Prevalence of Rifampicin-Resistant Tuberculosis among Patients Previously Treated for Pulmonary Tuberculosis in North-Western, Nigeria.

BACKGROUND: Drug-resistant tuberculosis (TB) is a significant public health problem. Greater than 90% of rifampicin (RIF)-resistant isolates were also isoniazid resistant, and hence, rifampicin resistance (RR) is frequently used as a surrogate for multidrug-resistant TB. SETTING: This study was conducted at Infectious Disease Hospital Kano in North-Western Nigeria. OBJECTIVES: The aim of this study was to determine the prevalence of RR among patients previously treated for pulmonary TB (PTB). MATERIALS AND METHODS: A total of 120 patients previously treated for PTB with current clinical features of PTB were recruited into this study. Relevant clinical information were obtained using a questionnaire. The sputum was collected and analyzed by the Gene Xpert MTB/RIF® machine to detect RR tuberculosis infection and blood screened for HIV infection. RESULTS: The mean (±standard deviation) age of the participants was 35.9 ± 14.3 years and they comprised 73 (60.8%) males and 47 (39.2%) females. HIV-seropositive rate was 11.7% among the participants. Of the 120 participants, PTB was detected in 35 (29.2%) of the participants by Gene Xpert MTB/RIF and 29 of them were cases of relapse. Five patients (4.2%) had RR tuberculosis and 80% of them were below the age of 45 years. CONCLUSION: The prevalence of RR is not high among previously treated PTB patients in this study when compared with other previous studies. This finding is a window for evaluating the efficacy of current interventions in the region and evidence for the consolidation of existing control policies.

Seroprevalence of eastern equine encephalomyelitis virus in birds and larval survey of Culiseta melanura Coquillett during an interepizootic period in central Ohio.

From June through August in 1999 and 2000, we conducted an avian serosurvey for eastern equine encephalomyelitis (EEE) virus at Killbuck Marsh Wildlife Area (KMWA), a focus of infection in central Ohio. We also monitored abundance of the suspected enzootic vector, Culiseta melanura Coquillett, in Brown's Lake Bog, an adjacent wetland. Of the 363 birds of 30 species sampled in 1999, three gray catbirds (Dumetella carolinensis) were positive for antibodies to EEE virus, representing 1.2% of the avian samples and 4.2% of the gray catbirds sampled. Given these results and the abundance of gray catbirds at this site, this species became the focus of our sampling efforts in 2000. However, none of the 109 samples collected from 98 catbirds in 2000 was positive for the virus. Culiseta melanura adults were monitored using resting boxes and CDC CO, light traps at both sites in 1999. Culiseta melanura larvae were monitored in 1999 and 2000 at Brown's Lake Bog, the closest known source of this species, approximately 5km from the avian serosurvey site. We suggest that dry conditions reduced the breeding and abundance of Cs. melanura in 2000 and possibly the transmission of EEE virus at KMWA.

Bupivacaine and lignocaine for ophthalmic surgery.

Bupivacaine 0.5% when used as a local anaesthetic for ocular cataract surgery does not give absolute ocular akinesia but provides adequate and prolonged pain relief. In comparison lignocaine provides good ocular akinesia at operation but pain relief is short lived. The mixture of the two local anaesthetics in equal volumes eliminated the disadvantages of their individual use.

Intensive care in a developing country: a review of the first 100 cases.

The role of an intensive care unit with regard to patient care and manpower training in a developing country was considered from an analysis of the first 100 admissions to the unit. The organisation and facilities available are outlined. The majority of cases admitted were post-surgical but the best results were achieved in training the nursing and medical staff to manage peritoneal dialysis and patients with eclampsia. Despite the lack of equipment and investigative facilities the overall mortality was 30%.

Entonox for casualties at 1000 m: use of nitrous oxide analgesia in Nigeria at moderate altitude.

Analgesia with nitrous oxide and oxygen (Entonox) has been found to give adequate pain relief for 90 minor casualty procedures in over 90% of cases at moderate altitude. It was self administered except in six patients. Children between 6 and 10 years of age comprised 14% of patients, and the majority of the remainder were young adults. Additional analgesia was required in 11 patients, with no increase in complications. Complications were few; drowsiness occurred in 9%, dizziness was troublesome in one patient, but there was no nausea or vomiting and no one became unconscious. In situations where trained personnel are scarce, and where supervision can only be given at the time of the procedure and even at moderate altitudes Entonox is a clinically effective safe analgesic.