Open Access Commentary

Potential Factors Responsible for the Development of Plasmodium falciparum and Plasmodium vivax Resistance to Anti-malarial Drugs in Some Parts of India

Harshul Batra

International Journal of TROPICAL DISEASE & Health, Page 68-72
DOI: 10.9734/IJTDH/2013/2806

Indiscriminate use of chloroquine (CQ) has resulted in chloroquine resistance in Plasmodium falciparum (Pf) in almost all regions of India. Due to the emergence of resistance to CQ in India, the current recommended first line of treatment for Pf has been the combination of artesunate with sulfadoxine-pyrimethamine (SP). Recently, chloroquine resistance to Plasmodium vivax (Pv) has also emerged in some parts of India. Poor drug quality and under dosing of antimalarial treatment are potential factors of drug resistance to malaria parasite. A caution is thus required for quality control of antimalarial drugs now in use and also inadequate treatment. There is an urgent need to strengthen National Drug Control Policy to empower Central Drugs Standard Control Organization to enforce definitive antimalarial drug legislations. Improvement in quality control in production and distribution of antimalarial drugs in India, combined with informed and enforced national guidance on the treatment of malaria, will help to combat the emergence of resistance to antimalarial drugs.

Open Access Original Research Article

Epidemiological Patterns of HIV/AIDS and Diabetes in Developing Countries: A Cluster Analysis

Tilahun Nigatu Haregu, Julian Elliott, Geoffrey Setswe, Brian Oldenburg

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2013/2523

Introduction: HIV/AIDS and Noncommunicable diseases are the major public health threats of developing countries. Analysis of joint epidemiological patterns of these diseases will help in designing and implementing appropriate interventions to mitigate their impacts.
Objectives: The overall aim of this study was to analyze Epidemiological patterns of HIV/AIDS and Diabetes in developing countries.
Methods: Country level HIV/AIDS and Diabetes prevalence data at four time points, between 2000 and 2010, for 68 countries in Sub-Saharan Africa, Southern and South Eastern Asia were transformed and analyzed. Joint geographic and temporal trends were described using numerical and graphic summaries. The level of Covariation between HIV and Diabetes prevalence was measured by Pearson correlation. K-means cluster analysis was conducted after the appropriate number of clusters was determined using scree plot technique. Analysis of variance was used to identify factors that differentiate the clusters.
Results: Diabetes had higher mean prevalence with increasing trend while HIV/AIDS had higher disability-weight adjusted mean prevalence with a decreasing trend during the study period. The findings suggest that HIV/AIDS and Diabetes were negatively correlated throughout the study period (r > 0.3, P <.05 in all four time points). Hence, countries with higher prevalence of Diabetes tend to have lower prevalence of HIV/AIDS and vice versa. Four clusters of countries with size 29, 12, 12 and 14 countries were identified. These clusters were found to have significant variation with respect to their mean HIV and Diabetes prevalences as well as time trends in their mean prevalences.
Conclusions: Diabetes and HIV are heading in reverse directions during the study period in the study regions. The identified clusters were found to describe these patterns of variation across geography and time. The clusters may be useful in considering a set of coordinated country level interventions.

Open Access Original Research Article

Differences in Schistosomiasis Knowledge among Irrigation Rice Farming Communities in Different Irrigation Schemes in Tanzania

Farida S. Salehe, Amon Z. Mattee, Andrew K. P. R. Tarimo, Jeroen H. J. Ensink, Madundo M. A. Mtambo

International Journal of TROPICAL DISEASE & Health, Page 13-24
DOI: 10.9734/IJTDH/2013/2479

Aim: To assess differences in schistosomiasis knowledge in farmers working in traditional, improved traditional and modern irrigation schemes in Tanzania.
Study Design: A cross-sectional survey among farmers practicing irrigation rice farming, in 2 different regions and 6 different irrigation systems.
Place and Duration of Study: The study was carried out between November and December 2011 in the Morogoro and Kilimanjaro Regions, Tanzania.
Methodology: Equal number of irrigators in each scheme was employed. Irrigators were chosen randomly by the researcher from the list of all farmers actually engaged in rice irrigation farming provided by the village governments in the six schemes. Two hundred and fourty samples (240) were used, 120 from each region (40 farmers practicing irrigation rice farming in each scheme). Independent sample t-test was used for testing schistosomiasis knowledge differences among irrigators between schemes with the same design and construction of their infrastructures between the two regions.
Results: More than 88% of irrigators surveyed in Kilimanjaro schemes had better knowledge regarding to all schistosmiasis items asked compared to those in Morogoro, particularly Chabi scheme-traditional. There were significant difference on irrigators knowledge on schistosomiasis symptoms (P<0.001), and predisposing factors (P<0.001) between Morogoro and Kilimanjaro Modern schemes. Knowledge on predisposing factors differed significantly (P<0.001) between irrigators in Morogoro and Kilimanjaro improved traditional schemes. Moreover significant difference were noted on irrigators knowledge on schistosomiasis symptoms (P<0.001), predisposing factors (P<0.004) and schistosomiasis control measures (P=0.003) between irrigators in Morogoro and Kilimanjaro traditional schemes.
Conclusion: From the results it appears that the level of farmers’ knowledge of schistosomiasis is related to: proximity to health facilities of the community, trainings that have been provided to farmers and farmer’s literacy rate. However the government should be responsible to improve health facilities, construct roads and deliver schistosomiasis education to communities in irrigation areas even for schemes which have not been planned, designed and constructed by the government.

Open Access Original Research Article

Rates and Risk Factors Associated with Surgical Site Infections in a Tertiary Care Center in South-Western Nigeria

O. E. Amoran, A. O. Sogebi, O. M. Fatugase

International Journal of TROPICAL DISEASE & Health, Page 25-36
DOI: 10.9734/IJTDH/2013/1769

Background: Surgical site infections [SSI] are one of the most common nosocomial infections. This study was therefore carried out to determine the incidence and risk factors associated with surgical site infection among patients in a tertiary care center in Western Nigeria.
Methods: The study was a 6 months Retrospective cohort study which reviewed case files obtained from the surgical departments. The study was carried out between 23rd January 2012 and 3rd february 2012 at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
Result: A total of 386 surgical patients were recruited into the study. The overall incidence rate of SSI was 13.0%. The children had the highest infection rate of 22.9%. Factors associated with SSI were Pre-existing Medical Condition [X2=70.76, p=0.00001] Department of Care [X2=11.68, p=0.039] and age[X2=9.50, p=0.05]. There was no statistically significant difference in the SSI rate among the respondents due to Sex [X2=1.74, p=0.187], Operation site [X2=9.01, p=0.109] and Occupation [X2=5.84, p=0.12]. Forty-nine (98.0%) out of the 50 clinical surgical site infections were culture-positive and 20 (40.0%) of them had polymicrobial infection. The most frequently isolated bacteria were Staphyloccocus aureus, 16 [32.7%] and E. Coli 17 [34.7]. Pre-existing medical condition [OR=0.46, C.I=0.36-0.59] and length of post operative stay in the hospital [OR=0.33, C.I=0.21-0.50] were predictors of risk of surgical site infection.
Conclusion: The study suggests that pre-existing medical condition and length of post operative stay in the hospital were predictors of risk of surgical site infection. This suggest that home based care of surgical wounds in patients that are ambulatory should be encouraged.

Open Access Original Research Article

Schistosomiasis in Ipogun: Update Assessment on Endemicity and Efficacy of Praziquantel in Chemotherapy

M. O. Oniya, M. A. Ishola, O.D. Jayeoba

International Journal of TROPICAL DISEASE & Health, Page 37-44
DOI: 10.9734/IJTDH/2013/2606

Aims: To assess the present endemicity of urinary schistosomiasis among school aged pupils in Ipogun, a notable endemic village in Ondo state, Nigeria and also the efficacy of single dose Praziquantel in chemotherapy.
Study Design: The overall goal of the study was to assess the current endemicity status and efficacy of Praziquantel in treatment at the standard dose of 40mg/kg body weight. Mass screening was conducted in all primary schools in the village after informed consent had been sought from their parents, teachers and the village king. The only age bracket excluded in the study were the under 3 year old.
Place and Duration of Study: Department of Biology, Federal University of Technology, Akure, Nigeria, between January and June 2012.
Methodology: Urine samples were collected from 567 pupils from five different primary schools in the village and examined for schistosome eggs using centrifugation method. Infected pupils at the first screening exercise were treated with single dose Praziquantel (40mg/kg body weight) and re-examined 3 weeks after treatment to assess cure rate.
Results: Results revealed that 100 pupils were positive at the first screening giving a prevalence rate of 18% and post-treatment urinalysis showed that 80 of the previously infected pupils were negative three weeks after initial treatment giving 80% parasitological cure rate. Infection was higher among male pupils than the female and pupils from schools that were close to the village river had the highest prevalence of infection.
Conclusion: Our findings revealed that prevalence of infection had reduced remarkably among the pupils in the village and that Praziquantel is still effective and remains a reliable drug of choice in chemotherapy in the study area.

Open Access Original Research Article

Timeliness and Out-of-Sequence Vaccination among Young Children in Burkina Faso – Analysis of Health and Demographic Surveillance System (HDSS) Data

N. Ouédraogo, M. Kagoné, A. Sié, H. Becher, O. Müller

International Journal of TROPICAL DISEASE & Health, Page 45-56
DOI: 10.9734/IJTDH/2013/2920

Aims: The aim of this study is to investigate the timeliness and out-of-sequence vaccination among children aged less than five years through the data of a local Health and Demographic Surveillance System (HDSS) in Burkina Faso.
Study Design: Cross-sectional study nested into an existing HDSS.
Place and Duration of Study: Nouna Health District in north-western Burkina Faso, over the period of September 2008 to December 2009.
Methodology: We used data of 7,644 children born between September 2003 and March 2009. Vaccination data were provided on the basis of events recorded on vaccination cards. We assessed vaccination timeliness and the frequency of out-of-sequence vaccination.
Results: The highest rates of timely administration were observed with vaccines recommended at birth (e.g. 68% for BCG) while the lowest rates were observed with vaccines given in late infancy (e.g. 33% for measles). The frequency of out-of-sequence vaccination between BCG and DTP/Penta 1 or between DTP/Penta 3 and measles were respectively around 5% and 4%. Out-of-sequence vaccination in early infancy occurred significantly more frequent in rural compared to urban areas contrary to out-of-sequence vaccination in late infancy. Both, timely and correct sequencing of vaccination have significantly improved in recent years in the study area.
Conclusions: This study supports that significant vaccination delay occurs in SSA communities with high vaccination coverage and that the frequency of out-of-sequence vaccinations varies substantially between countries.

Open Access Original Research Article

Sexual Risk Behaviour and Knowledge of HIV/AIDS among Male Prison Inmates in Kaduna State, North Western Nigeria

O. Audu, S. J. Ogboi, A.U. Abdullahi, K. Sabitu, E. R. Abah, O. P. Enokela

International Journal of TROPICAL DISEASE & Health, Page 57-67
DOI: 10.9734/IJTDH/2013/2901

Background: The average numbers of Nigerians who have been incarcerated over the past three decades when HIV/AIDS was discovered have been increasing and the seroprevalence of HIV/AIDS amongst the prison inmates remained higher than the national average due to the occurrence of risky sexual practices among inmates and inadequate HIV prevention, care and support services. This study assessed the sexual risk behaviour and knowledge of HIV/AIDS among inmates in Kaduna State, north western Nigeria.
Methodology: A descriptive cross sectional study with qualitative method of data collection (focus group discussion) was conducted on 107 inmates aged 20 to 55 years in Kaduna State Prisons Command between September 8th and October 2nd 2010. Information elicited were transcribed and translated where appropriate and presented as tables and in narrative forms with relevant quotations.
Results: The mean average age of the respondents was 34(±8.62) years. The general awareness and knowledge of causative agent of HIV infection was high (96.3% and 67.3% respectively). However, some have misconceptions of witchcraft (9.3%), enemies (11.2%), bacteria (12.1%) and mosquitoes’ bite (15.9%) as the causative agent/ mode of transmission of HIV infection. 99.5% acknowledged that HIV/AIDS and risky sexual practices occurred in prison but denied taking part. Sex in prison was often associated with homosexual behavior among the males but participants were pessimistic about condom distribution due to fear of promotion of homosexuality (65.4%) and non compliance with religion (34.6%).
Conclusion: Despite high level of awareness of HIV/AIDS among inmates, there are still misconceptions. Homosexual practices associated with HIV/AIDS transmission is practiced among the male inmates; however, the use of condom which is one of the evidence based strategies for the prevention of sexual transmission of HIV/AIDS is met with a high degree of resistance by inmates. Therefore, there is need for implementation of HIV/AIDS interpersonal communication and counseling programmes for the inmates in Nigeria prisons.