Malaria Burden in Pregnancy at Mulago National Referral Hospital in Kampala; Uganda

Pregnancy-associated malaria is a major global health concern. To assess the Plasmodium falciparum burden in pregnancy we conducted a cross-sectional study at Mulago Hospital in Kampala; Uganda. Malaria prevalence by each of three measures-peripheral smear; placental smear; and placental histology was 9(35/391); 11.3(44/389); and 13.9(53/382) respectively. Together; smear and histology data yielded an infection rate of 15.5(59/380) of active infections and 4.5(17/380) of past infections; hence 20had been or were infected when giving birth. A crude parity dependency was observed with main burden being concentrated in gravidae 1 through gravidae 3. Twenty-two percent were afflicted by anaemia and 12.2delivered low birthweight babies. Active placental infection and anaemia showed strong association (OR=2.8) whereas parity and placental infection had an interactive effect on mean birthweight (P=.036). Primigravidae with active infection and multigravidae with past infection delivered on average lighter babies. Use of bednet protected significantly against infection (OR=0.56) whilst increased haemoglobin level protected against low birthweight (OR=0.83) irrespective of infection status. Albeit a high attendance at antenatal clinics (96.8); there was a poor coverage of insecticide-treated nets (32) and intermittent preventive antimalarial treatment (41.5)

Staphylococcus Aureus Antibiotypes at Mulago Hospital

We investigated the levels of Staphylococcus aureaus antibiotypes in Mualgo Hospital; toward effective control antibiotic drug resistance in the country. One hundred and elven (n=111) strains of Staph. aureus were tested to fourteen (n=14) antibiotics using stokes method. The obtained resistance profiles were analyzed by WHOBET5 computer software. forty-six (n=46) different antibiotypes were detected. These were further subdivided into three major categories:- 1. Methicilin Resistant - methicilin Suscpetible Staphylococcus aureus (MSSA); 2. Methicillin Resistant Staphylococcus aureus (MR-MSSA) and 3. Methicillin Resistant Staphylocossus aureus (MRSA). These categories were associated with 4; 28 and 14 antibiotypes respectively. One of the antibiotypes did not show any resistance to the tested drugs; while others expressed resistance mechanisms. We noted that MSSA; MR-MSSA and MRSA antibiotypes did not show any resistance to the tested drugs; while others expressed resistance to one or more (up to 11) antibiotics. This result reflects large number of resistance mechanisms. We noted that MSSA; MR-MSSA and MRSA antibiotypes expressed 0-1; 2-7 and 4-11 resistance mechanisms respectively. Of significance; the medical wards were source of 24of the MR-MSSA and MRSA strains. The predominating antibiotypes showed resistance to many common well established drugs (Trimethoprim; Tetracycline; Chloramphenicol; Erythromycin; Gentamicin and Methicillin) as well newer drugs Sodium Cefuroxime and Ciprofloxacin. The increased number of Staph. aureus resistant antibiotypes reflected uncontrolled antibiotic usage. This problem call for increased vigilance and proper use of bacterial antibiotics. In this connection; the last - line drugs methicillin; Telcoplanin and Vocomycin should be properly administered in order to prolong and maintain their use