal carriage rate is high. Antigen detection is superior to culture techniques in asymptomatic carrier studies.

Antigens, Bacterial↗

Serologic tests for treponematoses in the United Arab Emirates.

BACKGROUND AND OBJECTIVE: Venereal syphilis is uncommon in the United Arab Emirates (UAE) and other Gulf states in the Middle East. Although nonvenereal syphilis (bejel) has been reported to be endemic in some of these countries, the extent of treponematoses in the UAE is unknown. The objectives were therefore, to investigate those who attended the outpatient clinic of a hospital in the UAE and to establish the seroprevalence of treponematoses and related clinical conditions. METHODS: One thousand and eighty-four patients were serologically screened with a Rapid Plasma Reagin (RPR) and Treponema pallidum hemagglutination (TPHA) tests. The charts of seropositive and seronegative patients, matched for age and sex, were reviewed and compared for clinical problems. RESULTS: A total of 47 people tested had antitreponema antibodies. The positivity rates varied considerably and rose with age from 0.36% for persons < 16 years to 8.3% for those > 50 years. Among the seropositive group, there were no obvious clinical signs of bejel on presentation, but osteoarthritis was significantly more common than in the seronegative group. CONCLUSIONS: In the UAE, although venereal syphilis is uncommon, there is a high seropositivity rate in the > 50-year age range possibly due to old or attenuated bejel.

Adolescent↗

Polymerase chain reaction for diagnosis and identification of distinct variants of Crimean-Congo hemorrhagic fever virus in the United Arab Emirates.

Viral hemorrhagic fever has re-emerged in the United Arab Emirates (UAE) since November 1993. Genomic RNA of Crimean-Congo hemorrhagic virus (C-CHFV) was detected by a newly developed, nested reverse transcriptase polymerase chain reaction (RT-PCR) in the sera of four (25.0%) of 16 suspected cases of viral hemorrhagic fever. The RT-PCR was based on oligonucleotide primers deducted from the small RNA segment encoding the nucleoprotein of the virus. By comparison with a nucleotide sequence of a C-CHFV isolate from a Chinese sheep, a divergence of 10.0-11.8% was detected in the C-CHFV variants causing the UAE outbreak. In the four positive sera, three phylogenetically distinct C-CHFV variants were amplified and confirmed by direct sequencing of the PCR fragments. These C-CHFV sequences were obtained directly from sera of infected humans without prior propagation in cell culture. The RT-PCR allows rapid detection of genomic C-CHFV RNA in clinical specimens and study of the molecular epidemiology of this infection.

Amino Acid Sequence↗

Treating chancroid with enoxacin.

Increasing resistance of Haemophilus ducreyi to antimicrobials necessitates further trials of new antimicrobial agents for treating chancroid. Enoxacin has excellent in vitro activity against H ducreyi, and a randomised clinical trial of three doses of enoxacin 400 mg at intervals of 12 hours compared with a single dose of trimethoprim/sulphametrole (TMP/SMT) 640/3200 mg was therefore conducted. Of 169 men enrolled in the study, 86 received enoxacin and 83 received TMP/SMT. Ulcers were improved or cured in 65/73 men treated with enoxacin and 57/70 men treated with TMP/SMT. This difference was not significant. At 72 hours after treatment, H ducreyi was eradicated from ulcers of 72/77 men treated with enoxacin and of 67/74 of those treated with TMP/SMT. Patients with buboes responded equally well to both treatments. Of 100 H ducreyi strains tested, all were susceptible to both 0.25 mg/l enoxacin and the combination of 0.25 mg/l TMP and 5 mg/l SMT. Although most men treated with either regimen were cured, neither regimen appeared to be the optimum treatment for chancroid. This study shows the efficacy of enoxacin for a soft tissue infection caused by Gram negative organisms.

Adolescent↗

Retrospective seroepidemiology of AIDS virus infection in Nairobi populations.

Among 446 sera from prostitutes in Nairobi, the prevalence of antibody to human immunodeficiency virus (HIV) rose from 4% in 1981 to 61% in 1985. None of 118 men with chancroid seen in 1980 had antibody to HIV compared with 15% of 107 such men in 1985. Among pregnant women, 2.0% were seropositive in 1985 versus none of 111 in 1981. Seropositive prostitutes and women with sexually transmitted diseases (STDs) tended to have more sex partners and had a higher prevalence of gonorrhoea, and in women with STDs, significantly more seropositive women practiced prostitution. Pregnant women and men with STDs who were born in the most-western region of Kenya were more likely to have antibody to HIV than were such groups from other geographic areas. Our results indicate that the AIDS virus was recently introduced into Kenya, that HIV can rapidly disseminate in a high-risk group of heterosexuals, and that prostitutes may have significantly contributed to the spread of the virus.

Acquired Immunodeficiency Syndrome↗

Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology, and risk factors.

We investigated the frequency of clinically defined upper genital tract infection (UGTI) and its relation to sexually transmitted diseases and other risk factors among 1,013 women initially studied while in labor at a Nairobi, Kenya maternity hospital. Women were enrolled during labor and followed up at seven days and one month postpartum. Cultures for Neisseria gonorrhoeae and Chlamydia trachomatis were done at enrollment and at day 7. The prevalence of gonococcal and chlamydial infections was 6.7% and 20.8%, respectively. The overall prevalence of UGTI was 20.3%. The development of UGTI was significantly correlated with gonococcal infection (odds ratio, 4.4; P less than .0001), chlamydial infection (odds ratio, 1.7; P less than .02), presence of ophthalmia neonatorum (odds ratio, 2.6; P less than .0001), labor greater than 12 hr (odds ratio, 1.8; P less than .01), and area of residence (odds ratio, 1.5; P less than .05). Postpartum UGTI, an enormous public health problem in Nairobi, would be partially susceptible to antenatal intervention programs focusing on sexually transmitted diseases.

Chlamydia Infections↗

The prevalence of sexually transmitted disease agents in pregnant women in Suva.

Routine testing of 440 women (257 Fijians, 183 Indians) at the first antenatal attendance identified Chlamydia trachomatis in 50% of Fijians and 38% of Indians; the seropositivity rates for syphilis were 14.2% and 1.7% respectively, and the isolation rates for N. gonorrhoeae were 3.1% in Fijians and 1.1% in Indians.

Adult↗

Single-dose ceftriaxone for chancroid.

Men with genital ulcers that were culture positive for Haemophilus ducreyi were treated with intramuscular ceftriaxone and randomized to three different dose regimens. All but 1 of 50 men treated with 1 g of intramuscular ceftriaxone were cured. Similarly, 0.5 and 0.25 g cured 43 of 44 men and 37 of 38 men, respectively. A single dose of 250 mg of intramuscular ceftriaxone is an effective treatment for chancroid.

Adult↗

Single-dose therapy of gonococcal ophthalmia neonatorum with ceftriaxone.

We conducted a randomized clinical trial comparing a single intramuscular dose of 125 mg of ceftriaxone with a single intramuscular dose of 75 mg of kanamycin followed by topical gentamicin for seven days, and with a single intramuscular dose of 75 mg of kanamycin followed by topical tetracycline for seven days, in the treatment of gonococcal ophthalmia neonatorum in Nairobi, Kenya. Of 122 newborns with culture-proved gonococcal ophthalmia neonatorum, 105 returned for follow-up. Sixty-one infants (54 percent) received ceftriaxone, 32 received kanamycin plus topical gentamicin, and 29 received kanamycin plus topical tetracycline. Sixty-six (54 percent) of the Neisseria gonorrhoeae isolates were penicillinase producing. All 55 newborns who received ceftriaxone and returned for follow-up were clinically and microbiologically cured. One of 26 returning newborns who received kanamycin plus tetracycline and 2 of 24 returning newborns who received kanamycin plus gentamicin had persistent or recurrent gonococcal conjunctivitis. Ceftriaxone also eradicated oropharyngeal gonococcal infection in 18 newborns, whereas oropharyngeal infection persisted in 2 of 8 newborns who had received kanamycin (P not significant). We conclude that 125 mg of ceftriaxone as a single intramuscular dose is very effective therapy for gonococcal ophthalmia neonatorum, with marked efficacy against extraocular infection and without the need for concomitant topical antimicrobial therapy.

Ceftriaxone↗