Introduction: Asymptomatic bacteriuria, the presence of bacteria in urine without symptoms of acute urinary tract infection, predisposes pregnant women to the development of urinary tract infections and pyelonephritis, with an attendant pregnancy related complications. Objective: To measure the prevalence of asymptomatic bacteriuria among antenatal clients at the Korle-Bu Teaching Hospital in Ghana and its' associated risk factors. Methods: A cross-sectional study involving 274 antenatal clients was conducted over a period of 4 weeks. A face to face questionnaire was completed and midstream urine collected for culture and antimicrobial susceptibility testing. Results: The prevalence of asymptomatic bacteriuria was 5.5%. It was associated with sexual activity during pregnancy (Fisher's Exact 5.871, p-value 0.0135), but not with sexual frequency. There were no significant associations with educational status, parity, gestational age, marital status and the number of foetuses carried. The commonest organism isolated was Enterococcus spp (26.7%) although the enterobacteriaceae formed the majority of isolated organisms (46.7%). Nitrofurantoin was the antibiotic with the highest sensitivity to all the isolated organisms. Conclusions: The prevalence of asymptomatic bacteriuria among antenatal clients at this large teaching hospital in Ghana is 5.5%, which is lower than what has been found in other African settings. Enterococcus spp was the commonest causative organism. However, due to the complications associated with asymptomatic bacteriuria, a policy to screen and treat-all pregnant women attending the hospital, is worth considering.

Background:The discharging ear is a common presentation in medical practice affecting all age groups but primarily children. This study shows the current aetiological causes of ear discharge and their antibiograms, data which would guide empirical treatment of ear infections, and also form a basis for further research. Methodology: This was a retrospective review of laboratory records of all ear swabs submitted for culture over a two year period in the Korle Bu Teaching Hospital Accra, Ghana. Data was obtained on demographic characteristics of patients, clinical diagnosis, isolated organisms and antibiotic susceptibility patterns of the isolated organisms. Data was analyzed by simple descriptive statistics. Results: A total of 351 ear swabs were received by the laboratory for processing over the two year period. Of these 277(78.9%) had microorganisms isolated. A significant number127 (47%) was obtained from children under five years. Pseudomonas spp was the commonly isolated organism 121(46%) followed by Staphylococcus aureus 33(12.5%) and Proteus spp 32(12.2%). Candida was the commonest isolated fungi 9 (69.2%). Susceptibility of Pseudomonas spp to commonly used ototopics (ciprofloxacin & gentamicin) was 93% and 74% respectively. Conclusions: Most cases of the discharging ear were found in children under the age of five years. The most common bacteriologic cause of the discharging ear was Pseudomonas spp followed by Staphylococcus aureus. Candida species was the commonest fungal cause of ear discharge. Ciprofloxacin and gentamicin are effective ototopic antimicrobial agents for empirical treatment of the discharging ear.

SUMMARY Introduction:Helicobacter pylori (H. pylori) discovered in 1982, has strongly been associated with multiple clinical disorders of the gastrointestinal tract. This study described the prevalence of H. pylori among large numbers of patients over two different time periods in Accra, Ghana. Methods: It was a retrospective records review on patients attending a quasi-government hospital in Accra, Ghana, during two time periods, 1999 and 2012. A total of 2401 records were reviewed, 1128 in first period and 1273 in second period. Biopsy was taken from the gastric antrum for Rapid Urease Test (RUT) in identifying H. Pylori. Data on patient characteristics, clinical diagnosis and findings upon endoscopy were analyzed by simple descriptive statistics. Associations between categorical outcome variables were determined by Chi square test at 95% significance level. Results: H. pylori infection was high in patients with upper gastrointestinal symptoms 69.7% (1999) and 45.2% (2012), and was even higher in patients with gastritis and duodenal ulcer. H. pylori infection however, decreased among patients over the period, 69.7% in 1999 to 45.2% in 2012. Sex differences in H. pylori infection was identified (higher among males) and young adults (21-40 years). Commonest symptom in all patients was non-ulcer dyspepsia, 86.9% in 1999 and 84.2% in 2012, while gastritis and duodenal ulcer were the commonest endoscopic finding in the two periods. Conclusion: Appropriate management guidelines in West Africa considering the high background H. pylori infection and other co-infections requiring particular antibiotic combination therapy is required.

SUMMARYBackground: A food borne illness was reported in GaEast district of Greater Accra Region among school children in May, 2007 after eating food provided at school. The objective of the investigation was to determine the source, mode of contamination and the causative agent. Methods: A case-control study was conducted, cases were schoolchildren with abdominal symptoms and controls were children of the same sex and class without any symptom during the same period. The school children were selected by systematic sampling. Food handlers and the children were interviewed by a structured questionnaire. Food handlers were physically examined and their stools and blood examined. The kitchen for food preparation was inspected. Risks of food borne infection from the foods eaten were determined using attack rates . Results: The minimum, peak and maximum incubation periods were 2, 11 and 61 hours respectively. The source was rice and groundnut soup (with the highest attack rate difference). Stool and blood samples of food handlers were not infective. Storage facility for food items was poor. No food samples were available for organism isolation. A protocol to prevent such outbreaks was nonexistent. Conclusion: The short incubation period and symptoms presented suggest an infective origin. The storage of the meat may potentially have been the point of contamination. The study showed that the schoolchildren ate contaminated food although the investigation could not determine the causative agent. Protocols to prevent such outbreaks need to be developed for the schools.

Although it was previously believed that systemic lupus erythematosus was uncommon among Africans, it has become increasingly apparent that the incidence is higher, and socioeconomic challenges such as physician shortages, poor medical facility access, and poor health literacy may worsen prognosis. This retrospective study examines characteristics and outcomes of hospitalized systemic lupus erythematosus patients over a two-year period and serves as a baseline for comparison for future studies to examine the outcomes with the provision of more dedicated care. There were 51 patient admissions over a two-year period, with a mean duration from start of illness to admission of approximately two years. Duration of admission ranged from one to 140 days with a mean period of 26.12 days (SD ± 26.6). There were 22 deaths (43.1% of admissions), which were mainly due to infections and renal complications. Factors associated with risk of death in regression analysis were: infections, fever, disease flare, musculoskeletal involvement, amenorrhea, depression, a clinical finding of hepatomegaly, and chest infection. Understanding the effect and outcome of systemic lupus erythematosus across different countries can elucidate the role of genetic, environmental, and other causative factors in the progression of the disease.