Open Access Original Research Article

Active Case Detection and Prevalence of Urinary Schistosomiasis and Malaria in Pupils of Kotto Barombi, Southwest Cameroon Using the CyScope® Fluorescence Microscope

Helen Kuokuo Kimbi, Godlove B. Wepnje, Judith Anchang-Kimbi, Calvin Tonga, Bate Ayukenchengamba, Conica Njabi, Larissa Kouodjip Nono, Hervé Nyabeyeu Nyabeyeu, Leopold Gustave Lehman

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2015/17109

Aim: This study was aimed at assessing the use of the CyScope® fluorescence microscope to determine the prevalence of urinary schistosomiasis (US) and malaria in Kotto Barombi.
Experimental Design: The study was a cross-sectional survey.
Place and Duration of Study: The study was carried out in Kotto Barombi, Cameroon from April to May, 2013.
Methodology: Urine and blood samples were collected from 216 pupils. US eggs were detected in urine by centrifugation and CyScope® methods for schistosome eggs. Malaria parasites were detected using Giemsa-stained blood films and CyScope® methods. The performance characteristics of the CyScope® for both infections were determined using light microscopy as gold standard.
Results: Overall prevalence of US was 43.4% and 48.5% by light microscopy and CyScope® respectively. Prevalence of US was significantly higher (P<0.01) in the Kotto Barombi Island (78.3%) than Mainland (33.8%). US prevalence was not affected by age, sex and socio-economic class (SEC). Mean intensity of US was 8.1 eggs/10 ml urine (Confidence interval, CI = 4.3–11.9). It was significantly higher (P =.01) in pupils from Island (36.5 eggs/10 ml, CI: 17.7–55.3) than Mainland (8.8 eggs/10 ml; 7.1–10.5), males (19.2 eggs/10 ml urine; CI: 9.2–29.2) than females (17.8 eggs/10 ml urine; CI: 13.1–22.5) and highest (P = .046) in the ≤6 years age group (36.9 eggs/10 ml; CI: 20.4–53.4) when compared with pupils in other age groups. Sensitivity and specificity of CyScope® for US were 90.6% and 83.8% respectively. Overall prevalence of malaria was 19.0% and 41.2% by light microscopy and CyScope® respectively and the difference was significant (P = .01). Malaria prevalence and density were not influenced by age; sex and SEC. Sensitivity and specificity of CyScope® for malaria were 68.3% and 64.9% respectively.
Conclusion: The CyScope® could be a useful tool for active case detection of both diseases especially in areas that lack electricity.

Open Access Original Research Article

Providers’ Perception of Quality of Care and Constraints to Delivery of Quality Maternal Health Services in Primary Health Centers of Enugu State, Nigeria

Edmund Ndudi Ossai, Benjamin S. C. Uzochukwu

International Journal of TROPICAL DISEASE & Health, Page 13-24
DOI: 10.9734/IJTDH/2015/16380

Aims: The aim of the study was to assess providers’ perception of quality of care and constraints to delivery of quality maternal health services in urban and rural primary health centers of Enugu state, Nigeria.
Study Design: This was a qualitative descriptive study.
Methodology: A descriptive study design using qualitative data collection and analysis method. Data was collected through a face to face in-depth interview using an interview guide between May and June 2013. A total of 24 providers participated in the study. They included six heads of department of health of six local government areas and officers-in–charge of eighteen primary health centers in urban and rural areas of Enugu state, Nigeria.
Results: Most of the providers perceived the quality of maternal health services in the primary health centers as good and they attributed this to results that were achieved. On measures the providers adopted to ensure clients satisfaction, most of the providers in the urban favoured good work attitude while those in the rural relied on provision of incentives. Inability of the health centers to remain open round the clock was identified as the major constraint to the delivery of quality maternal health care in the health centers and this was attributed to the prevailing security challenges in the study area. Other constraints included inadequate number of health workers, poor amenities, and inadequate equipment.
Conclusion: The providers in the study area perceived good quality care to be the same as good utilization of services at the health centers. This has made them to adopt client friendly measures like good work attitude and use of incentives to encourage the clients to utilize the health centers. This may invariably lead to good quality care. Also, they view situations that limit access to services at the health centers as constraints to delivery of quality maternal health care. The providers need adequate support from the local government authorities who are the custodians of primary health care in Nigeria and they should also involve the host communities in the discharge of their duties. The primary health centers should be adequately fenced and personnel employed for security purposes as this will improve access primarily and then good quality care. There is also the need to train the health workers specifically on good quality care.

Open Access Original Research Article

Usefulness of Ascitic Fluid Cholesterol and Protein in the Differential Diagnosis of Ascites in Nigeria: Comparison with Conventional Cytology

E. E. L. Ekpe, G. A. Ebughe

International Journal of TROPICAL DISEASE & Health, Page 25-33
DOI: 10.9734/IJTDH/2015/12611

Aim: This study was done to assess and evaluate the diagnostic accuracy of cholesterol and protein in differentiating ascites into malignant and non-malignant group in comparison with cytology.
Study Design: A cross sectional study to determine the correlation between ascitic fluid cholesterol and protein and malignant and non-malignant ascites.
Place and Duration of Study: This study was carried out at the clinics of gastroenterology, surgery, and obstetrics/gynecology at the Lagos University Teaching Hospital (LUTH), between August 2011 and July 2013.
Methodology: A total of 75 consecutive patients of Nigerian origin with ascites (37 malignant and 38 non-malignant) were studied for total cholesterol and total protein concentration in ascites. Also, cytology was done for all the 75 samples of ascitic fluid. Statistical analyses were carried out using SPSS software (version 15.0), and the level of significance set at p<0.05 and p<0.001.
Results: The ascitic fluid cholesterol and protein levels in malignant ascites were higher (values of 103.10±30.00 mg/dL for cholesterol and 38.72±18.00 g/L for protein respectively) than in non-malignant ascites (values of 33.20±22.00 mg/dL for cholesterol and 30.21±15.00 g/L for protein). The p value for cholesterol was less than 0.001. Cytology had sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy of 56.8%, 100%, 100%, 70.4%, and 78.6% respectively. Using a cut-off limit of 72.7 mg/dL, cholesterol had sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy of 94.6%, 94.7%, 94.6%, 94.7% and 94.7% respectively. Ascitic fluid total protein had sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy of 37.8%, 86.8%, 73.7%, 58.9%, and 62.7% respectively. Cholesterol was more sensitive than protein and cytology in the differentiating malignant from non-malignant ascites.
Conclusion: It was concluded that measurement of cholesterol in ascitic fluid can differentiate between malignant and non-malignant ascites, and can supplement cytology in the differential diagnosis of ascites.

Open Access Original Research Article

Prevalence of Malaria and Co-infection with Human Immuno-Deficiency Virus (HIV) in Selected Areas of Ondo State, Nigeria

E. O. Dada

International Journal of TROPICAL DISEASE & Health, Page 34-39
DOI: 10.9734/IJTDH/2015/16987

The prevalence of malaria and its co-infection with Human Immunodeficiency Virus (HIV) was investigated in Owena, Idanre Local Government Area and State Hospital Akure, Ondo State, Nigeria. A total of 150 blood samples (Total number at, Owena = 88 and the State Hospital = 62) were collected and examined respectively for the presence of malaria using thick and thin blood smear; and also for the presence of Human Immunodeficiency Virus (HIV) using Abbott Determine kit and Stat Pak kit. The age and sex related prevalence of malaria infection in Owena shows that the overall prevalence was 54.5%. Malaria was found to be high among females (54.7%) than in males (54.2%). The age and sex prevalence of malaria infection in State Hospital shows that the overall prevalence was (54.8%). Malaria was found to be higher in females (56.8%) than in males (52.0%). Co-infection of malaria with HIV by sex in Owena shows that the infection was generally low (2.3%) but prevalence was higher in females (3.1%) than in males (0.0%). The sex distribution of malaria with HIV as co-infection in State Hospital shows that the infection was generally low (4.8%) but higher in females (5.4%) than in males (4.0%). The reasons for the high prevalence of malaria with HIV co-infection were discussed. This study suggested the need for more enlightenment campaign and public awareness of malaria and HIV infection.

Open Access Original Research Article

Monitoring of Human Onchocerciasis in Delta State, Nigeria

J. O. Onojafe, A. O. Egwunyenga, J. C. Nmor

International Journal of TROPICAL DISEASE & Health, Page 40-48
DOI: 10.9734/IJTDH/2015/17505

Background: In Delta State, free doses of ivermectin are distributed annually to communities through the Community Directed Treatment with Ivermectin (CDTI). Despite this intervention approach, pockets of endemic foci still exits. Updated information of the epidemiology of human onchocerciasis is essential for planning effective control strategies. Thus this study aimed at investigating the current prevalence and distribution of human onchocerciasis in endemic communities of Delta State, Nigeria.
Methods: A cross-sectional study was carried out in three local government areas (Aniocha North, Aniocha South and Oshimili) comprising of 41 communities in Delta State, Nigeria. A total of 1,201 consented subjects were examined by skin snips biopsy. A pre-validated well structure questionnaire was used in collecting epidemiological information.
Results: The general prevalence of onchocerciasis in the studied communities was 11.5%. The prevalence did not vary among the three local government areas (P>0.05) though, the infection rate was highest in Aniocha North (12.5%), followed by Oshimili South (11.5%) and Aniocha South (10.7%). With respect to gender, the prevalence was insignificantly higher in males (12.2%) than in female (9.9%). Age-wise, the general pattern showed that the prevalence increased significantly with age. The prevalence of onchocerciasis generally differed widely among the various occupational groups sampled. The prevalence was almost two-fold among farmers (19.3%) compared to drivers and bike riders group (10.2%).
Conclusion: Although the prevalence of onchocerciasis has decreased, the infection still remainsa public health concern in the area. Occupation and age were significant risk factors that affected the prevalence of onchocerciasis. Thus, there is need for control measures to be tailored towards these high risk groups. Also, intensifying community treatment with ivermectin will help eliminate onchocerciasis in the studied communities.