Publications


2009

Etyang, AO, Amayo EO, Bhatt SM, Wamola IA, Maritim MC.  2009.  Comparison of bedside inoculation of culture media with conventional cerebrospinal fluid culture method in patients with bacterial meningitis. AbstractWebsite

Background: The yield of bacterial cultures from cerebrospinal fluid (CSF) at Kenyatta National Hospital (KNH) is very low. Bedside inoculation of culture media with CSF may improve yields.
Objective: To compare the culture yield of CSF inoculated onto culture medium at the bedside to that of CSF inoculated onto culture medium in the microbiology laboratory.
Design: Cross-sectional comparative study.
Setting: Accident and Emergency Department and medical wards at Kenyatta National Hospital.
Subjects: Cerebrospinal fluid from patients at KNH with a clinical diagnosis of acute meningitis.
Results: Two hundred and twenty CSF specimens were obtained during a four month period. S. pneumaniae was isolated from 24 CSF samples and H. influenzae from one. Bacterial cultures were positive in 25 (11.4%,95% CI 7.0-15.6%) samples inoculated at the bedside and 23 (10.5%,95% CI 6.5- 14.5%) samples inoculated at the laboratory. Bacteria were isolated 5 hours earlier in samples inoculated atthe bedside (95% CI4.34- 6.86 hrs, p<0.05). Four per cent of S. pneumaniae isolates were resistant to crystalline penicillin.
Conclusion: There was no significant difference in culture yield after bedside inoculation of culture media with CSF compared to traditional CSF culture method. Bedside inoculation of culture media with CSF resulted in faster time to positive culture.

2005

A., PROFWAMOLAISAAC.  2005.  Ogutu BR, Nzila AM, Ochong E, Mithwani S, Wamola B, Olola CH, Lowe B, Kokwaro GO, Marsh K, Newton CR.The role of sequential administration of sulphadoxine/pyrimethamine following quinine in the treatment of severe falciparum malaria in children.Trop Med I. Trop Med Int Health. 2005 May;10(5):484-8.. : IBIMA Publishing Abstract
Sulphadoxine/pyrimethamine (SP) is often administered with quinine in the treatment of severe falciparum malaria to shorten the course of quinine. The efficacy of SP alone in the treatment of non-severe malaria has been declining rapidly in East Africa, raising concerns of the usefulness of a shortened course of quinine followed SP. We audited the efficacy of quinine/SP in the treatment of severe malaria in Kenyan children. Children with severe falciparum malaria were treated with parenteral quinine followed by a single oral dose of SP. A clinical evaluation was performed 3 weeks later in which a blood sample was obtained for full haemogram, blood slide and analysis of the parasite dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) codons, mutations of which are associated with resistance to SP. A total of 452 children were enrolled, of whom 374 completed the study. Fifty-two (13.9%) children were parasitaemic by 3 weeks of whom 17 (4.5%) had fever as well. The treatment failure group had a significantly higher parasitaemia (129 061 vs. 43 339; P<0.001) and haemoglobin on admission, but only admission parasitaemia independently predicted treatment failure. Those with treatment failure had a significantly lower rise in haemoglobin at 3 weeks compared with treatment successes (9.0 vs. 10.0 g/dl). Of the 76 parasite isolates collected before treatment, 40 (53%) were triple mutant DHFR-double DHPS (Tp-Db), the genotype most associated with SP resistance. Three weeks after SP treatment, the proportion of Tp-Db increased to 72% (31/43). The high treatment failure rate and proportion of parasites with Tp-Db negate the use of SP to shorten the course of quinine treatment in East Africa.

2004

A., PROFWAMOLAISAAC.  2004.  Cunnington AJ, Kendrick SF, Wamola B, Lowe B, Newton CR.Carboxyhemoglobin levels in Kenyan children with Plasmodium falciparum malaria.Am J Trop Med Hyg. 2004 Jul;71(1):43-7.. Am J Trop Med Hyg. 2004 Jul;71(1):43-7.. : IBIMA Publishing Abstract
Heme oxygenase (HO) is thought to be induced in severe malaria, but the pathophysiologic consequences have not been examined. It is induced by hemolysis, oxidative stress, and inflammation. It degrades heme, producing carbon monoxide (CO), which causes elevated levels of carboxyhemoglobin (COHb). In a prospective study of 1,520 children admitted to a Kenyan district hospital, COHb levels were no higher in children with malaria than with other infections. The COHb levels in children with severe malarial anemia were higher than in other children with malaria, but significantly lower than in children with other causes of severe anemia such as sickle cell disease. Levels of COHb were not significantly higher in children with cerebral malaria or in those dying of malaria. These results do not support a systemic increase in HO activity in malaria compared with other infectious diseases, but the roles of HO and CO in malaria require further study.

2003

A., PROFWAMOLAISAAC.  2003.  English M, Ngama M, Musumba C, Wamola B, Bwika J, Mohammed S, Ahmed M, Mwarumba S, Ouma B, McHugh K, Newton C.Causes and outcome of young infant admissions to a Kenyan district hospital. Arch Dis Child. 2003 May;88(5):438-43.. Arch Dis Child. 2003 May;88(5):438-43.. : IBIMA Publishing Abstract
AIMS: To provide a comprehensive description of young infant admissions to a first referral level health facility in Kenya. These data, currently lacking, are important given present efforts to standardise their care through the integrated management of childhood illness (IMCI) and for prioritising both health care provision and disease prevention strategies. METHODS: Prospective, 18 month observational study in a Kenyan district hospital of all admissions less than 3 months of age to the paediatric ward. RESULTS: A total of 1080 infants were studied. Mortality was 18% overall, though in those aged 0-7 days it was 34%. Within two months of discharge a further 5% of infants aged <60 days on admission had died. Severe infection and prematurity together accounted for 57% of inpatient deaths in those aged <60 days, while jaundice and tetanus accounted for another 27%. S pneumoniae, group B streptococcus, E coli, and Klebsiella spp. were the most common causes of invasive bacterial disease. Hypoxaemia, hypoglycaemia, and an inability to feed were each present in more than 20% of infants aged 0-7 days. Both hypoxaemia and the inability to feed were associated with inpatient death (OR 3.8 (95% CI 2.5 to 5.8) and 7.4 (95% CI 4.8 to 11.2) respectively). CONCLUSIONS: Young infants contribute substantially to paediatric inpatient mortality at the first referral level, highlighting the need both for basic supportive care facilities and improved disease prevention strategies.

2002

A., PROFWAMOLAISAAC.  2002.  Kakai R, Wamola IA.Minimising antibiotic resistance to Staphylococcus aureus in developing countries.East Afr Med J. 2002 Nov;79(11):574-9.. East Afr Med J. 2002 Nov;79(11):574-9.. : IBIMA Publishing Abstract
OBJECTIVE: To assess the role of rational drug use and laboratory service in preventing the emergence of multiple antibiotic resistant Staphylococcus aureus in developing countries. DATA SOURCE: Literature search on compact disk-read only memory (CD-ROM) Medline and Internet using the key words: Staphylococcus and antibiotic resistance. A few articles were manually reviewed. STUDY SELECTION: Relevant studies or articles on antibiotic resistance with special reference to Eastern Africa, region are included in the review. DATA EXTRACTION: From individual studies or articles. DATA SYNTHESIS: Evidence for the spread of S. aureus multiple antibiotic resistance is synchronized under the headings: Introduction, current situation, antibiotic resistance control strategies, are outlined. CONCLUSION: There is need for concerted efforts between different groups to monitor changes in the epidemiology and antibiotic resistance of S. aureus. Strategies aimed at preventing transmission of resistant strains are remarkably effective when strictly enforced. Necessary attention should be given on the subject so that meaningful control measures preventing the expansion of antimicrobial resistance can be formulated, thereby ensuring the future successful treatment of Staphylococcal infections.

1998

A., PROFWAMOLAISAAC.  1998.  Mirza NB, Estambale BB, Wamola IA, Kariuki N, Onyono E, Kabiru P, Piollet M.Bacterial meningitis in children admitted in hospitals within Nairobi.East Afr Med J. 1998 Feb;75(2):73-6.. East Afr Med J. 1998 Feb;75(2):73-6.. : IBIMA Publishing Abstract
Four hundred and ninety nine children (aged between one month and five years) admitted with clinical features of meningitis were recruited in cross-sectional survey of bacterial meningitis in hospitals within Nairobi. Lumbar punctures were done on all of them and the cerebrospinal fluid (CSF) analysed bacteriologically and serologically for the common causative organisms. Two hundred and fifty (50.1%) cases were diagnosed clinically as having meningitis. Of these, 132 (52.8%) had turbid CSF specimens, while 118 (47.2%) were clear. When turbid CSF specimens were cultured, 83 (62.8%) yielded three common bacterial micro-organisms namely; Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae in that order of frequency. The implications of these findings in paediatric meningitis together with the drug sensitivity patterns is presented and discussed.

1997

A., PROFWAMOLAISAAC.  1997.  Muriuki SM, McDermott JJ, Arimi SM, Mugambi JT, Wamola IA.Criteria for better detection of brucellosis in the Narok District of Kenya.East Afr Med J. 1997 May;74(5):317-20.. East Afr Med J. 1997 May;74(5):317-20.. : IBIMA Publishing Abstract
Monthly disease summary sheets from 1986-1992 of 60 dispensaries, clinics and hospitals in Narok district, Kenya were reviewed for the occurrence of brucellosis and other diseases with "flu-like symptoms". Diseases with these symptoms accounted for about 52% of the 1,037,875 cases reported for the time period. These were classified as malaria (79.3%), rheumatism (7.1%), PUO (2.4%), and brucellosis (0.8%). Brucellosis was diagnosed by a positive Rose Bengal (RB) test routinely conducted in seven out of the 60 health units. In these units, 55% of flu-like cases were classified as malaria and 21.2% as brucellosis. Individual case records of patients at four dispensaries using the RB test during 1991-92 were assessed for specific predictor symptoms. For 625 RB tested patients, a positive test result was associated with joint pain, headache, and the combinations of joint pain with headache and lameness with headache. A logistic regression model correctly predicted the RB test result in 62.3% of the time. For the 465 patients examined by the blood smear examination, identification of malaria parasites was associated with, headache, joint pain and combinations of emesis with pale mucous membranes. This regression model correctly predicted positive results 67.2% of the time. Both models indicate that selected clinical predictors represented significantly increased odds of being positive to the respective tests. However, for both diseases, clinical signs alone appear insufficient for reliable diagnosis and differentiation probably due to resemblance in symptomatology between these two and other diseases.

1995

A., PROFWAMOLAISAAC.  1995.  Petit PL, Haarlem JV, Poelman M, Haverkamp MC, Wamola IA.Bacteraemia in patients presenting with fever. East Afr Med J. 1995 Feb;72(2):116-20.. East Afr Med J. 1995 Feb;72(2):116-20.. : IBIMA Publishing Abstract
In three studies, in Ghana and Kenya, blood from 639 patients admitted with fever was cultured. Standard treatments were antimalarials (54-100%) and antibiotics (39-90%). According to the criteria in use, however, only 10-31% had malaria alone; of those who received antibiotics, 66% were diagnosed with malaria, gastrointestinal infections, post-operative recuperations, circulatory problems, central nervous system disorders or FUO, and did not need antibiotics at the first encounter. For those with wounds and abscesses (8%), generalised antibiotic treatment can also be questioned. Bacteraemia was found in 71 (11.3%) patients; in the HIV patients, however, 5 (23%) of 22 had bacteraemia. This is a minimum incidence, since culture techniques were not optimal for the isolation of fastidious microorganisms. The most prevalent organisms isolated were Salmonella, Klebsiella/Enterobacter and S. aureus. Resistance (intrinsic and extrinsic) in the Gram- bacteria was high: 31-100% were resistant to amoxycillin, 0-80% to cotrimoxazole, 15-95% to chloramphenicol and 9-15% to gentamicin. The need for cultures and sensitivity tests for patients with prolonged or undiagnosed fever is stressed. Specific treatment should be given only when infections, whether malarial or bacterial, have been positively diagnosed.
A., PROFWAMOLAISAAC.  1995.  Kakai R, Bwayo JJ, Wamola IA, Ndinya-Achola JO, Nagelkerke NJ, Anzala AO, Plummer FA.Breastfeeding and immunity to intestinal infections.East Afr Med J. 1995 Mar;72(3):150-4.. East Afr Med J. 1995 Mar;72(3):150-4.. : IBIMA Publishing Abstract
{ The purpose of this study was to compare immune response in breast and non breastfed children presenting with diarrhoea at Paediatric Observation Ward, Kenyatta National Hospital (KNH-POW) and Maternal and Child Health Clinic, Pumwani Maternity Hospital (PMH-MCH). Blood and stool samples were collected from the first four consecutive children aged 5 years and below per day, presenting with or without diarrhoea from January to December, 1992. The stools were tested for total IgA by single radial immunodiffusion (SRID) and specific IgA by enzyme linked immunosorbent assay (ELISA). Peripheral blood CD4 and CD8 enumeration was done by flow cytometry. Stools were cultured for bacteria on selective media while ova and cysts of parasites were identified by wet preparation microscopy. A total of 457 children were enrolled into the study, 69.6% of whom presented with diarrhoea. Breastfed children tended to have a shorter duration of diarrhoea than either mixed fed or bottle fed (8.3 vs 9.8 vs 11.2 days
A., PROFWAMOLAISAAC.  1995.  Kakai R, Wamola IA, Bwayo JJ.Association of human rotavirus infection and intestinal rotavirus-specific immunoglobulin A in children with diarrhoea. East Afr Med J. 1995 Apr;72(4):217-9.. East Afr Med J. 1995 Apr;72(4):217-9.. : IBIMA Publishing Abstract
The purpose of this study was to determine the role of intestinal specific rotavirus IgA antibody in protection against diarrhoea due to rotavirus infection. Stool from children aged below 5 years with diarrhoea who reported to the Paediatric Observation Ward, Kenyatta National Hospital were examined for micro-organisms and IgA antibody. Specific rotavirus IgA antibody and antigen were determined using enzyme linked immunosorbent assay technique. Out of 153 stool specimens, 22% (34/153) were positive for rotavirus antigen and 15% (23/153) had IgA specific antibody to rotavirus. Children with specific IgA to rotavirus had no rotavirus except in two cases (p < 0.05). There was no difference in levels of specific IgA antibody between normal and malnourished children (p = 0.4). It is probable that intestinal specific IgA to rotavirus protects children against rotavirus diarrhoea.
A., PROFWAMOLAISAAC.  1995.  Mirza NB, Wamola IA, Estambale BA, Mbithi E, Poillet M.Typhim Vi vaccine against typhoid fever: a clinical trial in Kenya.East Afr Med J. 1995 Mar;72(3):162-4.. East Afr Med J. 1995 Mar;72(3):162-4.. : IBIMA Publishing Abstract
Safety, tolerance and immunogenicity of the purified Vi polysaccharide vaccine (Typhim Vi) against typhoid fever was evaluated in primary school children aged 5-15 years. A total of 435 children were vaccinated, each with a single intramuscular injection in the left deltoid muscle. One hundred and ten children were randomly selected for blood samples on day 0 (pre vaccination) and day 30 (post vaccination). Vi antibodies studied by Radio immuno assay (RIA) on 97(88%) paired sera showed a seroconversion rate of 76.2% and seroprotection rate after vaccination was 74.2%, while 6.2% of children already had protective immunity before vaccination. The vaccine was well tolerated. Most commonly reported reactions were mild pain at site of injection (83%), and a few complained of mild swelling (4.6%), induration (1.1%), itching (1.1%) and headaches (1.4%). All reactions were of mild severity and disappeared within 24 to 48 hours.
A., PROFWAMOLAISAAC.  1995.  Kakai R, Wamola IA, Bwayo JJ, Ndinya-Achola JO.Enteric pathogens in malnourished children with diarrhoea.East Afr Med J. 1995 May;72(5):288-9.. East Afr Med J. 1995 May;72(5):288-9.. : IBIMA Publishing Abstract

{ Enteric pathogens were determined from stools of 273 children aged less than 5 years at Kenyatta National Hospital (KNH), 43.6% (119/273) of whom were malnourished according to the Wellcome criteria. Rotavirus was detected by ELISA test, Salmonella, Shigella and E. coli by culture on MacConkey and Salmonella-Shigella agar at 37 degrees C overnight and Campylobacter on Skirrow's selective media at 42 degrees C for 48 hrs. These were identified by biochemical tests and serotyping using specific antisera. Whereas isolation rate for Campylobacter (0.0% vs 5.0%

A., PROFWAMOLAISAAC.  1995.  Kakai R, Bwayo JJ, Wamola IA, Ndinya-Achola JO, Plummer FA.Effect of human immunodeficiency virus on local immunity in children with diarrhoea. East Afr Med J. 1995 Nov;72(11):699-702.. East Afr Med J. 1995 Nov;72(11):699-702.. : IBIMA Publishing Abstract
{ The purpose of this study was to determine the relationship between intestinal mucosal immunity and diarrhoea. Stools were tested for total IgA by radial immunodiffusion, cultured for bacteria and examined for ova/cysts by microscopy. Peripheral blood was screened for HIV-1 antibody by ELISA, CD4 and CD8 enumerated by flow cytometry and phagocytic activity by C. albicans engulfment. A total of 271 children were enrolled with a mean age of 20.3 m (range 0.3-60.0 m). HIV exposed (born to HIV seropositive mothers) had more episodes of diarrhoea than HIV unexposed (born to HIV seronegative mothers) children in the first six months of life (26.0% versus 5.5%

1994

A., PROFWAMOLAISAAC.  1994.  Petit PL, Wamola IA.Typhoid fever: a review of its impact and diagnostic problems. East Afr Med J. 1994 Mar;71(3):183-8.. East Afr Med J. 1994 Mar;71(3):183-8.. : IBIMA Publishing Abstract
A retrospective analysis was done on the diagnosis of typhoid fever based on clinical symptoms and available laboratory data over the last 16 years from rural areas of four African countries. This analysis concentrated on the reliability of diagnosis without cultures which cannot be performed in most rural hospitals due to lack of the necessary expertise and equipment. The analysis showed the problem to be increasing perhaps because of interaction of salmonella infection with human immunodeficiency virus (HIV), malnutrition and other infections together with neglected sanitary facilities and lack of clean water. The use of certain cardinal clinical symptoms combined with available laboratory tests were shown to enhance the diagnosis of typhoid fever, especially in vulnerable persons. In conclusion the paper suggests that using the approach followed to obtain this data in rural tropical areas one can confidently make a diagnosis of typhoid fever.

1993

Temmerman, M, Moses S, Kiragu D, Fusallah S, Wamola I, Piot P.  1993.  Postpartum counselling of HIV infected women and their subsequent reproductive behaviour.
Wamola, IA, Mirza NB, Ombette JJ, Onyango FE.  1993.  Recent epidemic meningococcal meningitis in Nairobi. Abstract

This is a prospective study of the recent explosive epidemic of group A meningococcal meningitis that occurred in Nairobi from April 1989 to January 1990. It was compared with previous less explosive outbreaks that occurred from 1975 to 1981. The recent epidemic was correlated to its Neisseria meningiriais carrier status among case-control samples with carrier rate in nasopharyngeal respiratory pathogens of children born of human immunodeficiency virus (HIV-1) positive and negative mothers at about the same time of the outbreak. The effect of mass vaccination on the course of the outbreak is presented on selected affected areas of Nairobi city residents who were offered the bivalent meningococcal polysaccharide vaccine against serotype A and C

1992

A., PROFWAMOLAISAAC.  1992.  Wamola IA.Microbial contamination of commercial food products: fact or fiction.East Afr Med J. 1992 Mar;69(3):121-2.. East Afr Med J. 1992 Mar;69(3):121-2.. : IBIMA Publishing Abstract
An increase in illness due to measles is one of the potential consequences of the human immunodeficiency virus (HIV) epidemic in Africa. During a study of perinatal HIV transmission conducted in Kenya, the risk of acquiring measles before vaccination (9 months of age) was found to be 3.8 times higher in infants born to HIV-seropositive mothers than in control infants (10 [9%] of 109 vs. 5 [3%] of 194 infants; P = .02; odds ratio, 3.8; 95% confidence interval, 1.2-13.2). The majority of infants who developed measles in this study had significant sequelae related to their measles infection. The increased risk of measles appeared to be related to relatively lower anti-measles antibody titers detected in cord blood samples of affected infants born to HIV-seropositive mothers. However, 94% of all infants were susceptible to measles on the basis of ELISA testing at age 6 months regardless of maternal HIV serology. These observations highlight the need for improved measles vaccination strategies in Africa and for studies to delineate the effects of HIV infection on the incidence,
A., PROFWAMOLAISAAC.  1992.  Embree J E, Datta P, Stackiw W, Sekla L, Braddick J, Kreiss J K, Pamba HO, WAMOLA I.A . Increased risk of early measles in infants of HIV-1 seropositive mothers. J. Inf. Dis. 165: 262-7, 1992. J. Inf. Dis. 165: 262-7, 1992. : IBIMA Publishing Abstract
An increase in illness due to measles is one of the potential consequences of the human immunodeficiency virus (HIV) epidemic in Africa. During a study of perinatal HIV transmission conducted in Kenya, the risk of acquiring measles before vaccination (9 months of age) was found to be 3.8 times higher in infants born to HIV-seropositive mothers than in control infants (10 [9%] of 109 vs. 5 [3%] of 194 infants; P = .02; odds ratio, 3.8; 95% confidence interval, 1.2-13.2). The majority of infants who developed measles in this study had significant sequelae related to their measles infection. The increased risk of measles appeared to be related to relatively lower anti-measles antibody titers detected in cord blood samples of affected infants born to HIV-seropositive mothers. However, 94% of all infants were susceptible to measles on the basis of ELISA testing at age 6 months regardless of maternal HIV serology. These observations highlight the need for improved measles vaccination strategies in Africa and for studies to delineate the effects of HIV infection on the incidence,

1991

A., PROFWAMOLAISAAC.  1991.  Nduati RW and WAMOLA I.A. Bacteriology of acute septic arthritis J. Trop. Paed 37: 172-175, 1991. J. Trop. Paed 37: 172-175, 1991. : IBIMA Publishing Abstract
In a study of septic arthritis infants formed the bulk of patients though, notably, neonates were not encountered. Gram-negative bacterial of the Salmonella species, especially Salmonella typhimurium and Klebsiella species were the most important cause of septic arthritis in infants. Staphylococcus aureus was also isolated. The combination of blood cultures and joint aspirate cultures resulted in very high rate (72 per cent) of bacteria isolation. It is strongly recommended that every effort should be made to obtain two bacteriological specimens for culture to improve bacteriological diagnosis of the disease.
A., PROFWAMOLAISAAC.  1991.  Temmerman M, WAMOLA I.A and Piot P. A review of the impact of sexually transmitted diseases and HIV infection pregnancy outcome in Nairobi. J. Obs Gynae. East Africa 9: 54, 1991. J. Obs Gynae. East Africa 9: 54, 1991. : IBIMA Publishing Abstract
A total of 120 sets of blood cultures were performed aerobically from 60 children with clinically diagnosed septicaemia at Kenyatta National Hospital, Nairobi. Out of these, 36 (30%) sets from 19 (31.7%) patients yielded bacterial growth while 84 (70%) sets from 41 (68.3%) were negative. Salmonella typhimurium was the most frequently isolated bacteria (63%), followed by Staphylococcus aureus (15.8%). Salmonella typhimurium isolates were mostly multi-antibiotic resistant, most of them only sensitive to amikacin and cefotaxime, while all were resistant to ampicillin and co-trimoxazole, the most frequently used antibiotic in this hospital. PIP: Between March 1987-January 1988, physicians enrolled 60 pediatric patients with a fever who were admitted to the Kenyatta National Hospital in Nairobi, Kenya for various clinical conditions in a study to determine the types, frequency, and antibiotic sensitivity patterns of aerobic and facultative bacterial isolates. Most of the patients were 13 months-4 years old (45%). 31.7% of the patients had positive blood cultures. Staphylococcus aureus was the 2nd most common bacteria (15.8%) among these patients. Laboratory personnel isolated Salmonella typhimurium in most patients (63%). In fact, during the same period, the Diagnostic Microbiology Laboratory at the hospital identified Salmonella species in 48% of all isolated bacteria and 35% of these were S. typhimurium. S. typhimurium tended to be present in children with gastroenteritis (41.8%) or a fever of unknown origin (33.3%). S. typhimurium was very sensitive to amikacin and cefotaxime, but resistant to ampicillin and sulfamethoxazole-trimethoprim. Health workers in Kenya have frequently administered ampicillin and sulfamethoxazole-trimethoprim, but not amikacin and cefotaxime. 67% of the strains of S. typhimurium were resistant to gentamicin and 33% to chloramphenicol. These results along with those of other reports from this hospital indicated a dramatic rise in Gram negative bacteria resistance to antibiotics. Therefore physicians should no longer consider gentamicin as a 1st line antibiotic in treating suspected septicemia patients.
A., PROFWAMOLAISAAC.  1991.  Odhiambo F A, WAMOLA I.A and Ndinya-Achola J O. Aerobic and facultative bacterial isolates from blood cultures of children with clinically diagnosed septicaemia.East Afr Med J. 1991 Nov;68(11):869-74.. East Afr Med J. 1991 Nov;68(11):869-74.. : IBIMA Publishing Abstract
A total of 120 sets of blood cultures were performed aerobically from 60 children with clinically diagnosed septicaemia at Kenyatta National Hospital, Nairobi. Out of these, 36 (30%) sets from 19 (31.7%) patients yielded bacterial growth while 84 (70%) sets from 41 (68.3%) were negative. Salmonella typhimurium was the most frequently isolated bacteria (63%), followed by Staphylococcus aureus (15.8%). Salmonella typhimurium isolates were mostly multi-antibiotic resistant, most of them only sensitive to amikacin and cefotaxime, while all were resistant to ampicillin and co-trimoxazole, the most frequently used antibiotic in this hospital. PIP: Between March 1987-January 1988, physicians enrolled 60 pediatric patients with a fever who were admitted to the Kenyatta National Hospital in Nairobi, Kenya for various clinical conditions in a study to determine the types, frequency, and antibiotic sensitivity patterns of aerobic and facultative bacterial isolates. Most of the patients were 13 months-4 years old (45%). 31.7% of the patients had positive blood cultures. Staphylococcus aureus was the 2nd most common bacteria (15.8%) among these patients. Laboratory personnel isolated Salmonella typhimurium in most patients (63%). In fact, during the same period, the Diagnostic Microbiology Laboratory at the hospital identified Salmonella species in 48% of all isolated bacteria and 35% of these were S. typhimurium. S. typhimurium tended to be present in children with gastroenteritis (41.8%) or a fever of unknown origin (33.3%). S. typhimurium was very sensitive to amikacin and cefotaxime, but resistant to ampicillin and sulfamethoxazole-trimethoprim. Health workers in Kenya have frequently administered ampicillin and sulfamethoxazole-trimethoprim, but not amikacin and cefotaxime. 67% of the strains of S. typhimurium were resistant to gentamicin and 33% to chloramphenicol. These results along with those of other reports from this hospital indicated a dramatic rise in Gram negative bacteria resistance to antibiotics. Therefore physicians should no longer consider gentamicin as a 1st line antibiotic in treating suspected septicemia patients.
A., PROFWAMOLAISAAC.  1991.  Cameron W, Clementson D, D. J. Inf. Diseases. 1991. : IBIMA Publishing Abstract
OBJECTIVE: To measure the proportion of nosocomial diarrhea cases associated with Salmonella and Shigella species. DESIGN: Prospective 6-month survey. SETTING: Tertiary care center in a developing country. PATIENTS: Pediatric and adult patients admitted with the previous 24 hours and all consenting adult or pediatric medical patients with nosocomial diarrhea. OUTCOME MEASURES: Prevalence of Salmonella and Shigella species isolated from rectal swabs at admission and among subjects with nosocomial diarrhea. RESULTS: Salmonella species and Shigella species were isolated from 3.0% and 2.5%, respectively, of 667 patients screened on admission. All admission Salmonella isolates were identified in children under 13 years of age; Shigella prevalence was similar for children and adults. Children with Salmonella at admission were significantly older and more likely to have diarrhea, fever, and some indicators of malnutrition than those from whom Salmonella was not isolated. Salmonella and Shigella were isolated from rectal cultures in 36 (10%) and 9 (2.5%) of 360 nosocomial gastroenteritis cases, respectively. Nosocomial cases occurred equally in adults and children. In adults, nosocomial Salmonella acquisition was associated with sharing a room with a diarrhea patient and previous institutionalization. In children, it was associated with recent antimicrobial therapy, crowding at home, and age between 6 months and 6 years. Nine (41%) of 22 nosocomial Salmonella cases in adults occurred in patients with human immunodeficiency virus-type 1 (HIV-1) infection, while none of 79 HIV-1-positive patients had Salmonella isolated at admission. CONCLUSIONS: Salmonella is a frequent cause of nosocomial gastroenteritis in this tertiary care institution in a developing country. Risk factors appear to differ for children and adults, and HIV-1-infected subjects may be at increased risk of acquisition. Control measures feasible for the limited resources available to such institutions require evaluation. PIP: Researchers analyzed data on 667 patients admitted between March 9 and September 14, 1988 to the Kenyatta National Hospital in Nairobi, Kenya to verify the contribution of Salmonella and Shigella species to hospital acquired infections and to identify factors associated with admission and nosocomial infection. Laboratory personnel isolated Salmonella and Shigella in 12.5% (10% and 2.5% respectively) of the 360 patients with nosocomial diarrhea. Their overall prevalence was 3% and 2.5% respectively. These 2 bacteria were isolated from rectal swabs from 19 of the 27 hospital units. Most of the isolates were restricted to 5 units. All of the Salmonella isolates at admission were children under 13 years old (3.6% of 556 children). Shigella prevalence at admission was 2.5% for children and 3.6% for adults. The risk of nosocomial diarrhea caused by these 2 bacteria was much greater in children older than 6 months and younger than 6 years than in children of other ages (odds ratio [OR]=21.7; p=.006). The most significant variables which independently affected nosocomial diarrhea caused by these bacteria in children were recent antimicrobial therapy (OR=26.4; p=.001) and living in crowded homes (OR=1.2; p=.02). Another determinant was poor hair color indicating malnutrition (p=.03). Even though there were no significant differences between adults with nosocomial diarrhea caused by these bacteria and those with no nosocomial diarrhea, sharing a room with people with diarrhea, being in the hospital within the last 30 days, and being HIV-1 positive were factors that almost reached significance. In fact, 9 of their 22 (41%) adults with positive cultures of Salmonella were HIV=1 positive yet Salmonella was not isolated from any of the 70 HIV-1 positive patients at admission. Salmonella contributed greatly to nosocomial diarrhea at this hospital. The hospital should evaluate and redesign its control measures within available limited resources.
A., PROFWAMOLAISAAC.  1991.  Paton S, Nicolie L, Mwongera M, Kabiru P, Mirza N, Plummer F and WAMOLA I.A. Salmonella and Shigella Gastroenteritis at a public teaching hospital in Nairobi, Kenya. Inf. Control and Hosp. Epidemiol. 12(12): 710 1991. Inf. Control and Hosp. Epidemiol. 12(12): 710 1991. : IBIMA Publishing Abstract
OBJECTIVE: To measure the proportion of nosocomial diarrhea cases associated with Salmonella and Shigella species. DESIGN: Prospective 6-month survey. SETTING: Tertiary care center in a developing country. PATIENTS: Pediatric and adult patients admitted with the previous 24 hours and all consenting adult or pediatric medical patients with nosocomial diarrhea. OUTCOME MEASURES: Prevalence of Salmonella and Shigella species isolated from rectal swabs at admission and among subjects with nosocomial diarrhea. RESULTS: Salmonella species and Shigella species were isolated from 3.0% and 2.5%, respectively, of 667 patients screened on admission. All admission Salmonella isolates were identified in children under 13 years of age; Shigella prevalence was similar for children and adults. Children with Salmonella at admission were significantly older and more likely to have diarrhea, fever, and some indicators of malnutrition than those from whom Salmonella was not isolated. Salmonella and Shigella were isolated from rectal cultures in 36 (10%) and 9 (2.5%) of 360 nosocomial gastroenteritis cases, respectively. Nosocomial cases occurred equally in adults and children. In adults, nosocomial Salmonella acquisition was associated with sharing a room with a diarrhea patient and previous institutionalization. In children, it was associated with recent antimicrobial therapy, crowding at home, and age between 6 months and 6 years. Nine (41%) of 22 nosocomial Salmonella cases in adults occurred in patients with human immunodeficiency virus-type 1 (HIV-1) infection, while none of 79 HIV-1-positive patients had Salmonella isolated at admission. CONCLUSIONS: Salmonella is a frequent cause of nosocomial gastroenteritis in this tertiary care institution in a developing country. Risk factors appear to differ for children and adults, and HIV-1-infected subjects may be at increased risk of acquisition. Control measures feasible for the limited resources available to such institutions require evaluation. PIP: Researchers analyzed data on 667 patients admitted between March 9 and September 14, 1988 to the Kenyatta National Hospital in Nairobi, Kenya to verify the contribution of Salmonella and Shigella species to hospital acquired infections and to identify factors associated with admission and nosocomial infection. Laboratory personnel isolated Salmonella and Shigella in 12.5% (10% and 2.5% respectively) of the 360 patients with nosocomial diarrhea. Their overall prevalence was 3% and 2.5% respectively. These 2 bacteria were isolated from rectal swabs from 19 of the 27 hospital units. Most of the isolates were restricted to 5 units. All of the Salmonella isolates at admission were children under 13 years old (3.6% of 556 children). Shigella prevalence at admission was 2.5% for children and 3.6% for adults. The risk of nosocomial diarrhea caused by these 2 bacteria was much greater in children older than 6 months and younger than 6 years than in children of other ages (odds ratio [OR]=21.7; p=.006). The most significant variables which independently affected nosocomial diarrhea caused by these bacteria in children were recent antimicrobial therapy (OR=26.4; p=.001) and living in crowded homes (OR=1.2; p=.02). Another determinant was poor hair color indicating malnutrition (p=.03). Even though there were no significant differences between adults with nosocomial diarrhea caused by these bacteria and those with no nosocomial diarrhea, sharing a room with people with diarrhea, being in the hospital within the last 30 days, and being HIV-1 positive were factors that almost reached significance. In fact, 9 of their 22 (41%) adults with positive cultures of Salmonella were HIV=1 positive yet Salmonella was not isolated from any of the 70 HIV-1 positive patients at admission. Salmonella contributed greatly to nosocomial diarrhea at this hospital. The hospital should evaluate and redesign its control measures within available limited resources.

1990

A., PROFWAMOLAISAAC.  1990.  Temmerman M, Moses S, Kiragu D, Fusallah S, WAMOLA I.A and Piot P. Impact of single session post-partum counseling of HIV infected women on their subsequent reproductive behaviour. Aids Care vol. 2 (3), 1990. Aids Care vol. 2 (3), 1990. : IBIMA Publishing Abstract
During an ongoing study investigating the impact of maternal HIV infection on pregnancy outcome at a large maternity hospital in Nairobi, Kenya, asymptomatic HIV positive women who had recently delivered were informed of their HIV sero-status and counselled by a trained nurse regarding contraception and reproductive behaviour in a single session. Both HIV infected women and a comparison group of uninfected women matched for pregnancy outcome were followed up after an interval of one year. Contraceptive use, condom use and pregnancy rates were similar in both groups. Only 37% of HIV infected women had informed their partners of their sero-status. The single session of counselling for the HIV positive women did not seem to influence decisions on subsequent condom use or reproductive behaviour. More intensive approaches to counselling need to be developed and evaluated, but may be difficult to implement in the busy maternity and antenatal clinics commonly found in developing countries.

1989

A., PROFWAMOLAISAAC.  1989.  Chunge R, WAMOLA I.A, Kinoti J, Mutunga LN etc. Mixed infections in childhood diarrhoea: Results of a community study in Kiambu district, Kenya.East Afr Med J. 1989 Nov;66(11):715-23.. East Afr Med J. 1989 Nov;66(11):715-23.. : IBIMA Publishing Abstract
One thousand four hundred and twenty diarrhoea specimens from 846 children aged 0 to 60 months were collected and analysed for bacteria, parasites and rotavirus over a 16 month period, from June 1985 to September 1986 inclusive. The study was conducted in 4 villages situated in Kiambu District, Kenya. All the specimens were analysed for rotavirus and parasites, including Cryptosporidium. The majority of the specimens were analysed for enteropathogenic Escherichia coli (EPEC), Shigella, Salmonella, Campylobacter and Aeromonas. Only 387 specimens were analysed for enterotoxigenic E. coli (ETEC). However, of this proportion analysed for ETEC, 33% were positive. A total of 344 specimens were negative for any organisms while a further 140 were only positive for parasites which have been implicated as being pathogenic, including Ascaris lumbricoides, Hymenolepis nana, Trichomonas hominis and Blastocysts hominis were considered to be at least potentially pathogenic and capable of causing diarrhoea. An average of only 29.4% of these organisms occurred as single isolates. The remaining infections were mixed, with a maximum of 7 potentially pathogenic organisms occurring together in a single specimen. The associations of certain organisms were significant, notably Campylobacter with Giardia lamblia. Campylobacter with EPEC, EPEC with Ascaris, and G. lamblia with rotavirus. The latter was a negative association.
A., PROFWAMOLAISAAC.  1989.  Mutanda LN, Omari AM and WAMOLA I.A. Adaptation of a method of measuring zone diameters of bacterial growth inhibition by antibiotics to suit developing countries. East Afr Med J. 1989 Jul;66(7):441-7.. East Afr Med J. 1989 Jul;66(7):441-7.. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.
A., PROFWAMOLAISAAC.  1989.  Ajusi JD, Onyango FE, Mutanda LN and WAMOLA I.A. Bacteriology of unheated expressed breast milk stored at room temperature. EAMJ 66(6): 381 1989. EAMJ 66(6): 381 1989. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

1987

Fransen, L, Nsanze H, Ndinya-Achola JO, D' Costa L, Ronald AR, Piot P.  1987.  A comparison of single dose spectinomycin with 5 days of trimethoprim/sulphamethoxazole for the treatment of chancroid. Website

1985

Mirza, NB, Wamola IA.  1985.  Salmonella typhimurium outbreak at Kenyatta National Hospital (1985). Abstract

A total of 560 Salmonellae species were isolated from Jan-Dec 1985. Of these, 347 (62%) were from blood cultures, 180 (32%) from stools and 33 (6%) were from cerebrospinal fluid (CSF) and other body aspirates. S. typhimurium were the highest isolated. These were, 291 (52%) from blood cultures, 94 (17%) from stool cultures and 32 (6%) from CSF. S. typhimurium was also multi-drug resistant. More than 50% strains of S. typhimurium were resistant to ampicillin, tetracycline, kanamycin and chloramphenicol. The need for coordination between the laboratory and clinical staff to prevent the spill-over of infection with S. typhimurium and its epidemic spread is discussed.

1984

A., PROFWAMOLAISAAC.  1984.  WAMOLA I.A. Role of the Laboratory in Infectious Disease. Fiji Medical Association Annual Seminar. (14th . Fiji Medical Association Annual Seminar. (14th . : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

1983

Wamola, IA, Mirza NB, Ngugi JM, Bwibo NO.  1983.  Campylobacter gastroenteritis in Nairobi. Website

1982

A., PROFWAMOLAISAAC.  1982.  Mutanda LN, WAMOLA I.A and Kaviti JN. The Relationship Between the most commonly occurring Shigella serotypes and ages of patients. Medicom 4: 147, 1982. Medicom 4: 147, 1982. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

1981

A., PROFWAMOLAISAAC.  1981.  WAMOLA I.A, Mirza NB. Problems of Salmonella infections in a hospital in Kenya. EAMJ vol 58 (9): 677, 1981. EAMJ vol 58 (9): 677, 1981. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.
A., PROFWAMOLAISAAC.  1981.  WAMOLA I.A, Mirza NB and Ichoro O. Bacteriology of Septicaemia at Kenyatta National Hospital, Nairobi. Medicom, vol 3 (6): 1981. Medicom, vol 3 (6): 1981. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.
A., PROFWAMOLAISAAC.  1981.  Mirza NB, WAMOLA I.A and Bubi J. Resistance Patterns of Gram Negative Pathogens from Clinical Material. Medicom Vol 3 (4): 105. 1981. Medicom Vol 3 (4): 105. 1981. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.
A., PROFWAMOLAISAAC.  1981.  Nsanzumuhire, WAMOLA I.A and Mirza. Clinical Presentation and Management of Penicillin Resistant Pneumococcal Meningtitis. EAMJ 58: 611, 1981. EAMJ 58: 611, 1981. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.
A., PROFWAMOLAISAAC.  1981.  WAMOLA I.A, Mirza NB and Nsazumuhire H. Penicillin resistant Pneumococcal Meningitis in Kenyatta National Hospital, Nairobi, Kenya. EAMJ Vol 58: 112. Jan 1981. EAMJ Vol 58: 112. Jan 1981. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

1980

A., PROFWAMOLAISAAC.  1980.  WAMOLA I.A. Bacterial Stool Pathogens in Kenyatta National Hospital, Nairobi. EAMJ 57: 867-871, 1980. EAMJ 57: 867-871, 1980. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.
A., PROFWAMOLAISAAC.  1980.  Mirza and WAMOLA I.A. Meningococcal meningitis over the past thirteen years (1967-79) at Kenyatta National Hospital, EAMJ 57: 883-890, 1980. EAMJ 57: 883-890, 1980. : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

1979

A., PROFWAMOLAISAAC.  1979.  Kasili, WAMOLA I.A, Pamba, Shiramba and Broakman. Various Pathological Manifestations of Leprosy . EAMJ 56:59 (1979). : IBIMA Publishing Abstract
A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

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