Open Access Original Research Article

Knowledge and Attitude on Prevention of Mother to Child Transmission of HIV among Pregnant Women Attending Antenatal Clinic at Kisii Level Five Hospital in Kisii County, Kenya

Robert M. Kei, Taratisio Ndwiga, Stephen O. Okong’o, Simon N. Mburu

International Journal of TROPICAL DISEASE & Health, Page 44-51
DOI: 10.9734/IJTDH/2015/13342

Introduction: The acquired immunodeficiency syndrome (AIDS) epidemic is the greatest challenge to human kind in the 21st century. Over 35.5 million people are infected with Human immunodeficiency virus (HIV) worldwide and the majority of these infections are in the reproductive age group. Mother to Child Transmission (MTCT) of HIV infections is high especially in sub-Saharan Africa despite improvements in PMTCT services over the years. In 2006 there were 2.3 million children under 15 years living with HIV, and approximately 530,000 children were newly infected with HIV through mother to child transmission of the virus. A child dies of AIDS nearly every minute of every day.
Objective: To assess knowledge and attitude on prevention of mother to child transmission of HIV among pregnant women attending antenatal clinic in Kisii general hospital.
Methodology: An institution-based cross-sectional study was conducted among pregnant mothers attending antenatal care clinic at Kisii general hospital from February to April, 2014. A systematic random sampling technique was used to select the 328 respondents. Data were collected through structured pre-tested questionnaire. The data were then summarized into SPSS version 20.0, for windows and analyzed. Chi-square was used to calculate the association between, education, Occupation and age against knowledge on prevention of mother to child transmission.
Findings: The findings from the study showed that there was an association between the knowledge on PMTCT and Occupation (P = 0.05). A big number (52%) of the mothers did not know about PMTCT services which were being offered in the hospital. The study showed that the knowledge on PMTCT was associated to the age (P = 0.02). It was noted that respondents who had little or no knowledge of the services were mostly below 25 years of age and those with low education levels (P = 0,01). On the attitude towards PMTCT services it was found that three-quarters (77%) reported that it is good to take on PMTCT services if reactive and quarter (23%) of respondents reported that PMTCT services are wastage of time because AIDS has no cure.
Challenges that affect the PMTCT program include stigma still surrounding HIV and AIDS as a disease, which has led to 210 (64%) of the mothers not willing to know their status.
Conclusion: The utilization of the PMTCT services were affected by the low levels of HIV testing. The insufficient knowledge on PMTCT coupled with the negative attitude towards HIV testing, fear and stigma towards HIV and AIDS contributed to the low utilization of PMTCT services in Kisii level 5 Hospital in Kisii County.
Recommendation: The study recommends working in collaboration with all stakeholders to improve and increase on the sensitization and awareness to the communities on what PMTCT program is all about and what it entails. There is need to do a qualitative study to find out if the information given during counseling is enough and useful to pregnant women and to see if more counseling session are needed for pregnant women during antenatal visits.

Open Access Original Research Article

Factors Influencing Gestational Age at Booking at The University of Port Harcourt Teaching Hospital South-South Nigeria

Israel Jeremiah, Ngozi C. Orazulike, Inye F. Korubo

International Journal of TROPICAL DISEASE & Health, Page 52-57
DOI: 10.9734/IJTDH/2015/13357

Aim: To assess the factors influencing registration for antenatal care in Nigerian pregnant women.
Study Design: A cross-sectional study.
Place and Duration of Study: The antenatal clinic of the department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital from January 2013 to June 2013.
Methodology: A cross-sectional study involving 600 pregnant women attending the booking visit at the antenatal clinic in UPTH from January 2013 to June 2013 was undertaken using an interviewer administered structured questionnaire. Data management was done using Epi Info™ 7.1.4 statistical software.
Results: The mean gestation age at first antenatal attendance was 18.7±6 weeks. Only 133 women (22%) booked before 14 weeks gestation, most of these (89.5%) were primigravidae. Majority of the women [409(68%)] had their first visit between 14 weeks and 28 weeks. Primigravida were significantly more likely to book early in pregnancy (p=0.01). Age and educational status did not appear to influence the gestational age at booking. Distance of residence from the hospital also affected the gestational age at booking as those residing more than 10 km from the hospital were significantly less likely to register early (p=0.03). However availability of funds was a major determinant of when a pregnant would register for antenatal care.
Conclusion: Majority of our women register for antenatal care later in pregnancy than the prescribed first trimester due to poverty.

Open Access Original Research Article

Physico-Chemical and Thermotolerant Fecal Coliforms Analysis of Commercial Bottled Water in Dar es Salaam City in Tanzania

Caroline S. M. Kihupi, Lawi Yohana, Josephat A. Saria, Hamisi M. Malebo

International Journal of TROPICAL DISEASE & Health, Page 58-63
DOI: 10.9734/IJTDH/2015/14277

Background: There is currently an increased demand and consumption of bottled water in Tanzania especially among the middle and high income earners as it is generally perceived to be pure, clean and of good quality. This has led to the sale of different brands of bottled water on the Tanzanian market. Due to increased demand and consumption of bottled water in Tanzania, there has been a growing concern about the microbiological quality of this product. The objective of this study was to assess the physico-chemical quality parameters and microbial contamination level with thermotolerant fecal coliform bacteria commercial bottled water Dar es Salaam city in Tanzania.
Materials and Methods: This cross sectional study was done in randomly selected ten different commercial brand of bottled water available in commercial market of Dar es Salaam city in Tanzania. Tap water from Dar es Salaam Water Supply Company (DAWASCO) was also sampled for comparison. Fecal coliform were enumerated by the membrane filtration and commercial field testing DelAgua®kit. The physicochemical examination of the water samples was done to determine pH, turbidity and Total Dissolved Solids (TDS) of the water samples using a Hach spectrophotometer (Hach Company, Loveland, Colorado, USA).
Results and Discussion: All samples of bottled water (100%) analyzed did not show the presence of thermotolerant faecal coliform bacteria and thus meet the World Health Organization (WHO) acceptable value of zero cfu/ml. All the surveyed brands of bottled water were safe for drinking as they were devoid of any thermotolerant fecal coliforms bacteria. Tap water from DAWASCO revealed thermotolerant fecal coliforms contamination with mean CFU counts of 4.0/100ml. Coliform organisms found in tap water in this study were above the recommended levels by regulatory agencies such as Tanzania Bureau Standard (TBS), International Bottled Water Association (IBWA), Food and Drug Administration (FDA), United States Environmental Protection Agency for (USEPA), World Health Organization (WHO) and the European Community (EC).
The overall mean results of the physicochemical parameters of bottled water brands and tap water studied were within the recommended limits by TBS and WHO.
Conclusions: The absence of thermotolerant fecal coliform bacteria in the bottled water is indicative of safety for public consumption. Tap water from DAWASCO is unfit for human consumption and it needs to be treated to render it safe for human drinking. Physicochemical parameters revealed that the pH, TDS and turbidity were within the required levels by TBS and WHO. This indicates that, the manufacturers of bottled water brands and DAWASCO are conforming to the TBS and WHO standards on physicochemical requirements for drinking water.

Open Access Original Research Article

Rabies Virus Neutralizing Antibodies in Unvaccinated Rabies Occupational Risk Groups in Niger State, Nigeria

A. Garba, J. U. Umoh, H. M. Kazeem, A. A. Dzikwi, M. S. Ahmed, A. A. Ogun, P. A. Okewole, M. D. Habib, A. Zaharaddeen

International Journal of TROPICAL DISEASE & Health, Page 64-72
DOI: 10.9734/IJTDH/2015/14461

Aims: To determine the presence of rabies virus neutralizing antibodies (rVNA) as well the potency of the rVNA in rabies occupational risk humans in Niger State of Nigeria.
Study Design: Cross sectional study.
Place and Duration: Research was conducted at the Department of Veterinary Public Health, Ahmadu Bello University, Zaria, Nigeria and Rabies Unit, Centers for Disease Control and Prevention, CDC, Atlanta, USA, between May, 2012 and March, 2013
Materials and Methods: A total of 185 human volunteers were recruited from rabies risk occupational groups who filled a structured questionnaire on their previous bite history and vaccination status, between May and July, 2012. A 2 ml each of blood from volunteers was collected and centrifuged at 3000 rpm for 10 minutes and sera separated into pre-labeled vacutainers. Standard Rapid fluorescent focus inhibition test (RFFIT) was used to detect the presence of rVNA in the sera. Further end point titration of the rVNA positive human sera was conducted to determine the potency.
Results: The results indicated that, detectable titre of rVNA was recorded in 16.4% (23 of 140) viable human sera screened. Although from the questionnaire survey, 21.7% (5 out of the 23 positives) responded to have been vaccinated over ten years prior. At least 3 of the respondents (1 dog butcher and 2 dog meat consumers) who responded not previously vaccinated had some neutralizing antibody titre range of 0.65 – 0.7 IU/ml which is above the minimum protective titre (0.5IU/ml) recommended by WHO. Similarly, 3 respondents (2 veterinarians and 1 animal health personnel) who responded to have been previously vaccinated (> 10 years earlier) yet had a high titre range of 0.5 – 5.4IU/ml. The highest specific rate for rVNA of 25% each was seen amongst the dog butchers and pet owners followed by hunters (20%) and dog meat consumers (14.8%). Up to 125 (67.6%) of the volunteers do consume dog meat with only 12 (9.6%) of them being dog butchers who source dogs for slaughter from households within and outside their territories.
Conclusion: Although the WHO minimum protective titre of rVNA is 0.5 IU/ml, the presence of relatively high titres amongst these risk groups in this report is an indication of a serious public health threat. This study recommends the vaccination of rabies high risk groups and further screening of rabies occupational risk and non risk groups in the study area and Nigeria at large.

Open Access Review Article

Impact of Noise Pollution on Human Cardiovascular System

Esther O. Aluko, Victor U. Nna

International Journal of TROPICAL DISEASE & Health, Page 35-43
DOI: 10.9734/IJTDH/2015/13791

Noise pollution is one of the man-made environmental hazards that is given the least attention. By World Health Organization’s (WHO) definition, noise pollution is unwanted or excessive sound that can have deleterious effects on human health and environmental quality. Industrial facilities, entertainment joints, highway, railway, airplane traffic, construction activities and some indoor activities are major sources of noise. Prolong or frequent exposure to excessively loud noise can cause degeneration of the spiral organ resulting in high frequency deafness. Despite the awareness of noise impact on auditory function, people are still engaged in activities that generate loud noise. In some developing countries where electrical power supply is not reliable, the use of generators has contributed immensely to environmental noise. Studies have reported that noise increases the prevalence of hypertension which is one of the risk factors for cardiovascular disorders. The increasing number of hypertensive individuals in developing countries might be owed to incessant noise. If the governments of these countries do not take necessary measures to combat noise pollution, their countries might be populated with cardiovascular disease individuals.