Background The intestinal microbiota of neonates can be colonised by extended-spectrum β-lactamase-producing Enterobacteriales (ESBL-PE) with the risks of subsequent infections. The antimicrobial resistance profile of the gut flora of neonates is not well defined in Nigeria. This study determined the burden of rectal carriage of ESBL-PE among neonates. Methods We conducted a prospective longitudinal study among neonates admitted into a tertiary hospital from September 2019 to November 2019. Stools were sampled at admission and weekly until exit and processed by standard laboratory methods including polymerase chain reaction to identify ESBL genes. The ESBL-PE colonisation period prevalence at admission and acquisition rate were determined. Results The period prevalence of the ESBL-PE colonisation and acquisition rate were 46.5% (59/127) and 34.6% (36/104), respectively. Prolonged rupture of the amniotic membrane (PROM; >24 h; p=0.004, odds ratio [OR] 0.297), number of neonates on admission in the same room (p<0.001, OR 0.053) and presence of an ESBL-PE colonisers (p=0.004, OR 0.272) were independent risk factors for ESBL-PE rectal colonisation. ESBL-PE colonisation did not correlate with mortality (Fisher's exact test 1.342, p=0.196). Conclusions The rate of ESBL-PE neonatal rectal colonisation is high in our settings and this underscores the need for a review of neonatal admission protocols, embracing of antibiotic stewardship in the management of PROM, resistance surveillance and implementation of infection prevention and control in the neonatal unit.
Background and Aim: The deleterious effects of Resident Doctors' (RDs') long duty hours are well documented. Driven by concerns over the physician's well-being and patient safety, the RDs' duty hours in many developed countries have been capped. However, in Nigeria and many African countries, there are no official regulations on work hours of RDs. This study evaluated the work schedule of Nigerian RDs and its impact on their wellbeing and patient safety. Subjects and Methods: A national survey of 1105 Nigerian RDs from all specialties in 59 training institutions was conducted. With an electronic questionnaire designed using Google Forms, data on the work activities of RDs were obtained and analyzed using the IBM SPSS software version 24. The associations were compared using Chi-squared test with the level of significance set at < 0.05. Results: The mean weekly duty hours (h) of the RDs was 106.5 ± 50.4. Surgical residents worked significantly longer hours than non-surgical residents (122.7 ± 34.2 h vs 100.0 ± 43.9 h; P < 0.001). The modal on-call frequency was two weekday on-calls per week (474, 42.9%) and two weekend on-calls per month (495, 44.8%), with the majority of RDs working continuously for up to 24 hours during weekday on-calls (854, 77.3%) and 48–72 hours during weekend on-calls (568, 51.4%), sleeping for an average of only four hours during these on-calls. The majority of RDs had post-call clinical responsibilities (975, 88.2%) and desired official regulation of duty hours (1,031, 93.3%). Conclusion: The duty hours of Nigerian RDs are currently long and unregulated. There is an urgent need to regulate them for patient and physician safety.
Background: Statistics from the Nigeria demographic and health survey (NDHS) 2018 revealed that about 59% of women delivered at home and only 24% of babies were weighed at birth. Subsequently, many small babies may have been missed. It is therefore necessary to identify alternative and effective surrogates to birth weight especially in places where weighing scales are not available through the use of simple and familiar tools.Methods: It was a descriptive cross-sectional study involving the measurement of birth weight, occipitofrontal circumference (OFC), mid-upper arm circumference (MUAC), chest circumference (ChC), calf circumference (CC) and foot length (FL). Binary logistic regression analysis was used to determine degree of relationship between the anthropometric parameters and low birth weight. Cut-off values (with the highest sensitivity and specificity) were determined and diagnostic accuracy was performed using the area under the receiver’s operating characteristics (ROC) curve.Results: All anthropometric measurements correlated positively with birth weight. With each unit increase in the MUAC, the odds for low-birth weight outcome decreased with an odds ratio (OR) of 0.099 (95% CI 0.045-0.213; p<0.001). Cut-offs and area under the curve (AUC) values for OFC, MUAC, chest circumference, calf circumference and foot length were 32.9 cm, 9.8 cm, 30.2 cm, 9.8 cm and 7.4 cm; and 0.93, 0.97, 0.96, 0.96 and 0.92 respectively.Conclusions: MUAC had the best predictive performance in detecting low birth weight. The findings of this study provide an opportunity for early identification of low birth weight especially among out-of-facility births so that life-saving interventions can be instituted early.
Background: Statistics from the Nigeria demographic and health survey (NDHS) 2018 revealed that about 59% of women delivered at home and only 24% of babies were weighed at birth. Subsequently, many small babies may have been missed. It is therefore necessary to identify alternative and effective surrogates to birth weight especially in places where weighing scales are not available through the use of simple and familiar tools.Methods: It was a descriptive cross-sectional study involving the measurement of birth weight, occipitofrontal circumference (OFC), mid-upper arm circumference (MUAC), chest circumference (ChC), calf circumference (CC) and foot length (FL). Binary logistic regression analysis was used to determine degree of relationship between the anthropometric parameters and low birth weight. Cut-off values (with the highest sensitivity and specificity) were determined and diagnostic accuracy was performed using the area under the receiver’s operating characteristics (ROC) curve.Results: All anthropometric measurements correlated positively with birth weight. With each unit increase in the MUAC, the odds for low-birth weight outcome decreased with an odds ratio (OR) of 0.099 (95% CI 0.045-0.213; p<0.001). Cut-offs and area under the curve (AUC) values for OFC, MUAC, chest circumference, calf circumference and foot length were 32.9 cm, 9.8 cm, 30.2 cm, 9.8 cm and 7.4 cm; and 0.93, 0.97, 0.96, 0.96 and 0.92 respectively.Conclusions: MUAC had the best predictive performance in detecting low birth weight. The findings of this study provide an opportunity for early identification of low birth weight especially among out-of-facility births so that life-saving interventions can be instituted early.
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