Open Access Case Study

Ascaris lumbricoides Beyond Intestinal Obstruction

Henrique Pott-Junior, Alberto Pereira Ferraz

International Journal of TROPICAL DISEASE & Health, Page 119-124
DOI: 10.9734/IJTDH/2015/15678

Ascaris lumbricoides infestation remains the most common cause of eosinophilia. In addition, in cases of severe eosinophilia due to helminthinfestation, eosinophilic infiltration of several tissues may occur, and most likely to be clinically underestimated. If not early diagnosed, it can be severe and fatal. We describe the case of a 33 year-old man from Brazil, a unique case of Ascaris lumbricoides hipereosinophilia with systemic involvement including the heart, kidneys, and bone marrow, without symptoms. Transthoracic echocardiography revealed a dilated left ventricle with an endocardial thickening. A percutaneous renal biopsy revealed diffuse global glomerulonephritis and tubulointerstitial nephritis with renal eosinophilic infiltration. Bone marrow biopsy revealed eosinophilic infiltration without any signs of malignant disorder. The patient was successfully treated and resulted in significant organ improvement. Early institution of empiric therapy may be the most effective approach while perform an extensive empirical evaluation for alternative causes of disease.

Open Access Original Research Article

Seroepidemiology of Toxoplasmosis in Pregnant Women Attending Antenatal Clinics at the Center for Maternal and Child Health Care in Daloa in Ivory Coast

M. Koffi, I. Konaté, D. P. Sokouri, T. Konan, B. Ahouty, J. C. Bosso

International Journal of TROPICAL DISEASE & Health, Page 125-132
DOI: 10.9734/IJTDH/2015/15117

Background: Serological tests remain the basis of toxoplasmosis diagnosis since direct detection of Toxoplasma gondii by microscopy is less sensitive and PCR is inaccessible for routine screening. Unfortunately, serological screening in pregnant women for T. gondii-specific antibodies is not mandatory in the assessment of antenatal care in Ivory Coast. Furthermore the latest data published are about a decade.
Aim: To determine the seroprevalence in relation with certain risk factors and discuss epidemiological issue of different patterns seen among pregnant women in Daloa, in Ivory Coast.
Study Design and Setting: This is a prospective study. Pregnant women attending antenatal care clinics in maternal and child health care center were screened for IgG and IgM antibodies against T. gondii from February to August 2014.
Results: Out of 385 women, 113 (29.35%) were in their first pregnancy and the average age was 26 years with 14 and 47 years of age respectively for the youngest and the oldest mother. A hundred and sixty five (42.85%) of the women had ever been in contact with cats and 305 (79.22%) had ever eaten raw vegetables. 108 (28.05%) out of 385 women were in the third trimester of pregnancy.
226 out of 385 sera (58.70%) had positive IgG and all sera were tested negative for IgM. The remaining sera 159 (41.3%) had no IgG or IgM. The seroprevalence of IgG was correlated to the presence of cats in the household (P<0.001) and age group (P<0.05), whereas no significant association was observed with the consumption of raw vegetables, education and the type of housing. Out of the 159 sera tested negative, 45 (28.3%) were collected in the third trimester of pregnancy.
Conclusion: Our study shows that the prevalence of toxoplasmosis among women of reproductive age, particularly pregnant women is not insignificant in Ivory Coast and deserves more attention from the health officials.

Open Access Original Research Article

Malaria Diagnostic Testing among Public Health Physicians in Nigeria

H. I. Nwokeukwu, D. U. Inya-Agha, I. A. Kashim, D. A. Osunkwo, U. U. Onyeonoro

International Journal of TROPICAL DISEASE & Health, Page 133-140
DOI: 10.9734/IJTDH/2015/13283

Aims: Malaria is a major endemic public health problem in Nigeria and its diagnosis is often either missed or over-diagnosed. It is therefore necessary to determine the use of malaria diagnostic tests by the Community Health Physicians in Nigeria to make the appropriate diagnosis.
Methodology: A cross sectional study was conducted among Public Health physicians who attended the National Conference of the Association of Public Health Physicians of Nigeria which held in Ilorin, Kwara State, Nigeria, in the year 2013. The structured questionnaire was completed by all consenting physicians and analyzed with Excel and Epi-info.
Results: A total of 200 questionnaires were distributed but 125 (62.5%) responded. Majority of the respondents were females 69(55.2%), most physicians fell into the age group 31-40years 69(60%) and a large number were Registrars, 38 (46.6%). Although majority of the respondents said their usual diagnosis of patients for malaria were laboratory tests in adults 80.0% and children 79.5% but in the last diagnosis only 51% in adults and children 48% were made using laboratory tests.

Conclusion: The study showed that majority of the physicians would have desired to use diagnostic tests but the actual practice in the last diagnosis was low. This could be due to the urgency of treatment and delayed laboratory results. Laboratory results should be made available and timely in order to be used for diagnosis.

Open Access Original Research Article

Assessment of Breast Cancer Screening Practices among Women of Reproductive Age in Benin City, Edo State

Obi Andrew Ifeanyichukwu

International Journal of TROPICAL DISEASE & Health, Page 141-149
DOI: 10.9734/IJTDH/2015/15449

Breast cancer is becoming very prevalent in developing countries including Nigeria which is now being bedeviled by the twin public health challenge of both communicable and non-communicable diseases.
Aims: This study was conducted to assess breast cancer knowledge and screening practices among women of reproductive age in Benin City, with a view to improving breast cancer screening practices and minimize late presentation and attendant consequences.
Study Design: A descriptive cross sectional study design was utilized for this study.
Place and Duration of Study: This study was carried out in Central Hospital in Benin City, Edo State between September and December, 2013.
Methodology: This study was health facility based involving researcher administration of semi-structured questionnaires to 235 consenting women of reproductive age (15-49years) attending immunization clinics in Benin City. The data collected were analyzed using IBM Statistical Package for Sciences (SPSS) version 22.0 with statistical significance set at p< 0.05 and 95% Confidence Interval.
Results: The mean age and parity of respondents studied were 28.8±7.4 years and 2.19±1.85 children respectively. Two hundred and seventeen (92.3%) of the women studied, were aware of breast cancer with majority 201(92.6%) having poor knowledge of breast cancer. Furthermore, the practice of breast examination was 143 (65.9%) among respondents studied with self-breast examination accounting for 106(74.1%). In relation to breast cancer screening practice, primary level of education (OR=0.323; 95% CI=0.141 – 0.742) was the only significant predictor identified that less likely influenced the practice.
Conclusion: This study identified a high awareness with poor level of knowledge on breast cancer among women of reproductive age. The practice of breast examination was high with level of education identified as a significant predictor for breast cancer screening practice. There is need to create and strengthen breast cancer awareness campaign through all available media platforms and in schools not only for improved breast cancer screening practices but very importantly to improve knowledge on its presentation, risk factors and benefits of early detection and treatment for better health outcome

Open Access Review Article

Shiga Toxin and Non-Shiga Toxin-Producing Escherichia coli O157 from Cattle, Goats and Chickenin Ado-Ekiti, South West, Nigeria

A. O. Oluyege, O. Famurewa

International Journal of TROPICAL DISEASE & Health, Page 108-118
DOI: 10.9734/IJTDH/2015/7352

Background: Illnesses due to contaminated food, particularly food of animal origin, are perhaps the most widespread health problem in the contemporary world.
Aims: To detect Shiga toxin-producing Escherichia coli (STEC) in food animals in Ado-Ekiti, Nigeria and the possible risk to human health.
Study Design: Non-repeat faecal samples from various animals and poultry birds were examined for STEC.
Place and Duration of Study: Department of Microbiology, Ekiti State University, Ado-Ekiti, between January 2010 and December 2011.
Methodology: We investigated 722 non-repeat faecal samples from animals and poultry birds for the presence of STEC using bacteriological, serological, and tissue culture techniques. Detection of virulence genes was performed by PCR.
Results: Overall, 316 isolates of E. coli were recovered from 62.3% cattle, 19.6% local chicken, 10.1% goats, 4.1% broiler, 2.9% layers, and 0.9% cockerels. Of the non-sorbitol fermenting E. coli phenotype selected from the isolates, 13.3% were presumptively identified as O157 serotype based on inability to ferment sorbitol on sorbitol MacConkey agar (SMAC).
Serotyping using commercial kits capable of detecting O157 and non-O157STEC confirmed 6.6% of these as O157 comprising 4.1% from cattle and 2.5% from local chicken. Only 4.7% of the strains were serologically confirmed as non-O157 of which 0.9% was from cattle, 3.2% from goat and 0.6% from local chicken. Verocytotoxicity test and the presence of virulence genes stx1, stx2 and eae assayed by PCR showed the complete absence of virulence genes in the 13 serologically confirmed strains of O157 from cattle. The virulence gene stx1 was detected only in non-O157 strain from goat and local chickens.
Conclusion: This study has shown that the prevalence of E. coli O157 is low in food animals in the study area compared to reports from the developed countries. Furthermore, our study is the first to report the isolation of non-O157STEC in goat, a very common domestic animal, in the study area.