Concomitant bacteria in the blood of malaria patients in Owerri, southeastern Nigeria

Ukaga, CN; Orji, Chinelo C.; Orogwu, S.; Nwoke, Beb; Anosike, JC; Udujih, O.S.; Onyeka, P.I.K.; Awujo, N.C.

doi:10.4314/thrb.v8i3.45119

Cited by 14 publications

(12 citation statements)

References 5 publications

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“…However, malaria, as a comorbidity, did not determine the worst clinical trend of CAP. A complete training of all professional figures in charge of medical care and a deep comprehension of the interaction of different diseases are essential to improving correct diagnosis and treatment [23]. Gastroenteritis and dehydration are reported as common comorbidities that may predispose one to pneumonia [24].…”

Section: Discussionmentioning

confidence: 99%

Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania

Caggiano

Ullmann

Vitis

et al. 2017

IJMS

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Community-acquired pneumonia (CAP) is still the most important cause of death in countries with scarce resources. All children (33 months ± 35 DS) discharged from the Pediatric Unit of Itigi Hospital, Tanzania, with a diagnosis of CAP from August 2014 to April 2015 were enrolled. Clinical data were gathered. Dried blood spot (DBS) samples for quantitative real-time polymerase chain reaction (PCR) for bacterial detection were collected in all 100 children included. Twenty-four percent of patients were identified with severe CAP and 11% died. Surprisingly, 54% of patients were admitted with a wrong diagnosis, which increased complications, the need for antibiotics and chest X-rays, and the length of hospitalization. Comorbidity, found in 32% of children, significantly increased severity, complications, deaths, need for chest X-rays, and oxygen therapy. Malnourished children (29%) required more antibiotics. Microbiologically, Streptococcus pneumonia (S. p.), Haemophilus influenza type b (Hib) and Staphylococcus aureus (S. a.) were the bacteria more frequently isolated. Seventy-five percent of patients had mono-infection. Etiology was not correlated with severity, complications, deaths, oxygen demand, or duration of hospitalization. Our study highlights that difficult diagnoses and comorbidities negatively affect clinical evolution. S. p. and Hib still play a large role; thus, implementation of current vaccine strategies is needed. DBS is a simple and efficient diagnostic method for bacterial identification in countries with scarce resources.

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Section: Discussionmentioning

confidence: 99%

Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania

Caggiano

Ullmann

Vitis

et al. 2017

IJMS

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“…We did not calculate the proportion of positive malaria smears among routine specimens from participants with and without a fever. A study in Nigeria found concomitant bacteraemia in 44 (35.2%) of 125 malaria cases, with the highest frequency of co‐infection in the 31–40 and 6–10 years age groups (Ukaga et al. 2006).…”

Section: Discussionmentioning

confidence: 99%

Septicaemia in a population-based HIV clinical cohort in rural Uganda, 1996-2007: incidence, aetiology, antimicrobial drug resistance and impact of antiretroviral therapy

Mayanja

Todd

Hughes

et al. 2010

Tropical Medicine &Amp; International Health

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Summaryobjectives To describe the incidence and aetiology of septicaemia, and antimicrobial drug resistance in HIV-infected and uninfected individuals, and the impact of antiretroviral therapy (ART) on septicaemia.methods Between 1996 and 2007, we followed up a rural population-based cohort of HIV-infected and uninfected participants. The aetiology and incidence of septicaemia, and antimicrobial drug resistances were determined. ART became available in 2004, and its impact on the incidence of septicaemia was examined.results The overall septicaemia incidence (per 1000 pyrs) was 32.4 (95% CI 26.2-40.6) but was only 2.6 (95% CI 1.3-6.2) in HIV-negative patients and 67.1 (95% CI 53.4-85.4) in HIV-positive patients not on ART. Among those on ART, the overall incidence was 71.5 (95% CI 47.1-114.3), although it was 121.4 (95%CI 77.9-200.4) in the first year on ART and 37.4 (95%CI 18.9-85.2) in the subsequent period. Septicaemia incidence was significantly associated with lower CD4 counts. The commonest isolates were Streptococcus pneumoniae (SPN, n = 68) and Non-typhi salmonellae (NTS, n = 42). Most SPN isolates were susceptible to ceftriaxone and erythromycin, while resistance to cotrimoxazole and penicillin was common. All NTS isolates were susceptible to ciprofloxacin, but resistance to cotrimoxazole and chloramphenicol was common.conclusions Septicaemia incidence was higher in HIV-infected than in HIV-uninfected participants, and it remained high for some time among those who started ART. Starting ART earlier at higher CD4 counts is likely to lead to lower septicaemia incidence. Both SPN and NTS, the commonest isolates, were resistant to most commonly available antimicrobials. Blood culture laboratory surveillance systems to monitor antibiotic susceptibility and inform treatment guidelines are needed in Africa.

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“…Such a scenario could create advantageous conditions for malaria parasites and other pathogens. The presence of co-morbid pathogens has been reported and further confounds the clinical prognosis in patients with malaria [19].…”

Section: Hypothesis 1: Ntbimentioning

confidence: 99%

“…Other plausible mechanisms for adverse effects of increased plasma NTBI include: (i) potential interactions at various stages of the malaria parasite's life cycle (e. g., erythrocyte, hepatic stages); (ii) indirect effects on immune function via alterations in macrophage iron metabolism [20 -21]; (iii) increased expression of vascular endothelial adhesion molecules involved in sequestration of Plasmodium falciparum, increasing risk for severe forms of malaria, especially cerebral malaria [22 -23], the pathogenesis of which may be implicated [24]; and (iv) direct toxic effects mediated by harmful oxidative free-radical reactions [19].…”

Section: Hypothesis 1: Ntbimentioning

confidence: 99%

Considerations for the Safe and Effective Use of Iron Interventions in Areas of Malaria Burden - Executive Summary

Raiten

Namasté

Brabin

2011

International Journal for Vitamin and Nutrition Research

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In 2006, the World Health Organization and the United Nations Children's Fund released a joint statement advising that, in regions where the prevalence of malaria and other infectious diseases is high, iron and folic acid supplementation should be limited to those who are identified as iron-deficient. Although precipitated, in large part, by a recent report of adverse events associated with iron supplementation in children, questions about the risk/benefit of iron deficiency and mechanisms underlying potential adverse effects of iron in the context of infection are long-standing. Moreover, the implementation of this revised policy is compromised in most settings by the lack of consensus on the best methods to screen for iron deficiency. In response to these concerns a comprehensive review was conducted by a Technical Working Group (TWG), constituted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the U.S. National Institutes of Health, in partnership with the Bill and Melinda Gates Foundation. The review included an evaluation of the putative mechanisms associated with adverse effects of iron in the context of malaria; applicability of available biomarkers for assessing iron status in the context of infections; and evaluation of evidence with regard to the safety and effectiveness of available interventions to prevent iron deficiency, particularly in areas of endemic malaria. The aim of this paper is to summarize the technical details of the larger TWG review conclusion that the occurrence and mechanism(s) of adverse effects associated with providing iron supplements (i. e., pills/liquid) under conditions of malaria and high infection exposure remain a concern, especially in settings where care and treatment are not readily available or accessible. Iron deficiency remains a problem that demands appropriate clinical care. When target groups have already been identified as being iron-deficient, iron supplementation is the intervention of choice for the treatment of anemia and other manifestations of iron deficiency. Of available intervention options to prevent iron deficiency, supplements are probably least desirable, particularly for infants and children. This paper also provides a synopsis of the TWG responses to the recently published Cochrane Review on the safety of iron supplementation for children in the context of malaria, and a research agenda outlined by the TWG that can best address outstanding questions.

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Concomitant bacteria in the blood of malaria patients in Owerri, southeastern Nigeria

Cited by 14 publications

References 5 publications

Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania

Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania

Septicaemia in a population-based HIV clinical cohort in rural Uganda, 1996-2007: incidence, aetiology, antimicrobial drug resistance and impact of antiretroviral therapy

Considerations for the Safe and Effective Use of Iron Interventions in Areas of Malaria Burden - Executive Summary

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