The COVID-19 vaccination acceptance/hesitancy rate and its determinants among healthcare workers of 91 Countries: A multicenter cross-sectional study.

The aim of this study was to investigate the COVID-19 vaccination acceptance rate and its determinants among healthcare workers in a multicenter study. This was a cross-sectional multi-center survey conducted from February 5 to April 29, 2021. The questionnaire consisted of 26 items in 6 subscales. The English version of the questionnaire was translated into seven languages and distributed through Google Forms using snowball sampling; a colleague in each country was responsible for the forward and backward translation, and also the distribution of the questionnaire. A forward stepwise logistic regression was utilized to explore the variables and questionnaire factors tied to the intention to COVID-19 vaccination. 4630 participants from 91 countries completed the questionnaire. According to the United Nations Development Program 2020, 43.6 % of participants were from low Human Development Index (HDI) regions, 48.3 % high and very high, and 8.1 % from medium. The overall vaccination hesitancy rate was 37 %. Three out of six factors of the questionnaire were significantly related to intention to the vaccination. While 'Perceived benefits of the COVID-19 vaccination' (OR: 3.82, p-value<0.001) and 'Prosocial norms' (OR: 5.18, p-value<0.001) were associated with vaccination acceptance, 'The vaccine safety/cost concerns' with OR: 3.52, p-value<0.001 was tied to vaccination hesitancy. Medical doctors and pharmacists were more willing to take the vaccine in comparison to others. Importantly, HDI with OR: 12.28, 95 % CI: 6.10-24.72 was a strong positive determinant of COVID-19 vaccination acceptance. This study highlighted the vaccination hesitancy rate of 37 % in our sample among HCWs. Increasing awareness regarding vaccination benefits, confronting the misinformation, and strengthening the prosocial norms would be the primary domains for maximizing the vaccination coverage. The study also showed that the HDI is strongly associated with the vaccination acceptance/hesitancy, in a way that those living in low HDI contexts are more hesitant to receive the vaccine.

Physico-chemical, sensory and microbiological characteristics of plain yoghurt from bambara groundnut (Vigna subterranea) and soybeans (Glycine max).

Physico-chemical, sensory and microbiological characteristics of plain yoghurt from bambara groundnut and soybean milks were studied. Milks were prepared from bambara and soybean and then fermented using Lactobacillus delbruieckii subspp. bulgaricus and Streptococcus salivarus subspp. thermophilus to produce yoghurt. The yoghurts were stored at 7 °C and 27 °C for 9 days and their quality monitored. Results showed that pH of soy and bambara yoghurts decreased during the storage period for both storage temperatures. This decrease in pH was accompanied by simultaneous increase in titratable acidity. Total solids and apparent viscosities of soy and bambara yoghurts increased at 7 °C, but decreased at 27 °C during storage period. Bambara yoghurt received higher sensory acceptability than soy yoghurt. Predominant microorganisms in the stored yoghurts were lactic acid bacteria (LAB). The LAB count in the yoghurts stored at 7 °C decreased but increased at 27 °C during the storage period. Similar trends were followed by total aerobic bacteria, yeast and moulds counts. Pathogenic bacteria such as Salmonella, Coliform and E. coli were absent in all the yogurt samples. Yoghurts of acceptable quality and safety were produced from bambara groundnut and soybeans.

Evaluation of bacteriostatic potency of expired oral paediatric antibiotics and implications on infant health.

INTRODUCTION: In spite of significant risks, as well as non-clinical importance due to loss of potency, stiff penalties against administration of expired medications are still not appropriately enforced by health policy makers in many developing countries, possibly because of little evidence to support that expired medications are hazardous. The purpose of this study therefore, was to investigate the effect of expiration dates on in vitro bacteriostatic potentials of oral paediatric antibiotics. METHODS: Comparative bacteriostatic potentials of 31 expired and seven corresponding unexpired oral paediatric antibiotics were determined on infantile diarrhoeagenic bacteria, using a modification of agar well-diffusion method. RESULTS: Verall total percentage in vitro resistance rates against expired and unexpired paediatric antibiotics respectively were - E. coli (≤100% vs. ≤15.9%), Klebsiella pneumoniae (≤100% vs. ≤31.3%), Proteus mirabilis (≤91.7% vs. ≤41.7%) and Staphylococcus aureus (≤100% vs. ≤18.2%). Resistance rates of 45.5-55.8% (sulfamethoxazole + trimethoprim 5), 39.5-63.6% (amoxycillin 6), 46.5-54.5% (cotrimoxazole 7), 37.5-63.6% (ampicillin + cloxacillin 18), and higher resistance rates of ≥75.0-100% were exhibited towards remaining expired antibiotics. Higher total resistance and multiple antibiotic resistance (MAR) rates were also recorded against expired antibiotics (45.2-93.5%) compared to unexpired antibiotics (28.6-57.2%), except for few strains of E. coli and Proteus mirabilis. Furthermore, unexpired paediatric antibiotics exhibited wider zones of inhibition towards the test diarrhoeagenic bacteria (≥25.0 mm diameter). CONCLUSION: This study provided preliminary microbiological results on the appreciable reduction in in vitro bacteriostatic potentials, as well as higher resistance and multiple antibiotic resistance rates among expired oral paediatric antibiotics on infantile diarrhoeagenic bacteria. Apart from less-efficacy, administration of expired antibiotics can lead to increased antibiotic resistance and clinical treatment failure, as well as adverse drug reactions.

Soaps and germicides as adjunct topical antimycotic agents on candida species implicated in vulvovaginal candidasis.

OBJECTIVE: The study aims at evaluating the potentials of soaps and germicides/disinfectants as adjunct topical anti-vulvovaginal candidasis agents. METHODS: In vitro inhibitory activities of the test agents, prepared according to the manufacturer's specification for toilet and midwifery purposes were determined using modified agar well-diffusion method. RESULTS: Varied susceptibility patterns were exhibited by Candida albicans (26.5%), C. glabrata (18.4%), C. pseudotropicalis (14.3%) and C. tropicalis (40.8%) implicated in vulvovaginal candidasis, indicating Crusader oil (100%), Meriko (95%), Tetmosol (84.7%) and Aloe (68.4%) as the most inhibitory soaps against the Candida strains. The in vitro inhibitory activities of the germicides and disinfectants ranged between (Dettol; 34.6% and Purit; 84.6%) for C. albicans; (Roberts; 33.3% and Purit; 83.3%) for C. glabrata; (Roberts; 21.4% and Purit; 92.9%) for C. pseudotropicalis; (Dettol; 35.0% and Purit; 87.5%) for C. tropicalis respectively. All the Candida strains were totally inhibited by the germicides and disinfectants at the second lower dilutions, except in Morigad towards C. albicans (69.2%]) C. glabrata (72.2%), C. pseudotropicalis (92.9%) and C. tropicalis (82.5%) but none of the vaginal Lactobacillus strains was inhibited by the soaps, germicides or disinfectant. About 90% of a control group indicated relief after pubic cleansing with soaps, germicides and disinfectants. CONCLUSION: Results indicatied the safety of soaps, germicides and disinfectants as potential adjunct topical cleansing-agents in cases of vaginal itching and candidasis, a common mucosal infection caused by opportunistic yeasts of the Candida genus.

Clinical efficacy and health implications of inconsistency in different production batches of antimycotic drugs in a developing country.

OBJECTIVE: This study aimed at evaluating the in vitro efficacy and health implications of inconsistencies in different production batches of antimycotic drugs. MATERIALS AND METHODS: in vitro susceptibility profiles of 36 Candida spp. - C. albicans (19.4%), C. glabrata (30.6%), C. tropicalis (33.3%), and C. pseudotropicalis (16.7%) - obtained from human endocervical and high vaginal swabs (ECS/HVS) to two different batches (B1 and B2) of six antimycotic drugs (clotrimazole, doxycycline, iconazole, itraconazole, metronidazole and nystatin) was determined using modified agar well-diffusion method. RESULTS: None of the Candida strains had entirely the same (100%) susceptibility / resistance profiles in both batches of corresponding antimycotic drugs; while, different multiple antifungal susceptibility (MAS) rates were also recorded in batches 1 and 2 for corresponding antifungals. Only 14.3%, 27.3%, 16.7-33.3%, and 8.3-25.0% of C. albicans, C. glabrata, C. pseudotropicalis, and C. tropicalis strains, respectively, had similar susceptibility/resistance profiles toward coressponding antifungal agents in both batches; while up to 57.1% of C. albicans, 45.5% of C. glabrata, 66.7% of C. pseudotropicalis, and 50.0% of C. tropicalis strains were susceptible to one batch of antifungals but resistant to corresponding antifungals in the second batch. As high as 71.4% (C. albicans), 73.0% (C. glabrata), 50.0% (C. pseudotropicalis), and 66.74% (C. tropicalis) strains had differences of ≥ 10.0 mm among corresponding antimycotic agents. CONCLUSIONS: Candida strains exhibited different in vitro susceptibility / resistance patterns toward two batches of corresponding antimycotic agents, which has clinical implications on the efficacy of the drugs and treatment of patients. The findings of the present study will be of benefit in providing additional information in support of submission of drugs for registration to appropriate regulatory agencies.

The in vitro antimicrobial activities of metabolites from lactobacillus strains on Candida species implicated in Candida vaginitis.

BACKGROUND: Research from developing countries, such as Nigeria, on Lactobacillus species in the female urogenital tract and their role as a barrier to vaginal infection is limited. Therefore, the aim of this study was to assess the clinical biotherapeutic potential of indigenous Lactobacillus species. METHODS: Antimicrobial metabolites production were characterised using simple and easily reproducible qualitative and quantitative methods. The in vitro inhibitory effect of Lactobacillus antimicrobials on vulvovaginal candidiasis-associated Candida species was investigated using modified agar spot and agar well-diffusion methods. RESULTS: The maximum levels of lactic acid, hydrogen peroxide, and diacetyl from 20 vaginal Lactobacillus strains from diseased subjects were 1.46 mg/L, 1.36 mmol/L, and 1.72 mg/L respectively. From the 4 healthy subjects, the maximum level of lactic acid was 1.08 mg/L; hydrogen peroxide, 1.36 mmol/L; and diacetyl, 0.86 mg/L. The maximum productions of these substances occurred between 72 and 120 hours of incubation. The in vitro antagonistic activities of vaginal L. acidophilus, L. fermentum, L. brevis, L. plantarum, L. casei, L. delbrueckii, and L. jensenii from diseased subjects inhibited a maximum of 5.71% of the 35 Candida species tested, while vaginal L. acidophilus and L. plantarum from healthy subjects inhibited between 57.1% and 68.6% of Candida species in vitro. CONCLUSION: Antimicrobial-producing lactobacilli can be considered as adjunct biotherapeutic candidates for the treatment of vulvovaginal candidiasis.

Microbial evaluation and public health implications of urine as alternative therapy in clinical pediatric cases: health implication of urine therapy.

BACKGROUND: Cultural means of pediatric treatment during ill health is a mainstay in Africa, and though urine has been known to contain enteric pathogens, urine therapy is still culturally applicable in some health conditions and also advocated as alternative therapy. The study therefore, is to evaluate the microbial contents and safety of urine. METHODS: Urinary bacteria from cows and healthy children aged 5-11 years were identified by conventional phenotypic methods and antimicrobial susceptibility testing was performed using modified agar disc and well-diffusion methods. RESULTS: A total of 116 bacterial isolates (n = 77 children; n = 39 cows) were identified as Bacillus (10.4%; 5.1%)), Staphylococcus (2.6%; 2.6%), Citrobacter (3.9%; 12.8%), Escherichia coli (36.4%; 23.1%), Klebsiella (7.8%; 12.8%), Proteus (18.2%; 23.1%), Pseudomonas (9.1%; 2.6%), Salmonella (3.9%; 5.1%) and Shigella (7.8%; 12.8%) spp. Antibiotic resistance rates of the Gram-positive bacteria were high (50.0100%), except in Bacillus strains against chloramphenicol, gentamicin and tetracycline (14.3%), while higher resistance rates were recorded among the Gram-negative bacteria except in Citrobacter (0.0%) and Proteus (8.5%) spp. against gentamicin and tetracycline respectively. The Gram-negative bacteria from ito malu (cow urine) were more resistant bacteria except in Citrobacter (20.0%) and Shigella spp. (0.0%) against tetracycline and Proteus spp. (11.1%), (22.2%) against amoxicillin and tetracycline respectively. Multiple antibiotic resistance (MAR) rates recorded in children urinal bacterial species were 37.5-100% (Gram-positive) and 12.5-100% (Gram-negative), while MAR among the cow urinal bacteria was 12.5-75.0% (Gram-positive) and 25.0-100% (Gram-negative). Similar higher resistance rates were also recorded among the Gram-negative bacterial species from urine specimens against the pediatric antibiotic suspensions. CONCLUSION: The study reported presence of multiple antibiotic-resistant indicator bacteria in human urine and ito malu used as alternative remedy in pediatric health conditions like febrile convulsion.

Effect of production batches of antibiotics on in vitro selection criterion for potential probiotic candidates.

Fifty-four potential probiotic candidates were assayed for their phenotypic susceptibility to two batches of antibiotics manufactured by the same company, using the agar disc diffusion method on de Man, Rogosa, and Sharpe (MRS) agar. Cloxacillin was generally resisted (40.0-100%), while gentamicin (3.85-20.0%) was the least resisted antibiotic. The overall percentage differences among the potential probiotics in both batches of antibiotics were 76.5% in fermented foods, 67.3% in fermented beverages, and 53.9% in infantile fecal samples, respectively. There was slightly more overall resistance in batch 1 (46.1% and 46.7%) than in batch 2 (38.4% and 40.0%) of the test antibiotics except in the multiresistance of infantile probiotic candidates (53.8% and 61.5%, respectively). Six of the probiotic candidates did not have any corresponding matching similarity profile, while none of the 54 potential probiotics had 100% antibiogram similarity profiles in both batches of the test antibiotics, despite the fact that they met some other selection criteria such as inhibition of pathogenic bacteria and survival in simulated gastric and intestinal juices and bile. It is therefore suggested that, though routine antibiotic susceptibility testing has been advocated as an essential selection criterion for potential probiotic candidates, more than one batch of antibiotic discs be used in the phenotypic antibiotic screening in developing countries like Nigeria, in order not to lose the most promising indigenous probiotic candidates, since most of the antibiotics used for antibiotic susceptibility studies are imported into the country and their origin cannot be currently fully ascertained.