ABSTRACT
Background: Acute flaccid paralysis (AFP) surveillance was adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. The main objective of AFP surveillance is to detect the presence of circulating wild-type poliovirus and other subtypes of polioviruses. Stool specimen collection kits for AFP surveillance and data tools, regrettably are not always available in health facilities, and thus cause gaps in specimen collection and proper documentation which could ultimately lead to under-reporting of cases. Methods: This survey was undertaken to determine the availability of stool collection kits and data capturing tools in health facilities in some randomly selected states in Nigeria. The main aim was to relate the findings with the quality of the surveillance system in the areas visited and an overall indication of the functionality of the process in the country. Results: The outcome of the study found only 32,598 (74.7%) health facilities out of the 43,644 health facilities who visited and had stool specimen collection kits, while of the 43,582 health facilities visited, only 38,029 (87.3%) health facilities had data tools. Conclusions: Gaps were noticed in the supply of key AFP surveillance components to the health facilities visited, which by extension could apply to those not visited. Countries that are still polio-endemic will have to regularly survey their facilities for the availability of these very important materials. The methodology can be adapted to other diseases to evaluate the strength of the surveillance system.
ABSTRACT
Aim: The aim of this study was to isolate and characterize Salmonella strains associated with childhood acute gastroenteritis in Nigeria; as well as to evaluate the resistant patterns of the strains to the commonly used antimicrobials agents. Study Design: Children ≤ 5years having diarrhoea characterized by the occurrence of three or more loose or watery stool or at least one bloody loose stool in a 24-hour period were enrolled in the study. Methods: The study was conducted between July and December 2008. Samples were preenriched in buffered peptone water followed by selective enrichment using selenite cysteine and Rapaport-Vassilidis broths. Isolation and identification was made by inoculating the selectively enriched sample on to Xylose Lysine Deoxycholate agar followed by confirmation of presumptive colonies using different biochemical tests. The CLSI, 2006 method was used for antimicrobial susceptibility testing. Results: In all the 400 tested samples, 9 (2.3%) were positive for Salmonella isolates. Results showed that the children aged 0-5 months had the highest Salmonella infection rate of 5 (4.1%), followed by 13-24 months 4 (3.5%), while Salmonella infection was not present in the age groups of 25-36 months, 37-48 months, and 49-60 months. The highest (3.2%) Salmonella infection rate was seen among children on solid food followed by those on breast milk (2.5%), while those on a combination of breast milk and formula had no detectable level of Salmonella infection. The study recorded various degrees of resistance to four antimicrobials as observed in amoxicillin, cephalexin, and cefuroxime (55.6%) each, while resistance was observed in 77.8% of the isolates against amoxycillin-clavulanic acid. All isolates were susceptible to ciprofloxacin, nalidixic acid, and Ceftriaxone. Conclusion: The study reports Salmonella species as a potential pathogen isolated from stool samples of children with acute gastroenteritis. The overall resistance level of the isolates to amoxycillin-clavulanic was highest followed by resistance to amoxicillin, cephalexin, cefuroxime giving a cause for concern.