Oral rehydration of infants with diarrhoea. Nigerian experience.
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Biomedical subjects
Publications and source records attributed to O Ogunbi.
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5,576 people who had two or more of the following symptoms, running nose, cough, fever and crepitations/rhonchi over the chest were interviewed. 1,355 specimens of nasal and throat swabs from those interviewed were processed for viruses associated with upper respiratory tract infection. There was a sharp rise in 'flu-like symptoms in March 1976, followed by a much higher incidence from June, reaching a peak in August. Influenza A was isolated from most of the specimens collected. A few para-influenza II were also isolated. Our findings show that severe outbreaks of acute viral infection of the respiratory tract occurred during our wet season particularly around August.
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Six serotypes were found among haemolytic streptococci of Lancefield-group G. Members of these types accounted for about one-third of the strains isolated from human infections and carriers in Nigeria. The type antigens were similar to the M-protein antigens of group-A streptococci in that they were associated with the ability of the streptococci to survive and multiply in fresh human blood unless specific antibody was present. It was also possible to demonstrate in these group-G streptococci and non-type-specific M-associated protein similar to that formed by M-positive strains of group-A streptococci.
The feasibility and effectiveness of a programme for the community control of rheumatic fever and rheumatic heart disease were studied in a cooperative multicentre project initiated and coordinated by the World Health Organization. The programme was carried out in seven centres in various developing countries of Africa, America, and Asia according to a common protocol, and is under way in a further eight countries in Latin America. Pilot community programmes were shown to be practicable and effective in reducing the burden of rheumatic heart disease in developing countries and their extension to cover entire populations should be encouraged.
Microscopic examination of multiple faeces samples of 2 825 persons was carried out in the Metropolitan Lagos. Overall prevalence of Entamoeba histolytica was 11.2%. Prevalence increased rapidly in younger age groups and there were no real differences between males and females. Prevalence was high among families who ate together from the same plate, among those who ate with their fingers and among those who ate away from home. Prevalence was not associated with type of water supply but was seemingly influenced by storage of household supplies. A low infection rate was associated with the availability of water closets and toilet habit. No association was found between prevalence and standard of education but the rate of infection was increased among workers with high occupational interaction. Significant differences were found among different ethnic groups. The highest infection rate was recorded in the last month of the wet season.
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In Lagos 12 755 schoolchildren aged between six and 12 years were screened for evidence of rheumatic heart disease and showed a prevalence rate of 0.03%. Group C (27.7%) and group G (47.3%) predominated in the throat and in cases of pharyngitis, while group A predominated on the skin. Two hundred and sixty-six cases of pharyngitis were recorded, 70 (26.4%) were positive for beta-haemolytic streptococci. Half of the cases of streptococci while 28.2% and 21.1% were caused by groups C and G respectively. A diversity of serotypes of group A streptococci, which included types 49 and 55, and C and G streptococci were isolated from impetiginous skin lesions. The main point of interest is the association of group C and G streptococci with sore throat and skin infections. The pathogenicity of C and G in such circumstances merits further investigation. The present study also showed that prophylactic benzathine penicillin (Penadur) given to patients with rheumatic heart disease or rheumatic fever had been effective with no recurrent attack of acute rheumatic fever.
A bacteriological study of vaginal swabs taken from 78 parturient women at Lagos University Teaching Hospital (L.U.T.H.) is presented. 26.83% of the vaginal cultures were sterile. The most frequently isolated bacteria were Staphylococcus spp. 21.4%, followed by beta hemolytic streptococci 16.65%, of which approximately a half belonged to Lancefield group B. Escherichia coli was isolated in 11.1% of the cases. The implications for neonatal and puerperal sepsis are discussed.
Stool samples were collected from 2,099 persons and examined for parasites: 9.5 percent were infected with Entamoeba histolytica, 7.9 percent were infected with Giardia intestinalis and 15.5 percent were infected with Iodamoeba butschlii. The infections with E. histolytica and I. butschlii occurred more frequently in females than in males and adults were also more frequently infected than children. Infection with G. intestinalis, on the other hand, was more prevalent in males than in females and children were more frequently infected than adults with the highest incidence of infection (13.8 percent) in the age-group 1-5 years.
Three cases of staphylococcal scalded skin syndrome in Nigerian children are reported. The clinical features and bacteriological findings are discussed. It is suggested that the clinical condition is not as rare in our community as absence of reports on African children in the literature may suggest. A reference centre for phage typing of staphylococci from suspected cases in a developing country like our own is recommended.
Fifty cerebrospinal fluid specimens were studied by counter-immunoelectrophoresis (CIE), Gram's staining and culture techniques. Out of 33 test cases of pneumococcal, meningococcal and Haemophilus influenzae meningitides, 31 cases, were CIE positive, 24 were detected by Gram's staining while 27 were positive by culture. The 17 cases which served as controls did not give false positive results. The CIE is recommeded as an adjunct to bacterial culture in laboratory diagnosis of bacterial meningitis especially in areas where there is poor control of drug usage by people with resultant self antibiotic medication which makes definite bacterial meningitis specimens "sterile" on culture.
A new trichomonacidal agent, Tinidazole, (Fasigyn) has been used in a single oral dose of 2 g in 24 patients with very good results. An over-all cure rate of 100% (6 patients) was achieved in in-patients and of 94% 23 out of 24 patients in out-patients. The failures may be attributed to recurrence due to concomitant bacterial infection or to re-infection by a male partner. This regime is therefore strongly recommended as the treatment of choice for Trichomonal vaginalis infection.
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