Papers by James-Paul Kretchy
Advances in microbiology, 2021
Introduction: The recent surge in the number of antimicrobial resistant cases from hospitals and ... more Introduction: The recent surge in the number of antimicrobial resistant cases from hospitals and communities has created a need to study the points and sources of exposure to certain bacteria and determine their susceptibility to commonly used antibiotics. This study aimed at identifying and screening for drug-resistant Enterobacteriaceae isolated from chicken droppings and cow dungs in Onitsha, Anambra state, in the SouthEastern part of Nigeria. Methods: This is a cross-sectional descriptive study which included 50 chickens and 50 cow dung samples collected from five poultry houses and cow ranches respectively using sterile swab sticks. The samples were transported to the laboratory and processed following standard microbiological protocols. Isolates in the samples were recovered using MacConkey Agar, Eosin Methylene Blue Agar and Salmonella-Shigella Agar following standard microbiological procedures and then identified/characterized biochemically using commercial API 20E identification kits following the standard manufacturer's protocol. Isolates were subjected to antibiotic susceptibility testing on Muller Hinton Agar using Kirby Bauer double-disc diffusion technique. The multiple antibiotics resistance index was determined as well. Isolates with reduced susceptibility to Ceftazidime were screened for extended spectrum beta-lactamase, AmpC-and metallo-beta-lactamase-production using Rosco Diagnostic kit. Results: Sixty-two (100%) Gram-negative bacteria were isolated from a total of 100 samples collected from both sites, out of which 43 (69.4%) are Enterobacteriaceae. A total of 30/43 (69.8%
The emergence of acute, severe non hepA–E hepatitis of unknown etiology (ASHUE) has attracted glo... more The emergence of acute, severe non hepA–E hepatitis of unknown etiology (ASHUE) has attracted global concern owing to the very young age of the patients and its unknown etiology. Although this condition has been linked to several possible causes, including viral infection, drugs, and/or toxin exposure, the exact cause remains unknown; this makes treatment recommendations very difficult. In this review, we summarize recent updates on the clinical manifestations, complemented with laboratory results, case numbers with the global distribution and other epidemiological characteristics, and the possible etiologies. We also provide the proposed actions that could be undertaken to control and prevent further spread of this hepatitis. Since many etiological and pathological aspects of the acute non hepA–E hepatitis remain unclear, further research is needed to minimize the severe impact of this disease.
Parasitic Helminths and Zoonoses - From Basic to Applied Research [Working Title], Mar 14, 2022
Soil-transmissible helminths (STHs) infections are the most common sanitation-related public heal... more Soil-transmissible helminths (STHs) infections are the most common sanitation-related public health problems among people living in poor settlements of tropical and subtropical regions in low-and middle-income countries (LMICs). Though available data suggest the occurrence of disease in adults, children of schoolgoing age bear the greatest burden, affecting their cognitive development and physical growth. The characteristic high levels of poverty, poor environmental hygiene, open defecation practices, and inadequate sanitation and waste management systems, expose residents to the risks of STH infections. Walking bare-footed, inappropriate hand hygiene behaviour, and the unavailability/improper use of personal protective equipment (PPE) can impact transmission risks in endemic communities and among occupational risk groups. These have to be properly investigated, managed, and appropriate interventions communicated to decision-makers.
Advances in Microbiology, 2021
Introduction: The recent surge in the number of antimicrobial resistant cases from hospitals and ... more Introduction: The recent surge in the number of antimicrobial resistant cases from hospitals and communities has created a need to study the points and sources of exposure to certain bacteria and determine their susceptibility to commonly used antibiotics. This study aimed at identifying and screening for drug-resistant Enterobacteriaceae isolated from chicken droppings and cow dungs in Onitsha, Anambra state, in the SouthEastern part of Nigeria. Methods: This is a cross-sectional descriptive study which included 50 chickens and 50 cow dung samples collected from five poultry houses and cow ranches respectively using sterile swab sticks. The samples were transported to the laboratory and processed following standard microbiological protocols. Isolates in the samples were recovered using MacConkey Agar, Eosin Methylene Blue Agar and Salmonella-Shigella Agar following standard microbiological procedures and then identified/characterized biochemically using commercial API 20E identification kits following the standard manufacturer's protocol. Isolates were subjected to antibiotic susceptibility testing on Muller Hinton Agar using Kirby Bauer double-disc diffusion technique. The multiple antibiotics resistance index was determined as well. Isolates with reduced susceptibility to Ceftazidime were screened for extended spectrum beta-lactamase, AmpC-and metallo-beta-lactamase-production using Rosco Diagnostic kit. Results: Sixty-two (100%) Gram-negative bacteria were isolated from a total of 100 samples collected from both sites, out of which 43 (69.4%) are Enterobacteriaceae. A total of 30/43 (69.8%
Journal of Environmental and Public Health, 2021
Soil-transmissible helminthes (STH) infections are among the most common sanitation-related publi... more Soil-transmissible helminthes (STH) infections are among the most common sanitation-related public health problems in poor periurban settlements of tropical regions of low- and middle-income countries. In Ghana, research studies documenting the incidence rate, intensity, and occupational risk factors of STH infections among adults are scanty. A prospective cohort study of 261 waste handlers was conducted to investigate this. Stool samples were collected after 90 and 180 days of treatment with albendazole (400 mg per dose). The geometric mean intensity of STH among waste handlers after 180 days of treatment was 2.8 eggs/gram (light intensity), with an incidence rate of 1.5%. The proportion of waste handlers with light intensity STH infections was 4.8%. The odds of STH infection among female waste handlers were 80% lower when compared with male waste handlers (aOR = 0.2; 95% CI: 0.0–0.8). Waste handlers who used rubber gloves when working were 80% (aOR = 0.2: 95% CI: 0.2–1.9) protecte...
Acta Tropica, 2004
School age children carry the heaviest burden of morbidity due to intestinal parasitic infections... more School age children carry the heaviest burden of morbidity due to intestinal parasitic infections. Our objective was to determine the prevalence of these infections in primary school children living in Tehran and their association with socioeconomic factors and hygienic habits. In September 1998, a total of 19 213 subjects were invited to participate. Data on health and socioeconomic status and health-related behaviours, collected via questionnaires, physical examinations and stool sample analyses, were available for 19 209 persons, with a participation rate greater than 99.99%. All participants were subjected to three methods of microscopic examinations on the stool sample and an adhesive cellophane tape slide evaluation. The prevalence rate of intestinal parasitic infection among the students was 18.4%. Coinfection with two or three parasites was seen in 2%. With increase in educational level of parents (especially mothers), the infection rate of children was decreased. Girls showed a significantly higher positive rate than boys. Using piped water, correct method of washing vegetables and increase in the economic score of the family, resulted in a decrease in the infection rate. According to the results, low level of education and consequently poor socioeconomic and hygienic condition of families appear to be powerful determinants of infection.
Journal of Pharmaceutical Policy and Practice, 2021
Background Regular evaluation of antimicrobials prescriptions is important for optimal use. Objec... more Background Regular evaluation of antimicrobials prescriptions is important for optimal use. Objective This study determined the prescription patterns, class and costs of antimicrobials in the adult out-patient pharmacy of a Teaching Hospital in Nigeria. Methods A 1-year retrospective study from 1st January to 31st December 2018. The data, which included identification code, age, sex, antibiotics prescribed, number of antibiotics per prescription, number of medicines per prescription, dosage form, generic prescribing, drug on the essential drug list, and cost, were used in the analysis. The Chi-square test and Analysis of Variance were used to compare our data with the WHO–developed antimicrobial prescription Guidelines for Anatomical Therapeutic Chemical and Defined Daily Dose assignment of 2019. Results From 450 patient records, significantly more females (70%) were prescribed with antimicrobials ( P = 0.0038). The prescription pattern showed that antimicrobials selection by class...
ABSTRACT Mixed method design was used to investigate exposure to waste, use of personal protectiv... more ABSTRACT Mixed method design was used to investigate exposure to waste, use of personal protective gear (PPG), and self-reported health problems among 280 solid waste handlers in a peri-urban township of southern Ghana. From the survey, the most commonly reported health problems were bodily pains (56.4%), headache (38.6%) and fever (35.7%). In-depth interviews highlighted eye problems, stomach pains and nonspecific symptoms such as stress and tiredness. Waste handlers whose bare hands were exposed to waste had a higher likelihood to report fever [odds ratio (OR) = 1.89 (95% C.I 1.37 – 2.56), p < 0.0001] and diarrhoea [OR = 6.25 (95% C.I 4.17 – 10.00), p < 0.0001] compared with those who used rubber gloves. Similarly, waste handlers with uncovered mouth/nose had higher likelihood to report cough than those who used mouth/nose cover [OR = 7.69 (95% C.I 4.00 – 14.29), p < 0.0001]. Waste handlers who did not use PPGs consistently cited reasons including physical discomforts, impracticalities of wearing them in hot/humid conditions, inability of employers to supply or to finance PPGs. Waste handlers need affordable and suitable protective gear to reduce risk to health as well as the provision of water and soap to promote personal hygiene at work. Employers must educate and train waste handlers on disease preventive purposes of using PPGs.
Rapidly urbanising communities in southern Ghana are characterised by indiscriminate waste dispos... more Rapidly urbanising communities in southern Ghana are characterised by indiscriminate waste disposal and unconventional waste management practices. This study focused on key actors in the waste management sector in a semi-urban township of southern Ghana to assess the characteristics of the waste handling workforce and their activities, using a mixed method design. The actors were classified as local government, privategovernment, private self-employed and local community-based actors. The majority (76.8%; 215/280) of the waste handling workforce were private-government actors who performed multiple waste handling tasks. The waste management sector in southernGhana is emerging and though there are increasing numbers of private actors, there is still huge concentrations of piled-up waste within these communities. The study identified problems of inadequate logistics, low education and lack of training among the waste handling workforce which need to be tackled by all the actors. There...
Background: A critical component of safety in the work environment is adherence to safety protoco... more Background: A critical component of safety in the work environment is adherence to safety protocols for the protection of workers. The violation of safety procedures in the workplace has resulted in over a million workplace accidents globally, majority of which are reported in industrial hubs of low income countries. Methods: Cross-sectional design was used to quantitatively study 241 factory workers to establish demographic factors influencing adherence to safety protocols. Results: The results indicated that age (p<0.001), sex (p<0.001), education (p=0.035) and job position/rank (p=0.013) influenced adherence to safety protocols significantly. Females were more likely to adhere to safety protocols than males [odds ratio (OR)=2.61 (95% C.I 1.44–4.73), p=0.002]. Workers with University degrees had higher likelihood of adhering to safety protocols compared with Certificate holders [odds ratio (OR)=2.81 (95% C.I 1.14–6.95), p=0.025]. The odds of adherence to safety protocol amon...
Background: Malaria is still endemic in sub-Saharan Africa, with a high disease burden. Misconcep... more Background: Malaria is still endemic in sub-Saharan Africa, with a high disease burden. Misconceptions about malaria contribute to poor attitudes and practices, further increasing the burden in endemic countries. Studies have examined the knowledge, attitudes, and practices (KAP) of malaria among different populations. However, there seems to be no available literature reporting on the perspectives of day and night market traders. To the best of our knowledge, this is the first report on malaria KAP with a focus on day and night market traders. Methods: A descriptive cross-sectional study involving day and night market traders in 10 selected markets within the Greater Accra Region of Ghana was carried out. Data were collected from consenting respondents using a structured questionnaire. Results: Of the 760 respondents (33.3% (n = 253) night and 66.7% (n = 507) day traders) interviewed, there was no significant difference between the day and night market traders in terms of malaria K...
Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscrim... more Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscriminate solid waste disposal and open defecation practices. Persons engaged in waste handling in such communities perform their activities with little or no personal protective equipment. They are thus confronted with the risk of faecal pollution of the hands and other bodily parts. A mixed method approach was used to investigate 280 waste handlers performing different activities to estimate recent faecal pollution of their hands and to observe the utilization of personal protective equipment and sanitation/hygiene facilities during work. The log concentration of E. coli on hands of waste handlers after work (8.60 ± 4.20 CFU/hand, mean ± standard deviation) was significantly higher compared with the E. coli log concentration before work (2.95 ± 1.89 CFU/hand, mean ± standard deviation) (p<0.001). The odds of faecal pollution was significantly higher (aOR 4.2; 95% CI: 1.9–9.1) for worker...
Preventive Medicine Reports
Research in Social and Administrative Pharmacy
Research in Social and Administrative Pharmacy, Apr 1, 2020
The current coronavirus disease 2019 (COVID-19) pandemic is placing a huge strain on health syste... more The current coronavirus disease 2019 (COVID-19) pandemic is placing a huge strain on health systems worldwide. Suggested solutions like social distancing and lockdowns in some areas to help contain the spread of the virus may affect special patient populations like those with chronic illnesses who are unable to access healthcare facilities for their routine care and medicines management. Retail pharmacy outlets are the likely facilities for easy access by these patients. The contribution of community pharmacists in these facilities to manage chronic conditions and promote medication adherence during this COVID-19 pandemic will be essential in easing the burden on already strained health systems. This paper highlights the pharmaceutical care practices of community pharmacists for patients with chronic diseases during this pandemic. This would provide support for the call by the WHO to maintain essential services during the pandemic, in order to prevent non-COVID disease burden on healthcare systems particularly in low-and middle-income countries.
Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscrim... more Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscriminate solid waste disposal and open defecation practices. Persons engaged in waste handling in such communities perform their activities with little or no personal protective equipment. They are thus confronted with the risk of faecal pollution of the hands and other bodily parts. A mixed method approach was used to investigate 280 waste handlers performing different activities to estimate recent faecal pollution of their hands and to observe the utilization of personal protective equipment and sanitation/hygiene facilities during work. The log concentration of E. coli on hands of waste handlers after work (8.60 ± 4.20 CFU/hand, mean ± standard deviation) was significantly higher compared with the E. coli log concentration before work (2.95 ± 1.89 CFU/hand, mean ± standard deviation) (p&lt;0.001). The odds of faecal pollution was significantly higher (aOR 4.2; 95% CI: 1.9-9.1) for workers aged 35 years and above compared with those less than 35 years; and for workers at public toilet facilities (aOR 3.0; 95% CI: 1.0-8.4) compared with those who worked for private waste handling companies. Female workers were, however, 60% less likely (aOR 0.4; 95% CI: 0.2-0.8) to experience faecal pollution of their hands compared with males.
Mixed method design was used to investigate exposure to waste, use of personal protective gear (P... more Mixed method design was used to investigate exposure to waste, use of personal protective gear (PPG), and self-reported health problems among 280 solid waste handlers in a peri-urban township of southern Ghana. From the survey, the most commonly reported health problems were bodily pains (56.4%), headache (38.6%) and fever (35.7%). In-depth interviews highlighted eye problems, stomach pains and nonspecific symptoms such as stress and tiredness. Waste handlers whose bare hands were exposed to waste had a higher likelihood to report fever [odds ratio (OR) = 1.89 (95% C.I 1.37 – 2.56), p < 0.0001] and diarrhoea [OR = 6.25 (95% C.I 4.17 – 10.00), p < 0.0001] compared with those who used rubber gloves. Similarly, waste handlers with uncovered mouth/nose had higher likelihood to report cough than those who used mouth/nose cover [OR = 7.69 (95% C.I 4.00 – 14.29), p < 0.0001]. Waste handlers who did not use PPGs consistently cited reasons including physical discomforts, impractical...
Uploads
Papers by James-Paul Kretchy