Asymptomatic bacteriuria in diabetes mellitus patients in Southwest Cameroon.

BACKGROUND: Asymptomatic bacteriuria (ASB) is common in diabetics and predisposes these patients to more severe urinary tract infections (UTIs). Reports on the prevalence and etiology of ASB especially in developing countries appear contradictory. OBJECTIVES: To determine the prevalence and etiology of ASB and antimicrobial resistance of urinary isolates in diabetics and non-diabetics. METHODS: The study involved a total of 265 participants including 154 diabetes mellitus patients and 111 non-diabetics in Southwest Cameroon. Mid-stream urine was collected from consented subjects and each sample tested using the dipstick, microscopy and culture techniques. Isolates were identified using standard biochemical tests. RESULTS: ASB was detected in 33.2% of participants; 38.3% in diabetics and 26.1% in non-diabetics (P = 0.03). Coagulase-negative staphylococci (CNS) were the predominant organisms (36.3%) isolated from urine in both diabetics and nondiabetics. Other isolates included Klebsiella sp (15.9%), Candida sp (13.7%), E. coli (10.8%) and Serratia sp (10.8%). Candida sp was isolated more from diabetics than non-diabetics (P = 0.01). There was no significant difference in resistance between diabetics and non-diabetics (P > 0.05). Most isolates showed multiple resistance and ciprofloxacin was the most active ingredient against bacterial uropathogens. CONCLUSION: The study revealed a high prevalence of ASB in diabetics than in non-diabetics. A change in the aetiologic spectrum was observed with Staphylococcus sp accounting for majority of ASB. Most isolates showed multiple resistance in both diabetics and non-diabetics; therefore the need to speed up sensitization against antibiotic abuse in Southwest Cameroon.

Microscopy is more reliable than questionnaire-based methods in the diagnosis of malaria in school children.

The objectives of the study were to determine by the use of a structured questionnaire the prevalence of malaria and its associated symptoms amongst school children and to relate these to the prevalence of malaria determined by microscopic examination. The questionnaire was administered to 840 pupils of classes 3, 5 and 7 (age range 5-16 years) in 17 primary schools of the Kumba Health District of Cameroon. Blood samples were collected from the same individuals for identification of malaria parasites. The prevalence rate by microscopic examination was 41.4% significantly higher (P<0.001) than 23.9% obtained by questionnaire survey. Headache and fever had similar prevalence rates (53.6% and 53.0% respectively) which were significantly higher (P<0.001) than the prevalence rate of malaria by microscopic examination. Other malaria hyphen;related symptoms gave rates which greatly underestimated the prevalence of malaria (P<0.001). There was no significant correlation between the prevalence rates obtained by questionnaire and the rate of malaria by microscopy. The sensitivity and specificity of these screening tests for malaria were all low. The use of the microscope as a malaria diagnostic tool at primary health care unit is strongly recommended.