Browsing by Author "Ntulume, Ibrahim"

Now showing 1 - 7 of 7
  • Thumbnail Image
    Item
    Antibacterial Activity of Carica papaya against Methicillin resistant Staphylococcus epidermidis Isolated from Wards Surfaces of Kampala International University Teaching Hospital, Bushenyi, Uganda
    (Current Trends in Biotechnology and Pharmacy, 2019) Sunusi Adam, Abubakar; Ntulume, Ibrahim; Adeyemo, Rasheed; Akinola, Saheed; Jatau Abubakar, Ibrahim; Almustapha Aleiro, Adamu; Onkobah, Sarah; Micheni, Lisa; Namatovu, Alice
    This study aimed at determining the antibacterial activity of Carica papaya against Methicillin resistant Staphylococcus epidermidis isolated from doorknobs, bed rails, floors and walls of Surgical, Medical, Maternity, Pediatrics, Accident and Emergency, Semiprivate and Private wards of Kampala International University Teaching Hospital. The bacteria were isolated from the wards surfaces and identified using biochemical tests, Desferroxiomine and Fosfomycin antibiotics. Disc diffusion method was used to detect methicillin resistance in S. epidermidis using Cefoxitin (30 μg) disc. Fresh leaves and seeds of C. papaya was processed and extracted using standard methods. Antibacterial activities of the methanol, acetone and aqueous crude extracts were assayed using the agar well diffusion method. Phytochemical analysis, Minimum Inhibitory and Bactericidal concentration of the crude extracts were determined using broth dilution methods. Both C. papaya leaf and seed crude extract exhibited antibacterial activity against MRSE with MICs and MBCs ranges of 250 to 31.3mg/ml and 125 to 31.3 mg/mL for leaf and seed extracts respectively. This study concludes that C. papaya leaf and seed crude extracts were effective against Methicillin resistant S. epidermidis.
  • Thumbnail Image
    Item
    Antibiotic Susceptibility Pattern and Detection of Meca Gene in Methicillin Resistant Staphylococcus Epidermidis Isolated from Wards Surfaces of Kampala International University Teaching Hospital, Uganda
    (Romanian Archives of Microbiology and Immunology, 2020) Adam, Abubakar S.; Micheni, Lisa; Onkoba, Sarah K.; Ntulume, Ibrahim; Aliero, Adamu A.; Namatovu, Alice
    Staphylococcus epidermidis is a Gram positive, coagulase-negative staphylococcus that frequently causes device- or surgery-associated nosocomial infections worldwide. Drug-resistant strains such as methicillin resistant S. epidermidis (DR-SE) have been reported with serious clinical implications. Objectives: This study determined the percentage of S. epidermidis from wards surfaces of Kampala International University-Teaching Hospital (KIU-TH), the drug susceptibility patterns of the isolates and searched for mecA gene among Cefoxitin resistant isolates. Materials and Methods: A total of three hundred sixty-three (363) swab samples were collected from floors, door knobs and walls from different wards. S. epidermidis was identified after subjecting the samples to five tests including growth on mannitol salt agar, catalase, coagulase, Desferrioxamine and Fosfomycin tests. Susceptibility patterns of all the S. epidermidis isolates identified were tested against Amikacin, Cefazolin, Trimethoprim-Sulfamethoxazole, Ciprofloxacin, Gentamycin and Cefoxitin using the disc diffusion method. All the isolates resistant to Cefoxitin were analysed for the presence of mecA gene using the conventional polymerase chain reaction (PCR) method. Results: One hundred and twelve 112 (30.8%) strains of S. epidermidis were isolated from 363 samples collected. Out of 112 S. epidermidis isolates, 11 (9.8%) were found resistant to Cefoxitin and all Cefoxitin resistant isolates (100%) were found to have the mecA gene, while 89.3% of the strains were found non-susceptible to Trimethoprim-Sulphamethoxazole. Conclusion: This study found that S. epidermidis is present on wards surfaces of KIU-TH. S. epidermidis isolates harboured Trimethoprim-Sulfamethoxazole resistance in a high percent. All the isolates resistant to Cefoxitin were positive for the mecA gene. Taking into consideration the high rate of Trimethoprim-Sulphamethoxazole non-susceptibility, Cefazolin, Cefoxitin, Gentamycin and Amikacin are recommended as a better prescription for managing infections caused by S. epidermidis resistant to commonly used antibiotics in the studied area.
  • Thumbnail Image
    Item
    Factors associated with severity and anatomical distribution of Diabetic Foot Ulcer in Uganda: A multicenter cross-sectional study
    (Research Square, 2022) Mumbere Vahwere, Bienfait; Ssebuufu, Robinson; Namatovu, Alice; Kyamanywa, Patrick; Ntulume, Ibrahim; Mugwano, Isaac; Theophilus, Pius; Katembo Sikakulya, Franck; Okedi, Francis Xaviour; Mulumba, Yusuf; Jorge, Soria; Agaba, Gidio; Nasinyama, George William
    Diabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM) associated with high mortality and morbidity including amputations of lower extremities; and a high economic burden especially in low-income countries like Uganda. The aim of this study was to identify the factors associated with severity of DFU and assess the anatomical distribution of DFU among patients in Uganda. Methodology: This was a multicenter cross-sectional study conducted in 7 selected referral hospitals in Uganda. 117 patients with DM type 1 and 2 and foot ulcers were enrolled for this study from January to March 2021. Using the Wagner classification, patients were categorized as less severe DFU (grade 1 and grade 2) and severe DFU for grade 3 and above. A pre tested questionnaire was used to collect data. Data were analyzed using STATA Version 14 with significance at 95% and p-value of <0.05. Results: Out of 117 patients with DFU, 70 (59.8%) had severe DFU and 47 (40.2%) had less severe DFU. Mean age in years was 57.5 (SD15.2) among all study participants in general. The right foot was affected in (47.9%) of cases and the most frequent ulcer was found on the plantar of the foot (44.4%). Majority of the patients had one ulcer (50.4%) and the most frequent ulcer size was >5 cm (47.9%). Majority (61.5%) of the participants were female. Majority of participants, 90 (76.9%) also had uncontrolled blood sugars and 27(29.1%) had normal glycemia Severity of DFU was 3.4 more prevalent among patients with mild neuropathies (p=0.003), and 2.7 more prevalent for those with moderate neuropathies (p=0.005). Also, severity of DFU was 1.5 more prevalent in patients with an ulcer 5-10 cm of diameter (p=0.047) and 2.5 more prevalent in those with foot ulcer of more than 10 cm of diameter (p=.000). Conclusion:The study showed that most of the DFU patients have severe diabetic foot ulcer and uncontrolled glycemia. Neuropathies and ulcers more than 5cm wide are precipitating factors to severity of DFU and, therefore, early management is important to reduce the burden of the disease.
  • Thumbnail Image
    Item
    Plasmodium falciparum Malaria Clinical and Parasitological Outcomes after In-vivo Artemether- Lumefantrine (AL) Treatment at Bushenyi District Uganda
    (International Journal of Tropical Disease & Health, 2018) Nyabayo Maniga, Josephat; Aliero, Adamu Almustapha; Ntulume, Ibrahim; Okech, Matilda Angela; Claire Mack, Mugasa
    The aim of this study was to determine the Plasmodium falciparum malaria clinical and parasitological outcomes after in-vivo Artemether-Lumefantrine (AL) treatment at Bushenyi District Uganda. Study Design: This was a one-arm prospective longitudinal health point survey. Place and Duration: This study was carried out in Bushenyi District Uganda as from May 2017 to August 2017 for a period of four months at the selected four health centers. Methodology: A cohort of 283 human participants who had been confirmed of Plasmodium falciparum malaria was followed for a period of 28 days after treatment with Artemether-Lumefatrine (AL) drug. The follow up was done at fixed check up visits i.e. day 0, 1, 2, 3, 7, 14, 28. Parasitological and clinical evaluations were done at each subsequent follow up days. Consequently they were requested to fill a questionnaire which had aspects of malaria infection. Results: Out of the 283 participants recruited to this study 194 (68.6%) participants completed the follow up schedules while 89 (31.4%) were withdrawn from the study. There was adequate clinical and parasitological response (ACPR) among 53(27.3%) participants. There was late parasitological failure (LPF) among 43 (22.2%) participants. There was late clinical failure (LCF) among 23(11.9%) participants and there was early treatment failure (ETF) among 75 (38.7%) participants Conclusion: There was suspected Artemether- Lumefantrine (AL) poor response to Plasmodium falciparum malaria in the study area after 8 years of introduction to Uganda as a drug of choice for treatment of uncomplicated malaria. Those aged 5 years and below were 2.28 times more likely to present LCF as a clinical treatment outcome compared to other age groups when other factors were held constant. Molecular confirmation of the suspected resistance needs to be conducted in the collected Plasmodium falciparum isolates.
  • Thumbnail Image
    Item
    Superbugs-related prolonged admissions in three tertiary hospitals, Kano State, Nigeria
    (Pan African Medical Journal, 2019) Bashir, Alkali; Garba, Iliyasu; Aliero, Adamu A.; Kibiya, Abdurrazak; Abubakar, Muhammad H.; Ntulume, Ibrahim; Sarkinfada, Faruk; Agwu, Ezera
    superbugs are pathogenic micro-organism and especially a bacterium that has developed resistance to the medications normally used against it. As the superbug family increases, the need for appropriate diagnostic, treatment, prevention and control strategies cannot be over emphasized. Therefore, this work determined the distribution of superbug bacteria among patients on prolonged hospital admissions in three tertiary hospitals of Kano state, Nigeria. Methods: a descriptive cross sectional study was undertaken among 401 patients from medical, surgery, orthopedic and burn centre wards in a three tertiary hospitals in Kano state. A sample collected comprises wound/pus, urine, urine catheter and nasal intubation and were analysed using standard microbiological methods for Acinetobacter spp and other related nosocomial bacterial pathogens. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results: one hundred and thirty eight (138) isolates were recovered, from the studied participants. More than 80% of the nosocomial infections (NIs) were caused by Gram-negative bacteria, predominantly Escherichia coli, Klebseilla spp, Proteus spp, Pseudomona spp and Acinetobacter spp. In-vitro antibiotic susceptibility test revealed that acinetobacter were 100% resistant to amoxicillin, co-trimoxazole, perfloxacin and imipenem. Conclusion: Superbugs (Acinetobacter species) significantly contributed to delayed hospital admissions through observed 100% resistance to used antibiotics. The healthcare managers of these hospitals and the ministry of health need to take measures against this resistant bacteria (Acinetobacter spp) especially on prescribing antibiotics that showed 100% resistant from these studied hospitals.
  • Thumbnail Image
    Item
    Systematic Review and Meta-Analysis on Knowledge Attitude and Practices on African Animal Trypanocide Resistance
    (Tropical Medicine and Infectious Disease, 2022) Kasozi, Keneth Iceland; MacLeod, Ewan Thomas; Waiswa, Charles; Mahero, Michael; Ntulume, Ibrahim; Welburn, Susan Christina
    African trypanocide resistance is an emerging public health emergency whose control requires a revisit on farmer’s knowledge, attitudes, and practices in developing countries. African animal trypanocide resistance (AATr) is rife in an environment where drug use and policy decisions are disjointed. The objective of the study was to identify community factors responsible for the development of AATr. This was important since diminazene aceturate (DA), isometamidium chloride (ISM), and homidium bromide (HB) have existed for over 30 years and no new drugs have been provided to farmers. Methods: An electronic keyword search across 12 databases was conducted using a search criterion from 1806 to June 2022. This generated a total of 24 publications, but after removing duplicates, review articles, and nonrelated articles, a total of eight papers were included in the analysis by following the PRISMA checklist. A meta-analysis was conducted on the data extracted and the risk ratio and inverse variance at 95% confidence interval were calculated using RevMan®. Results: All the eight articles in the study showed that DA was the most preferred trypanocide in both West and Eastern Africa. Poor farmer knowledge of AATr and limited drug options were major drivers for trypanocide resistance. In addition, farmer treatments, use of untrained personnel, poor administration, poor dosing, and preparation of trypanocides were major drivers for the development of AATr and similarities were identified in DA and ISM practices (P = 0.13). Conclusions: AATr is spread in developing countries due to a lack of community knowledge, attitudes, and drug-use practices. This situation could be reversed through interdisciplinary collaborations in endemic communities by promoting effective treatments and responsible drug handling.
  • Thumbnail Image
    Item
    An Update on African Trypanocide Pharmaceutics and Resistance
    (Frontiers in Veterinary Science, 2022) Kasozi, Keneth Iceland; MacLeod, Ewan Thomas; Ntulume, Ibrahim; Welburn, Susan Christina
    African trypanosomiasis is associated with Trypanosoma evansi, T. vivax, T. congolense, and T. brucei pathogens in African animal trypanosomiasis (AAT) while T. b gambiense and T. b rhodesiense are responsible for chronic and acute human African trypanosomiasis (HAT), respectively. Suramin sodium suppresses ATP generation during the glycolytic pathway and is ineffective against T. vivax and T. congolense infections. Resistance to suramin is associated with pathogen altered transport proteins. Melarsoprol binds irreversibly with pyruvate kinase protein sulfhydryl groups and neutralizes enzymes which interrupts the trypanosome ATP generation. Melarsoprol resistance is associated with the adenine-adenosine transporter, P2, due to point mutations within this transporter. Eflornithine is used in combination with nifurtimox. Resistance to eflornithine is caused by the deletion or mutation of TbAAT6 gene which encodes the transmembrane amino acid transporter that delivers eflornithine into the cell, thus loss of transporter protein results in eflornithine resistance. Nifurtimox alone is regarded as a poor trypanocide, however, it is effective in melarsoprol-resistant gHAT patients. Resistance is associated with loss of a single copy of the genes encoding for nitroreductase enzymes. Fexinidazole is recommended for first-stage and non-severe second-stage illnesses in gHAT and resistance is associated with trypanosome bacterial nitroreductases which reduce fexinidazole. In AAT, quinapyramine sulfate interferes with DNA synthesis and suppression of cytoplasmic ribosomal activity in the mitochondria. Quinapyramine sulfate resistance is due to variations in the potential of the parasite's mitochondrial membrane. Pentamidines create cross-links between two adenines at 4–5 pairs apart in adenine-thymine-rich portions of Trypanosoma DNA. It also suppresses type II topoisomerase in the mitochondria of Trypanosoma parasites. Pentamidine resistance is due to loss of mitochondria transport proteins P2 and HAPT1. Diamidines are most effective against Trypanosome brucei group and act via the P2/TbAT1 transporters. Diminazene aceturate resistance is due to mutations that alter the activity of P2, TeDR40 (T. b. evansi). Isometamidium chloride is primarily employed in the early stages of trypanosomiasis and resistance is associated with diminazene resistance. Phenanthridine (homidium bromide, also known as ethidium bromide) acts by a breakdown of the kinetoplast network and homidium resistance is comparable to isometamidium. In humans, the development of resistance and adverse side effects against monotherapies has led to the adoption of nifurtimox-eflornithine combination therapy. Current efforts to develop new prodrug combinations of nifurtimox and eflornithine and nitroimidazole fexinidazole as well as benzoxaborole SCYX-7158 (AN5568) for HAT are in progress while little comparable progress has been done for the development of novel therapies to address trypanocide resistance in AAT.