Prevalence and antimicrobial resistance patterns of Enterococcus species isolated from laying hens in Lusaka and Copperbelt provinces of Zambia: a call for AMR surveillance in the poultry sector.

Background: The use of antimicrobials in layer poultry production for improved production, growth promotion, prophylaxis and treatment purposes has contributed to the development of antimicrobial resistance (AMR) in poultry. In Zambia, there is a paucity of information on the prevalence and AMR patterns of Enterococcus species isolated from laying hens. Objectives: This study investigated the prevalence and AMR patterns of enterococci isolated in layer hens in Lusaka and Copperbelt provinces of Zambia. Methods: A cross-sectional study was conducted from September 2020 to April 2021. Three hundred and sixty-five pooled cloacal swab samples were collected from 77 layer poultry farms. Enterococci identification and confirmation were performed using Analytical Profile Index (API 20 STREP) and 16S rRNA sequencing, respectively. A panel of nine antibiotics was used for antibiotic susceptibility testing and interpreted according to the CLSI 2020 guidelines. Data were analysed using SPSS version 23 and WHONET 2020. Results: A total of 308 (83%) single Enterococcus species isolates were obtained and showed resistance to tetracycline (80.5%), erythromycin (53.6%), quinupristin/dalfopristin (53.2%), ampicillin (36.72%), vancomycin (32.8%), linezolid (30.2%), ciprofloxacin (11.0%), nitrofurantoin (6.5%) and chloramphenicol (3.9%). The prevalence of enterococci resistant to at least one antibiotic was 99.4% (n = 306), of which 86% (n = 265) were MDR. Conclusions: This study found a high prevalence of antimicrobial-resistant enterococci. The presence of MDR requires urgent intervention and implementation of AMR surveillance strategies and antimicrobial stewardship programmes in layer poultry production in Zambia.

Factors Affecting Performance in Clinical Practice among Preservice Diploma Nursing Students in Northern Tanzania.

There is an increased call for improving the environment in which nursing students learn the clinical skills. Clinical practice in the clinical placement sites should allow students to apply their theoretical knowledge in a real environment, develop nursing skills and clinical reasoning, and observe and adapt the professional role. This study aimed at identifying the factors influencing performance in clinical practice among preservice diploma nursing students in Northern Tanzania. This study relied on a cross-sectional analysis of data collected from nursing schools in Northern Tanzania in which 208 (123 nursing students and 85 nurse tutors) participants were recruited in the study. Data was gathered using a self-administered questionnaire which collected information on sociodemographic characteristics and factors influencing clinical practice categorized in students' factors, hospital based factors, social-economic factors, and nurse tutors opinions assessed. Descriptive analyses and chi-square test were employed to understand the background information of the sample and association between variables. Majority of the nursing students (84.4%) agreed that clinical placement offers students adequate opportunity for clinical practical learning. Barriers to effective clinical learning was reported by 70.1% of the participants and the barriers include student factors such as lack of self-confidence and absenteeism, school factors such as improper supervision, and poor preparation of clinical instructors or clinical facility factors. We found a significant association between type of barrier and gender (chi-square 0.786, p=0.020). More male nursing students (62.1%) significantly reported unsupportive environment as a barrier and anxiety was more common in female nursing students (48.9%) (p=0.020). Reporting of barriers to effective clinical learning by students from different schools of nursing was not significant (P=0.696). In addition, age of participants did not have significant association with effective clinical practice (p=0.606). Student's factors and placement based factors played an important role to influence clinical learning experiences. Offering preclinical orientation, distributing and clarifying clinical learning objectives to students, and frequent visits and supervision of students in clinical area may improve student learning experience in clinical placement. In addition, tailoring the interventions to gender may improve learning experiences.

Prevalence of Intestinal Helminths Infestation in Children Attending Princess Marie Louise Children's Hospital in Accra, Ghana.

The deworming exercise program does not cover all children who are not in school. This study determined the prevalence and species type of helminth infestation and associated factors among children attending Princess Marie Louise Children's Hospital in Accra, Ghana. Children (225) below the age of 10 who have not taken antihelminthic drugs prior to the study period were recruited between May and June 2015. Children or guardians were interviewed using structured questionnaires and fresh stools were collected and processed for helminths species identification using microscopy. Data were analyzed using Stata version 12. Overall helminths infestation prevalence was 17.33% (39/225). The identified species were hookworm (10.22% (23/225)) and Ascaris lumbricoides (7.11% (16/225)). No double infestation was observed. Significant associations were observed between infestation and age group beyond 4 years (48 months) (aOR = 16.72, 95% CI 1.00-279.72), place of residence (aOR = 7.35, 95% CI 1.68-32.11), washing hands after using toilet (0.04, 95% CI 0.01-0.20), and dirt on fingernails of children (7.96, 95% CI 1.73-36.65). This study demonstrates high prevalence of helminths parasites, hookworm, and Ascaris lumbricoides in children attending PMLCH. Deworming exercise should be extended to children hospitals in developing countries.