Biomedical subjects
Publications and source records attributed to O K Alausa.
In Nigeria a training programme was devised whereby staff from health centres could appreciate the value of reliable data as a means of raising the standard of services. A process of learning by doing enabled the participants to turn routine data into tools for management and the improvement of service quality.
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Explore the source record for details and available documents.
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Marshall syndrome (ectodermal dysplasia) was diagnosed in a 14-year-old boy and is thought to be the first case reported from West Africa. Because of the saddle-nose deformity and bilateral cataracts all patients suspected of having congenital syphilis should be investigated for ocular or auditory defects, which would confirm the diagnosis of ectodermal dysplasia.
The present three-year longitudinal study has clearly demonstrated the advantages of modern and scientific livestock management over the traditional and extensive methods of animal husbandry in the prevention and control of bovine and human Brucella abortus infection. The occupational hazard, in relation to brucellosis, to which livestock farmers are exposed in Oyo State is closely related to the level of infection in the animal population, the level of environmental contamination and hygiene on the farm. This study has also revealed that many farmers could acquire subclinical brucellosis within two years of constant occupational exposure to source of infection. There was no seasonal variation found in the prevalence of brucella infection among the human and cattle population studied at the I.A.R.T. farm in Ibadan: climatic variation is therefore considered to play no important role in the prevalence of brucellosis in Southern Nigeria.
Brucellosis is a zoonosis, primarily a disease of domestic animals which, under special circumstances, may readily be transmitted to man through contact, ingestion, inhalation, and accidental inoculation (WHO, 1971). The animals that are commonly known to serve as sources of human infection are cattle, goats, sheep, and swine. The geographical distribution of human brucellosis is closely related to the endemicity of animal infection, the methods of animal husbandry, human food habits, the standard of hygiene, and other socio-economic activities (Abdussalam and Fein, 1975). Occupational risk of brucellosis is important because of the possibility of direct transmission of infection from infected animals to people employed in animal husbandry, especially in countries with developing livestock industry, where herding of animals still remain largely traditional and unscientific.
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Between January 1976 and March 1977, cerebrospinal fluid samples from 2130 patients at University College Hospital, Ibadan, Nigeria were examined, 130 patients were shown to have pyogenic meningitis. The commonest causative bacteria were Streptococcus pneumoniae (53.8%), Haemophilus influenzae (23%), Neisseria meningitidis (7.7%) and Klebsiella spp. (3%). Most of the infections occurred in very young children: 47% of all patients were under 1 year of age, and 69% were under 5 years old. The overall case fatality rate was 30% (Strep. penumoniae infection 28.6%, H. influenzae and N. meningitidis infection both 20%). All 4 patients with klebsiella infection died. There was a noticeable increase in the incidence of Strep. pneumoniae strains showing resistance to tetracycline, between 1974 and 1976, and this was attributed to the widespread use and abuse of the antibiotic among the general population. Two strains of H. influenzae were found to be resistant to ampicillin; such strains have not previously been reported from Nigeria. The results of the study support the use of a combination of ampicillin and gentamicin in the initial treatment of pyogenic meningitis in Ibadan.
A prospective clinical and bacteriological review of the pattern of bacterial infections and chemotherapy among 1931 patients admitted to University College Hospital, Ibadan, between July and September, 1976, showed that 394 patients (20%) had bacterial infections, but 940 patients (49%) received antimicrobial chemotherapy. Thus 58% of the patients were treated either prophylactically or without bacteriological confirmation of infection. Infections of the respiratory tract were commonest (28%), followed closely by wound infections (26%). Septicaemia accounted for 20% of all infections and this was particularly common among children. There was a preponderance of infections due to gram-negative bacteria (69%), with Klebsiella spp. being the most frequently encountered. Among the gram-positive organisms, Staphylococcus aureus accounted for the majority of the infections, particularly infections of wounds, while Salmonellae were responsible for the majority of septicaemias, except among young children, where Klebsiella spp. were predominant. Approximately 90% of urinary tract infections were caused by Klebsiella, Escherichia coli and Proteus spp. Almost all the patients with meningitis were children (93%) and the commonest infecting organisms were Haemophilus influenzae and Streptococcus pneumoniae. The most commonly used antibiotics (penicillin, streptomycin and ampicillin) did not bear a close relationship to the sensitivity patterns of bacteria causing infections in the hospital. Comparison of the bacterial sensitivity patterns for 1963, 1967, 1974 and 1976 showed that the current usage of antibiotics had led over the years to increasing proportions of resistant organisms.
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Radioimmunoassay of anti-tetanus antibodies produced in human serum in response to tetanus toxoid immunization was carried out by employing the non-specific precipitation effect of ammonium sulphate described by Farr (1958). The results showed that the method was sensitive and was able to differentiate between immune and non-immune persons. The effects of booster dose injection on the quantity and quality of antibodies produced during immunization were discussed, and the possible use of the method to predict the amount of immunogen, the timing and number of injections required for optimal host response in immunization schedules was suggested.
This review has shown a high incidence of neonatal septicaemia in a tropical environment. The predisposing factors leading to increased incidence of primary septicaemia include low maternal socioeconomic status, lack of adequate prenatal care, unsterile delivery practices in those born at home and increased incidence of susceptible hosts. Apart from gram-negative organisms, Staphylococcus aureus was the next common agent responsible for neonatal septicaemia. A combination of penicillinase-resistant penicillin and an eminoglycoside in particular gentamycin, should be the initial antibiotic of choice in suspected cases of neonatal septicaemia. Suggestions for reduction in the incidence of neonatal septicaemia were discussed.