ABSTRACT
Background: The objective was to study the extent of infertility knowledge, attitude and care seeking behavioral pattern of infertile men in Lagos.Methods: A cross sectional study was carried out using questionnaire between 2009 and 2014. Adult males who were clinically infertile, visiting the clinics for the first time and consented were studied. Descriptive statistics were used for the analysis.Results: Only 226 men, mean age 38±5.8 years participated. Up to 20.8% had sired a child for between >1 but <2, 20.4% for 2-5 and 58.8% for ≥6 years. Couples had coitus for once and >3 times (mean coitus 2.3±0.9 times) weekly. Only 11.1% knew about male-female factor infertility. Up to 42.9% knew about fertility and the sign of female ovulation and 38.1% correctly defined clinical infertility. Up to 40.3% switched treatment for competency of the new places and exorbitant price by 22.1%. Sixty-six (29.2%) made the first visit to a proper care place within a period >1 but <2 years, 45.1% within 2-3 years and 25.7% waited for >3 years. Majority (50 %) sought to know the causes of infertility, 14.6% how to improve fertility and 6.6% the reality of male infertility.Conclusions: Majority of the participants sought inappropriate help and delayed in seeking appropriate care. Poor collaboration and referral system observed. There is need for edification of both care providers and seekers to be ethical in their actions. Infertility care cost intervention is needed.
ABSTRACT
Background: Until recently, mechanisms of resistance to quinolones in Gram‑negative bacteria were believed to be only chromosome encoded. However, emergence of plasmid‑mediated quinolone resistance (PMQR) has been reported worldwide. Aim: This study investigated distribution of PMQR in Gram‑negative bacteria from a tertiary hospital in eastern part of Nigeria. Materials and Methods: Seventy‑one nonduplicate Gram‑negative bacterial isolates of eight species were analyzed for antimicrobial susceptibility, genotypic detection of various PMQRs, typed by random amplified polymorphic DNA (RAPD) and analysis of plasmids present, including replicon typing. Results: The minimum inhibitory concentrations showed MIC90 values as high as 256 μg/ml for fluoroquinolones. Carriage of PMQR was found to be 35.2%. Twenty (28.2%) isolates carried various qnr genes, of which seven (9.9%) qnrA1; four (5.6%) qnrB1; eight (11.3%) qnrS1 while one (1.4%) encoded qnrD1. Eighteen (25.4%) isolates were positive for aac(6’)‑Ib‑cr while carriage of multiple genes exists in some strains. Similarly, 13 isolates (18.7%) were found to carry PMQR efflux pump gene, qepA. Conjugation experiments revealed that the plasmids once transferred coded for fluoroquinolone resistance. The transconjugant strains carried a common plasmid estimated to be 65 kb. These plasmids were untypable for replicon/incompatibility. Typing revealed high diversity among all species tested with no identical RAPD pattern seen. Conclusion: This study further confirms high level resistance to many antimicrobials in different species of Gram‑negative bacteria including fluoroquinolones and spread of PMQR genes in Southern Nigeria.