International Journal of TROPICAL DISEASE & Health

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/151213

Chief Editor: Prof. William Ebomoyi
ISSN: 2278–1005

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.sciencedomain.org/journal-home.php?id=19

Browse

Now showing 1 - 20 of 792

Anticonvulsant and Depressant Activity of Methanol Leaf Extract of Croton zambesicus.
(2012-01) Kolawole, O T; Akiibinu, M O; Ayankunle, A A
Aims: To study anticonvulsant and central nervous system depressant activity of methanol leaf extract of Croton zambesicus (MECZ) in Swiss albino mice and investigate the role of serotonin in these activities. Methodology: Anticonvulsant activity of graded doses (200, 300 and 400 mg/kg p.o) of MECZ was assessed through seizures induced by picrotoxin and pentylenetetrazole (PTZ). Effects of the extract on pentobarbitone-induced sleep and amphetamine-induced stereotype behavior were also evaluated. Possible involvement of serotonergic pathways was studied using cyproheptadine (4mg/kg i.p), a non-selective serotonin antagonist (5-HT1/5HT2). Results: In both picrotoxin and PTZ-induced seizures, the extract significantly delayed onset of seizure (p<0.05) in a dose-dependent manner and provided significant protection against death. There was a dose-dependent increase of pentobarbitone sleeping time and a significant reduction (p<0.05) in the sleep latency. The extract also produced a significant reduction in amphetamine-induced stereotype behavior. Pretreatment with cyproheptadine abolished the anticonvulsant effect of the extract. The inhibitory effect of the extract on amphetamine-induced hyperactivity and its potentiation of pentobarbitone-induced sleep were also reversed by cyproheptadine. Conclusion: The results of this study showed that methanol extract of Croton zambesicus leaf possesses anticonvulsant activity and other CNS depressant activities and these activities are possibly mediated through interaction between serotonergic and GABAergic transmissions.
Anaemia in Critically Ill Children- A Case Study from Nigeria.
(2012-01) George, I O; Otaigbe, B E
Background and Aim: Anaemia is a common cause of morbidity and mortality in the tropics. World Health Organization estimated that anaemia affects one-quarter of the world's population and is concentrated within preschool age children and in resource-poor countries like ours. The aim of this study was to evaluate the prevalence and severity of anaemia in critically ill children presenting at the Children Emergency Ward of the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Materials and Methods: This was a retrospective study of anaemic children (1 month to 16 years) admitted into the Children Emergency Ward of the UPTH from January to December 2010. Medical case notes of the patients were reviewed. Information obtained included age, gender, presenting complaints, diagnosis, packed cell volume (PCV), blood transfusion and outcome. The PCV was determined by microhaemtocrit method. Data generated were analysed using SPSS for widow, version 12.0 (SPSS Inc, Chicago Illinois, USA). Descriptive statistics in the form of the frequency and percentage were used. Results: There were a total of 1581 children admitted into the Children Emergency Ward of the UPTH during the period of study. Four hundred and twenty three were confirmed to have anaemia of varying degree giving a prevalence of 26.8%. Most 295(69.7%) of the mothers were poorly educated and live in the urban slums. There were more males 418(67.1%) than females 205(32.9%). Fever, vomiting and weakness were the main presenting features. Ninety two patients (6.3%) had mild anaemia, 102 patients (6.5%) had moderate anaemia and 229 patients (14.5%) had severe anaemia. Two hundred and twelve of the critically ill children (50.1%) were transfused on account of severe anaemia. Malaria and septiicaemia were the commonest associated morbid conditions. Twenty five deaths were recorded. Severe anaemia accounted for 13(52.0%) of the total deaths. Conclusion: Anaemia is prevalent among Nigerian children in critical condition. Severe anemia is common and associated with increased risk of clinically relevant outcomes such as hospitalization and mortality.
Still Births in a Tertiary Hospital, Niger Delta Area of Nigeria; Less Than a Decade to the Millennium Developmental Goals.
(2012-01) Ugboma, H A A; Onyearugha, C N
Aims: To determine the prevalence and associated factors of stillbirths in the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, south-south Nigeria. Study Design: Retrospective study. Place and Duration of Study: Data were obtained from the delivery registers in the theatre, labour and isolation wards and the records department of the UPTH between 1st January 2005 and 31st December 2010. Methodology: We included 580 stillbirths (316 males and 264 females) whose data were analyzed using Epi-Info software version 6.04 and SPSS version 11. Results: The prevalence of stillbirths was 45 per 1000 births. Fresh stillbirths (SB) (50.9%) were not significantly more than macerated SB (49.1%) p=0.792. Preterms (47.8%) were insignificantly more than term SB (41.5%) p=0.765. Unbooked mothers (86.7%), age 25-34 years (70%) and lower parities 1, 2 and 0 (43.4% and 29% respectively) were significantly associated with stillbirth delivery p<0.05. Places of antenatal supervision of the unbooked mothers were primary health centre (27%), traditional birth attendants’ (25%), churches, (22.3%), private maternities, (21.1%). Predominant pregnancy and labour complications associated with SB were prolonged labour (23.1%) abruptio placentae (14.1%), retained second twin (21.8%). Significantly more SB were delivered vaginally (66.9%) than abdominally (33.1%) p=0.026. Conclusion: Lack of booking, inadequate pregnancy and labour supervision, avoidable delays are major contributors to high prevalence of stillbirths in Nigeria.
Gestational Diabetes: Risk Factors, Perinatal Complications and Screening Importance in Niger Delta Region of Nigeria: A Public Health Dilemma.
(2012-01) Ugboma, H A A; Aburoma, H; Ukaigwe, P
Aim: The study identified the incidence of undiagnosed gestational diabetes and its consequences on maternal/neonatal mortality and highlighted screening importance in an African urban setting in the Niger Delta region in Nigeria. Study Design: Randomised study. Place and Duration of Study: Pregnant women attending antenatal clinics in one tertiary, six primary, six secondary, hospitals, and six maternity homes in the Niger delta area of Nigeria between May 2006 to May 2009. Method: A total of 1920 pregnant women were recruited into the study. While 956 received the oral glucose test and formed the study group, 964 declined from continuing in the study, and formed the control group. Results: Women with gestational diabetes were at increased risk for premature rupture of membranes, preterm birth; breech presentation and high birth weight adjusting for maternal age. Conclusion: The presence of gestational diabetes in pregnancy is predictive of poor pregnancy outcome as it remains undetected in conception resulting in unto wards maternal/neonatal complications.
Cost Effectiveness of Intermittent Preventive Treatment of Malaria in Infants in Ghana.
(2012-01) Abotsi, Anselm Komla; Inkoom, Ebenezer; Ribaira, Eric; Mentec, Rozenn Le; Levy, Pierre; Lafarge, Herve; de Sousa Alexandra
Aim: In order to integrate malaria Intermittent Preventive Treatment in infants (IPTi) into the Ghana national immunization programme, there was the need to evaluate the feasibility of IPTi by assessing the intervention operational issues including its implementation costs, and its cost effectiveness. Study Design: Cross-sectional study. Place and Duration of Study: Upper East Region, Ghana, between July 2007 and July 2009 Methods: We calculated the costs of administrating IPTi during vaccination sessions; the costs of programme implementation during the first year of implementation (start-up costs) and in routine years (recurrent costs). For the purposes of cost-effectiveness analysis, all economic costs (including financial and opportunity costs) and the net cost were estimated. To estimate the cost effectiveness ratios of IPTi, the aggregate cost of providing the intervention for a reference target population of 1,000 infants was divided by its health outcome. Sensitivity analyses were carried out to understand the results robustness. Results: IPTi gross costs in start up and in routine years were estimated at 70.66 cents and 29.72 cents per dose, or $2.0 and $0.87 per infant, respectively. The gross cost per DALY saved was estimated at $3.49 and the net cost of IPTi for 1,000 infants was $-3,416.38 in the routine years rending IPTi a highly cost saving intervention. Sensitivity analyses showed that the cost per DALY saved never went up more than $4.50 maintaining the intervention still highly cost effective. Conclusion: IPTi in Ghana is a highly and robust cost effective intervention. The intervention is cost-saving and should be scaled up nationally to save children’s health and economic capital.
Assessment of Adult Peripheral Lymphadenopathy in Red Sea State, Sudan.
(2012-01) Ageep, Ali K
Background: Although peripheral lymphadenopathy is a common presentation in Red Sea State, Sudan, no previous work was made to assess its causes. So, this study is done to identify the underlying causes of peripheral lymph nodes enlargement in the adult patients. Place and Duration of Study: Red Sea Medical Center laboratory, Port Sudan, Sudan between November 2006 and June 2010. Methods: Three hundred twenty seven patients presented with lymphadenopathy were examined by FNAC and histopathological techniques. The sites and the causes of the enlarged lymph nodes were identified. Clinical data were collected in predesigned questionnaires. Results: Generalized lymphadenopathy was found in 25 patients (7.7%). The vast majority of the patients (69.4%) had cervical lymph node enlargement. The commonest cause of lymphadenopathy was tuberculosis (39.5%), followed by metastatic diseases (24.7%). Non Hodgkin’s and Hodgkin’s lymphoma represent 16.6% of the patients. Metastatic tumors commonly present after the age of 50 years (92.6%). Females are more affected by TB than males (60.1%). In this study, 180 of the cases were females and 147 cases were males. Conclusions: FNAC and in some cases lymph node biopsy should be done to any adult patient with chronic peripheral lymphadenopathy in the studied area. This will assist in the early diagnosis and proper management of the patients.
Self-Esteem and Attitudes of Girls Orphaned to HIV/AIDS towards Education in Kampala, Uganda.
(2012-04) Amongin, Hellen Christine; Oonyu, Joseph C; Baguma, Peter K; Kitara, David Lagoro
Aims: To examine the relationship between self-esteem and attitudes to education among orphaned and non-orphaned adolescent secondary school girls in Kampala. Study Design: Cross-sectional study. Place and Duration of Study: Institute of Psychology, School of Education, Makerere University, Kampala, Uganda between June and October 2005. Methodology: Questionnaire including the socio-economic indicators, Rosenberg General Self-Esteem Scale and the Attitude Scale were administered to 225 students who were selected by simple random sampling in six secondary schools in Kampala, Uganda. Results: Orphaned girls had lower self-esteem and most had a negative attitude to education compared to non-orphans. However, girls orphaned to HIV/AIDS had a higher self-esteem compared to those orphaned by other causes and there was a positive correlationship between self-esteem and attitude towards education among orphaned adolescent girls in Kampala, Uganda. Conclusion: Non-orphaned girls have a higher self-esteem than orphaned girls. Non-orphaned girls have a more positive attitude to education compared to orphaned girls. Girls orphaned to HIV/AIDS have slightly higher self-esteem than those orphaned by other causes, but had the worst attitude to education. Recommendations: A special needs program should be designed to support orphan girls in secondary school so as to enable them perform better in their education. Additional study should be conducted among secondary school boys to compare the effects of orphan hood to their education and to see whether there are some disparities in the two genders of the same age group.
Health-Seeking Behavior of Rural Dwellers in Southern Nigeria: Implications for Healthcare Professionals.
(2012-04) Iyalomhe, Godfrey B S; Iyalomhe, Sarah I
The Nigerian rural people demonstrate undesirable health-seeking behavior because of their cosmological and nosological notions which ascribe etiology of diseases and ill-health to entities far beyond the realm of the stethoscope. The present review is therefore solicited to enhance the health status of rural dwellers by providing potentially useful guidance that will enhance the knowledge of healthcare professionals with respect to the peculiar health-seeking behavior of rural dwellers so as to promote good patient-physician interaction and to provide empirical basis for rational health policy formulation. A manual literature and internet (Google, Medline, Embase, HINARI and Cochrane data bases) search showed that in a pluralistic medical milieu in which the rural dwellers find themselves, the decision to seek healthcare, where to do this and the form of care perceived as appropriate are all influenced by a multiplicity of factors relating to the person, the facility and the socio-cultural environment. Primarily, religious beliefs, use of Traditional African Medicine (TAM) and patients’ perception of reality influence health-seeking behavior. In order to adequately and successfully manage the Nigerian rural patients, the healthcare provider must pay attention to patients’ impression of illness and underpinning health beliefs during consultation, in therapeutics and in handling evolving complications of TAM and ethical dilemmas. Improvement of rural infrastructure and behavioral health promotion campaigns among the rural people together with rational health policy formulation and regulation of TAM practice, are imperative.
Egyptian Women’s Satisfaction and Perception of Antenatal Care.
(2012-04) Montasser, Nadia Abd El-Hamed; Helal, Randah Mohamad; Megahed, Walaa Mohamed; Amin, Sally Khairat; Saad, Adel Mohemed; Ibrahim, Talaat Refaat; Elmoneem, Haitham Mohemed Abd
Aim: to assess pregnant women perception of ANC (antenatal care) and their satisfaction with different aspects of care. Study Design: A Cross sectional study was conducted on 600 pregnant females. Place and Duration of Study: Shawa family medicine center in Shawa village in Mansoura, Dakahlia governorate from March 2010 to September 2010. Methodology: Our target group completed the questionnaire including socio-demographic data, duration of pregnancy and number of their antenatal visit, questions to assess; satisfaction about different aspects of quality of the care, to assess women perception for ANC components. Results: High satisfaction (>90%) was reported for waiting time for laboratory results, answering inquiries and help by staff, trust the doctor followed by cleanness of the center, privacy, most of accessibility items, most of physician performance items. Satisfaction (<30%) reported for location of the center, health education methods, explanation of the problems by physician. All females who came for repeated visits confirmed the application of follow up measures in each visit by doctors. The majority of the female (>75%) received proper nutritional care and fetal examination, performed ultrasound examination and only 65% actually received tetanus toxoid. <40% reported home visits, familial participation in care, had blood and stool analysis. Pregnant females were satisfied with most of the health education messages. Information about teeth care, breast care and clothing achieved lowest satisfaction (<20%). Conclusions: The majority of the females was satisfied by the quality of care and reported the perception of ANC components however; low satisfaction with health education components indicates a need for strategies to improve this important aspect of care.
Cutaneous Leishmainasis: A Ten-Year Study of the Epidemiology and Clinical Features in Salfit District (2001-2010).
(2012-04) Adawi, Shadi Hilmi Abd Allah
Aim: This study was conducted in order to provide information and evaluate the epidemiology of cutaneous leishmaniasis, incidence, geographical distribution and clinical spectrum of the disease for the period 2001- 2010 in Salfit district (Northwestern West Bank). Study Design: A retrospective study. Methods: Fifty patients with positive cutaneous leishmaniasis (23 males and 27 females) in Salfit district were recorded in Salfit Primary Health Care Center from 2001 to 2010. Results: The results show that the incidence of disease increased from 0.2 in 2001to 2.5 per 10000 person in 2010 and the disease distributed in 13 localities in Salfit district with more prevalence in Der ballut locality (24%). According to the history of CL medical reports which consist of time of the emersion of signs, the time of seeking of medical care taking in to consideration the incubation period for the leishmania parasite in cases, the results show that the frequency of main infection period took place during March. The disease affects both males and females in different age groups with more prevalence of cases occurred in patients ages 6-21 years (36.0%). The lesions were commonly single and nodules (60.5%), (54%) respectively and more prevalence in upper limbs (48%) especially in females (30.2%) and the duration of treatment of CL infection with sodium stibugluconate (pentostam) took mainly form 1-20 days. Limitations of Study: This was a retrospective study to evaluate the epidemiology of 50 positive CL cases in Salfit district recorded at Salfit Primary Health Care center (SPHC) for the period 2001 to 2010 and The data recorded at (SPHC) did not include the Suspected CL cases or species of Leishmaina parasite and possible species of vector and reservoir. Conclusion: The results show that CL is increasing in number year by year and spread over the localities in salfit district and become endemic area, so more studies are needed to determine the vectors and reservoirs as well as species of leishmania to help the decision makers put suitable strategies to control the disease.
Attitudes and Barriers to Post Graduate Education among Radiographers in South Eastern Nigeria.
(2012-04) Ugwu, Anthony Chukwudi; Erondu, Okechukwu Felix; Onwuazombe, Chinedu T
Background: This study is aimed assessing the attitudes of radiographers and perceived barriers to postgraduate radiography education in south-eastern Nigeria. Methods: The study utilized a self administered pre-tested questionnaire with structured and semi-structured questions. Respondents were practicing radiographers working in private, general and teaching hospitals in south-eastern Nigeria. A total of forty-one (41) radiographers participated in the study. This study was carried out in South-Eastern Nigeria made up of five states namely; Anambra, Enugu, Imo Abia and Ebonyi states. All radiographers in South-Eastern Nigeria who agreed to participate in the study were included. The following categories of registered radiographers where included in the study, Intern radiographers (fresh graduates), Youth corper radiographers (those undergoing one-year mandatory post-qualification national service) and radiographers currently in practice with or without post graduate certificate. Results: Physical, attitudinal and structural barriers were identified as obstacles to postgraduate radiography education. No significant correlation existed between attitude and all the categories of barriers in this study. A set of numerical scores ranging from 1.0 to 5.0 were assigned to the attitudes, otherwise called ‘attitude scores’. A score of 1.0 represents a less positive attitude, while a score of 5.0 represents a very positive attitude. Attitude scores to organizational barrier ranging from 2.70 to 3.67 were recorded among administrative cadre radiographers (chief and assistant chief). Environmental barrier score was found to be the least among M.Sc radiographers (2.46) and highest among radiographers in private establishments (3.58). Organizational barrier was noted to be significantly higher than other barriers. This study has shown a very positive attitude of radiographers towards postgraduate education. Organizational (university) barrier is perceived as the most dominant bottleneck. The study recommends the establishment of more post-graduate radiography programs in Nigerian Universities, recruitment of more lecturers as well as reduction in the duration and cost of undertaking such programs. Conclusion: The authors recognize that achieving a higher level of competence and professional expertise through post-graduate education requires commitment and cooperation between the individual radiographer, the employing organization and the tertiary institution. Furthermore, recognizing the dynamics and complexity of health-care systems, it would not be sufficient to make broad suggestions indicating that identified barriers to continuing formal education can be solved by implementing short-term plans.
Antimicrobial Properties of Euphorbia hyssopifolia and Euphorbia hirta against Pathogens Complicit in Wound, Typhoid and Urinary Tract Infections.
(2012-04) Alisi, Chinwe S; Abanobi, Samuel E
Dehydrogenase activity (DHA) in Gram-positive Staphylococcus aureus isolated from degenerated wound, Gram-negative Salmonella typhi isolated from stool, and Gram-negative Escherichia coli from a high vaginal swab were assayed. Inhibition of dehydrogenase activity of the test organisms by ethanol extract of Euphorbia hyssopifolia, and Euphorbia hirta, were determined and compared to standard antibiotics (Ciprofloxacin and Gentamycin). The total dehydrogenase assay was done using 2, 3, 5-triphenyl tetrazolium chloride (TTC) as the artificial electron acceptor which was reduced to the red-coloured triphenyl-formazan (TPF). Response of the bacterial isolates varied with extract concentration. Dehydrogenase activity was progressively inhibited in a logistic dose-response fashion in the test organism by the extracts and standard drugs. All extract and standards achieved at least 70% inhibition within the tested doses (0-2000µg/ml), except for Euphorbia hirta against Staphylococcus aureus. Threshold inhibitory concentrations (IC50) for Euphorbia hyssopifolia against Staphylococcus aureus, Salmonella typhi and Escherichia coli were 59.92µg/ml, 234.90µg/ml, and 492.46µg/ml respectively, while for Euphorbia hirta IC50 against Salmonella typhi and Escherichia coli was 99.67µg/ml,and 165.90µg/ml with no significant inhibition against Staphylococcus aureus. Inhibition of dehydrogenase activity in the test organism by the extract compared well with the standard antibiotics. Euphorbia hyssopifolia was effective against Gram-positive Staphylococcus aureus implicated in delayed wound healing than Gram-negative Salmonella typhi and Escherichia coli implicated in typhoid fever and urinary tract infections respectively, while Euphorbia hirta was effective against Gram-negative organisms implicated in typhoid fever and urinary tract infections, but not effective against Gram-positive Staphylococcus aureus. Secondary plant metabolites found in the extracts may be acting in synergy to bring about their pharmacologic functions and may explain reasons for ethno-medical usage.
Clinical Presentation of Infertility in an Outpatient Clinic of a Resource Poor Setting, South-East Nigeria.
(2012-04) Obuna, J A; Ndukwe, E O; Ugboma, H A A; Ejikeme, B N; Ugboma, E W
Aim: To identify the prevalence, common symptoms, signs, partner contribution, common diagnosis and outcome of infertility in a resource poor setting. Study Design: Descriptive retrospective study. Place and Duration of Study: Ebonyi state University teaching Hospital, Abakaliki south-east, Nigeria, in two years (1st January 2009 to 31st December 2010). Method: Case notes of patients who attended the infertility clinic over the study period were retrieved from the health services department of the hospital and analysed. Results: Infertility patients were 295 out of 1,913 new gynaecological cases during the period under review, forming 15.4% of the study population. The number of folders with complete information was 266 which were 90.2%. Primary infertility patients were 94(35.3%) of all infertility cases) while 172(64.7%) were secondary infertility. The age range was 19 to 47 years, with a mean value of 30.9±2.3 of two standard deviations across the mean. The mean parity was 1.4±0.8 and ranged between 0 – 7 children. Among those with previous deliveries, 68.2% had no living child. The predominant symptoms in the females were insomnia, inadequate coital exposure, galactorrhoea and vaginal discharge. The commonest demonstrable signs were galactorrhoea in 92(34.6%) patients, cervical excitation tenderness in 54(20.3%) and uterine mass in 65(24.4%).Some 44(16.5%) persons had no remarkable findings. Partner contributions were: 93 (34.9%) for females; 60(22.6%) males; 64(24.1%) both partners. Pelvic infections (75.5%) and tubal occlusion (16.9%) were the commonest aetiologic factors. Others were: endocrine disorders including polycystic ovarian diseases, uterine myoma, uterine synaechiae and tubo ovarian masses. The outcome of treatment was: 40(15.0%) pregnancies; 112(42.1%) still on treatment and counseling; 75(28.2%) referrals and 39(14.6%) patients lost to follow up. Conclusion: Astute history taking and physical examination helped in elucidating the cause of infertility in many of our patients. Secondary infertility as in other parts of our country takes upper hand thereby reinforcing the need for prevention of pelvic infection in women of reproductive age. Total cares of infertility couples require the cooperation of men, laboratory scientists, radiologists, and even clinical psychologists (it is multidisciplinary). Treatment outcome is still poor and may be improved through increased priority in public funding, equipment supply, and manpower training as well as health education.
Evaluation of the Effectiveness of Oseltamivir for the Treatment of 2009 Pandemic Influenza A (H1N1).
(2012-04) Lenzi, Luana; Grochocki, Mônica H C; Silva, Lineu R; Wiens, Astrid; Mello, Angela M; Pontarolo, Roberto
Aims: Evaluate retrospectively the effectiveness of treatment with oseltamivir in a Brazilian subpopulation infected during the 2009 pandemic influenza A(H1N1) and compare drug activity based on the presence or absence of other disease risk factors and also the time from onset of symptoms to initiation of treatment. Study Design: Observational and retrospective. Place and Duration of Study: Federal University of Paraná and Parana State Secretary of Health, between April 2009 and December 2010. Methodology: 1,917 patients were included (842 men, 1,075 women; age range 0-90 years) with positive diagnosis for the 2009 influenza virus A (H1N1) characterized by RT-PCR, whose notification forms were available at the time of data collection and that contained information of the use or not of oseltamivir. The patients were categorized by age, gender, symptoms, presence or absence of co morbidities, outcomes (cure or death) and treated or untreated with oseltamivir. The odds ratio (OR) was estimated using a multivariate logistic regression analysis. Kaplan-Meier method was used to determine if differences existed between the survival of untreated patients and oseltamivir treated patients. Results: Out of 1,917 patients, 1,644 had cleared the infection and 273 patients died. Age, education level, cardiopathies, nephropathies, immunodepression, smoking, diabetes, systemic arterial hypertension, obesity, diarrhea, dyspnea, hemoptysis and pneumonia were considered risk factors. The use of oseltamivir provided about 32.3 times more likely to clear the infection compared with untreated patients. Moreover, the effectiveness of oseltamivir is reduced by approximately 7-fold in smoking patients. For each day that passed to initiate treatment after the onset of symptoms, the risk of death increased by 32.3%. Conclusion: The findings suggest that treatment with oseltamivir was effective in producing favorable patient outcomes in those who contracted the 2009 influenza A (H1N1) strain.
Plasmodium falciparum Specific IgE, IgG and Anti-GPI IgG Antibodies in Cameroonian Children with Severe and Uncomplicated Malaria.
(2012-07) Achidi, Eric A; Apinjoh, Tobias O; Anchang-Kimbi, Judith K; Yafi, Clarisse N; Besingi, Richard; Awah, Nancy W; Troye-Blomberg, Marita
Aims: We investigated the role of antibodies in the pathogenesis of severe malaria in children by measuring and comparing plasma levels of antibodies to glycosyl phosphatidy linositol (GPI) and crude Plasmodium falciparum extract. Study Design: Cross-sectional case-control study. Place and Duration of Study: Five health institutions in two towns and seven primary schools in the South West region of Cameroon between April 2003 and December 2005. Methodology: A total of 649 children including 25, 156 and 233 cases of cerebral malaria (CM), severe malaria anaemia (SMA) and uncomplicated malaria (UM) respectively were recruited from health institutions and 233 apparently healthy controls (HC) from schools using predefined inclusion criteria. Malaria parasitaemia was determined by light microscopy using Giemsa-stained thick blood smears, haemoglobin level using a haemoglobinometer and blood cell count using a haemocytometer. The levels of total IgE, P. falciparum IgG, IgE and anti-GPI IgG antibodies were measured from plasma by the ELISA technique. Results: The mean white blood cell count (WBC) was higher in the severe malaria group compared with the HC group. Geometric mean parasite densities were significantly different (P<0.001) amongst the study groups but similar in the two severe malaria groups (Severe Malaria Anaemia and Cerebral Malaria). Seropositivity for IgG antibodies to P. falciparum was different within the study groups (P<0.001) and higher in the clinical cases compared to the HC group. Mean levels of anti-GPI IgG and P. falciparum specific IgE and IgG antibodies were significantly different among the study participant categories. Mean plasma levels of these antibodies were higher in the UM and HC groups when compared with the severe malaria groups. There was a significant positive correlation between the age of the participant and levels of anti-GPI IgG (P<0.001), P. falciparum IgE (P = 0.027) and total IgE (P = 0.020) antibodies. Conclusion: Our observation of lower levels of anti-GPI and P. falciparum specific IgE antibodies in the severe group compared with the control group suggest a protective role of these antibodies in the pathogenesis of severe malaria. The correlation observed between P. falciparum IgE, IgG and GPI IgG antibody levels with age confirm previous reports that immunity to malaria develops with age and is partially dependent on antibody production.
Risk Factors Associated with Bites due to Two Viperid Snakes: A Case Control Study.
(2012-07) Kularatne, Senanayake Abeysinghe Mudiyanselage; Weerakoon, Kosala Gayan Abeysundara Dissanayake; Rathnathilake, Ashoka; Kumarasiri Pallegoda, Vithanage Ranjith
Aims: This study was to assess victim’s environmental and behavioural risk factors that promote bites from two viperid snakes. Study Design: A case control study. Place and Duration of Study: Medical wards, General Hospital, Kurunegala, Sri Lanka, between June to December 2010. Methodology: Cases were recruited prospectively from consecutive admissions to the General Hospital, Kurunegala, Sri Lanka with proven viperid bites. Age and gender matched control group was selected from relatives and neighbourhood of the cases in a ratio of 1 case: 2 controls. Results: There were 56 cases and 112 controls with mean age 44 years and 45 years respectively. Of the 13 risk factors assessed, 7 risk factors showed a significant association with viperid bites. Those were (1) being in an ill lit place (OR, 95% CI= 6.6 (3.25-13.4), (2) being in outdoor places (OR, 95% CI= 148.8 (43.7-506), (3) working in a field (OR, 95% CI= 175 (31.4 – 976), (4) occupation as a field worker (OR, 95% CI= 5.3 (2.3-12 ), (5) low level of financial status (OR, 95% CI=9.9(2.75- 35.5), (6) lack of attached toilet (OR, 95% CI= 7.38 (2.15- 25.3), (7) presence of small rodents in the compounds (OR, 95% CI= 11 (4.88-24.9). Conclusion: Identifying easily remediable risk factors would help in preventing viperid snake bites.
Sociodemographic Determinants of Mortality in Hospitalized Under-Five Children at a Secondary Health Care Centre in the Niger Delta.
(2012-07) Okposio, Matthias M; Unior, Monday O; Ukpeteru, Felix O
Aims: To determine the socio-demographic factors associated with mortality in hospitalized under-5 children in the Niger Delta region of Nigeria. Study Design: Cross-sectional study. Place and Duration of Study: Paediatric unit of Mariere Memorial Central Hospital Ughelli, Nigeria between October 2011 and February 2012. Methodology: All inpatients aged 29 days to ≤ 60 months who met the inclusion criteria were consecutively enrolled and information on a range of demographic and clinical factors obtained using a structured questionnaire. The primary outcome variable was mortality. Data was coded and analysed using SPSS version 16 software. Results: Of the 600 children recruited for the study, 345(57.5%) were males while 255(42.5%) females. The case fatality rate was 51(8.5%). Significant risk factors associated with mortality were maternal age >30 years (p=0.001), low maternal educational status (0.001), lower socioeconomic class (p=0.006), late presentation (p=0.004). However, multiple logistic regression analysis showed late presentation to be the strongest determinant of mortality. ((OR=4.83, 95%CI: 1.458 to 15.993, p=0.01). Conclusion: Social factors play a significant role in the eventual health outcomes in hospitalized under-5 children with late presentation being the strongest predictor of mortality. Effort should therefore be made at creating awareness on seeking early treatment for childhood illnesses in recognized hospitals.
A Comparative Study of Contraceptive Use among Rural and Urban Women in Osun State, Nigeria.
(2012-07) Olalekan, Adebimpe Wasiu; Olufunmilayo, Asekun-Olarinmoye Esther
Aims: To compare contraceptive practices among rural and urban women in Osun State, South-western Nigeria. Study Design: Cross-sectional descriptive study. Place and Duration of Study: Osun state in southwestern Nigeria. The study was carried out between January and June 2010. Methodology: One thousand and twenty four women of reproductive age group, including 512 rural and 512 urban women were selected into this study using multistage sampling method. Research instrument used were pre-coded, pre-tested, semi structured interviewer administered questionnaires. Data was analyzed using the SPSS software. Results: Four hundred and thirteen rural respondents and 475 urban respondents were aware of contraceptives with only 86(16.8%) and 239(46.7%) respectively using a contraceptive method.” Seventeen (3.3%) and 95(18.6%) of rural and urban respondents respectively used their contraceptive methods consistently. Thirty eight (7.4%) and 118(23.1%) of rural and urban respondents respectively used a condom the last time they had sexual intercourse. Mean number of births per woman was 3.4+1.8 births per woman in rural and 2.9+1.5 births per urban woman. Sixty nine (13.5%) of rural and 164(32.0%) of urban respondents had discontinued their contraceptive method at one time or the other. Women with formal education in both locations had about one-half the fertility rate compared to women with no formal education (OR=0.59, 95% CI=0.45–0.95, p=0.001). Similarly, women who used contraceptives in both locations had about one-twelfth fertility rate compared to women not using contraceptives (OR=0.08, 95% CI=0.06–0.12 and p=0.019).” Conclusion: Awareness and use of contraceptives was higher in urban than rural respondents under study. Fertility was also higher among urban than rural women.
Effect of Storage Temperature and Sample Volume on Brucella melitensis Isolation from Goat Milk.
(2012-07) Zambriski, Jennifer A; Maves, Ryan C; Nydam, Daryl V; Ayvar, Viterbo; Cepeda, David; Castillo, Rosa; Díaz-Pino, Andre; Saito, Mayuko; Gilman, Robert H
Aim: To determine the impact of storage temperature and sample volume on milk culture success under a simulated field setting. Study Design: Prospective cohort study. Place and Duration of Study: Centro de Salud Global UPCH, Tumbes, Peru and Naval Medical Research Unit SIX, Lima, Peru. April, May and June 2010. Methodology: We aseptically collected milk from unvaccinated goats, and then experimentally inoculated the pooled milk sample with B. melintensis in order to compare the effect of two different sample volumes (2ml and 5ml) and two different storage temperatures (4ºC and -20ºC) on culture success. Results: We achieved higher culture success in refrigerated (4ºC) versus frozen (-20ºC) samples (OR 4, 95% CI 1.7, 9.6) and with 5-ml versus 2-ml aliquots (OR 9, 95% CI 3.3, 26.6). Conclusion: In resource-poor field settings where cold-chain and transportation are unreliable, use of ice for sample storage and transport of goat milk is an acceptable method for the purpose of culturing B. melintensis.
Determinants of Delivery Outcomes in Teenage Mothers at a University Teaching Hospital, South-Eastern, Nigeria.
(2012-07) Ugboma, Henry A A; Obuna, Johnson A; Ndukwe, Emmanuel O; Ejikeme, Boniface N
Aim: This study aims at identifying some delivery outcome determinants in teenage mothers and evaluating the effect of booking in light of these parameters. Study Design: A retrospective study. Place and Duration of Study: Teenage mothers who delivered in a teaching hospital in Nigeria over a 5-year period (between 1st Jan, 2003 and 31st Dec, 2007). Method: Labour ward register and midwives report books were used to get their hospital numbers. These case notes were retrieved subsequently from the health records department and relevant data extracted. Results: There were 8,297 deliveries during the study period and 453 cases of teenage mothers giving a teenage delivery incidence of 5.5%. Of the total teenage deliveries, older teenage mothers (16-19 years) constituted 94.7% while younger teenage mothers were 5.3%. Booked teenage mothers were 83.5% while 16.5% were unbooked. Still birth rate was 87 per 1000. No maternal death was recorded among the teenage mothers. Older teenagers had better obstetric indices such as higher vaginal delivery rate, lower caesarean section and instrumental delivery rate, reduced blood loss, better Apgar scores and less intra uterine fatal deaths than younger teenagers. However, some of these were not statistically significant and in some cases, were barely marginal. Conclusion: Influence of age on teenage delivery and other biological risk factors may not be as much as earlier perceived. Paying special attention to the socio-economic condition of teenage mothers and by extension, their access to essential obstetric care, may obviate the poor obstetric outlook hitherto attached to it.

Browse

Browsing International Journal of TROPICAL DISEASE & Health by Issue Date

Results Per Page

Sort Options