Open Access Original Research Article

Antibiotic Sensitivity of Staphylococcus aureus Isolated from Patients Attending Ruiru District Hospital, Kenya August to November 2012

E. Maingi, M. Mutugi, Z. Osiemo-Langat, S. Muya

International Journal of TROPICAL DISEASE & Health, Page 134-143
DOI: 10.9734/IJTDH/2015/16516

Aim: To determine the sensitivity of Staphylococcus aureus to commonly used antibiotics in patients with skin, soft tissue and upper respiratory tract infections.
Study Design: Cross sectional.
Place and Duration of Study: Samples were obtained from Ruiru District Hospital, Kenya between August and November 2012. The antibiotic sensitivity tests were done at the Laboratories of Jomo Kenyatta University of Agriculture and Technology at Juja, Kenya.
Methodology: The study included 100 in and outpatients with infections on clinical diagnosis, cellulitis, wound infection, ulcers, septic bruises, abscess (including furuncle / boil / superficial skin abscess). A questionnaire was used to collect patient demographic data from patient records and cultures from the hospital laboratory collected and transported to the Jomo Kenyatta University Laboratories for identification of staphylococcal colonies by culture and biochemical tests. Disc diffusion test was used to determine in vitro antibiotic sensitivities of the S. aureus isolates as per the Kirby-Bauer diffusion technique.
Results: The results indicate that the isolates were very resistant (10% sensitivity) to methicillin and gentamycin, moderately resistant (less than 40% sensitivity) to morepenem, erythromycin, oxacilin, ampicilin, penicillin, trimethoprime/sulfamethoxazole and amoxicillin/clavulanic acid but sensitive to minocycline (83.3%). The isolates were also sensitive to cefuroxime, ciprofloxacin, chlorophenicol and lincomycin (75, 58.3, 50 and 41.6% sensitivity respectively). In this regard, antibiotics such as gentamycin, chloramphenical, trimethoprime / sulfamethoxazole and ampicillin, on the WHO and Kenyan essential drugs list are unlikely to offer help to the patients in Ruiru District hospital. Minocycline would thus be the antibiotic of choice against Staphylococcus infections followed by cefuroxime (75%) and ciprofloxacin (58.3%) as the next alternative drugs of choice.

Open Access Original Research Article

Malaria Prevalence, the Use of Intermittent Preventive Therapy and Long Lasting Insecticidal Nets among Pregnant Women in Onitsha, Anambra State, Nigeria

Aribodor Dennis Nnanna, Ezenwa Patience Chinyeaka, Aribodor Ogechukwu Benedicta, Emelumadu Obiageli Fidelia, Eneanya Obiora Augustine

International Journal of TROPICAL DISEASE & Health, Page 144-149
DOI: 10.9734/IJTDH/2015/16630

Malaria prevalence, the use of intermittent preventive therapy (IPT) and long lasting insecticidal nets (LLINs) was studied among pregnant women in Onitsha, Anambra State, Nigeria. Peripheral blood were obtained from 204 pregnant women and examined microscopically for malaria parasites. Structured questionnaire was used to determine the use of IPT and LLIN among the pregnant women. The results showed an overall malaria prevalence of 40.5% (99/204) in pregnant women. Prevalence varied markedly within age groups, with ages 15-19 recording a value of 75%. Prevalence among the primigravidae was 55.1% compared to 39.5% for multigravidae. There was a statistical significance in prevalence by age and by parity (P<0.05). Compliance to the use of IPT was 53.9% (110/204). The result also showed that 79.4% (162/204) sleep under LLIN. Malaria was still a problem among pregnant woman and IPT reduced malaria during pregnancy.

Open Access Original Research Article

A Cross-sectional Study on the Influence of Altitude and Urbanisation on Co-infection of Malaria and Soil-transmitted Helminths in Fako Division, South West Cameroon

Judith Lum Ndamukong-Nyanga, Helen Kuokuo Kimbi, Irene Ule Ngole Sumbele, Yannick Nana, Sunjo Cyrilla Bertek, Kenneth J. N. Ndamukong, Leopold Gustave Lehman

International Journal of TROPICAL DISEASE & Health, Page 150-164
DOI: 10.9734/IJTDH/2015/17926

Aims: Malaria and soil-transmitted helminth (STH) infections are parasitic diseases afflicting populations that are impoverished and malnourished. The aim of this study was to assess the influence of altitude and urbanisation on Co-infection of malaria and soil-transmitted helminths in Fako Division, South West Cameroon.
Study Design/Place and Duration of Study: It was a cross-sectional survey carried out from 2012 to 2014 involving 1138 children aged 4 – 15 years in Fako Division.
Methodology: Structured questionnaire was administered to obtain demographic and socio-economic data. Blood samples were collected by pricking the finger. Malaria parasite prevalence, density and species were determined from Giemsa-stained thick and thin blood smears respectively. Quantitative estimation of helminth eggs was done by Kato-Katz thick smear technique. Based on height above sea level (a.s.l.), the study sites were classified as Lowland (<200 m.a.s.l), Lower middle belt (>200 but ≤ 400 m.a.s.l), Upper middle belt (>400 but ≤600 m.a.s.l.) and Highland (>600 m.a.s.l). The study communities were also classified into rural, semi-urban and urban areas.
Results: The overall prevalence was 38.1% (433) for malaria, 2.5% (29) for STHs and 0.9% (10) for malaria-STH co-infection. The prevalence of malaria was significantly highest (χ2 = 84.6, P <0.001) in urban areas (52.2%, 263) than in the semi-urban (29.4%, 152) and rural areas (15.4%, 18). Malaria prevalence was significantly highest (χ2 = 123.4, P <0.001) at the lowest altitude (60.5%, 182) and decreased as altitude increased to a minimum of 15.4% (18) at highland (>600 m.a.s.l). Only two species of soil-transmitted helminths [Ascaris lumbricoides (1.9%) and Trichuris trichiura (0.6%)] were found. The prevalence of STH was significantly higher (χ2= 33.8, P <0.0001) in rural (13.6%, 16) than urban (0.39%, 2) areas. The prevalence of STH was significantly highest (χ2 = 33.8, P <0.0001) at high altitude (13.6%, 16) than the upper middle-belt (2.0%, 8), lower middle-belt (1.2%, 4) and lowlands (0.7%, 2). The prevalence of co-infection varied significantly (χ2 = 72.2, P <0.0001) with level of urbanisation with the highest level of co-infection occurring in the rural areas (2.6%, 3) and the lowest level in the urban areas (0.2%, 1).
Conclusion: Malaria control measures need to be intensified especially in the lowland and urban areas. Deworming campaigns are yielding positive results in Fako Division.

Open Access Original Research Article

Efficacy of Fluorescence Microscopy in the Diagnosis of Tuberculosis in Guyana

Rajini Kurup, Lennox Serieux, Derwin Josiah, George Scaria

International Journal of TROPICAL DISEASE & Health, Page 165-169
DOI: 10.9734/IJTDH/2015/18133

Background: Tuberculosis is one of the potentially serious human diseases and is still one of the major causes of mortality. It ranks as the second most leading cause of death from a single infectious agent, after the human immunodeficiency virus (HIV).
Objective: The aim of the study was to evaluate the efficacy of Fluorescence microscopy (FM) technique to determine sensitivity in detecting TB between HIV positive and HIV negative patients in a poor resource country.
Methods: The study was a cross sectional and blind assessment on 50 suspected cases of TB among HIV positive and HIV negative patients using FM method against Zeihl Neelsen (ZN) staining method. Culture results were considered as gold standard.
Results: Of the total 50 specimens examined by ZN, FM and culture method 32%, 40% and 38% were found positive by ZN, FM and culture respectively. FM was sensitive to ZN on several aspects. The difference in their case detection rates were statistically significant (X2 = 35.3, p<0.001). In detecting overall patients for TB, FM method showed sensitivity of 90.0% (95% CI 68.3-98.5) over ZN method 75.0% (95% CI 50.9-91.3) with a kappa value of 0.83 (p≤0.05). FM method showed excellent sensitivity, sensitivity, PPV and NPV all with 100% (95% CI 48.0-100) among HIV-TB patients and an excellent kappa value of 1 (p≤0.05).
Conclusion: This study presented greater sensitivity of FM method over conventional ZN staining method in detecting TB among HIV positive patients. Fluorescence microscopy can be widely used even in peripheral laboratories where culture facilities are not available.

Open Access Original Research Article

Sexual Activity and Emergency Contraception among Female Students in the University of Rwanda

Josee Uwamariya, Jean Baptiste Nyandwi, Marie Francoise Mukanyangezi, Justin Ntokamunda Kadima

International Journal of TROPICAL DISEASE & Health, Page 170-177
DOI: 10.9734/IJTDH/2015/18475

Background: Less is known about sexual activity, unwanted pregnancy rate, and emergency contraception decision-making among female students in Rwandan Higher Education. By gathering such information, we are better able to develop preventive efforts that can reduce the likelihood of such incidents occurring over the students’ lifespan. The study explores sexual activity and describes how this group learns about, feels about and practices contraception in general with emphasis on emergency contraception (EC).
Methods: 296 undergraduate female students, aged 18-25 years old, registered in the University of Rwanda, Huye campus (former NUR-National University of Rwanda) during the academic year 2013-2014, were randomly recruited to complete a structured self-administrated questionnaire.
Results: The toll of sexually active students floated between 29% and 49%. Among them 5% agreed having been involved in unwanted sex, 3% had forced sex and 2% carried unintended pregnancy. The majority showed positive attitudes towards EC (67%), but less than half had adequate knowledge about EC (47.64%) and only 5.4% used EC.
Conclusion: More than half of UR female students could be sexually active and the risk of getting unintended pregnancy is not negligible. There is need to mount proper strategies to largely disseminate information about EC, not for encouraging sex practices among students but to prevent unwanted pregnancy and correlated unsafe abortions, maternal morbidity or class drops out.