We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from 2002 through 2007 in 98 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) National Nosocomial Infections Surveillance System (NNIS) definitions for device-associated health care-associated infection, we collected prospective data from 43,114 patients hospitalized in the Consortium's hospital ICUs for an aggregate of 272,279 days. Although device utilization in the INICC ICUs was remarkably similar to that reported from US ICUs in the CDC's National Healthcare Safety Network, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infections (CLABs) in the INICC ICUs, 9.2 per 1000 CL-days, is nearly 3-fold higher than the 2.4-5.3 per 1000 CL-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia was also far higher, 19.5 vs 1.1-3.6 per 1000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 6.5 versus 3.4-5.2 per 1000 catheter-days. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (80.8% vs 48.1%), Enterobacter species to ceftriaxone (50.8% vs 17.8%), and Pseudomonas aeruginosa to fluoroquinolones (52.4% vs 29.1%) were also far higher in the Consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 14.3% (CLABs) to 27.5% (ventilator-associated pneumonia).

Background:Healthcare acquired infections (HCAIs) otherwise call nosocomial infection is associated with increased morbidity and mortality among hospitalized patients and predisposes healthcare workers (HCWs) to an increased risk of infections. The study explores the knowledge and practices of infection control among HCW in a tertiary referral center in North-Western Nigeria.Materials and Methods:This is a cross-sectional study. A self-administered structured questionnaire was distributed to the study group (of doctors and nurses). Data on knowledge and practice of infection control were obtained and analyzed. Study population were selected by convenience sampling.Results:A total of 200 responses were analyzed, 152 were nurses while 48 were doctors. The median age and years of working experience of the respondents were 35 years (interquartile range [IQR] 31–39) and 7 years (IQR 4–12), respectively. Most of the respondents 174/198 (87.9%) correctly identified hand washing as the most effective method to prevent HCAI, with nurses having better knowledge 139/152 (91%) (P = 0.001). Majority agreed that avoiding injury with sharps 172/200 (86%), use of barrier precaution 180/200 (90%) and hand hygiene 184/200 (92%) effectively prevent HCAI. Only 88/198 (44.4%), 122/198 (61.6%), and 84/198 (42.4%) of the respondents were aware of the risks of infection following exposure to human immunodeficiency virus, hepatitis B virus and hepatitis C virus-infected blood, respectively. About 52% of doctors and 76% of nurses (P = 0.002) always practice hand hygiene in between patient care.Conclusion:Gaps have been identified in knowledge and practice of infection control among doctors’ and nurses’ in the study; hence, it will be beneficial for all HCW to receive formal and periodic refresher trainings.

Background/Objectives: The acute impact of Hibiscus sabdariffa calyces (HSC) extract on postprandial vascular function and other cardiometabolic risk factors have not been studied previously. This study investigated the acute impact of HSC extract consumption on blood pressure (BP), vascular function and other cardiometabolic risk markers. Subjects/Methods: Twenty-five men with 1% to 10% cardiovascular disease (CVD) risk (determined by QRISK®2) were randomised to consume either 250 mL of the aqueous extract of HSC or water with breakfast in a randomised, controlled, single‐blinded, 2-meal cross-over study (ClinicalTrials.gov, NTC02165553) with a two weeks washout period between study days. BP was measured at baseline and hourly for 4 h. Flow mediated dilatation (FMD) of the branchial artery was measured at baseline, 2 and 4 h post intervention drink consumption. Results: Acute consumption of aqueous extract of HSC caused a significant increase in % FMD (p < 0.001), a non-significant decrease in systolic BP (SBP) and diastolic BP (DBP); non-significant increase in urinary and plasma nitric oxide (NOx) and reduced response of serum glucose, plasma insulin, serum triacylglycerol and C-reactive protein (CRP) levels; significant (p = 0.026) improvement in the area under systemic antioxidant response curve (0 to 2 h); no significant changes in arterial stiffness following the acute consumption of the extract of HSC. Gallic acid, 4-O-methylgallic acid, 3-O-methylgallic acid and hippuric acid reached a maximum plasma concentration at 1 to 2 h post consumption of the extract of HSC. Conclusion: The extract of HSC improved postprandial vascular function and may be a useful dietary strategy to reduce endothelial dysfunction and CVD risk, although this requires confirmation.

Unskilled home delivery is a threat to maternal and child health. In northern Nigeria, many pregnant women attend antenatal care but opt to deliver at home despite knowing the potential consequences. An institutional delivery, helps reduce various complications during childbirth, and therefore decreases the rates of maternal and child mortality. To explore the determinants of home delivery after attending antenatal services, this study employed a cross-sectional design and a non-probability purposive sampling technique. Findings of the study revealed that, majority (74.1%) of the women predominantly between the ages of 25-35 years, (29±6.4) quit antenatal care to deliver at home mainly due to maternity staff attitude and presence of male healthcare workers during delivery. The study concluded that, pregnant women are aware of the importance of antenatal care and, do deliver at home due to behavioural, sociocultural and religious preferences. To combat the maternal mortality in this region, values and beliefs of the women and families should be put into cognizance. Additionally, healthcare workers should be respectful and create a conducive environment in the maternity centres. More maternity centres including waiting homes should be provided.

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The extract of Hibiscus sabdariffa calyces (HSC) is consumed as an infusion in many countries and considered to have lipid lowering ability (1)(2)(3), although the evidence is limited. This study aimed to investigate the acute impact of HSC extract consumption on cardiometabolic risk markers in men with 1 to 10 % risk ofdeveloping cardiovascular disease (CVD) in 10 years.A randomised, controlled, single-blinded, cross over study involving 22 men (49 ± 2 years and BMI 26·9 ± 0·7 kg/m 2 ), was conducted in accordance with the declaration of Helsinki and Consolidated Standards of Reporting Trials (CONSORT). The study was registered as NTC02165553 ClinicalTrials.gov. Volunteers were randomised to consume either 250 ml of the aqueous extract of HSC (containing 150 mg anthocyanins) or water control with mixed breakfast (containing 70·2 g carbohydrate, 50·1 g fat and 8·6 g protein), followed by a lunch (containing 70·1 g carbohydrate, 24·9 g fat and 12·8 g protein) at 2 hours on two separate occasions separated by 2 weeks. Blood samples were collected at 0, 30, 60, 90, 120, 150, 180, 210 and 240 minutes post consumption of the extract of HSC or water. Postprandial glucose, insulin, triacylglycerol (TAG), total antioxidant capacity (TAC) and C-reactive proteinultra sensitive (CRP-US) responses were determined.There was significant increase (p = 0·026) in the area under 0 to 120 minutes TAC response curve when hibiscus drink consumption was compared to water (1). Although there was a tendency towards a reduced serum glucose, plasma insulin, serum TAG and CRP-US levels following acute consumption of the extract of HSC, these changes did not reach statistical significance (p > 0·05).Acute consumption of HSC extract (containing 150 mg anthocyanins) improved postprandial systemic antioxidant response, but did not affect postprandial glycaemic, lipidaemic or inflammatory responses.

This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.

No seroconversion occurred among those that received either or both HIV and HBV PEP and completed PEP treatment.