Status of imported malaria in Kuwait: experience from Al-Jahra Hospital

To illustrate the incidence of malaria positive cases reported at Al-Jahra hospital, compared to the total number of patients whose blood was examined for malaria parasites over a period of four years from 1996-1999 in the same hospital. Subjects and method: The present study involved 1446 in- and out-patients who suffered from fever of unknown origin. The method applied involved examination of Giemsa -stained thick and thin blood films. Over a period of four years, blood samples from 1446 Kuwaiti and non-Kuwaiti patients were examined for malaria, and only 202 [14%] were positive. Of the positive cases, 183 patients [90.6%] showed P. vivax parasites in their peripheral blood, 15 patients [7.4%] showed P. falciparaum and four patients [2%] showed mixed infections. Tn 1996, 60/432 [14%] of examined patients were positive and in succeeding years 1997, 76/ 431 [17.6%]; 1998, 32/317 [10.1%] arid in 1999, 34/266 [12.8%] of examined patients were positive. The male:female ratio of positive patients was 83.7%:16.3%, and 42% arid 54% of positive patients were of age groups 21-30 years and 31-40 years, respectively. The massive economical development achieved in Kuwait and other Arabian gulf countries, following oil production, necessitated the importation of skilled workers of productive age. A significant number of these workers originated from malaria-endemic countries, and some of them were found to be positive for malaria. From the results of this study, it is clear that the problem of imported malaria still exists, although the number of positive cases has decreased in the last few years. This decrease can be traced to many reasons including prior examination of blood samples of imported workers in their countries, a step of great help in the process of controlling the disease in Kuwait

Conventional antibiotic susceptibility tests fail to detect clinically significant B-lactamase activity in enterobacteriaceae

A series of Enterobacteriaceae isolated in Farwania Hospital since 1992, containing Bush Group 1 and Group 2 be beta -lactamases were tested for antibiotic susceptibility to beta -Iactam and other antibiotics using a variety of methods. Wild type and stably depressed Group 1 producers were tested in parallel and enzyme hyperproduction found to confer resistance to all the beta -lactams tested, except imepenem. Group 2be producers were resistant to aztreonam and ceftazidime and had increased MICs for cefotaxime, although the MIC of most [0.5-2.0 mg/l] meant that they were still designated susceptible according to NCCLS breakpoints. The possibility of treatment failure, if beta -lactams are used to treat infections caused by these organisms is discussed