Nkechi V. Offiah

Microbial health risk posed by table eggs in Trinidad

A survey of the microbial quality of table eggs sold in Trinidad was conducted. For 23 poultry layer farms each visited twice approximately 1 month apart, 25 pooled eggs constituted a composite sample, for 14 shopping malls each visited twice approximately 1 month apart, six pooled eggs made a composite sample and for a total of 102 other retailers across the country each visited once over a 4-month period, six pooled eggs constituted a composite sample. Swabs of egg shells and egg content were tested for selected bacteria. Twenty-four (13.0%), 68 (37.0%), and two (1.1%) of a total of 184 composite eggs (shells, egg content or both) sampled were positive for Salmonella, Escherichia coli, and Campylobacter respectively. All 184 samples tested were negative for Listeria spp. Salmonella was recovered from seven (3.8%) egg shell samples only compared with 14 (7.6%) egg content samples only positive for the pathogen. Fifty-two (28.3%) egg shell samples and seven (3.8%) egg content samples were positive for E. coli. Both isolates of Campylobacter coli originated from egg contents. Of a total of 24 composite egg samples positive for Salmonella, eight different serotypes of Salmonella were isolated from a total of 24 Salmonella-positive composite eggs of which S. Enteritidis was the most prevalent, 58.3% (14/24). Salmonella Georgia was isolated for the first time in Trinidad. Failure to properly handle or heat table eggs sold in Trinidad poses a potential health hazard to consumers because of their poor microbial quality.

Ethnobotanical survey of medicinal plants used in the treatment of animal diarrhoea in Plateau State, Nigeria.

BackgroundThe use of medicinal plants in the treatment of diseases has generated renewed interest in recent times, as herbal preparations are increasingly being used in both human and animal healthcare systems. Diarrhoea is one of the common clinical signs of gastrointestinal disorders caused by both infectious and non-infectious agents and an important livestock debilitating condition. Plateau State is rich in savannah and forest vegetations and home to a vast collection of plants upheld in folklore as having useful medicinal applications. There is however scarcity of documented information on the medicinal plants used in the treatment of animal diarrhoea in the state, thus the need for this survey. Ten (10) out of 17 Local Government Areas (LGAs), spread across the three senatorial zones were selected. Farmers were interviewed using well structured, open-ended questionnaire and guided dialogue techniques between October and December 2010. Medicinal plants reported to be effective in diarrhoea management were collected using the guided field-walk method for identification and authentication.ResultsA total of 248 questionnaires were completed, out of which 207 respondents (83.47%) acknowledged the use of herbs in diarrhoea management, while 41 (16.53%) do not use herbs or apply other traditional methods in the treatment of diarrhoea in their animals. Medicinal plants cited as beneficial in the treatment of animal diarrhoea numbered 132, from which 57(43.18%) were scientifically identified and classified into 25 plant families with the families Fabaceae (21%) and Combretaceae (14.04%) having the highest occurrence. The plant parts mostly used in antidiarrhoeal herbal preparations are the leaves (43.86%) followed by the stem bark (29.82%). The herbal preparations are usually administered orally.ConclusionRural communities in Plateau State are a rich source of information on medicinal plants as revealed in this survey. There is need to scientifically ascertain the authenticity of the claimed antidiarrhoeal properties of these plants and perhaps develop more readily available alternatives in the treatment of diarrhoea.

Prevalence of antimicrobial residues in table eggs in Trinidad.

The prevalence of antimicrobial residues in pooled table eggs from layer farms, shopping malls, and supermarkets in Trinidad was determined. A total of 23 layer farms and 14 shopping malls were sampled twice, 1 month apart, whereas 102 supermarkets were each sampled once. For each farm, 25 eggs were randomly collected and pooled to constitute a composite sample, whereas six eggs from each farm source available at sale outlets were randomly sampled from malls and supermarkets to constitute a composite sample. Questionnaires were administered at the farms to determine the occurrence of risk factors for contamination of antimicrobial residues in eggs and at sale outlets to determine storage conditions. The Charm II test was used to qualitatively detect antimicrobial residues (beta-lactams, macrolides, sulfonamides, and tetracyclines). Of 46 composite eggs tested from farms, 3 (6.5%) were contaminated with residues compared with 5 (16.1%) of 31 and 16 (15.0%) of 107 mall and supermarket eggs, respectively, but the difference was not statistically significant (P > 0.05). The residues detected were as follows: sulfonamides, 12 (6.5%) of 184; macrolides, 7 (3.8%) of 184; tetracycline, 5 (2.7%) of 184; and beta-lactam, 0 (0.0%) of 184. The difference was statistically significant (P < 0.05). The use of medicated feeds on farm, claim of adherence to the antimicrobial withdrawal period, and temperature of egg storage did not significantly (P > 0.05) affect the prevalence of residues in eggs. It was concluded that the presence of antimicrobial residues, particularly sulfonamides, in table eggs could be of public health significance to the consumer.

Occurrence of aflatoxins in peanuts, milk, and animal feed in Trinidad.

The prevalence of aflatoxin B1 (AFB1) in 186 peanut products (140 peanuts, 32 peanut butter, and 14 nut cakes) from supermarkets, road vendors, and sale outlets, and 40 feed samples from dairy farmers was determined using the radioimmunoassay method (Charm II) test for aflatoxins. The frequency of aflatoxin M1 (AFM1) was also determined in 175 raw milk samples from milk collection centers and 37 pasteurized milk samples obtained from supermarkets and sale outlets. Overall, from a total of 438 samples tested, 18 (4.1%) were positive for aflatoxin comprising 5 (2.2%) of 226 peanut products and feeds positive for AFB1, and 13 (6.1%) of 212 milk samples positive for AFM1. All 186 peanuts and peanut products were negative (0.0%) for AFB1 while 5 (7.4%) of 40 dairy feed samples were positive. Of the 175 raw milk samples tested, 13 (7.4%) were contaminated with AFM1 while all pasteurized milk samples were negative. The detection of AFB1 in feed and AFM1 in milk is of public health importance considering the practice of raw milk consumption by the farmers and their families in the country.

Abdominal obesity in type 2 diabetic patients visiting primary healthcare clinics in Trinidad, West Indies

Objective - To compare the blood pressure and metabolic parameters of type 2 diabetic patients with high waist circumference (WC) with those of type 2 diabetic patients with normal WC. Design - After 10-14 h overnight fasting, weight, height, waist and hip circumferences and blood pressure were measured, and blood samples taken for glucose, glycated haemoglobin, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol and insulin determinations. Insulin resistance was calculated using the homeostatic model assessment (HOMA) method, while high WC was considered as WC > 102 cm and 89 cm for males and females, respectively. Setting - Two primary care clinics in Trinidad, West Indies. Patients - 190 confirmed type 2 diabetic patients with mean duration of 9.2 years were studied. Results - About 75% and 17% of female and male patients, respectively, had high WC. Although blood pressure and lipid levels did not differ (p > 0.05) between patients with high and normal WC, the former group of patients had significantly higher mean levels of basal insulin and insulin resistance in each gender group (p < 0.001). However, female patients had an overall higher prevalence rate of hypercholesterolaemia (75% vs 52%) and higher LDL-cholesterol (84% vs 68%) than male patients (p < 0.001). Conclusions - Although there was similarity in the control of blood pressure and metabolic parameters irrespective of WC, patients with high WC might be at a comparatively higher risk of cardiovascular disease owing to greater basal insulin resistance. Early detection and treatment of abdominal obesity should therefore be encouraged in the primary healthcare setting.

Cardiovascular Risk in Obese and Nonobese Patients with Type 2 Diabetes in the West Indies

OBJECTIVE To evaluate the impact of obesity on glycemic control and the risk of progressing to cardiovascular disease (CVD) in obese and nonobese type 2 diabetic patients in primary care settings. METHODS One hundred and ninety patients (64 men, 126 women) with type 2 diabetes (mean duration 9.2 years) were studied after an overnight fast. Weight, height, waist and hip circumferences and blood pressure were measured and blood samples were taken for glucose, glycated hemoglobin (HbA(1c)), total cholesterol, triglyceride, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and creatinine determinations. RESULTS About 85% of the patients had HbA(1c) levels > 7.0%, and 48% had a diastolic blood pressure (BP) >83 mm Hg, while 40% had a total cholesterol/HDL-cholesterol ratio greater than 6. The prevalence rates of hypercholesterolemia, hypertriglyceridemia, high BP and ratios of total cholesterol to HDL-cholesterol between the obese and nonobese patients were similar irrespective of sex (p > 0.05). Multiple linear regression analysis confirmed that ethnicity, sex, age and duration of diabetes had significant impact on the cardiovascular risk in this population. CONCLUSION Both obese and nonobese diabetic patients had poor glycemic control and their risk of CVD was not independent of age, sex, ethnicity and duration of diabetes. We suggest strict metabolic control and improved diabetes health education at the primary care level.

Antifertility Properties of the Hot Aqueous Extract of Guaiacum officinale

The hot aqueous extract of the aerial part (leaves, flowers, fruits and tender branches) of Guaiacum officinale Linn (Zygophyllaceae) was evaluated for antifertility effects. In over 50 trials, the extract caused abortion in mice and rats. The extract caused abortion in the second and third trimesters only. The abortion ED 50 in pregnant mice was 320.50 ± 20.00 mg/kg, while the LD 50 was 1280.13 ± 9.03 mg/kg. At a dose of 480.75 mg/kg, the extract significantly reduced the litter size in mice when given during the first trimester (day 5) of pregnancy. The extract did not produce contraction of either the primed or gravid uteri derived from these animals. Similarly, the extract did not cause contraction of the guineapig ileum. However, it potentiated the contractions caused by acetylcholine. These findings tend to support the utility of the hot water extract of Guaiacum officinale in folk medicine for antifertility purposes.

The importance of diabetes health education in developing countries.

Measurement of HbA1c remains the cornerstone of management of glycaemic control in people with diabetes, being the major factor in assessing an individual’s risk of microvascular complications. The need for standardization of measurements, particularly to allow comparison of individual values with the Diabetes Control and Complications (DCCT) and the UK Prospective Diabetes Study (UKPDS) results, and for service audit, benchmarking and quality assurance, remains a crucial issue of world-wide interest and importance. In the UK in 2000, experts agreed that within the limits of knowledge and technical expertise available at the time, as a first step towards standardization, harmonization of results could be achieved by using HbA1c assays which were DCCTtraceable and which reported results comparable to DCCT and UKPDS values [1,2]. Methods currently used to measure HbA1c in clinical practice achieve this by using calibration material whose values have been assigned by the US National Glycohemoglobin Standardisation Program (NGSP). Since the publication of this agreement as a Consensus Statement, there has been a significant shift in the UK to DCCT-aligned assays. Information from the external quality assessment schemes confirms that currently around 80% of UK laboratories participating in the scheme use DCCT-aligned methods. Following similar discussions in the USA, under the auspices of the NGSP, a similar shift has occurred: 62% of laboratories report DCCT-traceable results. The UK Consensus Statement recognized that this procedure was a pragmatic first step and that formal standardization required much more work. The NGSP Clinical Advisory Committee met recently to discuss how to move forward. The signatories to this letter were invited to attend as representatives of the UK Consensus Statement Group (S.M.M.), the International Diabetes Federation (P.D.H.), UKPDS central laboratory (S.E.M.) and The International Federation of Clinical Chemistry (W.G.J.). The International Federation of Clinical Chemistry (IFCC) has developed a specific HbA1c method which has been accepted internationally as the IFCC official Reference Method. Primary reference materials are currently being investigated in the hope that they could be used world-wide as a standardization tool. Clearly, the development of a valid chemical standard is highly desirable. After initial difficulties, in recent unpublished studies, it has been found that the regression line and line obtained between NGSP values and the IFCC Reference Method are now almost parallel. Results obtained with the IFCC standard are approximately 1.5–2.0% HbA1c lower than with NGSP, as might be expected from non-specific interference measured by the method used in the DCCT. Validation of the IFCC standard material continues. From the end of 2003, an EU Directive on the use of in vitro diagnostic equipment (IVD Directive; Directive 98/9/EC) will require that ‘the traceability of values assigned to calibrators and/or control materials must be assured through available reference measurement procedures and/or available reference materials of a higher order’ (Annex I–Essential Requirements. Part A. General Requirements, Clause 3). However, as the IFCC standard material is still under investigation, it would seem precipitous to recommend universal adoption of the IFCC calibration to achieve standardization of HbA1c results at the moment. Long-term evaluation of the stability of the IFCC reference method relationship to the DCCT/UKPDS assay must be ensured if clinicians are to have confidence in it. In addition, whilst it is vitally important in the future to have a chemically specific standardization anchor for HbA1c measurement, it remains equally important that expression of results remains linked to DCCT/UKPDS values. We would therefore strongly endorse for the time being the procedure for HbA1c harmonization described in the 2000 Consensus Statement. The position will be re-evaluated next year by the NGSP and the International Diabetes Federation.

Development of impaired glucose tolerance and diabetes in follow-up offspring of Caribbean patients with type 2 diabetes: analysis of 5-year follow-up study.

Abstract Several reports agreed that the antecedent markers for developing diabetes in offspring of type 2 diabetic patients involve excess body weight and insulin resistance. This study examined the pattern of changes in anthropometric and biochemical risk factors for developing diabetes in a follow-up offspring of Caribbean type 2 diabetic patients. Results of 46 offspring of type 2 diabetic patients who had received one-to-one individualized diet and exercise counseling for 5 years in our laboratory were analyzed. Changes in anthropometric (body weight, waist circumference) and biochemical (insulin, glucose, lipids, HOMA-insulin resistance, HOMA-percent β-cell function) parameters over the 5-year period were analyzed using ANOVA tests. Of the 46 offspring, 10.9 and 2.2%, respectively, developed impaired glucose tolerance (IGT) and diabetes. Over the years, IGT offspring had a significant step-wise increase and decrease in fasting and 2-h postprandial plasma glucose levels (P < 0.05) and percent B-cell function (P < 0.001), respectively. Again, a non-significant step-wise increase was observed in body mass index, waist circumference and HOMA-insulin resistance levels (P > 0.05). While we await the results of medication-based intervention studies in different populations, exercise and diet counseling will remain the only available lifestyle intervention strategy for slowing IGT progression to diabetes.