The bioload and aflatoxin content of herbal medicines from selected states in Nigeria.

BACKGROUND: There is increased reliance on traditional herbal medicines by several millions of people worldwide, especially in West Africa and Nigeria in particular. This is due to escalating cost of good quality drugs and consequent proliferation of faked cheaper drugs. However, non standardization of production and handling methods have resulted in herbal medicines with varying quality and safety indices, thus resulting in possible public health concerns. This work investigated the microbial load and aflatoxin levels in herbal medicines from selected states in Nigeria. MATERIALS AND METHODS: A total of 210 samples obtained from various renowned herbal medicine practitioners from some selected states in Nigeria, based on their medicinal uses, were analyzed to determine the microbial load by the plate count method and aflatoxin contamination levels using thin layer chromatography with aflatoxin standards. RESULTS: At least six bacterial genera (Bacillus, Pseudomonas, Salmonella, EPEC, EHEC, Streptococcus and other coliforms) and 6 fungal genera (Aspergillus, Penicillium, Rhizopus, Cladosporium, Geotricum and Candida) were isolated. Aflatoxin B1, B2 and G1 were detected in varying concentrations in the samples analyzed, with an average occurrence of 18.6%. Some of these herbal concoctions were found to contain unacceptably high bioload, according to WHO standards. CONCLUSION: Microbial contamination and the presence of aflatoxins in herbal medicines appear to be an endemic problem in Nigeria, as observed in this work, probably due to poor observation of basic hygiene during preparations and poor storage conditions. The findings in this work may serve in developing and instituting public health standards for the production and safety of herbal remedies in Nigeria.

The Prevalence and Antimicrobial Susceptibility Profile of Methicillin-Resistant Staphylococcus Aureus Isolates from Clinical Specimens in a Tertiary Hospital; South East Nigeria

Pathogenic microorganisms resistant to commonly used antibiotics are of worldwide concern. Methicillin-resistant Staphylococcus aureus (MRSA) has been reported worldwide and causes both hospital and community-associated infections in humans. Sixty-five (65) Staphylococcus aureus isolates from clinical samples were screened for methicillin resistance in order to evaluate the prevalence of methicillin-resistant strains at Ebonyi State University Teaching Hospital; Abakaliki and to determine the antimicrobial susceptibility profile of MRSA strains. Susceptibility testing of the isolates to oxacillin and to some other conventional antimicrobial sensitivity discs commonly used in the study area was done using Kirby-Bauer disc diffusion technique. Of the 65 Staphylococcus aureus isolates screened; 15 (23) were susceptible to methicillin while 50 (77) were resistant to methicillin. The Methicillin-resistant isolates showed 100resistance to ciprofloxacin; ceftriaxone; nitrofurantoin and erythromycin. The percentage resistance recorded for other antibiotics were ofloxacin (88); ampicillin (76); gentamicin (72); while the lowest resistance; (40) was recorded for vancomycin. It was noted that vancomycin is still the antibiotic of choice for the treatment of MRSA infections. It was concluded that the prevalence of MRSA is high in the study area; and this should necessitate caution in the prescription of antibiotics without proper indication

Childhood suppurative otitis media in Abakaliki: isolated microbes and in vitro antibiotic sensitivity pattern.

BACKGROUND: Suppurative otitis media (SOM) is the most common pediatric problem seen by otolaryngologists in Nigeria. Devising simple and effective ways of treating pediatric patients with suppurating ears, especially in situations without a specialist care, will help prevent chronicity. Our experience with som at the ebonyi state university teaching hospital (ebsuth), abakaliki, is reviewed in this study. it may serve as a guide in patient care. OBJECTIVE: Determine the bacteriology of SOM in children in Abakaliki and ascertain their sensitivity to common antibiotics. MATERIALS AND METHODS: A 2-year retrospective analysis of ear swabs culture results and case files of children aged 0-18 years with SOM managed in EBSUTH. RESULTS: Sixty-five patients with discharging ears were reviewed. Of these, 73% were ≤ 5 years, of which 41.5% were infants. About 83% had unilateral ear discharge. Acute suppuration was seen in 67%. Overall swab yield was 87.7%; Pseudomonas was (57.4%), Klebsiella (16.4%), and Proteus species (11.5%). Ciprofloxacin showed 60% sensitivity, Gentamicin (58%), and Ceftazidime (35%). Amoxicillin/Clavulanic acid, ceftriaxone, and cefuroxime showed sensitivity of 4.3%-9.7%. CONCLUSIONS: Treatment protocols of SOM in children should emphasize the use of Ciprofloxacin or Gentamicin, especially in situations with limited access to laboratory services or specialist care.

Compliance by cerebral palsy (CP) patients attending a child neurology service, in a developing country: a preliminary study.

In an attempt to determine the extent to which cerebral palsy patients complied with doctors' recommendations, by regularly attending the follow-up clinics of the Paediatric Neurology Unit of the University of Nigeria Teaching Hospital (UNTH) Enugu, the records of the CP patients seen in the Unit during three years (1985-1987) were scrutinized. A very high default rate of over 88% was noted. Of the 155 CP patients registered during the period, only 18 were still attending the clinic by the end of 1988, the follow-up period ranging from 12 to 47 months. Default from follow-up correlated significantly with the socio-economic status of the patients. There was no correlation between compliance and the type of CP, or the presence of other concurrent neurological disorders. It is thought that early recognition of factors that are associated with poor compliance is important. It will result in early identification of the group at risk for default, and in efforts being made to give them the support and advice that will enable them to benefit fully from the available services.