Open Access Short Communication

Evaluation of Field Performance of Insecticide-Treated Mosquito Nets in North-Western Burkina Faso

Valérie R. Louis, Athanase Badolo, Tabea Schröer, Wamdaogo M. Guelbeogo, Justin Tiendrebéogo, Albrecht Jahn, Maurice Yé, N’Falé Sagnon, Olaf Mueller

International Journal of TROPICAL DISEASE & Health, Page 284-289
DOI: 10.9734/IJTDH/2012/2110

Aims: The aim of the study was to evaluate the field performance of insecticide-treated mosquito nets (ITNs) in north-western Burkina Faso.
Study design: Cross-sectional survey.
Place and Duration: The study took place between September and November 2008 (end of rainy season) in rural north-western Burkina Faso.
Methodology: Standard WHO bioassays were performed on field-collected ITNs from three areas of different insecticide pressure: semi-urban Nouna town, three villages with cotton agriculture, and three villages without cotton agriculture. Data on age and washing frequency of ITNs was collected, and deltamethrin content was determind by HPLC.
Results: The mean age of field-collected ITNs was 2.1 years. The mosquito mortality rate (Anopheles gambiae sl.) after 24 hours was 4% for the negative controls, 90% for the positive controls, and 73% for field-used ITNs. Differences in mosquito mortality between sub-areas disappeared after controlling for confounding variables.
Conclusion: This study demonstrates that under real life conditions, deltamethrin still shows some level of effectiveness despite ongoing insecticide pressure. However, deltamethrin resistance has been observed in other parts of the country and thus close surveillance of ITN efficacy is needed. More frequent replacement of ITNs is also recommended.

Open Access Original Research Article

Association between Sickle Cell Trait and Low Density Parasitaemia in a P. falciparum Malaria Holoendemic Region of Western Kenya

Walter Otieno, Benson B. A. Estambale, Joash R. Aluoch, Stacey M. O. Gondi, José A. Stoute

International Journal of TROPICAL DISEASE & Health, Page 231-240
DOI: 10.9734/IJTDH/2012/1762

Aims: The frequency of the mutant gene for sickle cell is widely distributed in the sub-Saharan Africa, the Middle East, and the Indian subcontinent. There is epidemiologic evidence that sickle cell trait confers a survival advantage against malaria and that the selection pressure due to malaria has resulted in high frequencies of the mutant gene in areas of high malaria transmission. We carried out a study to look at the relationship between sickle cell trait, age, haemoglobin level, and malaria parasite density.
Methods: We carried out a cross-sectional study between the months of October and December, 2004 in Kombewa Division of Kisumu West District, a P. falciparum malaria holoendemic area with entomological inoculation rates estimated at 31.1 infective bites per person per year. We screened and quantified malaria parasitaemia in participants (age 0 to 45 years n = 342). Haemoglobin electrophoresis was performed on blood from all the participants.
Results: In total, 402 participants were screened of which 342 were enrolled. Of these, 280(81.4%) had haemoglobin AA, 60(17.4%) had haemoglobin AS and 2(0.6%) had haemoglobin SS. Those with HbAA and HbAS were included for the analysis bringing the total number to 340 participants. For asymptomatic individuals in the community who displayed no signs of an acute or chronic illness and who were P. falciparum malaria parasite positive; the mean parasite density/µL for HbAS of 4064.0 (95% CI 1858.0 – 6270.0) was significantly lower than that of HbAA 11,067.9 (95% CI 7616.0 – 14520.0) (P = 0.001).
Conclusion: The sickle cell carrier status is high (17.4%) in this population and is protective against high density parasitaemia. It is suggested that any malaria intervention strategies should factor in the possibility of sickle cell trait as a confounder to the protective effect of the intervention.

Open Access Original Research Article

Predictors of Hypertension among Adult Tribal Males of India

A. K. Kapoor, Kiran Saluja, Deepali Verma, Satwanti Kapoor

International Journal of TROPICAL DISEASE & Health, Page 241-256
DOI: 10.9734/IJTDH/2012/1750

Background: Cardiovascular diseases (CVD) have increased worldwide equally burdening people from different ethnic and socio-economic groups. Hypertension is an eminent modiï¬able risk factor for CVD and relates to body adiposity, which can be evaluated by various anthropometric measurements.
Objective: The present study reports prevalence of under nutrition and hypertension, potential predictors of hypertension and new cutoff values for various disease associated adiposity markers in six tribal populations inhabiting different states in India.
Methods: Cross sectional sample of 910 adult males aged 46.98 ±17.17 years was studied. Anthropometric measurement (height, body weight, body circumferences, skinfold thicknesses), blood pressure and socio-demographic characteristics were ascertained. General and regional adiposity indices, muscle diameter and fat % were derived. Descriptive, multivariate regression analyses were performed. Receiver operating characteristics (ROC) was used to determine optimal cutoffs values.
Results: Underweight (45.3%) and hypertension [Systolic blood pressure (SBP) - 15.2%, Diastolic blood pressure (DBP)-25.5%] co-exist increasing the morbidity in the tribal population under study. General adiposity measures were better predictors of hypertension. Body mass index (BMI), fat% (negatively associated), age and mid upper arm circumference (positively associated) were independent risk factor for hypertension. Out of all reported cut offs, the new BMI cutoff values (20.12 kg/m2 and 18.98 kg/m2) and for mid upper arm circumference (MUAC) (21.44cm and 21.95cm) for predicting SBP and DBP respectively corresponding nearly to earlier reported standards by World health Organization (WHO).
Conclusion: The inverse association of general adiposity markers with blood pressure among the present subjects indicates that CVD is not only prevalent among the affluents but is also affecting the socio-economically and nutritionally deprived groups. Population specific cutoffs for the anthropometric markers are needed to identify individuals with different body compositions at risk. Long term treatment expenses and health burden further depletes the limited economic resources of these vulnerable groups creating a vicious cycle of CVD and under nutrition.

Open Access Original Research Article

Bone Marrow Transplantation to Cure Sickle Cell Disease using the Diffusion of Innovation Theoretical Model

E. William Ebomoyi

International Journal of TROPICAL DISEASE & Health, Page 257-271
DOI: 10.9734/IJTDH/2012/1793

This project outlined use of the diffusion of innovations model to disseminate bone marrow transplantation technology for the cure of sickle cell anemia and other hemoglobinopathies. Besides, we Identified technologically developed nations that have the relevant medical workforce and infrastructures for BMT. Also discussed, is the necessity of equipping transplant facilities with the construction of the CLEAN ROOM with the state- of- the science resources to protect SCD patients from nosocomial infections. To save human lives and avoid unnecessary casualties, the medical team must protect their patients from hospital acquired infections (HAI), nosocomial and iatrogenic diseases during administration of transplant innovative device. Medical institutions must maintain continuity in sustainable, scientific workforce development. Finally, we explored the ethical, legal, social, and financial implications of adopting Bone Marrow Transplantation medical innovations to cure sickle cell anemia.

Open Access Original Research Article

Red Blood Cell Immune Complex Binding Capacity in Children with Sickle Cell Trait (HbAS) Living in P. falciparum Malaria Holoendemic Region of Western Kenya

Walter Otieno, Benson BA Estambale, Michael M Odera, Joash R Aluoch, José A Stoute

International Journal of TROPICAL DISEASE & Health, Page 272-283
DOI: 10.9734/IJTDH/2012/1761

Aims: Malaria infection leads to the formation of circulating immune complexes (CICs) which have been implicated in the pathogenesis of complicated malaria which includes severe malarial anemia. Children with sickle cell trait (HbAS) are less predisposed to getting severe manifestations of malaria. We carried out a study to determine the competence of the red blood cells (RBCs) of children with HbAS to bind immune complexes (ICs) and compared this with normal hemoglobin (HbAA).
Methods: Children (aged 0-192 months) were enrolled in a nested case controlled study conducted in Kombewa Division, Kisumu West District, Kenya. Based on hemoglobin (Hb) type, children were stratified into those with HbAS (n=47) and HbAA (n=69). The 47 HbAS individuals were matched to 69 HbAA of similar age. The children were further categorized into three cohorts (0-12, 13-48 and 49-192 months). Immune complex binding capacity (ICBC) was quantified using a FACScan flow cytometer under normal and reduced oxygen saturation.
Results: The mean immune complex binding capacity for the HbAS cells was significantly higher than that of HbAA cells (P=0.0191) under normal oxygen saturation or under reduced oxygen saturation (P=0.0050). When a matching variable (UNIANOVA) was done to control for age, gender, the presence or absence of malaria parasitaemia, the binding capacity was again significantly higher for the HbAS than for HbAA under normal oxygen saturation (P=0.025) and under reduced oxygen saturation (P=0.003). The binding capacity was lowest in the 7-12 months age group for both HbAS and HbAA; however, the overall picture showed that HbAS individuals had higher immune complex binding capacity than HbAA in all the age cohorts.
Conclusion: These results demonstrate that the protection afforded by HbAS against severe manifestations of malaria may be partly due to higher immune complex binding capacity of the HbAS compared to the HbAA cells. This high binding capacity may lead to the mopping up of ICs formed during malaria attacks and therefore protect these cells from deposition and subsequent destruction.

Open Access Original Research Article

Anti-diabetic Activity of Aqueous Extracts of Vitex doniana Leaves and Cinchona calisaya Bark in Alloxan–Induced Diabetic Rats

C. N. Ezekwesili, H. A. Ogbunugafor, J. O. Ezekwesili–Ofili

International Journal of TROPICAL DISEASE & Health, Page 290-300
DOI: 10.9734/IJTDH/2012/1693

Vitex doniana Sweet and Cinchona calisaya WEED are tropical medicinal plants endued with important pharmacological properties. The effects of aqueous extracts of V. doniana leaves and C. calisaya bark on alloxan-induced diabetes mellitus in Wistar albino rats were evaluated. Diabetes mellitus was induced by a single intraperitoneal ( i.p) injection of 150 mg/kg body wt of alloxan monohydrate. The aqueous extracts of V. doniana leaves and C. calisaya bark were administered intraperitoneally to four diabetic groups at same doses of 50 and 100 mg/kg body wt. The actions of the extracts were compared with that of the standard oral hypoglycaemic agent, glibenclamide. Both extracts caused significant (p < 0.001) decreases in blood sugar levels of the rats at both doses tested. At 50 mg/kg body wt. V. doniana leaf extract produced 82.9% reduction in blood sugar level (i.e from 492.8 to 84.5 mg/dl) after four days whereas, C. calisaya caused 64.4% decrease. Unlike C. calisaya bark, V. doniana at both doses tested, was more potent than the reference drug, glibenclamide (0.3 mg/ kg body wt.). The antidiabetic activity of V. doniana did not vary with the dose, whereas the observed effect of C. calisaya decreased with increase in dose. C. calisaya exhibited higher antidiabetic activity at a lower dose of 50 mg/kg body wt. Both medicinal plants therefore possess valuable antidiabetic property. Their effects on the antioxidant status were also investigated. V. doniana and C. calisaya extracts caused increases in the activity of SOD and lipid peroxidation when compared with control, but the increases were lower than that produced by alloxan, indicating attenuation of free radical generation. Quantitative phytochemical analyses of both extracts showed the presence of saponins(0.92%), flavonoids(7.05%), alkaloids(1.8%), and cardiac glycosides(2.8%) in V. doniana, whereas saponins(2.0%), flavonoids(5.0%), alkaloids(6.0%), and cardiac glycosides(3.54%) were detected in C. calisaya.

Open Access Original Research Article

Presence of Aedes albopictus in Palestine –West Bank

Shadi Hilmi Abd Allah Adawi

International Journal of TROPICAL DISEASE & Health, Page 301-310
DOI: 10.9734/IJTDH/2012/2660

Aim: This study confirmed the establishment of Aedes (Stegomyia) albopictus (Skuse, 1894) and provided information about its distribution during the period of July to October 2012 in Salfit district (Northwestern West Bank).
Study Design: A cross- sectional study.
Methods: A cross- sectional survey was conducted in West Bank - Salfit district to collect larvae and adults of the Aedes albopictus from two localities in Salfit district during the period of July to October 2012.
Results: Adult Aedes albopictus were collected from outdoor sites of different habitats in two localities in Salfit district (Mas-ha and AZ-Zawia locality) and different immature stages (larvae and pupae) were found in Salfit district (Mas-ha locality).
Limitations of Study: The study discussed the presence of Ae. albopictus in two localities in salfit district and data about other species of mosquito were neglegted in the study.
Conclusion: The results show that adults and larvae were found confirming the establishment of the species in the area. More studies are needed to understand the ecology and biology of Aedes albopictus and its distribution in Salfit district and its possibility of transmitting viral diseases.