Background Hand hygiene practices (HHP), as a critical component of infection prevention/control, were investigated among physiotherapists in an Ebola endemic region. Method A standardized instrument was administered to 44 randomly selected physiotherapists (23 males and 21 females), from three tertiary hospitals in Enugu, Nigeria. Fifteen participants (aged 22–59 years) participated in focus group discussions (FGDs) and comprised 19 participants in a subsequent laboratory study. After treatment, the palms/fingers of physiotherapists were swabbed and cultured, then incubated aerobically overnight at 37°C, and examined for microbial growths. An antibiogram of the bacterial isolates was obtained. Results The majority (34/77.3%) of physiotherapists were aware of the HHP protocol, yet only 15/44.1% rated self-compliance at 71–100%. FGDs identified forgetfulness/inadequate HHP materials/infrastructure as the major barriers to HHP. Staphylococcus aureus were the most prevalent organisms, prior to (8/53.33%) and after (4/26.67%) HPP, while Pseudomonas spp. were acquired thereafter. E. coli were the most antibiotic resistant microbes but were completely removed after HHP. Ciprofloxacin and streptomycin were the most effective antibiotics. Conclusion Poor implementation of HPP was observed due to inadequate materials/infrastructure/poor behavioral orientation. Possibly, some HPP materials were contaminated; hence, new microbes were acquired. Since HPP removed the most antibiotic resistant microbes, it might be more effective in infection control than antibiotic medication.

Between 1984 and 1986 a total of 1000 faecal samples and rectal swabs were cultured from patients presenting with diarrhoea. Shigellae were isolated from 5·6% of these samples. Shigella flexneri was the commonest isolated (68%), followed by Sh. sonnei (23%). A total of 22·8% of children (0–12 years of age) were positive for shigellae. Twenty‐seven (48·2%) strains were sensitive to all the five antibiotics tested (streptomycin, chloramphenicol, tetracycline, ampicillin and sulphonamide). A total of 22 (39·2%) were resistant to three or more antibiotics. Nine (16%) were resistant to all five. The public health significance of the study is discussed.

Hepatitis delta virus (HDV) is responsible for the most severe form of liver disease in humans. So far, eight genotypes (HDV-1 to -8) have been individualized worldwide.Little is known about HDV strains that spread in Nigeria. HDV genotyping was performed in 15 anti-HDV positive samples from a cohort of 306 hepatitis B virus (HBV)-infected patients in Abuja (Nigeria). Phylogenetic analyses revealed 90% were HDV-1, two among them clustering with European/Asian HDV-1, the remaining one being HDV-6. It was also found that two members of a couple superinfected with the same HDV strain, were enveloped by two different HBV strains of genotype E. K E Y W O R D S blood, epidemiology, hepatitis B virus, hepatitis D virus, satellite, subviral agents, virus classification

The role of Plesiomonas shigelloides was determined in patients attending health centres and cottage hospitals in parts of Enugu State of Nigeria had diarrhoea. During the 12-month study (March 2012-Feb 2013), P. shigelloides was isolated from 51 (7.2%) patients who had diarrhoea and none from 500 patients without diarrhoea (p<0.01) recruited from a match control group. The age and sex distribution of the P. shigelloides patients showed that the age group 19-31 months (16.7%) yielded the highest isolation for Plasiomonas shigelloides, while females 31 (60.8%) were higher than males 20 (39.2%), though the difference was not statistically significant (p>0,05). A seasonality distribution in favour of rainy season was also observed with the highest cases recruited in the periods June-August (54.9%) and September-October (23.5%). Only 2 (3.9%) were recruited between December and February. Thirty-seven (5.2%) patients had single infection with Plesimonas while 14 (2.0%) were co-infected with other bacterial pathogens. No parasitic agents were detected in the samples analysed. Twenty-seven (73%) of the patients with simple Plesimonas infection had watery diarrhoea; 24 (64.8%) had abdominal pain; 12 (32.4%) had fever, 7 (18.9 %) had visible mucus in stool, 6 (16.2%) had bloody diarrhoea while 5 (13.5%) were vomiting. Of the 5 children up to 5 years of age who had single infection, 3(60%) were clinically dehydrated. Of the 37 who had single infection, 8 (21.6%) had diarrhoea >/-14 days. The antibiogram shows that the Plesimonas strains were highly resistant to the more available antibiotics in the area, with Ampicillin having a resistivity of 90.2%, Trimetoprim sulphamethoxazole (66.7%) and Tetracycline 51%, while the less available ones like Imipenem (2%), Aztreneonam and Cefotaxime (3.9%) each, and Laevofloxacillin (5.9%), had the least resistance. The findings may be of Public Health importance for creating awareness among physicians about the clinical profile and management strategy of P. shigelloides-diarrhoea in the area.

Dental caries is one of the most prevalent and costly diseases that are a challenge to health care providers. There is limited data on the bacterial profile and risks associated with dental caries in Nigeria. The study aimed to isolate and identify bacteria and risk factors associated with dental caries in Enugu. It was a case-controlled study. A total of 336 samples were randomly collected comprising of 125 healthy subjects and 211 patients with dental caries attending various hospitals and dental clinics in Enugu, Nigeria. Samples were subjected to standard microbiological and biochemical techniques. Standardized questionnaires were used to record demographic variables and risk factors. A total of 635 and 254 microorganisms were isolated from carious lesions and healthy subjects respectively. Of these 635 isolates, 218 (34.4%) Gram-positive bacilli, 210 (33.0%) Gram-positive cocci, 46 (7.2%) Gram-negative cocci, and 43 (6.8%) yeasts were recovered. Two hundred and seven samples were (98.1%) polymicrobial while 4 samples (1.9%) were monomicrobial. Among the organisms recovered, anaerobic Lactobacillus spp (141, 66.8%) was the most prevalent followed by Streptococcus mutans (104, 49.2%), and the least were Actinomyces israelii and Capnocytophaga spp (1, 0.05%) respectively. Of the 254 isolates from apparently healthy subjects, Streptococcus sanguis ranked highest and the least was Porphyromonas gingivalis. The factors that were found to be significantly associated with dental caries were level of education P=0.005, feeding habit P= 0.001, Favourite snack P=0.004, sweet consumption P< 0.0001, type of gum P < 0.0001, history of toothache P < 0.0001, visit dentist P< 0.0001, and the bleeding gum P < 0.0001. This research highlighted the polymicrobial nature of carious lesions and associated predictors of dental caries.  Hence public enlightenment and the implementation of oral health education in schools are crucial.