International Journal of TROPICAL DISEASE & Health

Awareness and Factors Associated with TB-LAMP Positivity among Patients with Presumptive Pulmonary Tuberculosis in Ibadan, Nigeria

2026-10-27T07:34:41+00:00

Aims: To assess awareness of tuberculosis (TB) and the factors associated with TB-LAMP positivity among patients with presumptive pulmonary tuberculosis (PTB) at a specialised chest hospital in Ibadan, Nigeria.

Study Design: Hospital-based cross-sectional study.

Place and Duration of Study: Chest Hospital, Jericho, Ibadan, Oyo State, Nigeria, between October 2025 and July 2026.

Methodology: A total of 157 patients with presumptive PTB were selected by systematic sampling and interviewed using a structured questionnaire. Awareness was scored from eight items (0-8); scores below the sample mean were classified as poor awareness. TB-LAMP results were abstracted from hospital laboratory records and were used as the study outcome variable. Associations were assessed with the chi-square test and binary logistic regression (odds ratios with 95% confidence intervals); p < 0.05 was significant.

Results: Of 157 respondents, 87 (55.4%) had poor overall awareness (mean score 3.45 ± 1.36 of 8) and 85 (54.1%) had ever heard of TB. TB-LAMP was positive in 52 (33.1%). Poor awareness (crude OR 0.72, 95% CI 0.37-1.41) and having heard of TB (OR 1.57, 95% CI 0.80-3.09) were not associated with TB-LAMP positivity. In multivariable analysis, being a farmer, student or unemployed was independently associated with positivity (adjusted OR 2.57, 95% CI 1.25-5.31; exploratory grouping). The single-item awareness measure did not differ by sex, marital status, education or religion (all p > 0.05).

Conclusion: Awareness of PTB was inadequate among patients with presumptive PTB but was not associated with TB-LAMP positivity. Occupational grouping (farmer, student or unemployed) was the only independently associated factor; this exploratory finding requires confirmation. Routine, structured TB education at the point of care is recommended.

Prevalence and Risk Factors Associated with Nasal Colonizing Staphylococcus aureus among Cohorts of Nigerian University Students

2026-10-28T06:55:36+00:00

Background: Nasal carriage of Staphylococcus aureus may provide a reservoir for transmission in university communities.

Aim: This study examined carriage and antimicrobial susceptibility among students at Godfrey Okoye University, Enugu, Nigeria.

Methods: Nasal swabs were collected from 250 participants, comprising 125 male and 125 female students. Students receiving antimicrobial treatment at the time of sampling were excluded. Isolates were cultured on mannitol salt agar and characterised using colonial and biochemical procedures. Antimicrobial susceptibility was assessed by disc diffusion, with cefoxitin used for phenotypic methicillin-resistance screening. Twenty phenotypically multidrug-resistant isolates were selected for PCR analysis targeting 16S rRNA and mecA.

Results: S. aureus was recovered from 67 male participants (53.6%) and 69 female participants (55.2%), yielding 136 isolates. Of these, 130 showed resistance to at least one tested antibiotic, and 80 were resistant to three or more antibiotics. The multiple-antibiotic-resistance index exceeded 0.2 in 81 isolates. Among 670 recorded antimicrobial responses for male isolates, 262 were resistant, compared with 166 resistant responses among 690 observations for female isolates. The reported chi-square analysis found different distributions of susceptibility categories between the two groups. PCR findings indicated the presence of mecA-positive isolates within the selected subset.

Conclusion: Nasal carriage and antimicrobial resistance occurred in both student groups. Molecular detection of mecA in selected isolates does not establish the prevalence of methicillin resistance across the full cohort. The findings support further laboratory surveillance and prudent antimicrobial use.

Insured but Still Paying: Out-of-Pocket Payments, Catastrophic Expenditure and Forgone Care among Women Using Reproductive, Maternal, Newborn and Child Health Services in Six Districts of Northern Ghana

2026-10-29T09:52:07+00:00

Aims: To estimate out-of-pocket (OOP) payments, catastrophic health expenditure (CHE) and forgone care among women using reproductive, maternal, newborn and child health services in Northern Ghana, and to compare CHE by financing model.

Study Design: Community-based cross-sectional household survey.

Place and Duration of Study: 36 communities in Tamale Metropolis, Yendi, Sagnarigu, Savelugu, Gushegu and Karaga, Northern Region, Ghana, from 10 February to 14 April 2026.

Methodology: We interviewed 864 women aged 15 to 49 years who had been pregnant, had given birth or had cared for a child under five in the previous year. CHE was defined as household health spending above 10% or 25% of consumption; the revised Sustainable Development Goal (SDG) indicator 3.8.2 was a sensitivity measure. The analysis used design-weighted proportions, Rao-Scott tests and cluster-robust logistic regression. The null hypothesis that the incidence of CHE among women does not differ by financing model was tested with a joint Wald test.

Results: A medical OOP payment was reported by 57.4% (95% confidence interval [CI] 52.8 to 61.8) of women, including 42.5% (36.9 to 48.3) of those with an active National Health Insurance Scheme (NHIS) card. CHE at 10% affected 7.5% (5.8 to 9.6) of households, 14.7% in rural districts and 19.4% in the poorest quintile. CHE did not differ by financing model (χ²(4) = 3.29, P = .51), so the null hypothesis was not rejected. Wealth was the strongest observed correlate (richest vs poorest quintile adjusted odds ratio [AOR] 0.08, 0.02 to 0.31). Being uninsured was associated with forgone care (AOR 4.33, 2.09 to 8.97). Revised SDG hardship affected 32.1% of rural and 3.6% of urban households.

Conclusion: An active NHIS card was more closely associated with whether women obtained care than with how much households spent. Continuous cover for mothers and children, reliable medicine supply and targeting by need could protect the poorest households.

Serum β2-Microglobulin and Cardiac Valvular Calcification in Patients Receiving Maintenance Haemodialysis: Association, Calcification Burden and Diagnostic Performance

2026-11-02T12:12:55+00:00

Background: Cardiac valvular calcification (CVC) is a prevalent cardiovascular complication among patients receiving maintenance haemodialysis (MHD). β2-Microglobulin (β2-MG), a middle-molecular-weight uraemic toxin, has been associated with cardiovascular disease in patients with chronic kidney disease. This study investigated the association between serum β2-MG and CVC and evaluated its discriminatory performance in patients undergoing MHD.

Methods: This cross-sectional observational study enrolled 100 adult patients with end-stage kidney disease receiving MHD for at least 3 months. Serum β2-MG and mineral-bone parameters were measured, and transthoracic echocardiography was performed to assess CVC. Associations were evaluated using correlation and multivariable logistic regression analyses. Receiver operating characteristic (ROC) analysis was performed to assess the discriminatory performance of β2-MG.

Results: CVC was detected in 52% of patients. Serum β2-MG levels were significantly higher in patients with CVC than in those without calcification (median, 148.05 vs. 28.80 mg/L; P < 0.001). β2-MG showed a strong positive correlation with calcification burden (r = 0.770, P < 0.001). Its association with CVC remained significant after adjustment for age, sex, dialysis duration, phosphorus, and parathyroid hormone (adjusted OR per 1 mg/L increase, 1.039; 95% CI, 1.022–1.057; P < 0.001). ROC analysis demonstrated an AUC of 0.941 (95% bootstrap CI, 0.888–0.983). A cut-off of 75.62 mg/L yielded 84.62% sensitivity and 97.92% specificity.

Conclusion: Serum β2-MG was strongly associated with CVC and greater valvular calcification burden in patients receiving MHD. Its high discriminatory performance warrants validation in larger prospective multicentre studies.

Drinking-water Handling Practices and Self-reported Illness Histories among Hostel-resident Undergraduates at a Federal University in Owerri, Nigeria: A Cross-Sectional Survey

2026-11-02T13:07:21+00:00

Background: Drinking-water safety may be affected by collection, transportation, storage and handling after collection. Information on these behaviours among university hostel residents in southeastern Nigeria is limited.

Objective: To describe drinking-water handling practices and self-reported histories of selected illnesses among undergraduates residing in three selected university hostels in Owerri, Imo State, Nigeria.

Methods: An institution-based cross-sectional questionnaire survey was conducted between June and September 2026 among 525 undergraduates in three purposively selected hostels at Alvan Ikoku Federal University of Education, Owerri. Seventeen water-handling items and five illness-history items were summarised using frequencies and percentages. No drinking-water microbiological testing or independent verification of illness histories was undertaken.

Results: Of the 525 respondents, 205 (39.0%) were male and 320 (61.0%) were female. Boiling was reported by 78 (14.9%), point-of-use chlorination by 9 (1.7%), cleaning collection utensils with soap and water before each use by 64 (12.2%), and handwashing with soap before handling stored water by 218 (41.5%). Reported histories included diarrhoea in 329 (62.7%), typhoid in 406 (77.3%), dysentery in 131 (25.0%), gastroenteritis in 123 (23.4%), and hepatitis A–E of unspecified type in 9 (1.7%). Illness categories could overlap, and their recall periods and diagnostic bases were not established.

Conclusion: Selected water-handling behaviours, including boiling and point-of-use chlorination, were infrequently reported, whereas covered containers were commonly reported. Illness responses represent unverified histories and cannot be interpreted as confirmed waterborne disease prevalence. The findings do not establish water contamination or an association between handling practices and illness.

Residential Proximity to Crude Oil Activities and Cancer Occurrence among Surgical Patients in Rivers State: A Case–Control Study

2026-11-03T10:44:53+00:00

Background: Nigeria first experienced the “black gold” era with the discovery of crude oil in commercial quantities at Oloibiri Community in the old Rivers State in January 1956.

Aim: This study explored the relationship between residence in areas of crude oil activities and the occurrence of cancers among surgical cancer patients in Port Harcourt, Nigeria.

Materials and Methods: A case-control study was conducted among admitted surgical cancer patients in Port Harcourt using a designed study proforma. The analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 23.0.

Results: There were 401 cancer cases and 400 non-cancer respondents (controls), matched for age and sex. The mean age was 55.44±13.4 years; 797 respondents (cases: n = 399, 50.1%; controls: n = 398, 49.9%) were Nigerians, and 621 (77.5%) were from Rivers State. There were 178 (44.4%) cancer cases among patients residing in Rivers South East Senatorial District, 153 (38.2%) in Rivers East Senatorial District, 67 (16.7%) in Rivers West Senatorial District, and 3 (0.7%) for whom the senatorial district was not applicable. There was no statistically significant association between senatorial district and cancer status. However, residence in communities with crude oil activities was associated with higher odds of cancer (OR = 42.970, 95% CI = 27.50–67.15, P < 0.001). Residence for more than 10 years in communities with crude oil activities was also associated with higher odds of cancer (OR = 15.120, 95% CI = 8.540–27.157, P < 0.001).

Conclusion: The odds of cancer were higher among residents of communities where crude oil activities are carried out. This study provides a pioneer account of surgical cancers in areas of crude oil activities and warrants further studies.

Assessment of Hand Hygiene Knowledge, Attitudes and Practices among Primary School Pupils in the Achiase District, Ghana

2026-11-04T11:45:57+00:00

Aims: To describe hand hygiene knowledge, attitudes, self-reported behaviours and school WASH support among primary school pupils in Achiase District, Ghana.

Study Design: School-based cross-sectional survey.

Place and Duration of Study: Selected public primary schools in Achiase District, Eastern Region, Ghana, September–October 2025.

Methodology: A multistage sample of 389 pupils aged 6–12 years completed interviewer-administered questionnaires, and a school-facility checklist was used. Questionnaire responses were summarised descriptively. Associations with an overall questionnaire practice category were explored using chi-square tests and logistic regression.

Results: Good knowledge was reported for 93.1% and positive attitudes for approximately 93% of pupils. However, only 13.1% identified the recommended minimum hand-rubbing duration, 1.8% reported handwashing after toilet use and 8.5% reported consistent soap-and-water use. Functional school handwashing facilities were reported by 10.3% of pupils. A separate overall practice summary classified 13.9% as good; this category does not represent confirmed adherence to every individual practice. Very large residence-related adjusted odds ratios were recorded, but the semi-urban subgroup was small (n = 7) and the estimates require cautious interpretation.

Conclusion: Knowledge of handwashing benefits was generally high, but several self-reported hygiene behaviours and enabling school conditions were limited. Practical instruction and improved access to handwashing facilities warrant consideration alongside further evaluation of behaviour and school WASH provision.

Typhoid Fever Knowledge, Attitudes, and Preventive Practices among Cooked-food Vendors in Omega New Market, Paynesville, Monrovia, Liberia: A Cross-Sectional Study

2026-11-04T11:54:28+00:00

Background: Typhoid fever remains a public health concern in Liberia, yet evidence on typhoid-related knowledge, attitudes and preventive practices among cooked-food vendors in local markets is limited. This study assessed these dimensions among vendors at Omega New Market, Paynesville, Monrovia.

Methods: A descriptive cross-sectional survey was conducted between May and July 2026 among 155 cooked-food vendors aged 18 years and above. Data were collected using a structured questionnaire administered through Google Forms and analysed using descriptive statistics, chi-square tests and logistic regression in SPSS version 26.

Results: All participants were women. Overall, 69.7% demonstrated good knowledge, 48.4% had favourable attitudes and 43.9% reported good preventive practices. None reported receiving formal food safety training. Only 31.6% reported always washing their hands with soap before handling food, and 49.7% knew that a typhoid vaccine was available. Bivariate analyses identified associations between preventive practices and age, education, food-vending experience, culinary-water source, self-reported typhoid history and attitude. In the reported adjusted analysis, more than three years of vending experience and use of hand-pump water were associated with higher odds of good preventive practices; education and self-reported typhoid history were also associated with the outcome.

Conclusion: The results indicate differences between knowledge, attitudes and reported practices among the surveyed vendors. Practical food hygiene education and context-specific preventive measures merit consideration, while the cross-sectional findings do not establish causal relationships.

Determinants of Auto-medication among People with Symptoms Related to COVID-19 in Yaoundé, Cameroon: A Qualitative Study

2026-11-05T13:24:34+00:00

Background: Since the emergence of coronavirus disease 2019 (COVID-19), many people with symptoms suggestive of the disease have followed therapeutic routes outside the formal healthcare system. Auto-medication, the use of any remedy without the advice of a health professional, is widespread in sub-Saharan Africa. Understanding why people avoided formal care during COVID-19 remains essential for preparedness against future epidemics. This study aimed to analyse the determinants of auto-medication among people with symptoms related to COVID-19 in Yaoundé, Cameroon.

Methods: A phenomenological qualitative study was conducted between July and September 2020. Data were collected through the triangulation of three techniques: direct observation in four households in different neighbourhoods of Yaoundé, semi-structured individual interviews with 12 purposively selected residents (until saturation), and one 90-minute focus group discussion with 10 participants (4 women, 6 men). Data were analysed thematically and interpreted through the Health Belief Model (HBM) and commitment theory.

Results: Participants were informed about the symptoms and barrier measures of COVID-19, so auto-medication did not stem from a lack of knowledge. Seven of the 12 interviewees usually treated flu-like symptoms with herbal remedies, four used roadside drug sellers and one used a health facility. Determinants were behavioural, psychological, socio-economic, socio-cultural and health-system-related. Through the HBM lens, two opposite pathways led to the same behaviour: participants who denied or minimised the disease saw no need for formal care, while those who feared it saw the hospital itself as a threat. In both cases, the perceived barriers to formal care (isolation and lost income, stigma, fear of contamination in hospitals and the non-return of bodies for religious burial) outweighed its perceived benefits, whereas home remedies were seen as familiar, affordable and within personal control. Cues to action came mainly from neighbours, relatives, social media and religious figures rather than from health authorities.

Conclusion: Auto-medication was a reasoned response to the perceived costs of formal care rather than simple ignorance. Future epidemic responses should lower these costs through income support during isolation, community-based and home-based testing, safe and dignified burials designed with religious leaders, visibly safe health facilities, and partnerships with trusted community messengers and informal drug providers.

Asymptomatic Malaria Parasitaemia and Anaemia among pregnant women at Antenatal Booking in Southwest Nigeria: Implications for Routine Screening within Maternal Health Services in Endemic Settings

2026-11-09T06:35:31+00:00

Background: Asymptomatic malaria parasitaemia may be missed when antenatal testing is guided by symptoms, although its association with maternal anaemia remains relevant in endemic settings.

Objective: This study assessed the prevalence of asymptomatic malaria parasitaemia and its association with anaemia among pregnant women attending antenatal booking in Ile-Ife, Southwest Nigeria.

Methods: A hospital-based descriptive cross-sectional study was conducted over 20 weeks at Seventh-Day Adventist Hospital. Of 156 systematically recruited asymptomatic pregnant women, 146 had complete data and were included in the analysis. Sociodemographic and obstetric information was obtained using an interviewer-administered questionnaire. Malaria parasitaemia was identified by microscopy, and haemoglobin concentration was measured using an automated haematology analyser. Associations were examined using chi-square tests, an independent-samples t-test and multivariable logistic regression.

Results: Participants had a mean age of 30.2 ± 4.1 years. Asymptomatic malaria parasitaemia was detected in 56 women (38.4%), while 91 (62.3%) had anaemia. Mean haemoglobin concentration was lower among malaria-positive women (9.76 ± 1.65 g/dL) than among malaria-negative women (10.51 ± 1.62 g/dL; p = 0.008). After adjustment for selected covariates, parasitaemia was associated with increased odds of anaemia (adjusted odds ratio 2.170, 95% confidence interval 1.015–4.639; p = 0.046).

Conclusion: Asymptomatic parasitaemia was common and associated with anaemia at booking. These findings support consideration of early malaria assessment alongside established antenatal prevention strategies, while broader studies are needed before changes to routine screening policies.

Skilled Delivery, Neonatal Survival and the Integration of Community Engagement Mechanisms in Two Rural Ghanaian Municipalities: A Mixed-Methods Study

2026-11-10T13:51:00+00:00

Aims: To compare skilled delivery and neonatal survival between two rural Ghanaian municipalities implementing pregnancy schools, community-financed emergency transport and community-led advocacy, and to explore how participants link these mechanisms to each other and to maternal and newborn outcomes.

Study Design: Convergent mixed-methods study combining a cross-sectional survey with focus group discussions (FGDs) and key informant interviews (KIIs).

Place and Duration of Study: Nkwanta South (Oti Region) and Gushegu (Northern Region) municipalities, Ghana, January to August 2026.

Methodology: We surveyed 420 women (210 per municipality; response rate 97.7%) and conducted 6 FGDs and 20 KIIs. Outcomes were compared using chi-square tests, risk differences and adjusted logistic regression; qualitative data were analysed thematically and integrated in a joint display.

Results: Skilled delivery was reported by 66.2% of women: 72.9% in Nkwanta South and 59.5% in Gushegu (difference 13.3 percentage points, 95% CI 4.4 to 22.3; adjusted odds ratio 2.7, 95% CI 1.8 to 4.1). Reported neonatal survival was 94.3% and 89.5% (difference 4.8 points, 95% CI -0.4 to 10.0; p = 0.074), with about 44% power. Six qualitative themes described an integrated pathway to safe delivery, supplies linked to survival, earlier arrival, and trust and accountability. Findings converged for delivery and diverged in strength for neonatal survival.

Conclusion: Skilled delivery was substantially higher where engagement structures were better developed, and participants described the mechanisms as reinforcing one another. Both municipalities remained below national coverage, and the survey could not show a difference in reported neonatal survival. Community engagement may help women reach skilled care, but newborn survival also depends on facility-level capacity.

Giant Epigastric Hernia Containing Wandering Caecum, Appendix, Ascending Colon and Terminal Ileum: A Case Report and Literature Review

2026-11-05T10:24:04+00:00

Background: Epigastric hernia is a common occurrence in surgical practice globally; however, it is often “sacless”. This study reports the clinical features, reviews the literature, and discusses the rare finding of a giant epigastric hernia containing the caecum and other viscera.

Methods: Consent was obtained from the patient and the hospital’s Research and Ethics Committee. The clinical case notes of the patient, who first presented in February 2026 and re-presented in September 2026, were used to extract data for the study.

Case Presentation: A 37-year-old female patient (Gravida 5, Para 2, with 2 alive) presented with an 8-year history of abdominal protrusion associated with occasional pain. The swelling gradually increased from a small mass to approximately the size of the patient’s two palms, without associated obstructive symptoms. Significant examination findings included a young woman with morbid obesity (BMI = 48.7 kg/m²), with a pendulous protruding epigastric mass measuring 20 cm by 25 cm. Laboratory investigations were normal. A diagnosis of a huge pendulous impacted epigastric hernia was made in a multiparous woman with morbid obesity. She underwent elective hernia repair and abdominoplasty under general anaesthesia. Intra-operatively, a huge epigastric hernia sac containing the caecum, ascending colon, appendix, terminal ileum, and greater omentum was found. She underwent appendicectomy, Mayo’s repair, and abdominoplasty, with a satisfactory outcome.

Conclusion: A rare combination of three features—an epigastric hernia with a sac, giant size, and a wandering caecum—is reported in a young woman with morbid obesity.