Background: Foot ulcers in diabetes mellitus subjects cause morbidity and mortality and lead to non-traumatic amputations worldwide. Knowledge of the microbial burden in the ulcers may improve patients' care and management. Objectives: This prospective study was designed to isolate, identify and carry out antibiotic susceptibility testing on bacterial isolates associated with diabetic foot ulcers among subjects in University of Calabar Teaching Hospital. Methods: Subjects with diabetic foot ulcer were recruited after obtaining ethical clearance from the Research Committee and informed consent from the subjects. Samples were obtained from subjects using sterile swabs and subjected to microscopy and culture. Isolates were identified using standard bacteriological techniques. Kirby-Bauer method was used for susceptibility testing. Results: Out of the 50 subjects recruited, 19 (38.1%) were males and 31 (62.0%) were females with mean age of 55.4 ± 10.1 and a minimum age of 40.0 years. All the subjects had grade 4 wounds. The study recorded 100% infection rates among subjects with 70.0% polymicrobial infections. A total of 97 isolates were obtained from the 50 subjects accounting for the average of 1.94 isolates per subject. The most prevalent isolate was Staphylococcus aureus (32 (32.9%)), while the least isolated pathogen was Klebsiella pneumonia (10 (20.4%)). Females harboured more isolates (61 (62.9%)) than males (36 (37.1%)), but infection rates were not significantly associated with gender (χ² = 15.0, p ≥ 0.05). Erythromycin was the most effective antibiotic agent (65.6%) against S. aureus while gram-negative bacteria were more susceptible to augmentin (87.5%) and ciprofloxacin (75.0%). Conclusion: The multiple antibiotic resistance of the bacterial isolates calls for the need to monitor resistance. The best practice is to perform antibiotic susceptibility testing before treatment. Wounds should be evaluated for bacterial agents before treatment is instituted. Information on the mi.uction of morbidity and amputation rates on the patients.

BackgroundHome management of uncomplicated malaria (HMM) is now integrated into the community case management of childhood illness (CCM), an approach that requires parasitological diagnosis before treatment. The success of CCM in resource-constrained settings without access to parasitological testing significantly depends on the caregiver’s ability to recognise malaria in children under five years (U5), assess its severity, and initiate early treatment with the use of effective antimalarial drugs in the appropriate regimen at home. Little is known about factors that influence effective presumptive treatment of malaria in U5 by caregivers in resource-constrained malaria endemic areas. This study examined the factors associated with appropriate HMM in U5 by caregivers in rural Kassena-Nankana district, northern Ghana.MethodsA cross-sectional household survey was conducted among 811 caregivers recruited through multistage sampling. A caregiver was reported to have practiced appropriate HMM if an antimalarial drug was administered to a febrile child in the recommended regimen (correct dose and duration for the child’s age). Binary logistic regression was used to determine factors associated with appropriate HMM.ResultsOf the 811 caregivers, 87% recognised the symptoms of uncomplicated malaria in U5, and 49% (n = 395) used antimalarial drugs for the HMM. Fifty percent (n = 197) of caregivers who administered antimalarial drugs used the appropriate regimen. In the multivariate logistic regression, caregivers with secondary (OR = 1.71, 95% CI: 1.03, 2.83) and tertiary (OR = 3.58, 95% CI: 1.08, 11.87) education had increased odds of practicing appropriate HMM compared with those with no formal education. Those who sought treatment in the hospital for previous febrile illness in U5 had increased odds of practicing appropriate HMM (OR = 2.24, 95% CI: 1.12, 4.60) compared with those who visited the health centres.ConclusionsHalf of caregivers who used antimalarial drugs practiced appropriate HMM. Educational status and utilisation of hospitals in previous illness were associated with appropriate HMM. Health education programmes that promote the use of the current first line antimalarial drugs in the appropriate regimen should be targeted at caregivers with no education in order to improve HMM in communities where parasitological diagnosis of malaria may not be feasible.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1777-3) contains supplementary material, which is available to authorized users.

, an outbreak of influenza was reported in Mexico and California and within months, it spread to all continents of the world. An influenza pandemic has always posed a threat to global public health. The objective of this study was to assess the knowledge, attitude, reported practice and preparedness of health care providers in Calabar, Nigeria, regarding the H1N1 pandemic. This was a prospective study. A semi-structured questionnaire was administered on health care providers in Calabar, Nigeria. One hundred and forty-five (41.6%) respondents reported that the infection was transmitted from pigs to humans whereas 53 (15.1%) reported that it was transmitted from humans to humans. Two hundred and thirty-one (66.0%) respondents were not willing to work in a hospital unit where patients with Influenza A H1N1 are treated. One hundred and thirty-eight (39.4%) respondents were willing to receive vaccination against Influenza A H1N1 while majority, 212 (60.6%) were not willing. There are gaps in knowledge of respondents regarding H1N1 infection and their level of preparedness is low. Capacity building in emergency preparedness for infectious disease epidemic is recommended.