Search results for: dental hygiene

Authors: R. O. Rominu, C. Sinescu, D.M. Pop, M. Hughes, A. Bradu, M. Rominu, A. Gh. Podoleanu

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Bonding has become a routine procedure in several dental specialties – from prosthodontics to conservative dentistry and even orthodontics. In many of these fields it is important to be able to investigate the bonded interfaces to assess their quality. All currently employed investigative methods are invasive, meaning that samples are destroyed in the testing procedure and cannot be used again. We have investigated the interface between human enamel and bonded ceramic brackets non-invasively, introducing a combination of new investigative methods – optical coherence tomography (OCT), fluorescence OCT and confocal microscopy (CM). Brackets were conventionally bonded on conditioned buccal surfaces of teeth. The bonding was assessed using these methods. Three dimensional reconstructions of the detected material defects were developed using manual and semi-automatic segmentation. The results clearly prove that OCT, fluorescence OCT and CM are useful in orthodontic bonding investigations.

Keywords: Optical coherence tomography, Confocal Microscopy, Orthodontic Bonding.

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Authors: L. B. Gboeloh, K. Elele

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Gastrointestinal parasitic infections are common health problems in sub-Saharan Africa. A cross- sectional study was carried out to determine the prevalence of gastrointestinal parasites among workers in major abattoirs in Port Harcourt, Nigeria. These abattoirs are located in Trans-Amadi, Rumuodumaya, Mile III and Easter-by-Pass. Formol-ether concentration technique was used to isolate the ova and cysts from faecal samples. Out of 201 workers (herdsmen, butchers, and cleaners) investigated for the presence of these parasites, 89 (44.2%) were infected with one or more parasites. The prevalence of the parasites among herdsmen and cleaners was significantly (P<0.05) higher. However, there was no significant (P>0.05) difference in the prevalence of gastrointestinal parasites in relation to age. Parasites identified included Ascaris lumbricoide (33.3%), tapeworm (4.97%), Entamoeba histolytica (5.47%), hookworms (13.9%), Trichuris trichiura (9.95%), Gardia lamblia (3.48%), and Schistosoma mansoni (1.9%). The frequency of A. lumbricoide was significantly (P<0.05) higher than other parasites. Many workers (65.2%) had single infection than double (23.6%) and triple infection (11.2%). Sanitary improvements, increased level of personal hygiene, routine surveillance by public health practitioners and veterinary experts as well as hygienic operation using modern technologies to process meat at these abattoirs will go a long way to control occupational gastrointestinal parasites among workers.

Keywords: Abattoirs, Gastrointestinal parasites, Port Harcourt, Workers.

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Authors: Y. N. Phang, E. F. Loh

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The zero inflated models are usually used in modeling count data with excess zeros where the existence of the excess zeros could be structural zeros or zeros which occur by chance. These type of data are commonly found in various disciplines such as finance, insurance, biomedical, econometrical, ecology, and health sciences which involve sex and health dental epidemiology. The most popular zero inflated models used by many researchers are zero inflated Poisson and zero inflated negative binomial models. In addition, zero inflated generalized Poisson and zero inflated double Poisson models are also discussed and found in some literature. Recently zero inflated inverse trinomial model and zero inflated strict arcsine models are advocated and proven to serve as alternative models in modeling overdispersed count data caused by excessive zeros and unobserved heterogeneity. The purpose of this paper is to review some related literature and provide a variety of examples from different disciplines in the application of zero inflated models. Different model selection methods used in model comparison are discussed.

Keywords: Overdispersed count data, model selection methods, likelihood ratio, AIC, BIC.

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Authors: Benjamin Osei-Tutu

Abstract:

Food contaminated with biological, chemical and physical hazards usually leads to foodborne illnesses which in turn increase the disease burden of developing and developed economies. Restaurants play a key role in the food service industry and violations in application of standardized food safety management systems in these establishments have been associated with foodborne disease outbreaks. This study was undertaken to assess the level of compliance to the Code of practice that was developed and implemented after conducting needs assessment of the food safety management systems employed by the Food Service Establishments in Ghana. Data on pre-licence inspections were reviewed to assess the compliance of the Food Service Establishments. During the period under review (2012-2016), 74.52% of the food service facilities in the hospitality industry were in compliance with the FDA’s code of practice. Main violations observed during the study bordered on facility layout and fabrication (61.8%) and this is because these facilities may not have been built for use as a food service establishment. Another fact that came to the fore was that the redesigning of the facilities to bring them into compliance required capital intensive investments, which some establishments are not prepared for. Other challenges faced by the industry regarded issues on records and documentations, personnel facilities and hygiene, raw materials acquisition, storage and control, and cold storage.

Keywords: Assessment, Accra, food safety management systems, restaurants, hotel.

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Authors: J. Franková, V. Pivodová, F. Růžička, J. Ulrichová

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An implant elicits a biological response in the surrounding tissue which determines the acceptance and long-term function of the implant. Dental implants have become one of the main therapy methods in clinic after teeth lose. A successful implant is in contact with bone and soft tissue represent by fibroblasts. In our study we focused on the interaction between six different chemically and physically modified titanium implants (Tis-MALP, Tis-O, Tis- OA, Tis-OPAAE, Tis-OZ, Tis-OPAE) with alveolar fibroblasts as well as with five type of microorganisms (S. epidermis, S.mutans, S. gordonii, S. intermedius, C.albicans). The analysis of microorganism adhesion was determined by CFU (colony forming unite) and biofilm formation. The presence of α3β1 and vinculin expression on alveolar fibroblasts was demonstrated using phospho specific cell based ELISA (PACE). Alveolar fibroblasts have the highest expression of these proteins on Tis-OPAAE and Tis-OPAE. It corresponds with results from bacterial adhesion and biofilm formation and it was related to the lowest production of collagen I by alveolar fibroblasts on Tis-OPAAE titanium disc.

Keywords: titanium disc, alveolar fibroblasts, microorganisms, adhesion

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Authors: Siripen Yiamjanya, Kevin Wongleedee

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Food safety is an important concern for holiday makers in foreign and unfamiliar tourist destinations. In fact, risk from food in these tourist destinations has an influence on tourist perception. This risk can potentially affect physical health and lead to an inability to pursue planned activities. The objective of this paper was to compare foreign tourists- demographics including gender, age and education level, with the level of perceived risk towards food safety. A total of 222 foreign tourists during their stay at Khao San Road in Bangkok were used as the sample. Independent- samples ttest, analysis of variance, and Least Significant Difference or LSD post hoc test were utilized. The findings revealed that there were few demographic differences in level of perceived risk among the foreign tourists. The post hoc test indicated a significant difference among the old and the young tourists, and between the higher and lower level of education. Ranks of tourists- perceived risk towards food safety unveiled some interesting results. Tourists- perceived risk of food safety in established restaurants can be ranked as i) cleanliness of dining utensils, ii) sanitation of food preparation area, and iii) cleanliness of food seasoning and ingredients. Whereas, the tourists- perceived risk of food safety in street food and drink can be ranked as i) cleanliness of stalls and pushcarts, ii) cleanliness of food sold, and iii) personal hygiene of street food hawkers or vendors.

Keywords: Food Safety, Foreign Tourists, Perceived Risk, Khao San Road.

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Authors: A. Alhazza, B. Alnaser

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Orthodontic restorative materials are widely used for the direct restoration of teeth or for cosmetic dentistry purposes. These materials have helped to solve many dental problems, providing healthy and beautiful smiles for many patients. In this study, we aimed to investigate whether the pH value has an effect on the surface structure of a nanohybrid composite material. Five different types of highly consumed beverages were selected to examine their effect on the surface structure of the nanohybrid composite material. The beverages had different pH values in the range of 3–6, i.e., they were all acidic. The material was investigated under the hardest conditions of surface exposure to the drinks by immersing the material for a long period. The specimens were examined using scanning electron microscopy (SEM) at different magnifications to investigate the effect of these beverages on the morphology of the nanohybrid composite material discs. All specimens showed an effect including pores, cracks, protrusions, and surface roughness as a result of the beverages. The degree of effect differed from one experimental group to another, but there was no relationship between the pH (acidity) value and the degree of effect on the surface structure of the specimens.

Keywords: Acidity, beverage, SEM, dentistry.

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Authors: Lara A. Alshawawreh, R. Sean Smith, John B. Wood

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This study focuses on the sheltering response in the Middle East, specifically through reviewing two Syrian refugee camps in Jordan, involving Zaatari and Azraq. Zaatari camp involved the rapid deployment of tents and shelters over a very short period of time and Azraq was purpose built and pre-planned over a longer period. At present, both camps collectively host more than 133,000 occupants. Field visits were taken to both camps and the main issues and problems in the sheltering response were highlighted through focus group discussions with camp occupants and inspection of shelter habitats. This provided both subjective and objective research data sources. While every case has its own significance and deployment to meet humanitarian needs, there are some common requirements irrespective of geographical region. The results suggest that there is a gap in the suitability of the required habitat needs and what has been provided. It is recommended that the global international response and support could be improved in relation to the habitat form, construction type, layout, function and critically the cultural aspects. Services, health and hygiene are key elements to the shelter habitat provision. The study also identified the amendments to shelters undertaken by the beneficiaries providing insight into their key main requirements. The outcomes from this study could provide an important learning opportunity to develop improved habitat response for future shelters.

Keywords: Culture, post-disaster, refugees, shelters.

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Authors: C. Sinescu, M. Negrutiu, R. Negru, M. Romînu, A.G. Podoleanu

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The fixed partial dentures are mainly used in the frontal part of the dental arch because of their great esthetics. There are several factors that are associated with the stress state created in ceramic restorations, including: thickness of ceramic layers, mechanical properties of the materials, elastic modulus of the supporting substrate material, direction, magnitude and frequency of applied load, size and location of occlusal contact areas, residual stresses induced by processing or pores, restoration-cement interfacial defects and environmental defects. The purpose of this study is to evaluate the capability of Polarization Sensitive Optical Coherence Tomography (PSOCT) in detection and analysis of possible material defects in metal-ceramic and integral ceramic fixed partial dentures. As a conclusion, it is important to have a non invasive method to investigate fixed partial prostheses before their insertion in the oral cavity in order to satisfy the high stress requirements and the esthetic function.

Keywords: Ceramic Fixed Partial Dentures, Material Defects, Polarization Sensitive Optical Coherence Tomography, Numerical Simulation

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Authors: J. Palán, M. Zemko

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COMTES FHT has been active in a field of research and development of high-strength wires for quite some time. The main material was pure titanium. The primary goal of this effort is to develop a continuous production process for ultrafine and nanostructured materials with the aid of severe plastic deformation (SPD). This article outlines mechanical and microstructural properties of the materials and the options available for testing the components made of these materials. Ti Grade 2 and Grade 4 wires are the key products of interest. Ti Grade 2 with ultrafine to nano-sized grain shows ultimate strength of up to 1050 MPa. Ti Grade 4 reaches ultimate strengths of up to 1250 MPa. These values are twice or three times as higher as those found in the unprocessed material. For those fields of medicine where implantable metallic materials are used, bulk ultrafine to nanostructured titanium is available. It is manufactured by SPD techniques. These processes leave the chemical properties of the initial material unchanged but markedly improve its final mechanical properties, in particular, the strength. Ultrafine to nanostructured titanium retains all the significant and, from the biological viewpoint, desirable properties that are important for its use in medicine, i.e. those properties which made pure titanium the preferred material also for dental implants.

Keywords: CONFORM SPD, ECAP, titanium, rotary swaging.

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Authors: Sanjay Saraf

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The oral cavity can be the site for early manifestations of mucocutaneous disorders (MD) or the only site for occurrence of these disorders. It can also exhibit oral lesions with simultaneous associated skin lesions. The MD involving the oral mucosa commonly presents with signs such as ulcers, vesicles and bullae. The unique environment of the oral cavity may modify these signs of the disease, thereby making the clinical diagnosis an arduous task. In addition to the unique environment of oral cavity, the overlapping of the signs of various mucocutaneous disorders, also makes the clinical diagnosis more intricate. The aim of this review is to present the oral signs of dermatological disorders having common oral involvement and emphasize their   importance in   early detection of the systemic disorders. The aim is also to highlight the necessity of oral examination by a dermatologist while examining the skin lesions. Prior to the oral examination, it must be imperative for the dermatologists and the dental clinicians to have the knowledge of oral anatomy. It is also important to know the impact of various diseases on oral mucosa, and the characteristic features of various oral mucocutaneous lesions. An initial clinical oral examination is may help in the early diagnosis of the MD. Failure to identify the oral manifestations may reduce the likelihood of early treatment and lead to more serious problems. This paper reviews the oral manifestations of immune mediated dermatological disorders with common oral manifestations.

Keywords: Vesiculobullous lesions, Desquamative gingivitis, Nikolsky’s sign, Erythema.

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Authors: Gouda K. Helal, Marwa I. Shabayek, Heba A. El-Ramly, Heba A. Awida

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The adverse effects of Clindamycin (Clind.) / Ibuprofen (Ibu.) combination on liver, kidney, blood elements and the significances of antioxidants (N-acetylcysteine and Zinc) against these effects were evaluated. The study includes: Group I; control n=30, Group II; patients on Clind.300mg/Ibu.400mg twice daily for a week n=30, Group III; patients on Clind.300mg/Ibu.400mg+Nacetylcysteine 200mg twice daily for a week n=15 and Group IV; patients on Clind.300mg/Ibu.400mg+Zinc50mg twice daily for a week n=15. Serum malondialdehyde (MDA), alanine transferase (ALT), aspartate transferase (AST), γ glutamyl transferase (GGT), creatinine, blood urea nitrogen (BUN) were measured. Applying one way ANOVA followed by Tuckey Kramer post test, Group II showed significant increase in ALT, AST, GGT, BUN and decrease in Hb, RBCs, platelets than Group I. Group III showed significant decrease in ALT, AST, GGT, BUN than Group II. Moreover, Group IV showed significant decrease in ALT, AST, GGT and increase in Hb, RBCs, and platelets than Group II. Conclusively, Adding Zinc or Nacetylcysteine buffer the oxidative stress and improve the therapeutic outcome of Clindamycin/Ibuprofen combination.

Keywords: Clindamycin, Ibuprofen, Adverse effects, Antioxidant, Zinc, N-acetylcysteine.

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Authors: Ilma Robo, Saimir Heta, Nedja Hysi, Vera Ostreni

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Introduction: Marginal gingivitis is a disease with considerable frequency among patients who present routinely for periodontal control and treatment. In fact, this disease may not have alarming symptoms in patients and may go unnoticed by themselves when personal hygiene conditions are optimal. The aim of this study was to collect retrograde data on the prevalence of marginal gingiva in the respective group of patients, evaluated according to specific periodontal diagnostic tools. Materials and methods: The study was conducted in two patient groups. The first group was with 34 patients, during December 2019-January 2020, and the second group was with 64 patients during 2010-2018 (each year in the mentioned monthly period). Bacterial plaque index, hemorrhage index, amount of gingival fluid, presence of xerostomia and candidiasis were recorded in patients. Results: Analysis of the collected data showed that susceptibility to marginal gingivitis shows higher values according to retrograde data, compared to cross-sectional ones. Susceptibility to candidiasis and the occurrence of xerostomia, even in the combination of both pathologies, as risk factors for the occurrence of marginal gingivitis, show higher values ​​according to retrograde data. The female are presented with a reduced bacterial plaque index than the males, but more importantly, this index in the females is also associated with a reduced index of gingival hemorrhage, in contrast to the males. Conclusions: Cross-sectional data show that the prevalence of marginal gingivitis is more reduced, compared to retrograde data, based on the hemorrhage index and the bacterial plaque index together. Changes in production in the amount of gingival fluid show a higher prevalence of marginal gingivitis in cross-sectional data than in retrograde data; this is based on the sophistication of the way data are recorded, which evolves over time and also based on professional sensitivity to this phenomenon.

Keywords: Marginal gingivitis, cross-sectional, retrograde, prevalence.

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Authors: Saimir Heta, Ilma Robo, Vera Ostreni, Glorja Demika, Sonila Kapaj

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Suturing, as a procedure of joining the lips of the lembo or wound, is important at the beginning of the healing process. This procedure helps to pass the healing process from the procedure per secundam to the stages of healing per primam, thus logically reducing the healing time of the wound. The purpose of this article is to publish some data on the clinical characteristics of periodontal suturing, presenting the advantages and disadvantages of different types of suture threads. The article is a mini-review type of articles selected from the application of keywords on the PubMed page. The number of articles extracted from this article publication page is in accordance with the 10-year publication time limit. The element that remains in the individual selection of the dentist applying the suture is the selection of the suture material. At a moment when some types of sutures are offered for use, some elements should be considered in the selection of the suture depending on the constituent material, the cross-section of the suture elements, and whether it collects bacteria in the "pits" created by the material. The presence of bacteria is a source of infection and possible delay in the healing of the sutured wound. The marketing of suture types offers a variety of materials, from which the selection of the most suitable suture type for specific application cases is a personal indication of the dental surgeon based on professional experiences and knowledge in this field.

Keywords: Suture, suture material, types of sutures, clinical application.

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Authors: Raviporn Madarasmi, Anjalee Vacharaksa, Pravej Serichetaphongse

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The host response in peri-implant tissue may differ from that in periodontal tissue in a healthy individual. The purpose of this study is to investigate the expression of inflammatory cytokines in peri-implant crevicular fluid (PICF) from single implant with different abutment types in comparison to healthy periodontal tissue. 19 participants with healthy implants and teeth were recruited according to inclusion and exclusion criteria. PICF and gingival crevicular fluid (GCF) was collected using sterile paper points. The expression level of inflammatory cytokines including IL-1α, IL-1β, TNF-α, IFN-γ, IL-6, and IL-8 was assessed using enzyme-linked immunosorbent assay (ELISA). Paired t test was used to compare the expression levels of inflammatory cytokines around natural teeth and peri-implant in PICF and GCF of the same individual. The Independent t-test was used to compare the expression levels of inflammatory cytokines in PICF from titanium and UCLA abutment. Expression of IL-6, TNF-α, and IFN-γ in PICF was not statistically different from GCF among titanium and UCLA abutment group. However, the level of IL-1α in the PICF from the implants with UCLA abutment was significantly higher than GCF (P=0.030). In addition, the level of IL-1β in PICF from the implants with titanium abutment was significantly higher than GCF (P=0.032). When different abutment types was compared, IL-8 expression in PICF from implants with UCLA abutment was significantly higher than titanium abutment (P=0.003).

Keywords: Abutment, dental implant, gingival crevicular fluid and peri-implant crevicular fluid.

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Authors: Ilma Robo, Saimir Heta, Greta Plaka, Vera Ostreni

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Purpose: Drug gingival hyperplasia is an uncommon pathology encountered during routine work in dental units. The purpose of this paper is to present the clinical appearance of gingival hyperplasia caused by medications. There are already three classes of medications that cause hyperplasia and based on data from the literature, the clinical cases encountered and included in this study have been compared. Materials and Methods: The study was conducted in a total of 311 patients, out of which 182 patients were included in our study, meeting the inclusion criteria. After each patient's history was recorded and it was found that patients were in their knowledge of chronic illness, undergoing treatment of gingivitis hypertrophic drugs was performed with a clinical examination of oral cavity and assessment by vertical and horizontal evaluation according to the periodontal indexes. Results: Of the data collected during the study, it was observed that 97% of patients with gingival hyperplasia are treated with nifedipine. 84% of patients treated with selected medicines and gingival hyperplasia in the oral cavity has been exposed at time period for more than 1 year and 1 month. According to the GOI, in the first rank of this index are about 21% of patients, in the second rank are 52%, in the third rank are 24% and in the fourth grade are 3%. According to the horizontal growth index of gingival hyperplasia, grade 1 included about 61% of patients and grade 2 included about 39% of patients with gingival hyperplasia. Bacterial index divides patients by degrees: grading 0 - 8.2%, grading 1 - 32.4%, grading 2 - 14% and grading 3 - 45.1%. Conclusions: The highest percentage of gingival hyperplasia caused by drugs is due to dosing of nifedipine for a duration of dosing and application for systemic healing for more than 1 year.

Keywords: Drug gingival hyperplasia, horizontal growth index, vertical growth index.

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Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira

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Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Keywords: Absenteeism, health/safety integration, work accommodation management, total worker health.

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Authors: W. Thepsuwan, N. Monmaturapoj

Abstract:

Calcium phosphate cement (CPC) is one of the most attractive bioceramics due to its moldable and shape ability to fill complicated bony cavities or small dental defect positions. In this study, CPC was produced by using mixture of tetracalcium phosphate (TTCP, Ca4O(PO4)2) and dicalcium phosphate anhydrous (DCPA, CaHPO4) in equimolar ratio (1/1) with aqueous solutions of acetic acid (C2H4O2) and disodium hydrogen phosphate dehydrate (Na2HPO4.2H2O) in combination with sodium alginate in order to improve theirs moldable characteristic. The concentration of the aqueous solutions and sodium alginate were varied to investigate the effect of different aqueous solutions and alginate on properties of the cements. The cement paste was prepared by mixing cement powder (P) with aqueous solution (L) in a P/L ratio of 1.0g/0.35ml. X-ray diffraction (XRD) was used to analyses phase formation of the cements. Setting time and compressive strength of the set CPCs were measured using the Gilmore apparatus and Universal testing machine, respectively. The results showed that CPCs could be produced by using both basic (Na2HPO4.2H2O) and acidic (C2H4O2) solutions. XRD results show the precipitation of hydroxyapatite in all cement samples. No change in phase formation among cements using difference concentrations of Na2HPO4.2H2O solutions. With increasing concentration of acidic solutions, samples obtained less hydroxyapatite with a high dicalcium phosphate dehydrate leaded to a shorter setting time. Samples with sodium alginate exhibited higher crystallization of hydroxyapatite than that of without alginate as a result of shorten setting time in a basic solution but a longer setting time in an acidic solution. The stronger cement was attained from samples using the acidic solution with sodium alginate; however the strength was lower than that of using the basic solution.

Keywords: Calcium phosphate cements, TTCP, DCPA, hydroxyapatite, properties.

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Authors: Gerald Amatre, Julius Bunny Lejju, Morgan Andama

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Despite several interventions, jigger flea infestations continue to be reported in the Busoga sub-region in Eastern Uganda. The purpose of this study was to identify factors that expose the indigenous people to jigger flea infestations and evaluate the effectiveness of any indigenous materials used in flea control by the affected communities. Flea compositions in residences were described, factors associated with flea infestation and indigenous materials used in flea control were evaluated. Field surveys were conducted in the affected communities after obtaining preliminary information on jigger infestation from the offices of the District Health Inspectors to identify the affected villages and households. Informed consent was then sought from the local authorities and household heads to conduct the study. Focus group discussions were conducted with key district informants, namely, the District Health Inspectors, District Entomologists and representatives from the District Health Office. A GPS coordinate was taken at central point at every household enrolled. Fleas were trapped inside residences using Kilonzo traps. A Kilonzo Trap comprised a shallow pan, about three centimetres deep, filled to the brim with water. The edges of the pan were smeared with Vaseline to prevent fleas from crawling out. Traps were placed in the evening and checked every morning the following day. The trapped fleas were collected in labelled vials filled with 70% aqueous ethanol and taken to the laboratory for identification. Socio-economic and environmental data were collected. The results indicate that the commonest flea trapped in the residences was the cat flea (Ctenocephalides felis) (50%), followed by Jigger flea (Tunga penetrans) (46%) and rat flea (Xenopsylla Cheopis) (4%), respectively. The average size of residences was seven squire metres with a mean of six occupants. The residences were generally untidy; with loose dusty floors and the brick walls were not plastered. The majority of the jigger affected households were headed by peasants (86.7%) and artisans (13.3%). The household heads mainly stopped at primary school level (80%) and few at secondary school level (20%). The jigger affected households were mainly headed by peasants of low socioeconomic status. The affected community members use soil-cow dung-ash mixture to smear floors of residences as the only measure to control fleas. This method was found to be ineffective in controlling the insects. The study recommends that home improvement campaigns be continued in the affected communities to improve sanitation and hygiene in residences as one of the interventions to combat flea infestations. Other cheap, available and effective means should be identified to curb jigger flea infestations.

Keywords: Cow dung-soil-ash mixture, infestations, Jigger flea, Tunga penetrans.

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Authors: Benjamin Osei Tutu, Sharon Annison

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On 21^st November, 2016, an outbreak of foodborne illness occurred after a buffet lunch served during a stakeholders’ consultation meeting held in Accra. An investigation was conducted to characterise the affected people, determine the etiologic food, the source of contamination and the etiologic agent and to implement appropriate public health measures to prevent future occurrences. A retrospective cohort study was conducted via telephone interviews, using a structured questionnaire developed from the buffet menu. A case was defined as any person suffering from symptoms of foodborne illness e.g. diarrhoea and/or abdominal cramps after eating food served during the stakeholder consultation meeting in Accra on 21^st November, 2016. The exposure status of all the members of the cohort was assessed by taking the food history of each respondent during the telephone interview. The data obtained was analysed using Epi Info 7. An environmental risk assessment was conducted to ascertain the source of the food contamination. Risks of foodborne infection from the foods eaten were determined using attack rates and odds ratios. Data was obtained from 54 people who consumed food served during the stakeholders’ meeting. Out of this population, 44 people reported with symptoms of food poisoning representing 81.45% (overall attack rate). The peak incubation period was seven hours with a minimum and maximum incubation periods of four and 17 hours, respectively. The commonly reported symptoms were diarrhoea (97.73%, 43/44), vomiting (84.09%, 37/44) and abdominal cramps (75.00%, 33/44). From the incubation period, duration of illness and the symptoms, toxin-mediated food poisoning was suspected. The environmental risk assessment of the implicated catering facility indicated a lack of time/temperature control, inadequate knowledge on food safety among workers and sanitation issues. Limited number of food samples was received for microbiological analysis. Multivariate analysis indicated that illness was significantly associated with the consumption of the snacks served (OR 14.78, P < 0.001). No stool and blood or samples of etiologic food were available for organism isolation; however, the suspected etiologic agent was Staphylococcus aureus or Clostridium perfringens. The outbreak could probably be due to the consumption of unwholesome snack (tuna sandwich or chicken. The contamination and/or growth of the etiologic agent in the snack may be due to the breakdown in cleanliness, time/temperature control and good food handling practices. Training of food handlers in basic food hygiene and safety is recommended.

Keywords: Accra, buffet, C. perfringens, cohort study, food poisoning, gastroenteritis, office workers, Staphylococcus aureus.

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