Open Access Minireview Article

Burden of Malaria and Prospective Challenges in South-East Asia Region: A Review

Amit Bhattacharya, Neetu Bharti

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2015/18502

Malaria caused 350 to 500 million clinical episodes in the year 2000 and remains the fifth most deadly infectious disease worldwide after respiratory infections, HIV/AIDS, diarrhoeal diseases, and tuberculosis. Though malaria remains a global health concern in developing nations, the approximate malaria-infected cases reduced from 227 million cases in 2000 to 198 million cases in 2013 globally. Notably in Africa over the last decades, malaria eradication programmes have received greater international attention leading to reduction of parasite-infected cases by 26%, with a decrease in cases from 173 million in 2000 to 128 million in 2013. Nevertheless malaria remains a global health concern in developing nations. The World Health Organization (WHO) South-East Asia Region (SEAR) comprises of 11 member states (Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste) of which 10 countries are malaria endemic while Maldives has been declared malaria-free nation since 1984. Presently no licensed malaria vaccine is available and vaccine developers are working on several novel approaches to make a breakthrough as these vaccines would probably be crucial factor to prevent the transmission and onset of malaria. Further due to excessive dependence on artemisinin-based combination therapy (ACTs), emergence of drug resistant parasites, malaria co-infection in immunocompromised patients and newer P. knowlesi strains are fuelling this severe public health problem. Effective measures such as routine surveillance of the antimalarial drug efficacy, newer rapid diagnostic tools (RDTs) and appropriate treatment regimes will help to monitor and limit this deadly disease especially in the malaria-endemic countries. In this review, the various intertwined factors leading to malaria burden – a continuing problem for global health- specially in South-East Asia region are highlighted.

Open Access Original Research Article

Intestinal Parasitosis among Primary School Pupils in Coastal Areas of the Cape Coast Metropolis, Ghana

Kwabena Dankwa, Ransford Oduro Kumi, Richard K. D. Ephraim, Latif Adams, Daniel Amoako-Sakyi, Samuel Essien-Baidoo, Samuel Victor Nuvor

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2015/18026

Background: Intestinal parasitosis remains a major public health burden in developing countries such as Ghana. The burden of disease is heaviest among vulnerable populations and yet epidemiologic data from these populations are limited.
Objectives: The present study aimed at assessing the prevalence and risk factors of intestinal parasitosis among primary school pupils in coastal communities of the Cape Coast metropolis in the Central Region of Ghana.
Methods: A cross-sectional survey of primary schools in coastal areas of the Cape Coast metropolis in the Central Region of Ghana was undertaken. Stool samples were collected and examined using wet mount and formol-ether concentration techniques. Data on socio-demography, environmental and hygiene behaviour was obtained through the administration of a structured questionnaire.
Results: Out of the 230 samples examined, 44 (19.1%) were positive for a least one intestinal parasite. The most predominant parasite in this study was Giardia lamblia (6.5%). Hookworm was the most common (3.9%) intestinal helminth seen in this study. The prevalence of Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni and Strongyloides stercoralis were 3.0%, 2.2%, 1.7% and 1.7% respectively. Pit latrine toilet facility emerged as a risk factor for infection in this study.
Conclusion: Intestinal parasitosis is high in basic schools in coastal communities in Cape Coast. The provision of better and hygienic toilet facilities may be a significant boost to control measures.

Open Access Original Research Article

Phytochemical Analysis and Screening of Ugandan Medicinal Plants for Antifungal Activity against Candida albicans

Kakudidi Esazah, Ayorekire Fredric, Okeng- Ogwal Jasper, Anywar Godwin

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2015/18056

Aims: The potential activity against Candida albicans of five commonly used medicinal plant species of Bwindi Impenetrable Forest National Park in southwestern Uganda was investigated.
Study Design: The phytochemical profiles of Tetradenia riparia, Erucastrum arabicum, Plectranthus lactiflorus, Solanecio mannii and Platostoma africanum were analysed .
Place and Duration of Study: The experiments were carried out in the Department of Pharmacology and Therapeutics, College of Health Sciences, Makerere University and Department of Microbiology and Parasitology, College of Veterinary Medicine and Biosecurity, Makerere University, between September 2012 and January 2013.
Methodology: The Agar well diffusion method was used to measure the antifungal activity against Candida albicans (ATCC 10231). The Minimum Inhibitory Concentration (MIC) was determined by the serial dilution method and the phytochemical analyses were made by standard of the plant extracts phytochemical tests.
Results: Antifungal activity of both ethanol and diethylether extracts of Tetradenia riparia surpassed the Nystatine standard (31 and 28 > 25, respectively) as well as those of other four plant species. The MIC values for the ethanol and ether crude extracts were 0.0312 and 0.0156 g/ml respectively. The plant species tested proved to be positive for different phytochemicals including tannins, coumarins and steroidal glycosides.
Conclusion: Generally, all plant species proved to be active against Candida albicans. Tetradenia riparia exhibited the highest antifungal activity and it is considered to be a potential source of antifungal drugs.

Open Access Original Research Article

Pentazocine abuse in Sickle Cell Disease Patients Seen at a Tertiary Hospital in Nigeria: A Chronic Menace

O. E. Iheanacho, I. P. Ezenwenyi, M. E. Enosolease

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2015/18336

Background: Pentazocine abuse in patients with Sickle cell disease (SCD) has not received adequate attention in Nigeria. Many of these SCD patients have had their conditions unduly worsened and quality of life severely breached by complications of pentazocine abuse. Despite the growing incidence observed in clinical practice and palpable tendency to degenerate further, given the current ease of access to the drug in our environment, it has remained underreported. This study evaluated the myriad physical complications and socioeconomic burden of pentazocine abuse on patients with SCD.
Method: This study was carried out on SCD patients (attending the adult hematology clinic) who abused parenteral pentazocine. Data were obtained mainly from detailed history and physical examination. The findings were analysed accordingly.
Results: Eleven SCD patients who abused pentazocine were recruited and comprised of 8 males (72.7%) and 3 females (27.3%). Their mean age was 34±6 years, 81.8% were not married, 81.8% had some kind of job and 22.2% of these suffered loss of job. The mean duration of pentazocine abuse was 7.4±3.7 years while mean dose of pentazocine injected by the study participants on daily basis was 279±228 mg; 63.6% needed no prescription papers to purchase the drug and 36.4% used forged prescription papers. The mean monthly expenditure on pentazocine was NGN 27,000±22,000 (Nigerian Naira). It was also noted that 18.2% (2) of the study participants abused other drugs alongside pentazocine. As high as 90.9% (10) had scars and/or ulcers; 63.6% (7) developed lymphedema while 90.9% (10) had some degree of fibrous myopathy. Majority (63.6%) of the participants had fixed contractures and/or deformities of their limbs (and digits) with varying degrees of loss of joint movement and/or gait abnormalities observed in 72.7% (8) of participants.
Conclusion: We advocate vigorous sensitization of both healthcare givers and SCD patients on the risk and complications (consequences) of pentazocine abuse. This is to underscore the need for more caution with pentazocine prescription and use. As much as possible oral formulations, when necessary, should be recommended since most of the observed physical complications were apparently due to the parenteral route of administration of the drug. Finally, any SCD patient presenting with the highlighted physical complications must be considered as a case of pentazocine abuse until proven otherwise.

Open Access Original Research Article

Evaluation of the Tuberculosis Surveillance System in District Hyderabad, Province Sindh-Pakistan, 2012

Muhammad Asif, Mirza Amir Baig, Muhammad Nadeem Shah

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2015/17492

Aims: To identify strengthens and weaknesses of Tuberculosis (TB) surveillance system of District Hyderabad and suggest recommendations for improvement.
Study Design: Descriptive evaluative study
Place and Duration of Study: This research work was conducted in Provincial directorate of health, district health offices, and TB sentinel sites of District Hyderabad, between February and March, 2012.
Methodology: A total of 26 stakeholders were identified by using purposive sampling technique based on their involvement in and relevance to the TB surveillance system. Data was collected by review of medical records and stakeholder interviews by using “Centers of Disease Control (CDCs) Updated Guidelines for the Evaluation of Surveillance Systems. Attributes were rated as good, fair and poor on the basis of obtained score.
Results: System was good in simplicity and flexibility due to simple case definition and adaptation of new changes. Presence of laboratory component and 90% completeness of forms led to good rank in data quality. The system covered limited (n=12) health facilities which caused fair representativeness. The staff was highly motivated to provide accurate, consistent and complete information and suggested good acceptability of system. Due to quarterly reporting, timeliness was poor and led to delays in outbreak identification and mitigation responses. Sensitivity and positive predictive value were 26% and 56.8% respectively. The system was fair in stability as supported by ministry of health with multinational donors.
Conclusion: The TB Surveillance system was satisfactory in all attributes except representativeness, sensitivity, and timeliness. Increased establishment of sentinel sites at public and private health facilities and added frequency in reporting time were recommended.