Open Access Short Communication

Serum Magnesium Levels in Women with Breast Cancer in Benin City, Nigeria

K. Atoe, J. O. Idemudia, O. Eboreime

International Journal of TROPICAL DISEASE & Health, Page 723-728
DOI: 10.9734/IJTDH/2014/5041




Aim: The aim of this study was to compare the serum magnesium levels of patients with breast cancer and apparently healthy people without the disease.
Study Design: This is a cross-sectional prospective study.
Place and Duration of Study: The study was carried out at the Department of Surgery, Central Hospital, Benin City and Department of Chemical Pathology, University of Benin Teaching Hospital Benin city, Nigeria, between July, 2011 and October 2012.
Methodology: A total of 60 female participants from Central Hospital, Benin City, Nigeria were recruited for this study. 30 of the women (50%) had breast cancer and 30 women (50%) without the disease served as control. Venous blood was obtained from participants and serum magnesium level was determined using standardized laboratory methods.
Results: The results showed a statistically significant reduction in serum magnesium level of patients with breast cancer compared with those without the disease.
Conclusion: We demonstrated from this present study that the participants with breast cancer have reduced serum magnesium level compared to those without the disease (control) and it is advisable to cautiously add magnesium as an adjuvant therapy in the management of breast cancer.

Open Access Original Research Article

Glycaemic Control in Patients with Type 2 Diabetes Mellitus in a Secondary and Tertiary Health Center in Oredo and Egor Local Government Areas in Benin City, South-South Nigeria

O. F. Adewolu

International Journal of TROPICAL DISEASE & Health, Page 621-633
DOI: 10.9734/IJTDH/2014/7994

Diabetes is the commonest endocrine metabolic disorder in Nigeria.
Aim: The aim was to assess the level of glycaemic control in type 2 diabetics in Oredo and Egor local government areas in Benin metropolis, with a view of planning improved diabetes care.
Study and Design: This is a cross sectional study.
Place and Duration of the Study: The study was carried out in the department of medicine Central Hospital Benin (Secondary Health center), department of Medicine University of Benin teaching Hospital (Tertiary Health center) and department of chemical pathology, University of Benin teaching hospital Benin City Nigeria between October 2012 and June 2013.
Methodology: Fasting Blood sample of 126 type 2 diabetics (38.1% males and 61.9% females from the secondary health centre and 781 type 2 diabetics (47.1% male and 58.3% females ) from the tertiary health centre was assayed for plasma glucose and Glycated haemoglobin. Body mass index was calculated from measured height and weight and blood pressure measurements taken with mercury sphygmomanometer.
Results: Mean fasting plasma glucose and mean glycated haemoglobin was 142.2±7.2mg/dl, 8.3±2.1% and 145.8±5.4mg/dL,8.3±2.6% for patients in the secondary and tertiary health centres respectively. 20.6% of the patients in the secondary health centre and 40.5% of those in the tertiary health centre had glycated haemoglobin values < 7% as recommended by the American Diabetes Association (ADA). 25.3% and 20.6% of the patients in the secondary and tertiary health centres respectively, met the blood pressure target recommended by ADA.
Conclusion: Most diabetics in Egor and Oredo Local Government Areas, Benin City, south-south Nigeria still have suboptimal glycaemic control, are hypertensive and have chronic complications of the disease. Improved Health care delivery, and subsidization of health care is recommended.

Open Access Original Research Article

Application of Remotely-sensed Data for Modeling Malaria Infection in Lokoja, Nigeria

Olarewaju Oluseyi Ifatimehin, Fanan Ujoh

International Journal of TROPICAL DISEASE & Health, Page 634-644
DOI: 10.9734/IJTDH/2014/7337

Aims: To estimate incidences of malaria infection in an urban setting using Remotely sensed data and matching same with hospital records to validate the use of Remote sensing data as a methodology for studying the prevalence of malaria.
Study Design: Analyses of 2006 Nigeriasat-1 and Land sat ETM+satellite data for modeling malaria infection.
Place and Duration of Study: Lokoja, Capital city of Kogi State in Central Nigeria, between March 2012 and January 2013.
Methodology: Extraction of land use types, NDVI and LST maps using ILWIS 3.3 and Idrisi software. Cross tabulation of extracted maps to carry out correlational analyses while buffer analysis was conducted to ascertain risk zones of malaria infection in the town. The clinical data was used in determining the recorded incidence of malaria in the study area.
Results: Built-up area, sand bars and vacant land occupy least land cover (i.e. 28.31%) while urban agricultural land, vegetation and water bodies covered 344.33km2 (59.72%), 41.98km2 (7.28%) and 18.51km2 (3.21%), respectively. The LSE value ranges from 0.92 to 0.989 with an average of 0.955 whereas the highest emissivity is recorded where vegetation is very dense and the lowest recorded for Sand bars. The LST for sand bars, vacant land and built-up area recorded the highest average temperatures of 41.13°C, 35.66°C and 34.56°C, respectively. The highest negative correlation was found in vegetation (-0.96) with other negative values recorded for urban agricultural land and water bodies. The lowest correlation (0.65) was recorded from areas covered with sand bars. The UHI map shows that temperatures at the periphery are lower (about 18°C) but higher at the core (from 26°C to 40°C).
Conclusion: The interplay of NDVI, LST and land use/cover types of Lokoja provides the impetus for the rising incidence of malaria in Lokoja town. Proper urban planning which will support sufficient drainages, effective waste removal, sanitary landfill sites, vegetation control, fumigation, etc. can boost sanitary conditions whilst minimizing the availability of breeding sites for mosquito larvae. At the household levels, extensive use of bed nets and periodic fumigation appear to be the most appropriate short-term measures for curtailing the incidences of malaria at the study area.

Open Access Original Research Article

Possession, Attitudes and Perceptions of Insecticide-treated Bed Nets among Pregnant Women in a Post Conflict District in Northern Uganda

James Henry Obol, Pamela Atim, Kenneth Luryama Moi

International Journal of TROPICAL DISEASE & Health, Page 645-660
DOI: 10.9734/IJTDH/2014/6496

Background: The use of insecticide-treated bed nets (ITNs) is one of the main strategies to control malaria in Uganda. The Uganda’s Ministry of Health had set a target of 50% of households to be covered with ITNs by the year 2007. This study aims at determining ITN possession, attitudes and perceptions among pregnant women who were living in internally displaced persons’ (IDP) Camps where buildings offered little or no protection against mosquitoes in Gulu district.
Methods: A cross sectional study was conducted in 20 randomly selected IDP camps in Aswa and Omoro counties, Gulu district, Northern Uganda. Probability proportion to size cluster sampling technique was used to determine the numbers of expectant mothers in the selected camps. Consecutive sampling method was used by moving to the next nearest household until the required numbers of respondents were generated from each camp. Data was collected using well designed pretested questionnaires. The questionnaires were administered by trained research assistants who were fluent in the local language (Acholi).
Results: ITN possession: 42% of respondents (95% CI 0.39 – 0.46) possessed ITN. 98% of the respondents reported that it was good to use ITN. 97% of the respondents perceive ITN as being effective at preventing mosquitoes bites which transmit malaria. 96% of the respondents who owned ITN were willing to continue using ITNs. Factors associated with ITN possession were; Having attended antenatal services (aOR 1.92, 95% CI 1.24 – 2.98, P-value 0.004); Having attained formal education (aOR 1.55, 95% CI 1.03 - 2.35, P-value 0.036); Willingness to buy ITN (aOR 1.98, 95% CI 1.22–3.21, P-value 0.006) and Willingness to recommend ITN use to others (aOR 3.77, 95% CI 1.12 – 12.77, P-value 0.033).
Conclusion: Majority of the respondents had positive attitudes and perceptions towards ITN use. However, more than half of the respondents lacked ITN which was below the target set by Uganda Ministry of Health. Therefore government and other stakeholders should scale up free ITN distributions among the vulnerable groups if the Ministry of Health and the Roll Back Malaria Global Partnership Target is to be achieved.

Open Access Original Research Article

Hypertension-the Major Cause of Morbidity, Hospitalisation and Mortality among Non-communicable Diseases in the Gambia

Semeeh Akinwale Omoleke, Sanna Sambou, Ismael Abubakar, Adewale Luqman Oyeyemi

International Journal of TROPICAL DISEASE & Health, Page 661-671
DOI: 10.9734/IJTDH/2014/9307

Aim: This study aimed at investigating the major cause of morbidity, hospitalisation and mortality among Non-communicable Diseases (NCDs) in The Gambia, in an effort to raise awareness on the alarming trend and thus stimulating appropriate responses from stakeholders.
Method: Descriptive and inferential statistics were used to analyse a nation-wide routine hospital-based data on NCDs in The Gambia. Data were also presented in tables showing the trend of morbidity (in and out-patient case), hospitalisation and mortality between 2008 and 2011.
Result: Hypertension as a risk factor for cardiovascular diseases constitutes more than half (55%) of all hospital admissions due to NCDs while cardiovascular diseases as a whole constitute well over 60% of all hospital admissions from NCDs. Of all NCDs studied, morbidity due to hypertension constitutes 80%, nearly responsible for all morbidities due to cardiovascular diseases for the years considered. Seventy percent (70%) of all deaths due to NCDs were caused by cardiovascular diseases, and hypertension was an important factor for NCDs related mortality (47.9% in 2008 to 55.8% in 2011;p-value=0.13). There were increments in morbidity and mortality due to hypertension and cardiovascular diseases between 2008 and 2011. However, there was reduction in hospitalisation due to cardiovascular diseases, but not the case with hypertension (incremental change). The differences in morbidity and hospitalisation were statistically significant for cardiovascular diseases (p<0.0001 and p=0.034 respectively) while only increment in morbidity due to hypertension was statistically significant (p<0.0001).
Conclusion: This study shows that hypertension as a risk factor for cardiovascular disease is the greatest cause of morbidity, hospitalisation and mortality among NCDs in The Gambia. Hence, a holistic approach tailored towards preventing the acquisition/onset of the modifiable risk factors (of hypertension and CVD) should be instituted as well as programmes capable of preventing target organ damage among the population already affected.

Open Access Original Research Article

The Study of Social Profile and Some Health Problems Associated With Body Weight Disorders in Upper Egypt Male Youth

Sameh S. Zaytoun, Raouf M. Afifi, Hesham Ayoub, Mohamed Alsenbesy, Hanan Nomeir

International Journal of TROPICAL DISEASE & Health, Page 672-682
DOI: 10.9734/IJTDH/2014/9362

Background: Body weight disorder is a common health problem, unfortunately. The excess weight of the enlarged adipose tissue mass together with the metabolic changes of obesity can induce serious health problems and increase the risk for many diseases. Aim: To study social profile and some medical health problems associated with obesity among Upper Egypt male youth.
Methods: A cross-sectional study was carried out in Qena University Hospital with a total number of 500 male individuals 18-30 years old, attending medical examinations for different causes. Participants were submitted to: filling a predesigned questionnaire, clinical interview, body mass index (BMI) measurement, fasting blood glucose (FBG) level, and postprandial serum glucose (PPG) level, as required.
Results: The mean age was 25±4.55 years. Middle social class comprised most individuals with normal weight [χ2(df=6) 35.01, p<0.001]. Among them, too, who were weight disordered, middle class subjects with overweight accounted up to 63.2%, those with obesity accounted up to 45.2%, and those with underweight accounted up to 42.1%. More than half (57.9%) of those with underweight, and 41.9% of the obese were of low social class; while most of high social class youth were either normal (14/30,46.7%)- or over-weight; none were underweight [χ²(df=6)=35.01, p<0.001]. Also, 6.1% participants were obese. Further, 3.2% and 6.5% of obese persons were diabetics and hypertensive, respectively [Fisher’s exact, p=0.003, Fisher’s exact, p=0.002, respectively]. Young adults with family history of obesity were more than five-folds prone to obesity compared to those counterparts without family history of obesity (OR=5.72, 95%CI:1.05-32.43).
Conclusion: Obesity is associated with comorbid medical problems among young adult males in the Upper Egypt district. Particularly low socioeconomic class individuals, as well as those with a positive family history of obesity disorder problem are at greater risk.

Open Access Original Research Article

Nocturnal Enuresis among School-age Children in South-eastern Nigeria: A Concealed Social Malaise

J. M. Chinawa, H. A. Obu, P. C. Manyike, O. I. Odetunde

International Journal of TROPICAL DISEASE & Health, Page 683-695
DOI: 10.9734/IJTDH/2014/8945

Background: We describe the pattern of nocturnal enuresis among school–age children in South-eastern Nigerian.
Methods: A total sample size of 245 pupils was selected for the purpose of this study with age between 6 and 12 years. The Stratified method of sampling was employed to get a sample that represents the population. Selection of the two schools was done based on the cooperation and readiness of the management and parent/guardian to participate in the research.
Results: Two hundred and forty five children were enrolled for the study with 151 male (61.6%) while the female children are 94 (38.4%).The prevalence of enuresis was noted to be 22.8%.The prevalence is higher in males (60%) than 39% in females (P value <0.05) with higher incidence in lower socioeconomic background and in children with positive family history of bedwetting in the first degree relative though not significant.
Conclusions: The prevalence of nocturnal enuresis in our setting is 22.8%, which is higher than that obtained in various studies elsewhere in the world with a male preponderance. There were strong association between the prevalence of nocturnal enuresis and socioeconomic background.

Open Access Original Research Article

Indications for Gynaecological Consultation by Women at a Rural Outreach Centre in North-Central Nigeria

Jonathan Abina Karshima, Victor Chuwang Pam, Terkaa Atim, Philip Pine Abata, Michael Ira Reich

International Journal of TROPICAL DISEASE & Health, Page 696-712
DOI: 10.9734/IJTDH/2014/5408

Aims: To identify the reasons for consultations, the common clinical diagnosis and disease pattern at a rural gynaecologic outreach clinic.
Study Design: Descriptive Retrospective Study.
Place and Duration of Study: NKST Hospital Mkar-Gboko, Benue state, North-central Nigeria, in seven years (1st April 2005 to 31st July 2012).
Methodology: Information from the case notes of patients who attended the outreach clinic over the study period were retrieved and analysed. Majority of the patients came by self-referral.
Results: Of the 1,733 women that attended the clinic during the study period, 1,605 (92.6%) women made the inclusion criteria and formed the study population. The age range was 15 to 78 years; mean value of 33.6 +/- 9.5 year; 78% of the women were ages 21 – 40 years. The mean parity was 2.1 +/- 2.7and ranged between 0 to 13 children. 68% of the women were para 0 – 2 whilst 18% had parity of 5 and above. The women had 73 reasons and 2,390 presenting complaints, 49.6% of them had multiple presenting complaints (average 1.5 complaints per woman).Most common complaints were inability to conceive, lower abdominal pain and leaking of urine and /or faeces amongst 38%, 11% and 10% of the women respectively. There were 63 disease conditions with 1,793 clinical diagnoses. About 12% of the women had multiple clinical diagnoses. The three leading clinical diagnoses were infertility, genital fistulae and uterine myoma, in 46%, 12% and 10% of the women respectively; followed by sundry other gynaecological disorders (9%) and medical disease conditions (5%) in which hypertension, diabetes mellitus and retroviral diseases were more frequent in that order. Some women (n = 21; 1%) came for second opinion.
Conclusion: Gynaecological diseases are diverse and common among women in rural central Nigeria. Inability to conceive, lower abdominal pain and incontinence of urine and or faeces were the three main reasons women sought consultation with the gynaecologist at Mkar. Infertility, genital fistulae, uterine myoma, non-communicable medical disorders and retroviral diseases were leading clinical diagnoses. Extending the services of Gynaecologist to the rural areas in the region may reduce the access gap to women’s health and enhance national development.

Open Access Original Research Article

Seroprevalence of HBsAg among Female Patients Seeking Healthcare in Bo Government Hospital, Southern Sierra Leone: 14-Months Database Study

Mohamed Koroma, Jia B Kangbai

International Journal of TROPICAL DISEASE & Health, Page 713-722
DOI: 10.9734/IJTDH/2014/7951

Background: Chronic hepatitis B virus (HBV) seroprevalence varies globally but is positively correlated with the prevalence of HIV since both have the same route of transmission-contact with infected body fluids. Sierra Leone has a nascent hepatitis B epidemic and there is a paucity of research data and public health awareness about the infection. Bo where this research is done is the second largest city of Sierra Leone and is the regional headquarters of southern Sierra Leone.
Aim: To determine the seroprevalence of hepatitis B surface antigen (HBsAg) among female healthcare seekers who used the main government referral hospital in Bo, southern Sierra Leone.
Methodology: We retrospectively analysed the serological diagnostic results of HBsAg for female healthcare seekers at the Bo Government Hospital. We later determined the HBsAg seroprevalence for various categories of the study subjects; pregnant women, lactating mothers, girls 5-18years and adults >18years for the period under review.
Place and Duration of Study: This study is a multicenter investigation conducted at the Bo Government Hospital laboratory, the Departments of Community Health and Clinical Sciences and Environmental Health Sciences at Njala University in Bo southern Sierra Leone. All laboratory diagnostic tests for HBsAg diagnosis were conducted at the Bo Government Hospital laboratories from May 2012 to June 2013. Literature review and data analysis were done at Departments of Community Health and Clinical Sciences and Environmental Health Sciences at Njala University
Study Subjects: A total of 2,218 female subjects took part in this investigation; girls 5-18yrs (15.2%), adults females >18yrs (48.9%), pregnant women (17.4%), and lactating women (18.3%). Study subjects were between 5-45yrs; mean age 26yrs; HBsAg+ mean age was 24yrs; HBsAg- mean age was 29yrs.
Results: One thousand and fifty four (47.5%) of all females who sought healthcare service at the Bo Government Hospital laboratory during the period under review were tested positive for HBsAg; 159(7.1%) pregnant women, 168 (7.5%) lactating mothers, 154 (6.9%) were girls 5-18yrs and 573 (25.8%) were >18yrs. Forty-five percent (154/339) of all girls between 5-18years who took part in this study were HBV seropositive.
Discussions: Few independent investigations in Sierra Leone have estimated the national HBsAg seroprevalence at 2.6%-5.1%. One import of this study is the high 154/2218(6.9%) HBsAg seroprevalence rate among girls 5-18 years which can be attributed to multiple sex partners, unsafe sex practice and other socioeconomic and behavioral factors that might have been prevailing during the period under review. The generally high HBsAg seroprevalence rate in our study can also be as a result of our large cohort size and the low sensitivity and specificity of the Rapid Determine diagnostic test kits used in our study compared to previous similar studies conducted in Sierra Leone.
Conclusions: The high seroprevalence rate of HBsAg among girl between 5-18years in this study emphasizes the need for a robust public health preventive and control measures for HBsAg including HBsAg vaccination, routine blood screening, and safe sex practice as a means of reducing the spread and prevalence of HBV infection in Bo.

Open Access Original Research Article

Prevalence and Intensity of Schistosomiasis in Adjacent Human Communities along the River Kochi, West Nile Region of Uganda

Ejotre Imran, B. Makanga, S. Nachuha, M. Mpezamihigo

International Journal of TROPICAL DISEASE & Health, Page 729-739
DOI: 10.9734/IJTDH/2014/9600

Aim: To assess the prevalence of Schistosomiasis in adjacent human communities along the River Kochi, West Nile region of Uganda in relation to the presence of infected Biomphalaria snails
Study Design: A combination of cross sectional field survey and laboratory analysis
Place and Duration of Study: This study was conducted between October 2007 and March 2008 along the River Kochi in the West Nile Region, Uganda.
Methodology: Five sites along this river that were approximately 20km apart were selected. Stool samples were collected from 40 randomly selected families, 20 living within 3km from the river banks and 20 beyond 3km. Four hundred and eighty nine stool samples (157 from children, 159 from adolescents and 173 from adults) were analysed and examined using standard methods for the presence of Schistosoma Mansoni cercariae on a monthly for a period of six months. Biomphalaria species snails living in the river were collected using a sweep net and screened for the presence of S. mansoni cercariae. A generalised Linear Model was used to establish associations between human parasitic infections with age and gender. Spearman’s rank correlations coefficient was used to explore the relationship between infected Biomphalaria snail numbers and infection incidence in humans.
Results: Percentage infection of 24.1% (118/459) was recorded. Prevalence of Schistosomiasis was lower in children than in adolescents (P=.001) and adults (P=.013), and was overall slightly higher in males than females (P=.014). A Spearman’s rank correlations coefficient of (rs=.710) revealed that there was a link between infected Biomphalaria snail numbers and infection incidence in humans.
Conclusion: From the results it appears that Schistosomiasis is still present in West Nile region and is associated with the presence of infected Biomphalaria snail species. Male adolescents and adults are more prone to infection than the females. There is need for regular surveys and continuous Schistosomiasis education to the communities.