ABSTRACT
Objective To assess if water from improved sources are microbiologically safe in Niassa province, Mozambique, by examining the presence of total coliforms in different types of water sources. Methods We conducted a cross-sectional household survey in two rural districts of Niassa province during the dry season, from 21 August to 4 October 2019. We observed water sources and conducted microbiological water quality tests and structured household interviews. Findings We included 1313 households, of which 812 (61.8%) used water from an improved source. There was no significant difference in presence of total coliforms between water sampled at improved and unimproved water sources, 62.7% (509 samples) and 65.7% (329 samples), respectively (P-value=0.267). Households using improved water sources spent significantly longer time collecting water (59.1 minutes; standard deviation, SD: 55.2) than households using unimproved sources (49.8 minutes; SD: 58.0; P-value <0.001). A smaller proportion of households using improved sources had access to water sources available 24 hours per day than that of households using unimproved sources, 71.7% (582 households) versus 94.2% (472 households; P-value <0.001). Of the 240 households treating water collected from improved sources, 204 (85.4%) had total coliforms in their water, while treated water from 77 of 107 (72.0%) households collecting water from an unimproved source were contaminated. Conclusion Current access to an improved water source does not ensure microbiological safety of water and thereby using access as the proxy indicator for safe drinking and cooking water is questionable. Poor quality of water calls for the need for integration of water quality assessment into regular monitoring programmes.
Subject(s)
Drinking Water , Water Quality , Water Contamination Control , MicrobiologyABSTRACT
Background: Risk assessment is the means of identifying and evaluating potential errors or problems that may occur in testing process. The aim of this study was to perform risk assessment of antimicrobial susceptibility testing (AST) process in clinical microbiology laboratories of Niamey, Niger Republic. Methodology: We conducted a descriptive cross-sectional study from October 1 to December 31, 2019, to evaluate AST performance in seven clinical microbiology laboratories at Niamey, the capital city of Niger republic. The evaluation focused on the determination of the criticality index (CI) of each critical point (frequency of occurrence of anomalies, severity of the process anomaly, and detectability of the anomaly during the process) in the AST process and the performance of the AST through an observation sheet using two reference strains; Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 29213. Results: The criticality index (CI) was greater than 6 for most of the critical points related to material, medium, equipment, method and labour for the AST process in all the laboratories. A range of 18-100% errors on the inhibition zone diameters of the reference strains were observed. Major and/or minor categorization (Sensitive S, Intermediate I and Resistance R) discrepancies were found at all the laboratories for either one or both reference strains. The antibiotics most affected by the S/I/R discrepancies were trimethoprim (100%), vancomycin (100%), amoxicillin (80%) and amoxicillin + clavulanic acid (70%). Conclusion: This study showed a deficiency in the control of critical control points that impacts the performance of the AST reported by the laboratories in Niger. Corrective actions are needed to improve the performance of AST in clinical microbiology laboratories in Niger
Subject(s)
Humans , Quality Control , Microbial Sensitivity Tests , Medical Laboratory Science , Microbiology , Critical Illness , NigerABSTRACT
Introduction : A l'heure actuelle, aucune étude n'a été publiée concernant la pneumonie acquise sous ventilation mécanique au Centre Hospitalier de Soavinandriana. L'objectif est de déterminer les caractéristiques de cette pathologie au sein d'un service de Réanimation Polyvalente. Matériels et Méthodes : Une étude rétrospective, descriptive, transversale sur une période de 12 mois (de janvier à décembre 2016), incluant tous les patients âgés de plus de 18 ans, développant une PAVM. Ont été exclus les patients un examen cytobactériologique des crachats négatif. Les paramètres étudiés étaient : l'âge, le motif d'admission, l'antibiothérapie probabiliste entamée, la microbiologie, la durée de séjour en réanimation et l'issue des patients. Résultats : Cent soixante-dix patients ont eu une ventilation mécanique de plus de 2 jours, parmi lesquels 32 patients avaient une PAVM (soit une fréquence de 20%). L'âge médian était de 53 ans, de sex-ratio 3,57. Vingt-deux cas présentaient une pathologie vasculaire céré¬brale. Dix-huit patients ont un antécédent neurologique et 15 patients avaient un antécédent cardiovasculaire. L'amoxicilline-acide clavulanique et le métronidazole étaient utilisés comme antibiothérapie probabiliste initiale. Les germes les plus fréquemment retrouvés étaient le Pseudomonas aéruginosa (15 cas) et le Klebsiella pneumoniae (10 cas). Ils sont sensibles à l'amikacine et à l'imipenème. La durée médiane de la ventilation mécanique était de 7j et celle du séjour en réanimation 17j. Le taux de mortalité était de 56%. Conclusion : La fréquence de cette pathologie est élevée. La connaissance de l'écologie bactérienne locale permettrait de modifier l'antibiothérapie probabiliste afin de diminuer la mortalité