Search

Introduction:

As members of the Japan Disaster Relief (JDR) team in Banda Aceh, three of the authors treated 1,891 patients following the tsunami of 2004. Of the 367 cases with traumatic injuries, 216 cases required antimicrobial therapy. The medical services were continued by the Japan Self-Defense (JSD) Medical Team until mid-March 2005. Of the 216 cases initially treated by JDR, 54 required prolonged antimicrobial therapy for persistent symptoms despite repeated debridement.The aim of this study is to recommend an appropriate antimicrobial therapy for water-associated wound infections in the absence of laboratory services in disaster settings following tsunami.

Methods:

The JDR and JSD treatment records were analyzed retrospectively. In August 2006, 19 months after the tsunami, the authors investigated pathogens in natural aquatic habitats in the affected area in Banda Aceh. At the same time, interviews with tsunami survivors were performed to determine the influential factors that facilitated wound infections after the tsunami.

Results:

From the 49 water samples tested, Aeromonas sp., Vibrio sp., Klebsiella sp., and Proteus sp. were isolated from 24, 16, 15, and six samples, respectively. Regardless of the genus, almost all of the isolated gram-negative bacilli were sensitive to ciprofloxacin and gentamicin.

Conclusions:

From the microbiological test results and analyses of the medical records and interviews, the researchers recommend the following regimen when clinical microbiological tests are not available: initial treatment with beta-lactam penicillins for three days, followed, if the first antimicrobial is not effective, by ciprofloxacin or any other relevant new quinolones, with the addition of gentamicin if necessary.

The Gambia Estuary, a “normal” estuary with a decreasing salinity gradient from the mouth towards the head, is moderately exploited by small-scale fisheries and does not receive any severe pollution from either agriculture or industrial activities. Neither the Gambia River nor its estuary are artificially impounded. As the last large West African estuary free of major human disturbance, it is of considerable interest for comparative studies on the effect of major environmental perturbations in West African estuarine ecosystems. The aquatic environment and fish communities of the Gambia Estuary (about 250 km long) were studied by purse seine sampling at different periods in the river cycle, covering all hydro-climatic seasons that are characteristic of West African estuaries. Emphasis was placed on the diversity, composition, structure and distribution of fish assemblages in relation to fluctuations in physico-chemical factors such as water temperature, salinity and turbidity. Results on the aquatic environment, mainly the salinity range (from freshwater to 39) and dissolved oxygen (never a limiting factor for fish in the estuary) and on the main characteristics of the fish fauna (high diversity of life cycles, all the ecological categories represented) indicated that the Gambia Estuary was free of major climatic perturbation and reinforced the choice of this system as a reference for the study of the effects of major perturbations on estuarine tropical fish communities.

Search Results

Refine search

Refine search

Actions for selected content:

2 results

Antimicrobial Therapy for Water-Associated Wound Infections in a Disaster Setting: Gram-Negative Bacilli in an Aquatic Environment and Lessons from Banda Aceh

Fish diversity and distribution in the Gambia Estuary, West Africa, in relation to environmental variables

Search Results

Refine search

Refine search

Actions for selected content:

Save Search

2 results

Antimicrobial Therapy for Water-Associated Wound Infections in a Disaster Setting: Gram-Negative Bacilli in an Aquatic Environment and Lessons from Banda Aceh

Fish diversity and distribution in the Gambia Estuary, West Africa, in relation to environmental variables