Open Access Original Research Article

The Epidemiology of Trachoma in the Lower Shire Valley of Southern Malawi and Implications for the “SAFE” Strategy

Khumbo Kalua, Isaac Singini, Mavuto Mukaka, Laura Senyonjo

International Journal of TROPICAL DISEASE & Health, Page 494-508
DOI: 10.9734/IJTDH/2014/7437

Aims: To determine the prevalence of trachoma and associated risk factors in the Lower Shire Valley of Southern Malawi.
Study Design: Population based cross sectional study.
Place and Duration of Study: Lower Shire Valley of southern Malawi between July and October 2012.
Methodology: Children aged 1-9 years (total 2957) were assessed for clinical signs of active trachoma follicular (TF) and adults aged 15 and above (total 2247) were assessed for signs of trachoma trichiasis (TT), which is potentially blinding trachoma. A questionnaire survey was conducted to explore the potential risk factors.
Results: A total of 2957 children aged 1-9 years who were assessed for clinical signs of TF and 2247 adults aged 15 and above were assessed for signs of TT.The prevalence of TF among children aged 1-9 years was found to be 18.5% (95% CI 16.4-20.8) in Nsanje and 7.8% (95% CI 6.6-9.2) in Mwanza districts respectively. The prevalence of TT in adults aged 15 and above was 0.5% (95% CI: 0.1-0.9) in Nsanje district and 0.2% (95% CI: 0.1-0.4) in Mwanza district, respectively. In regards to risk factors, only the presence of a dirty face was associated with trachoma follicular (TF) in Nsanje and Mwanza districts (P< 0.001).
Conclusion: In this study, prevalence of active trachoma infections was 18.5% in Nsanje and 7.8% in Mwanza district. Dirty face was associated with trachoma follicular in both districts. According to WHO, Nsanje therefore needs a SAFE (Surgery, Antibiotics, Face Washing and Environmental) control strategy.

Open Access Original Research Article

Seroprevalence of Hepatitis B Surface Antigen (HBsAg) in Akoko-Edo Local Government Area of EDO State, Nigeria

A. O. Ogundare, A. I. Akinyemi, I. E. Imade

International Journal of TROPICAL DISEASE & Health, Page 509-516
DOI: 10.9734/IJTDH/2014/6885

Aims: To determine the seroprevalence of Hepatitis B surface antigen (HBsAg) in Akoko-Edo Local Government Area of Edo State, Nigeria.
Study Design: The study focused on socio-demographic characteristics of volunteers such as age, sex, marital status and location.
Place and Duration of Study: This study was carried out among apparently healthy individuals of Akoko-Edo Local government area of Edo State, Nigeria between October 2012 and December 2012.
Methodology: The HBsAg one step hepatitis B surface antigen test strip, a rapid chromatographic immunoassay for the qualitative detection of Hepatitis B surface antigen in serum/plasma, was used for screening the volunteers.
Result: Out of the 455 volunteers screened, 125 people (27.5%) were positive which consist of 49 male (28.7%) and 76 females (26.8%). Age related prevalence for HBsAg was 18.2% and 9.2% among those aged 10-40 and 40-70 years respectively. Among single individuals of 101, prevalence of 25.3% was recorded while only 6% (24) was recorded as prevalence among married individuals. This study also reveals that the highest prevalence of HBsAg was observed in Ojirami-Dam community with 40.3% prevalence while the least was observed in Umeme-Osu community with 16.4% prevalence.
Conclusion: This study shows high prevalence of hepatitis B among children and young adult in Akoko-Edo Local Government Area of Edo State, Nigeria. The incidence of the infection among individuals between ages of 10-40 years with 83 people infected (66.4%) calls for concern among the people of the area. This provides evidence for urgent public awareness and mass immunization of the people in area.

Open Access Original Research Article

Perception and Home Management of Malaria in Rural Communities in Imo State, Nigeria

E. A. Nwoke, S. N. O. Ibe, U. M. Chukwuocha, B. O. Nworuh, C. I. C. Ebirim

International Journal of TROPICAL DISEASE & Health, Page 517-529
DOI: 10.9734/IJTDH/2014/8606

Aims: The objectives were to determine the rural communities’ knowledge on cause, transmission, spread of malaria, breeding sites of mosquitoes, signs and symptoms, health seeking behaviour of respondents, preventive measures and patterns of home management of malaria in the rural communities in Imo State.
Study Design: A descriptive survey design was used.
Place and Duration of Study: Imo State, Nigeria, between February 2013 and April 2013.
Methodology: The sample size was 2674 adults (1650 males, 1024 females, age range 20-70 years). A structured, validated and reliable questionnaire (r = 0.81) and focus group discussion were used as instruments for data collection.
Results: The result showed that out of 2674 respondents, 1683(62.9%) reported that malaria is transmissible while 976(36.5%) reported that malaria is not transmissible. Majority 2262(84.6%) noted that malaria spreads through mosquito bite while insignificant number said malaria spreads through drinking dirty water and eating unhygienic food. 1501(56.1%) noted that stagnant dirty water is a common breeding site for mosquitoes. Most of the respondents had good knowledge of the signs and symptoms of malaria which was used in prompt diagnosis. Majority 41% first patronized medicine stores followed by 38.5% that visited the hospital and health centers. In terms of preventive measures practiced by respondents, the majority 1049 and 1028 used mosquito bed nets and insecticide spray respectively while 237 used firewood smoke to drive mosquitoes away. In the pattern of home management of malaria, 62.3% used anti-malaria drugs, 10.5% used a special herb, Azadirachta indica (dogonyaro/Akum shut up leaf), 6.9% used combination of seven leaves (Pawpaw, mango, guava, Nchuanwu (Occimum basilicum) and awolowo leaf (Chromolaena odorata), orange and lemon grass) While 6.0% used prayers to God.
Conclusion: Based on the above results and to keep abreast with the conventional practice, the rural communities require health education on home management of malaria.

Open Access Original Research Article

Rapid Oral Fluid HIV Antibody Testing in Exposed Babies: A Diagnostic Study

Regina Oladokun, Nkiru David, Biobele Brown, Kikelomo Osinusi

International Journal of TROPICAL DISEASE & Health, Page 530-539
DOI: 10.9734/IJTDH/2014/7761

Aims: The usefulness of rapid oral fluid HIV antibody tests has rarely been evaluated in exposed babies.
Study Design: A diagnostic survey comparing the performance of oral fluid HIV antibody test and the routine rapid blood screening test.
Place and Duration of Study: University College Hospital, Ibadan and Nigerian Institute of Medical Research, Lagos, between May 2010 and April 2011.
Methodology: The study involved children aged less than 18 months referred for screening in two large HIV care programmes in Nigeria using rapid antibody tests - an oral fluid test (Test A) and the routine blood test (Test B). The testing was blinded and HIV status was confirmed using DNA PCR.
Results: A total of 94 children were studied with ages ranging from 0.13 to less than 18months. Out of the 94 parallel tests, when compared with DNA PCR, there were 7 (7.5%) discordant results. Test A gave one false positive, one false negative and no indeterminate result. Test B gave four false positive, one false negative and two indeterminate results. Test A had a sensitivity of 93.3%, specificity of 98.7%, positive predictive value of 93.3% and negative predictive value of 98.7% compared with Test B which had 90.0%, 92.9%, 60.0% and 98.7% respectively. Among the caregivers 88 (93.6%) preferred oral fluid testing to blood as it is painless and easy to perform.
Conclusion: Compared with the rapid antibody blood test, the oral fluid test correlates better with DNA PCR in detecting the absence of infection in HIV exposed babies. Given this performance, it may be useful in expanding testing in HIV exposed children in settings where there are challenges with early infant diagnosis.

Open Access Original Research Article

Malaria Parasitaemia Association with ABO Blood Types among Students of a Private University in Western Delta, Nigeria

F. D. Otajevwo, S. F. Igoniwari

International Journal of TROPICAL DISEASE & Health, Page 540-554
DOI: 10.9734/IJTDH/2014/8479

Aim: The focus of this work was to investigate any relationship between ABO blood types and malaria parasitaemia among students of a private University based in Western Delta, Nigeria.
Study Design: Whole blood samples were obtained from a randomly sampled number of students and dispensed into ethylene-diamine-tetra-acetic acid (EDTA) containers which were appropriately labelled. Collected blood samples were tested for ABO blood types and malaria parasites by standard methods. Data obtained were statistically analyzed.
Place and Duration of Study: The study was carried out in the Microbiology and Biotechnology laboratory of Western Delta University, Oghara, Nigeria between May, 2013 to October, 2013.
Methods: Venous blood of 2ml volume was obtained by venepuncture from 360 students made up of 150 (41.7%) males and 210 (58.3%) females of 28years average and who were both symptomatic and asymptomatic for malaria due to Plasmodium falciparum. Malaria parasite screening was done by both P. falciparum antigen rapid (Micropoint, USA) test and Giemsa staining. ABO blood typing was done using Monoclonal Antisera A, B and D. Results obtained were analyzed for any association by chi-square statistical method.
Results: One hundred and forty one (41.6%) male and 198 (58.4%) female samples were rhesus positive. Nine (42.9%) and 12 (57.1%) males and females respectively were rhesus negative. ABO blood group frequency occurrence was 55.8 %( O), 22.5 %( A), 18.3 %( B) and 3.4 %(AB). A total of 255 (70.8%) students were infected with P. falciparum parasites of which 55.3% and 44.7% were females and males respectively. ABO blood group malaria parasitaemia frequencies were 76.4 %(O), 56.3% (B), 52.4% (A) and O.O% (AB) for non-severe malaria and 70.5% (O), 58.3% (A), 55.6% (AB) and 50.0% (B) for severe plasmodiasis. Whereas there was significant association between malaria infection and gender (P<0.05), there was no significant association between severe and non-severe malaria parasitaemia in relation to ABO blood types (P>0.05).
Conclusion: The presence of rhesus negative factor up to 5.8% suggested a gradual and steady rise in the frequency occurrence of the factor when compared to reports of earlier studies. ABO blood groups O and AB recorded the highest and lowest frequencies respectively. The highest parasitaemia rate was observed among group O individuals and also among female O individuals compared to male O individuals. More female than male students suffered from both severe and non-severe forms of plasmodiasis. There was no significant association of all ABO blood types with severe and non-severe malaria parasitaemia clinically implying that all ABO blood types are equally at risk and therefore, available malaria prophylactic and therapeutic strategies should be directed at subjects of all groups.

Open Access Original Research Article

Substance Use and Perceived Consequences on Health and Safety among Commercial Motorcyclists in Ibadan North Local Government, Ibadan, Nigeria

Chizoma M. Ndikom, Obed B. Ndikom, Ezinne Uvere

International Journal of TROPICAL DISEASE & Health, Page 555-567
DOI: 10.9734/IJTDH/2014/7939

Introduction: Motorcycling is a globalized mode of transport patronized by many road users especially in Nigeria. Although, fraught with negative health outcomes. This study sought to access the perceived consequences of substance use on health and safety among commercial motorcyclists in Ibadan, Nigeria.
Design and Method: Using a cross-sectional survey design, registered and consenting eighty commercial motorcyclists were recruited. A 39 item, interviewer-administered questionnaire containing motorcyclists’ demographic characteristics, perceived consequence of substance use, behaviour towards substance use and consequences of substance use was used to obtain information. Collected data was analyzed at p≤0.05 of significance.
Results: The respondents were mainly within 30-39 years (36.3%); previously traders (42.5%) and have attained secondary school level of education (45.0%). Though, 57.5% of the respondents positively affirmed the ability of an individual under the influence of alcohol to cause accident, 46.3% of them hold the belief that it is good for mood modification and did not affect health negatively (70%). Up to 36.2% of the respondents agreed to have used substances while driving. Enhancement of visibility while driving (51.3%), relaxation (47.5%) and assists in forgetting problems (42.5%) were reasons given by motorcyclists for this. Fifty percent of the motorcyclists have been involved in a fatal accident. There no significant association between educational level and perception about substance use at p=0.258 but association between perception on substance use and age of respondents was significant at p=0.05. The Perception and Behavior of motorcyclists’ Riders were significantly different at p= 0.04.
Conclusion: Although, the respondents know that substance use had some negative consequences, yet many still indulged in it even when on duty. Positive behavioural change interventions should be implemented among motorcyclists.

Open Access Original Research Article

The Effect of Co-infection of HIV and Hepatotropic Viruses on Selected Biochemical and Haematological Markers of Patients in Northeastern Nigeria

Simon O. Obi, Haruna A. Baba, Marycelin M. Baba, Grace I. Amilo, Alhaji Bukar

International Journal of TROPICAL DISEASE & Health, Page 568-581
DOI: 10.9734/IJTDH/2014/8017

Background: As deaths caused by HIV declines with the use of HAART, liver disease associated with co-infection of HIV with hepatotropic viruses has become an increasing cause of morbidity and mortality.
Aim: To assess the effect of HIV-mono and co-infections with hepatotropic viruses on haematological and biochemical markers of the patients.
Methodology: 109 HIV patients from tertiary health facilities in northeastern Nigeria were initially screened with Immuno chromatographic kit for HIV antibody and confirmed by western blot prospectively and consecutively. However, Hepatitis B virus surface antigen (HBsAg) and Hepatitis C virus (HCV) antibody were detected on the HIV positive patients by ELISA. Blood donors served as control. The study was conducted between January and October 2012.
Results: Of the HIV patients 12.8% and 4.6% had HBsAg and HCV antibody respectively. The prevalence rate of Hepatitis B virus (HBV) infection among males was 12.8% while females had 12.9% but lower rates of HCV were obtained in both males (5.1%) and females (3.3%). However, HIV mono-infections had higher mean baseline values for haemogblobin (Hb), CD4 and platelet counts, protein C (PC) and protein S (PS) in comparison with HIV/ HBV/HCV co-infections (P<0.05). In addition, Prothrombin time and partial thromboplastin time were lower in HIV mono- infection in contrast to co-infections (P<0.05). Similarly, the mean values of Serum liver enzymes such as Aspartate transaminase (AST), Alanine transaminase (ALT), Akaline Phosphatase (ALP) and creatinine were lower in HIV mono-infection compared with HIV/HBV or HIV/HCV co-infection (P<0.05). Total white blood cell count (WBC), total cholesterol (TCH), Random blood sugar (RBS) and potassium (K+) were not significantly different (P>0.05) in both groups.
Conclusion: Co-infections of HIV and hepatotropic viruses do occur. Haematological and biochemical parameters serve as pointers for early detection of liver disease in HIV patients. The development of novel therapeutic approaches to impede co-infection of HIV and hepatotropic viruses is encouraged.

Open Access Original Research Article

Effect of Malaria and Geohelminth Infection on Birth Outcomes in Kumasi, Ghana

Ntui N. Asundep, Pauline E. Jolly, April P. Carson, Cornelius A. Turpin, Kui Zhang, Nana O. Wilson, Jonathan K. Stiles, Berhanu Tameru

International Journal of TROPICAL DISEASE & Health, Page 582-594
DOI: 10.9734/IJTDH/2014/7573

Aim: In 2005, the Ghana Health Service mandated malaria and helminths chemoprophylaxis during antenatal care visits. The aim of this study was to investigate the prevalence of malaria and helminth infections and their relationship with adverse birth outcomes (low birth weight, stillbirth, and preterm) following the implementation of these treatments.
Study Design: A quantitative cross-sectional study.
Method: The study was conducted on 630 women presenting for delivery in the Komfo Anokye Teaching Hospital and the Manhyia District Hospital from July to November 2011. Socio-demographic information and medical and obstetric history were collected. Laboratory analyses for the presence of malaria and helminths were performed. Association of malaria and helminths with birth outcomes was assessed using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals.
Results: The prevalence of malaria, helminths and adverse birth outcomes was 9.0%, 5.0% and 22.2%, respectively. Compared with women who received malaria prophylaxis, women without malaria prophylaxis were two times more likely to have malaria infection (aOR = 2.1; 95% CI = 1.06-4.17). Women who were not screened for helminths were twice as likely to be infected with helminths (aOR = 2.4; 95% CI = 1.15-5.12) than women who were screened for helminths. For women infected with hookworm or Schistosoma mansoni, the odds of having an adverse birth outcome (aOR = 3.9; 95% CI = 1.09-14.20) and stillbirth (aOR = 7.7; 95% CI = 1.21-36.38) were greater than for women who were not infected.
Conclusion: The prevalence of malaria, helminths and adverse birth outcomes was lower than previously reported 9.0% vs. 36.3, 5.0% vs. 25.7 and 22.2% vs. 44.6, respectively. Helminth but not malaria infection was found to be significantly associated with adverse birth outcomes.

Open Access Original Research Article

Users’ Satisfaction with Services Provided Under National Health Insurance Scheme in South Western Nigeria

Kayode O. Osungbade, Taiwo A. Obembe, Abidemi Oludoyi

International Journal of TROPICAL DISEASE & Health, Page 595-607
DOI: 10.9734/IJTDH/2014/7280

Aims: National Health Insurance Scheme became operational in Nigeria over eight years ago; yet, population coverage is below 20% and healthcare services are provided ineffectively and inefficiently. Satisfaction surveys might be part of useful interventions required to increase universal healthcare coverage and improve optimal access and success of the scheme.
Study Design: A cross-sectional, exploratory study.
Place and Duration of Study: Federal Secretariat, Ibadan, Nigeria. 4 weeks of the month of July, 2011.
Methodology: 380 eligible federal staff completed a self-administered modified SERVQUAL questionnaire, which assessed satisfaction domains of healthcare provider services (competence), staff attitude and waiting time. Clients’ experiences were related to a health facility visit in the last three months preceding the survey and assessed on a 5-point Likert scale of “very poor = 1”, “poor = 2”, “good = 3”, “very good = 4” and “excellent = 5”. Associations between dependent and independent variables were subjected to Chi-square test and logistic regression at P-value of 0.05.
Results: 201 (52.8%) male and 179 (47.2%) female participated in the study. Their mean age was 42.5±8.0 years. Most frequently health conditions for which services were sought were malaria (52.9%), medical check-up (5.8%) and dental problem (2.9%). 55.6% of participants were satisfied with drug services, 56.2% with healthcare provider services, 77.8% with waiting time and 51.7% with staff attitude. Education and type of health facility were predictors of satisfaction with healthcare provider services. Length of years of enrolment was a predictor of satisfaction with waiting time while length of years and grade level attained in service were predictors of satisfaction with staff attitude.
Conclusion: Periodic documentation of experiences of enrollees in relation to satisfaction domains of social insurance is useful as it could help identify and prioritise appropriate interventions required to improve its effectiveness and efficiency.

Open Access Original Research Article

The Antibiotic Resisting Profile of Salmonella spp Isolated from the Sewage of the Campus of the University of Cocody, Abidjan, Côte d’Ivoire

Coulibaly Kalpy Julien, Gadji Alahou André Gabazé, Kouadio Kouamé, Koffi Kouadio Stephane, Yapo Ossey Bernard, Dosso Mireille

International Journal of TROPICAL DISEASE & Health, Page 608-620
DOI: 10.9734/IJTDH/2014/7499

Background: Recent studies have shown that wastewater is contaminated by salmonella sp., pathogenic antibiotics-resisting bacteria. Using wastewater in periurban agriculture in Abidjan is likely to be the source of food-borne diseases such as salmonellosis. However, what we know about these resistant salmonella spp. in wastewater is limited in the country.
Aims: This study aims to establish the susceptibility profile of Salmonella spp., isolated from wastewater to antibiotics and to antimetabolite commonly used by medical practitioners.
Study Design: Spatio-temporal variation was taken into account.
Place and Duration of Study: The study took place from August 2008 to January 2009 at the main campus of the university of Cocody in Abidjan.
Methodology: Sampling was done on a weekly basis. Wastewater samples were collected at four different sewers in the campus area. Salmonella sp was isolated by a standard method of laboratory. The resistance of these isolated species to antibiotics was determined according to the disk diffusion method of Kirby-Baeur. The serotypes of salmonella were identified with the Kauffman-White table
Results: Five serotypes of eleven strains, which consist of 4 Hato, 3 Farmsen, 2 Derby, 1 Essen and 1 Ovonmouth, were isolated and tested in order to determine their resistance to antibiotics. Amongst the various classes of antibiotics, high resistance was found to sulfonamid (100%), followed by cefotaxime (46.67%) and tetracycline (9.1%). Ampicillin, amoxicillin and clavulanic acid, gentamicin, kanamycin, amikacin, ciprofloxacine, nalidixic acid and chloramphenicol had a high potentiality: their efficacity in the elimination of the Salmonella sp was proved at a level of 100%. Although the majority of strains tested (85.94%) were eliminated by the antibiotics, the serotypes Derby, Hato and Farmsen showed resistance.
Conclusion: The Wastewater in the area of the main campus of the University of Cocody contains the antibiotic-resisting strains of salmonella sp. In spite of the fact that the efficacity of some antibiotics in the elimination of Salmonella sp. is proved, the resistance of these strains to third generation of cephalosporin and sulfamid is worrisome. Further studies should be carried out to determine the effects of this antibiotic-resisting salmonella species on humain health.