BackgroundThe isolation of Extended spectrum βlactamase (ESBLs) producing Enterobacteriaceae among food handlers and their implication as sources of food borne outbreaks are a public health concern. This study seeks to investigate the prevalence of faecal carriage of these bacteria among food handlers in the West Coast Region of The Gambia.MethodThis study enrolled 600 participants from 60 Lower Basic Schools in West Coast Region of the country. Stool samples collected from the participants were presumptively screened for the ESBLs producing Enterobacteriaceae, using Drigalski agar, supplemented with 2mg/L cefotaxime. The bacterial colonies that grew on each Drigalski agar were tested for ESBL production by the double disk synergy test as recommended by Clinical and Laboratory Standard Institute (CLSI-2015). The confirmatory analysis for ESBL was determined as the zone of inhibition of cefotaxime and/or ceftazidime to ≥5mm from that of cefotaxime /clavulanicacid and/or ceftazidime/clavulanic acid. The presumptive screening of isolates for AmpC phenotypes was done by testing the organism against cefoxitin. The prevalence of the ESBL carriage was presented in percentages. The association of risk factors to the faecal carriage of ESBLs producing Enterobacteriaceae was performed by Pearson Chi-squared and Fishers Exact at (p ≤ 0.05).ResultThe prevalence of faecal carriage ESBL producing Enterobacteriaceae among food handlers was 5.0% (28/565). We found50% (14/28) and3.57% (1/28) ESBL producing bacteria were presumptive AmpC and carbapenemase resistance phenotype. Themost abundant ESBL producing Enterobacteriaceae were Klebsiella spp 32.1% (9/28) and Escherichia spp 28.6% (8/28). The use of antibiotics in the last 3 months was found to be significantly associated (P = 0.012) with the faecal carriage of ESBLs producing Enterobacteriaceae.ConclusionThe prevalence of faecal carriage of ESBLs producing Enterobacteriaceae among food handlers in the Gambia is low. The history to use of the antibiotics in the last three months was found to be significantly associated with this prevalence. Therefore, the institution of a robust antimicrobial surveillance and treatment of patients with such infections are necessary to curb the spread of these multidrug resistant bacteria in the country. Rational prescription and usage of the antibiotics especially cephalosporin should be advocated both in public and private health facilities.

No abstract

No abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a positive-sense single stranded RNA virus with high human transmissibility. This study generated Whole Genome data to determine the origin and pattern of transmission of SARS-CoV-2 from the first six cases tested in The Gambia. Total RNA from SARS-CoV-2 was extracted from inactivated nasopharyngeal-oropharyngeal swabs of six cases and converted to cDNA following the ARTIC COVID-19 sequencing protocol. Libraries were constructed with the NEBNext ultra II DNA library prep kit for Illumina and Oxford Nanopore Ligation sequencing kit and sequenced on Illumina MiSeq and Nanopore GridION, respectively. Sequencing reads were mapped to the Wuhan reference genome and compared to eleven other SARS-CoV-2 strains of Asian, European and American origins. A phylogenetic tree was constructed with the consensus genomes for local and non-African strains. Three of the Gambian strains had a European origin (UK and Spain), two strains were of Asian origin (Japan). In The Gambia, Nanopore and Illumina sequencers were successfully used to identify the sources of SARS-CoV-2 infection in COVID-19 cases.

Introduction: Irrational prescription and use of antibiotics are found to be risk factors to the spread of antibiotic resistance. Studies have shown that more than half of the admitted patients at the Paediatric Department of the Edward Francis Small Teaching Hospital (EFSTH) in The Gambia have been treated with antibiotics in the year 2015 alone. It was also evident that 74.5% of clinical isolates were resistant to ampicillin which was the most prescribed antibiotic among these patients. Therefore, the need to assess health care workers’ knowledge, attitude and practices on the phenomenon of anti-microbial resistance (AMR) and antibiotic usage in the Gambia. Materials and Methods: This cross-sectional study was conducted using self-administered questionnaires which were adopted from related studies. The questionnaires were administered at 60 randomly selected health facilities (both public and private) from around the country with a sample size of 225 respondents in 2016. Descriptive analyses were performed for each study variable and rates were reported as percentages. The results are presented in the form of contingency tables with their respective related Chi-squared (χ2) statistics values. The interpretations of the P-values are based on the less than or equal to 0.05 (5%) significance level. Result: The study revealed that 63.27% of the respondents were nurses, 41.7% of them had a work experience between 0-4 years of service and most of the respondents work in the urban areas. Most of health care workers have knowledge on the right usage of antibiotics and understood that frequent usage of antibiotic could compromise the effectiveness of antibiotics. The study found 94.14% of the health care workers agreed there exists antibiotic abuse in both hospital and community settings. However, 23.08% of the respondents are not aware those antibiotics are not effective against viral infections such as common cold. Conclusion: Therefore, majority of the health care workers had knowledge about antibiotic resistance and are aware of the frequent and abuse of antibiotic use could contribute to the development of antibiotic resistance in the country. However, they were less informed of the cost involved in the treatment and management of multidrug resistance patients using fewer and expensive antibiotics. Moreover, some of the health care workers had misconception on the treatment of viral infections with antibiotics (such as antibacterial) and there also exists disproportionate distribution of trained health workers in the country. Therefore, refresher training on prudent usage of antibiotics for health care workers especially doctors and nurses must be strengthened.