Microbial contamination of multi-use ophthalmic solutions in Kenya.

BACKGROUND/AIMS: Contaminated ophthalmic solutions represent a potential cause of avoidable ocular infection. This study aimed to determine the magnitude and pattern of microbial contamination of multi-dose ocular solutions at the Department of Ophthalmology, University of Nairobi, at the Kenyatta National Hospital, Kenya. METHODS: 101 vials were obtained for microbial examination after an average use of 2 weeks. The dropper tip and the residual eye drop were examined for contamination. The specimens were cultured, the number of colonies counted, the organisms identified and susceptibility testing to selected antimicrobial agents was done. RESULTS: Six (6%) of the 101 analysed vials were contaminated: 4/77 vials (5%) from a multi-user setting and 2/24 vials (8%) from a single user setting. Three contaminations (3/38, 8%) occurred in vials from the eye ward, another three (3/59, 5%) in vials from the outpatient clinic. Most bacteria identified belonged to the normal commensal flora of the eye. Isolated contaminants were micrococci (n = 2), Staphylococcus epidermidis, Haemophilus sp, Bacillus sp and a Gram negative rod. The dropper tip was more often contaminated (n = 6) than the residual solution (n = 1), and only one vial showed a contamination of both the drop and the tip. CONCLUSION: Our data show a contamination rate of 6%, which is in the lower range of data published on the contamination of eye drops elsewhere (0.07% to 35.8%).

Prevalence of trachoma in six districts of Kenya.

OBJECTIVES: To estimate the prevalence of active trachoma (TF) in children aged one to nine years and potentially blinding trachoma (TT) in adults aged 15 years and older in six known trachoma-endemic districts in Kenya. DESIGN: Community based survey. SETTING: Six known trachoma endemic districts in Kenya (Samburu, Narok, West Pokot, Kajiado Baringo and Meru North). SUBJECTS: A total of 6,982 children aged one to nine years and 8,045 adults aged 15 years and older were randomly selected in a two stage random cluster sampling method: Twenty sub-locations (clusters) per district and three villages per sub-location were randomly selected. Eligible children and adults were enumerated and examined for signs of trachoma. RESULTS: Blinding trachoma was found to be a public health problem in all the surveyed districts. Active trachoma was a district wide public health problem in four districts (Samburu, Narok, West Pokot and Kajiado) and only in some of the sub-locations of the other two (Baringo and Meru North). CONCLUSIONS: There is need for district trachoma control programmes preferably using the WHO recommended SAFE strategy in all the surveyed districts. Extrapolation of these survey results to the entire country could not be justified. There is need to survey the remaining 12 suspected endemic districts in Kenya.