Bacterial infections of the head and neck fascial spaces in Nigerians.

BACKGROUND: Bacterial infections of the head and neck region remain a major public health concern in Nigeria despite the availability and widespread use of antibiotics in the country. OBJECTIVE: This study was conducted to determine the pattern, aetiology, management and outcome of head and neck fascial space infections at Ife. METHODS: All consecutive patients who presented with fascial space infections between January 1995 and July 2004 at the Maxillofacial Unit of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria were admitted into the study. A structured questionnaire was completed for each patient and analyzed in respect of patients' demographics, source of infection, predisposing factors, location of infection; treatment and outcome. RESULTS: One hundred and three patients were managed during the study period. There were 55(53.4%) males and 48(46.6%) females with age ranging from 1-85 years. Submandibular space was the most common single space involved followed by the buccal space. The fascial spaces around the mandible were more involved those around the maxillae and scalp for all age groups. Four patients presented with Ludwigs' angina. Odontogenic infections arising from pulpitis, periodontitis and pericoronitis caused over 70% of the space infections. Microbial cultures showed mixed aerobic and anaerobic bacteriology. Management was by incision and drainage/decompression, removal of the source, use of antibiotics and supportive care. Two deaths were recorded in the course of this study. CONCLUSION: Bacterial infections of the head and neck region remain a major health hazard among Nigerians with spread of infection commonly involving the submandibular and the buccal spaces.

Digitally recycled incubators: better economic alternatives to modern systems in low-income countries.

UNLABELLED: The need to maintain a neutral thermal environment is critical to newborn care. AIM: To investigate reasons for the insufficiency of functional incubators and develop a cost-effective technique for using electronic digital components to recycle obsolete incubators in Nigeria. METHODS: Following interview of 84 clinicians and administrators in Nigerian hospitals, it was identified that inadequate funding was the main reason for lack of functional incubators. Two groups of incubator units were then created and their performance compared. Sixteen units of modern (group A) and 19 units of obsolete (group B) incubators were obtained from six hospitals. An assembly design applying independent generic components for recycling systems was specified and produced. These were sourced through the internet at competitive cost and fitted into the reconstructed panels of the obsolete systems. The functional performance of each recycled system was rigorously monitored for 6 months and graded using ten performance indices. The same indices were used to quantify group A systems. RESULTS: The performance of the recycled incubators (group B) was found to be similar to those of modern incubators. Group B's cost index was found to be 25% of that of group A's. CONCLUSION: Appropriate incubator recycling is a cost-effective method of re-equipping hospitals in low-income countries.