Cholera outbreak caused by drinking lakeshore water contaminated by feces washed down from a hill-side residential area: Kaiso Village, Uganda

Introduction: cholera is a bacterial diarrheal disease caused by Vibrio cholerae. On 15 October 2015, a cholera outbreak involving dozens of cases and 2 deaths was reported in Kaiso, a lakeshore fishing village. The district health department responded by setting up a treatment center and sensitizing the community. Despite initial response, the outbreak persisted, prompting a detailed epidemiological investigation to identify the source and mode of transmission and recommend evidence-based interventions to stop the epidemic.Methods: we defined a suspected case as onset of acute watery diarrhoea in a Kaiso Village resident from 1st October 2015 onward; a confirmed case was a suspected case with Vibrio cholerae isolated from stool. We performed descriptive epidemiology to generate a hypothesis, and conducted a case-control study to compare exposure histories of 61 cases and 126 controls randomly selected among village residents (age ≥ 4 years in both groups). We conducted environmental assessment and obtained meteorological data from a local weather station.Results: 123 suspected cases (2 deaths) were line-listed at the village's cholera clinic. The initial 2 deceased cases had onset on 2nd and 10th October. Heavy rainfall occurred during 7­11th October, setting in a point-source outbreak which started on 12th and peaked on 13th October. Three water collection points (WCP) A, B and C were associated with the outbreak. 9.8% (6/61) of case-persons and 31% (39/126) of control-persons usually collected water from WCP A. In comparison, 21% (13/61) of case-persons and 37% (46/126) of control-persons usually collected water from WCP B (OR = 1.8, 95%CI: 0.64-5.3) and 69% (42/61) of case-persons and 33% (41/126) of control-persons from WCP C (OR = 6.7; 95%CI = 2.5-17). 100% (61/61) of case-persons and 93% (117/126) of control-persons never treated/boiled drinking water (OR = ∞, 95%CIFisher = 1.0-∞). A gully channel from a hillside open defecation area washed down feces to the lakeshore at WCP C.Conclusion: this outbreak was caused by drinking lakeshore water contaminated by feces washed down a gully from the village. We recommended water boiling and treatment, fixing the broken piped-water system, and constructing latrines. The outbreak was stopped by implementing treatment and boiling of drinking water at household level

Asthme et déjections de chauves souris au quartier Bastos de Yaoundé

OBJECTIFS: Une enquête au sein des populations de ce quartier de Yaoundé a révélé en 2009 une prévalence de 36% de signes de l'asthme parmi ses habitants (crises dyspnéiques paroxystiques, rhinites, éternuements, sifflement respiratoire). Ce quartier est densément peuplé de chauves-souris. Le but de notre étude est d'une part de confirmer le taux élevé de l'asthme par une épreuve fonctionnelle simple et de rechercher d'autre part d'éventuels rapports entre l'asthme et les chauves-souris dont les fèces polluent l'environnement immédiat. MÉTHODES Il s'agit d'une enquête basée sur la mesure du DEP (Débit Expiratoire de Pointe) à l'aide du peakflowmètre de Wright. Deux quartiers, Bastos et Ngousso ont été revisités comme en 2009. Une épreuve de peakflowmétrie a été réalisée dans les 2 quartiers (Bastos peuplé de chauve-souris et ayant présenté le plus de signes d'asthme: 36% en 1999). Le quartier Ngousso, non peuplé de chauves-souris, n'a présenté que 2,4% de signes d'asthme en 1999. Cinquante sujets ont été sélectionnés avec leur consentement dans chacun des 2 quartiers pour l'épreuve de peakflowmétrie. La fourchette d'âges pour nos 2 échantillons a ciblé des sujets de 15 à 75 ans. Ce choix était basé sur la capacité de bien exécuter 2 tests peakflowmétriques. Le premier suivi d'une inhalation de 3 bouffées de salbutamol, puis le second 5 minutes plus tard. RÉSULTATS: 45 habitants sur les 50 de Bastos (90%) reconnaissent la présence des chauves-souris dans leur quartier. Seulement 2 de Ngousso (4%) ont pu le faire. Il existe une différence sur ce fait entre les 2 quartiers (p<0.0001). 35 habitants de Bastos (70%) savent reconnaître les déjections de chauves-souris contre (2%) à Ngousso. cette connaissance est significativement différente dans les 2 quartiers (p<0.0001). La variation du DEP (Débit Expiratoire de Pointe) a été franche chez 16 sujets de Bastos versus 2 asthmatiques connus de Ngousso. La prévalence de l'asthme est de 32% à Bastos versus 4% à Ngousso (p<0.0001). CONCLUSION: La prévalence de l'asthme est plus élevée dans le quartier Bastos densément peuplé de chauves-souris. La pollution de l'environnement par les déjections disséminées des chauves-souris autour des habitations y jouerait un rôle. Les déjections de chauves-souris seraient un facteur favorisant de l'asthme. Elles constituent depuis le guano, un milieu favorable de culture des champignons où pousse principalement Mycoplasma capsulatum qui est très allergisant et connu comme facteur déclenchant. Les acariens qui sont une cause bien connue de l'asthme sont également véhiculés par les chauves-souris qui s'infestent depuis leurs fientes en milieu humide. Une étude plus étroite reliant la présence des chauves-souris dans la maison (plafond par exemple) et l'asthme devra être envisagée pour plus de pertinence de notre observation

Astrosvirus infection children in Lagos, Nigeria

A preliminary investigation was conducted to screen for astrovirus in Lagos. Two hundred and fifteen (215) faecal samples collected from children under 5 years old with diarrhoea (161) and without diarrhoea (54) admitted at paediatric clinics in Lagos State were studied. The stool specimens were examined for the presence of human astrovirus antigen using a monoclonal antibody-based ELISA (Astrovirus RIDASCREEN® r-Biopharm, Germany) technique. Astrovirus was detected in 40.4 percent(65/161) of the diarrhoeal stools compared to 11.1 percent (6/54) of the control specimens. Astrovirus was found to infect younger children and about three quarter of the children infected was under 12 months of age. The prevalence of infection decreases with age group and was statistically significant (P = 0.0470). Although, prevalence of infection is more in males than females but this is not significant. This study shows that astrovirus is an important agent of acute gastroenteritis among children in Lagos state

Bacterial Etiology of Diarrhoeal Diseases in Children Under 5 Years Old in Ombadda Hospital - Sudan

Abstract:This study was conducted in Ombadda hospital in order to isolate and identify the bacterial aetiology of diarrhoea in children under 5years of age and determine their antibiograms. Stool specimens were collected from children seeking treatment at Ombadda and Omdurman paediatric hospitals from April to September 2008. The stool specimens were cultured on conventional media; and the isolates were identified by biochemical tests; and confirmed by serology. Enteropathogenic E.coli (EPEC) was the predominant isolate (42.11); followed by Salmonella paratyphi B (31.58);Salmonella typhi (10.53) V. cholerae (10.53) and Shigella flexneri(5.26). The enteric bacterial pathogens were susceptible to cefuroxime and ceftriaxone.V.cholerae was susceptible to amoxicillin.This study showed high proportion of bacterial diarrhoea among children less than five years old. The most common causative agent is EPEC which is not part of routine investigation of stool culture in all of the laboratories in Sudan

Epidemiologie moleculaire des betalactamases a spectre elargi produites par des Enterobacteriaceae d'origine fecale isolees chez les habitants de residences estudiantines a l'Universite de Kinshasa (RDC)

Objectif : Determiner l'epidemiologie moleculaire des Enterobacteriaceae productrices des betalactamases a spectre elargi (E-BLSE) chez les habitants de residence estudiantines a l'Universite de Kinshasa. Methodes : Des echantillons de selles preleves chez 516 etudiants ont ete examines pendant la periode du 15 novembre 2005 au 30 avril 2006. A l'aide de la galerie API 20E; nous avons pu identifier les differentes souches d'enterobacteries. La production de BLSE a ete recherchee par le test de synergie en double disque; puis confirmee et caracterisee par la focalisation isoelectrique; la PCR et le sequencage des genes de resistance. Un questionnaire a permis de recueillir les informations sur la demographie et les antecedents d'antibiotherapie des sujets inclus dans l'etude. Resultats : La frequence des E- BLSE etait de 17;8chez ces etudiants. Aucune correlation n'a ete notee entre un antecedent d'antibiotherapie et la presence d'E-BLSE. Parmi les E-BLSE isolees; Escherichia coli etait l'espece majoritaire (65); suivi de Klebsiella pneumoniae (26) etn d'Enterobacter cloaceae (5;4). CTX-M-15 etait l'ESBL predominante (29); suivie de CTX-M-28 (19;6); TEM- 68 (16;8); TEM-104 (9;3); CTX-M-3 (9;3); CTX-M-n 22 (4;7) ; SHV-12 (4;7); TEM-168 (1;9); TEM-144 (0;9); SHV-5 (0;9); SHV-2 (0;9); CTX-M-34 (0;9); CTX-M-62 (0;9). CTX-M-15 etait presente dans toutes les souches d'Escherichia coli isolees. Conclusion : Cette etude est; a notre connaissance; la premiere sur l'epidemiologie et la caracterisation des BLSE en RDC. La frequence des E-BLSE dans les residences estudiantines de l'Universite de Kinshasa; ainsi que la presence d'une grande variete de BLSE; justifieraient l'extension de ce type d'enquete dans la communaute et en milieu hospitalier; afin d'evaluer l'ampleur reelle du probleme et de definir des strategies adequates de pharmacovigilance et de lutte contre les bacteries multiresistantes aux antibiotiques

Parasitoses du peril fecal dans la Commune de Sotouboua au Togo

Une enquete parasitologique a ete effectuee de Juin a Novembre dans 4 ecoles de la Commune de Sotouboua dans la Region Centrale du Togo. Ce travail montre que sur 672 eleves; 244 hebergent des parasites soit 36 pour cent des enfants en age scolaire. L'ankylostomiase est l'helminthiase la plus frequente. La bilharziose genito-urinaire a un taux de frequence assez eleve ce qui nous fait penser qu'en organisant une enquete generale dans la Prefecture de Sotouboua et surtout en mettant en oeuvre des techniques de diagnostic plus performantes; le taux de positivite pourrait etre augmente

The intensity of Schistosoma mansoni in the fishing villages of Bugonga and Kitubulu in Entebbe Peninsula; Uganda

The intensity of Schistosoma mansoni infection in the fishing villages of Bugonga and Kitubulu; and the occurrence of snail intermediate host population in the two villages are described and compared. A total of five hundred and six faecal samples from both villages were examined by modified Kato's technique and the prevalence infection rate at Kitubulu was 40.3pc with mean egg count of 187 eggs per gram(epg) while in Bugonga it was 32.4pc and 126 epg respectively. The snail intermediate host for S. mansoni in the two villages was 2;750 Biomphalaria choanomphala at Kitubulu and 1;268 at Bugonga. But at Kitubulu in the vicinity of the village 185 Biomphalaria peifferi occurred in small localized population. The cercarial screening test conducted on 4;018 B. choanomphala and 185 B. peifferi from the two villages revealed higher snail infection rate for both mammalian and non-mammalian cercariae at Kitubulu than Bugonga. Variations in infection rates both among the inhabitants and host snail populations in the two villages are discussed

Faecal contamination level; survival of salmonella typhi and pH changes in 'Gari' and its potential public health hazard in Lagos

The pH changes; faecal contamination level; survival of nalidixic-acid resistant salmonella typhi in 'gari' soaked in water was examined. The pH values showed that 'gari' had a range of pH 3.76 to pH 6.24. The mean pH values showed that there were no appreciable change for gari types from various sources within the studied time period of 120 minutes. Faecal coliform contamination of 4 to 2;400/g using the MPN technique were recorded in 33of the 36 'gari' samples. This high faecal coliform contamination rate of gari; a popular fermented cassava food is unacceptable and it is of public health importance. Our survival experiment showed that the seeded enteric pathogen slightly decreased in colony-forming unit (cfu) with log(0.3 10) 0.3 within the studied 120 minutes. It is concluded that our local foods should be monitored regularly for public health safety; and improved hygienic practices should be emphasized as an intervention for diarrhoeal diseases in developing countries

The intestinal faunas of man and mountain gorillas in a shared habitat

The primate fauna of the Impenetrable (Bwindi) Forest in southwest Uganda includes both man and the mountain gorilla Gorilla gorilla beringei. The intestinal parasite faunas of these two species were described by examining faecal samples. Of 16 parasites in the combined fauna only one; Strongyloides fuelleborni; was shared by both host species