Review of cases of nosocomial XXXX in Nigeria: the high price of poor medical practice.

@entity1 @entity3082 @entity26210 @entity26211 @entity204
OBJECTIVE: To investigate two hospital outbreaks of @entity26210 in southern central Nigeria. SETTING: Hospitals and clinics in urban and rural areas of Imo State, Nigeria. DESIGN: Medical records were reviewed in hospitals and clinics in both areas. @entity1 with presumed and laboratory confirmed @entity26210 were identified and contracts traced. Hospital staff, @entity1 , and local residents were questioned, records were carefully reviewed, and serum samples were taken. Serum samples were assayed for antibody specific to @entity26211 , and isolates of @entity26211 were obtained. RESULTS: Among 34 @entity1 with @entity26210 , including 20 @entity1 , six nurses, two surgeons, one physician, and the son of a @entity1 , there were 22 @entity204 (65% fatality rate). Eleven cases were laboratory confirmed, five by isolation of virus. Most @entity1 had been exposed in hospitals (attack rate in @entity1 in one hospital 55%). Both outbreak hospitals were inadequately equipped and staffed, with poor medical practice. Compelling, indirect evidence revealed that parenteral drug rounds with sharing of syringes, conducted by minimally educated and supervised staff, fuelled the @entity3082 among @entity1 . Staff were subsequently infected during emergency surgery and while caring for nosocomially infected @entity1 . CONCLUSION: This outbreak illustrates the high price exacted by the practice of modern medicine, particularly use of parenteral injections and surgery, without due attention to good medical practice. High priority must be given to education of medical staff in developing countries and to guidelines for safe operation of clinics and hospitals. Failure to do so will have far reaching, costly, and ultimately devastating consequences.
