Evaluating Disease Threats to Sustainable Poultry Production in Africa: Newcastle Disease, Infectious Bursal Disease, and Avian Infectious Bronchitis in Commercial Poultry Flocks in Kano and Oyo States, Nigeria.

The growth of the poultry industry in Nigeria is constrained by major poultry diseases, despite the implementation of vaccination programs. This study aimed to assess the level of protection against Newcastle disease (ND), infectious bursal disease (IBD), and avian infectious bronchitis (IB) afforded by current vaccination schedules and characterize the circulating virus strains in commercial poultry flocks in Nigeria. A cross-sectional study was conducted on 44 commercial poultry farms in Oyo and Kano states of Nigeria. Serum and tissue samples and data on flock, clinical and vaccination records were collected on each farm. Farms were classified as being protected or not protected against ND, IBD and IB based on a defined criterion. Real-time reverse transcription polymerase chain reaction (rRT-PCR) testing was performed for each target virus on tissue samples and positive samples were sequenced. A total of 15/44 (34.1%), 35/44 (79.5%), and 1/44 (2.3%) farms were considered to be protected against ND, IBD, and IB, respectively, at the time of sampling. NDV RNA was detected on 7/44 (15.9%) farms and sequences obtained from 3/7 farms were characterized as the lentogenic strain. Infectious bursal disease virus (IBDV) RNA was detected on 16/44 (36.4%) farms tested; very virulent (vv) IBDV and non-virulent (nv) IBDV strains were both detected in 3/16 (18.8%) positive samples. Sequences of IBDV isolates were either clustered with a group of genotype 3 virulent IBDV strains or were related to vaccine strains MB and D78 strains. IBV RNA was detected on 36/44 (81.8%) farms, with variant02, Massachusetts, 4/91, and Q1 variants detected. Sequences of IBV isolates were either clustered with the vaccines strains Massachusetts M41 and H120 or were most closely related to the D274-like strains or a clade of sequences reported in Nigeria and Niger in 2006 and 2007. This study revealed that most study farms in Oyo and Kano states did not have adequate protective antibody titers against IBV and NDV and were therefore at risk of field challenge. Infectious bursal disease virus and IBV RNA were detected on farms with a history of vaccination suggesting potential vaccination failure, or that the vaccine strains used mismatch with the circulating strains and are therefore not protective.

Temporary vesicostomy in pediatrics: What are the potential predictors of functional and morphological improvement of the upper urinary tract?

INTRODUCTION: Vesicostomy is a simple, well-tolerated, and reversible procedure with few complications that safeguards upper urinary tract (UUT), decreases VUR grade, decreases UTI, and preserves renal function and should be considered in patients with PUV who have undergone prior valve ablation and bladder function not improved, and in myelodysplastic children that do not respond to catheter drainage [1-4]. OBJECTIVE: We evaluated the temporary vesicostomy as a safeguard of the UUT in children with bladder outlet obstruction, bladder dysfunction, and high-grade VUR with sepsis and assessed the possible predictors of the UUT's morphological and functional improvement since these have been rarely explored in previous reviews. STUDY DESIGN: We evaluated the outcome and complications of temporary vesicostomy who were operated on 69 children at our center from 2014 to 2019. RESULT: There were 63 (91.3%) boys and 6 (8.7%) girls who underwent vesicostomy at a mean age of 15.38 ± 2.74 months old. Twenty-nine cases (42%) were diagnosed as primary VUR, 23 (33.3%) had posterior urethral valve (PUV), and 5 (7.2%) had voiding dysfunction, while 12 (17.4%) were neurogenic bladder. Twenty-five (36.2%) patients were diagnosed prenatally and the remainder (44, 63.8%) postnatally. All patients were evaluated at least one year postoperatively. UTI was diagnosed in all cases before vesicostomy; 47 (68.1%) had a single episode of UTI and 22 (31.9%) had recurrent episodes of UTI. Mean serum creatinine was 1.75 ± 0.13 (0.7-4.8) mg/dl. Serum creatinine and the rate of UTI significantly improved (p-value <0.01). Seven (10.1%) cases were complicated with prolapse, 8 (11.6%) with stenosis, and 10 (14.5%) with peristomal dermatitis, all of them were males. DISCUSSION: About 75.4% of cases developed morphological improvement, while 24.6% of cases not improved (p-value = 0.0001). Improvement or stability of glomerular filtration rate (GFR) was seen in 84.1%, while 15.9% deteriorated GFR (p-value = 0.0001). This deterioration is associated with prenatal renal dysplasia. Age less than one year, abdominal swelling, severe HUN, grade V VUR and recurrent UTI before vesicostomy all independently affect functional improvement after vesicostomy. CONCLUSION: Vesicostomy is a simple, reversible, and well-tolerated surgery with few complications that is indicated in children with bladder outlet obstruction, bladder dysfunction, and high-grade VUR to protect UUT, improve renal function, decrease VUR, hydronephrosis, and febrile UTI. Age less than one year, abdominal swelling, severe HUN, grade V VUR and recurrent UTI before vesicostomy all were predictors that independently affect morphological and functional outcomes after vesicostomy.

Comparison of Subureteral Endoscopic Injection of Dextranomer/Hyaluronic Acid and Lich-Gregoir Ureteral Reimplantation in the Treatment of Pediatric Primary Vesicoureteral Reflux: A Prospective Randomized Study.

Background: The gold standard of surgical intervention of vesicoureteral reflux (VUR) is open ureteral reimplantation with high success and low complication rates. However, in recent years, endoscopic injection, dextranomer/hyaluronic acid (Dx/HA), has become an effective therapy for VUR. It is noted that limited prospective randomized trials compare the different surgical techniques of especially endoscopic injection versus open procedures. We aimed to compare the outcomes of endoscopic injection of Dx/HA and Lich-Gregoir open technique of ureteral reimplantation for grades III and IV primary VUR in pediatric patients. Materials and Methods: Between January 2016 and December 2018, 60 pediatric patients with grades III and IV primary VUR were included in a prospective randomized trial. Thirty cases with 45 refluxing ureters managed by endoscopic injection of Dx/HA comprised group A. Open Lich-Gregoir technique used in the other 30 cases with 48 refluxing ureters composed of group B. Renal ultrasound, voiding cystourethrography, and renal scintigraphy were used for follow-up. The surgical success rate, cost-effectiveness, and occurrence of complications were evaluated and compared in both groups. Results: Sixty pediatric patients with 93 refluxing ureters (41 females and 19 males) were included in the trial. The mean follow-up for all patients was 17.7 ± 7.1 months. Overall reflux resolution was 80% (36/45) of the ureters in group A after a single injection and 93.75% (45/48) of the ureters in group B. The difference between the two groups was not statistically significant concerning clinical or anatomical preoperative factors and surgical success rate. There was a statistically significant difference between the two groups in terms of operative time and hospital stay. Conclusion: This comparative study demonstrated a high success rate of open ureteral reimplantation (Lich-Gregoir) procedure over the endoscopic injection of Dx/HA therapy to manage primary VUR grades III-IV. Clinical Trial Number: NCT04798443.

Evaluation of commercially available aroA delated gene E. coli O78 vaccine in commercial broiler chickens under Middle East simulating field conditions.

The broiler industry in the Middle East (ME) faces many challenges related to bacterial infections, including M. gallisepticum, M. synoviae, E. coli, and other gram-negative bacteria, exacerbated by various errors in the brooding process. Antibiotics use in the first three days of life, such as Linco-Spectin 100 SP, tilmicosin, enrofloxacin, tylosin, colistin, and doxycycline, is the trend in the market to control such challenges. This study aimed to evaluate the efficacy of the newly introduced aroA E. coli vaccine (Poulvac E. coli) and its ability to reduce over-reliance on the heavy use of antibiotics in the ME. The study was conducted on 160 broiler chicks, divided into eight even groups. Each group was treated differently in terms of antibiotic therapy and ages at the time of Poulvac E. coli administration and the challenge of virulent avian pathogenic E. coli (APEC), serotype O78. Spray application of Poulvac E. coli at seven days of age plus Linco-Spectin 100 SP during the first three days provided the best results for zero mortality after challenge with APEC, while Poulvac E. coli at seven days with enrofloxacin during the early three days resulted in 10% mortality. Poulvac E. coli hatchery vaccination protected birds against mortality but reduced body weight gain compared to the 7-day group vaccinated with Linco-Spectin 100 SP during the first three days. Poulvac E. coli given on day one or day seven did not affect the immune response to concurrent respiratory viral vaccines and, in some cases, improved response. This study shows that Poulvac E. coli at seven days of age, together with Linco-Spectin 100 during the first three days, has produced the best results in terms of protection and performance in the ME high presence of avian pathogenic E. coli field challenge.

Recent approaches for control of E. coli and respiratory complex in Middle East.

This study was conducted on 100 one-day-old broiler chicks to evaluate the effect of Poulvac E. coli vaccine in reduction of clinical signs and complications after concurrent infectious bronchitis virus (variant 02) and virulent E. coli O78 challenges. The birds were evaluated for clinical signs, mortality for 7 days post-infection, PM lesion score, average body weight and serological evaluation. Re-isolation and RT-PCR for the challenging infectious bronchitis virus (IBV) variant 02 were conducted thereafter. The results showed that the Poulvac E. coli at one-day old chicks in the presence of co-infection with virulent E. coli and IBV variant 02 provides better body weight gain at 35 days than the other groups. The challenge with IBV variant 02 alone in non-vaccinated birds doesn't give any mortality; this indicated that the severity of IBV variant 02 increased by the presence of co-infection with Avian Pathogenic E. coli (APEc). The mortality percentage associated with both E. coli and IBV variant 02 infections in the none vaccinated group by Poulvac E. coli was 25% while this percentage was 10% of the vaccinated group. The Poulvac E. coli is not negatively affecting the immune response against different concurrent viral vaccines like Infectious bursal disease (IBD), and moreover, it improves the immune response against some others like Newcastle disease virus (NDV), Avian Influenza (AI) H5 and IBV.

Endopyelotomy versus redo pyeoloplasty for management of failed pyeloplasty in children: A single center experience.

PURPOSE: We compared endopyelotomy to redo pyeloplasty for the treatment of failed pyeloplasty in children to identify factors that may have an impact on outcome and favor one procedure over the other. METHODS: Of 43 patients with recurrent UPJO, EP was performed in 27 and RP was performed in 16. Age, gender, side, presentation of secondary UPJO, hospital stay, complications and success rates were compared. Success was defined as radiographic relief of obstruction as determined by ultrasound or diuretic renography at latest follow-up. RESULTS: Mean (Range) patient age was 7.2 years (range 6 months to 17 years) in EP (group 1) while 7.4 (range 6 months to 17 years) in RP (group 2). EP technique consisted of retrograde cold-knife in 17 patients, retrograde holmium laser in 8 and antegrade cold-knife in 2. RP was performed in 16 patients. All the patients with failed EP had a stricture greater than 15 mm. Mean length of the narrowed ureteral segment was 17.8 mm in the failed EP group vs 10 mm in the successful group (p < 0.001). Mean Hospital stay was 1 day for the EP group and 5 days for the RP group (p < 0.001). Mean follow-up was 17 months (range 12 to 43) after EP and 21 months (12 to 51) after RP. There was no statistical significance between both groups regarding the postoperative degree of hydronephrosis, parenchymal thickness, split renal functions and renal drainage. The overall success was (86%); the success was nonsignificantly higher in RP (93.8%) vs (81.5%) in EP. CONCLUSION: In selected children, retrograde endopyelotomy is safe and may give comparable short-term outcomes as open redo pyeloplasty for correction of secondary UPJO after failed pyeloplasty. Narrowed ureteral segment greater than 15 mm and preoperative grade 4 hydronephrosis were factors significantly associated with a poor outcome after EP. A LEVEL-OF-EVIDENCE RATING FOR CLASSIFYING STUDY QUALITY: LEVEL III Retrospective comparative study.

Avian influenza H5N1 vaccination efficacy in Egyptian backyard poultry.

Raising backyard poultry under low biosecurity conditions is a common practice in Egypt. While vaccination is routinely applied in Egypt in commercial settings to curb the spread of avian influenza viruses, it remains less commonly used in backyard settings. We assessed the immunogenicity and protective efficacy of a H5N1 vaccine based on a contemporary Egyptian clade 2.2.1.2 virus among turkeys, ducks, geese, and chickens raised together in a backyard setting. Results showed that this vaccine elicits an immune response in all tested species reaching up to a hemagglutination inhibition titer of 10 log2 after a booster dose. However, this response varied between species. When challenged, vaccinated birds survived and shed less virus in comparison with unvaccinated birds. However, unvaccinated ducks showed no symptoms of infection and survived the duration of the experiment. Moreover, vaccinated ducks shed more virus as compared to vaccinated birds of other species. Hence, we recommend avoiding mixing various species in the backyards of Egypt. Our data indicates that vaccination can be effective in the backyard setting in Egypt, although planning should consider the species covered.

Molecular characterization of the capsular antigens of Pasteurella multocida isolates using multiplex PCR.

The use of molecular techniques for detection and characterization of the Pasteurella multocida is very important for rapid and specific detection and characterization of the organism. During the period from 15th February, 2014 to 15th April, 2015, 425 nasopharyngeal swabs and 175 lung and spleen samples were collected and examined by conventional methods, 80 strains (18.82%) of P. multocida were isolated from the calves, sheep and goat with respiratory manifestation. Meanwhile, 77 strains (44%) were isolated from emergency slaughtered animals. All the recovered strains were positive for specific PCR for detection of P. multocida strains previously identified as P. multocida by standard microbiological techniques. Multiplex PCR for molecular typing of the capsular antigens of the recovered P. multocida revealed positive amplification of 1044 bp fragments specific to the capsular antigen type A with 105 strains (66.88%), and amplification 511 bp fragments of the capsular antigen type E with 52 strain (33.12%) and absence of B, D and F antigens. Multiplex PCR for molecular typing of the capsular antigens of P. multocida can be used as a simple, sensitive, rapid, reliable technique instead of the serological techniques for identification of the capsular antigens of P. multocida.

Management of lower ureteric stones: a prospective study.

OBJECTIVE: To discuss the current concepts in lower ureteric stone management. MATERIAL AND METHODS: Between October 2008 and November 2010, 190 patients of both sexes and of different age groups with lower ureteric stones, underwent in situ extracorporeal shock wave lithotripsy (ESWL) (48 cases), ureterorenoscopy (URS) (120 cases) and open stone surgery (OSS) (22 cases). The patients' clinical and radiological findings, as well as stone characteristics, were reviewed and correlated with the stone-free status. RESULTS: In the ESWL group, the operative time was 43.13 +22.5 min; the average number of sessions/patients was 1.5 sessions; the average number of SW/patients was 4500 SW/patients; the average energy was 16.5 kV; the average stone burden was 7.8/mm; the overall stone-free rate was 75% (36/48); and the average radiation exposure time was 3.5 min. In the URS group, the operative time was 49.21 +16.09 min; the average stone burden was 10.81mm; the overall stone-free rate was 97.5% (117/120); the average hospital stay was 3.99 days; and the average radiation exposure time was 0.75 min. In the OSS group, the operative time was 112.38 +37.1 min; the overall stone-free rate was 100% (22/22); and the average hospital stay was 9.74 days. CONCLUSION: In the management of patients with lower ureteral stones, URS, SWL and OSS were considered acceptable treatment options. This recommendation was based on the stone-free results, morbidity and retreatment rates for each therapy.

Antimicrobial susceptibility and molecular typing of multiple Chlamydiaceae species isolated from genital infection of women in Egypt.

This study investigated the existence of vaginal Chlamydia infection and the prevalence of the disease in symptomatic gynecologically diseased women in Egypt. In addition, the antibiotics penicillin, tetracycline, and erythromycin were evaluated for their in vitro antichlamydial activity of the isolated strains. Vaginal swabs (n=160) were collected from females gynecologically diseased using cotton swabs. Samples were tested for Chlamydia by Vero cells tissue culture, chicken embryo, Gimenez staining, direct fluorescein-conjugated monoclonal antibody staining, and immunoperoxidase. Polymerase chain reaction (PCR) analyses conducted for the presence of chlamydial DNA was used to detect its specific DNA by the omp2 gene. PCR analyses conducted for the presence of chlamydial DNA revealed that 112/160 (70%) were positive for Chlamydiaceae. The specific DNA defined by the omp2 gene identified them as Chlamydia trachomatis (17/112, 15.2%), Chlamydophila psittaci (56/112, 50.0%), and Chlamydophila abortus (40/112, 35.7%). The antibiotics penicillin, tetracycline, and erythromycin at different concentrations were effective in inactivating the viability of Chlamydiaceae isolates.

Laparoscopic approach significantly reduces surgical site infections after colorectal surgery: data from national surgical quality improvement program.

BACKGROUND: The goal of this study was to compare surgical site infection (SSI) rates between laparoscopic (LAP) and open colorectal surgery using the National Surgical Quality Improvement Program (NSQIP) database. STUDY DESIGN: We identified patients included in the NSQIP database from 2006 to 2007 who underwent LAP and open colorectal surgery. SSI rates were compared for the 2 groups. Association between patient demographics, diagnosis, type of procedure, comorbidities, laboratory values, intraoperative factors, and SSI within 30 days of surgery, were determined using a logistic regression analysis. RESULTS: Among 10,979 patients undergoing colorectal surgery (LAP 31.1%, open 68.9%), the SSI rate was 14.0% (9.5% LAP vs 16.1% open, p < 0.001). LAP patients were younger (p < 0.001), with lower American Society of Anesthesiologists (ASA) scores (p < 0.001) and comorbidities (p = 0.001) involving benign and inflammatory conditions rather than malignancy (p < 0.001), but operative time was greater (p = 0.001). On multivariate analysis age, ASA > or = 3, smoking, diabetes, operative time >180 minutes, appendicitis or diverticulitis, and regional enteritis diseases were found to be significantly associated with high SSI; the LAP approach was associated with a reduced SSI rate. CONCLUSIONS: The LAP approach is independently associated with a reduced SSI when compared with open surgery and should, when feasible, be considered for colon and rectal conditions.