Open Access Case Study

Case Report and Literature Review: Podoconiosis in Southwestern Uganda

Philip Dwek, Ling Yuan Kong, Meghan Wafer, William Cherniak, Romina Pace, Isabelle Malhamé, Dean Simonsky, Geoffrey Anguyo, Eben Stern, Michael Silverman

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2015/17672

Aims: This report presents one confirmed and two suspected cases of podoconiosis in the Kabale region of southwestern Uganda. Podoconiosis has not previously been described in Uganda outside of the eastern region bordering Kenya. The aim of this case report is to increase awareness of the condition in order to enhance prevention and treatment efforts.
Presentation of Cases: Podoconiosis is associated with chronic barefoot exposure to red volcanic soil, with greater prevalence in high-altitude, impoverished areas of the tropics. This report describes one confirmed case and two suspected cases. Case 1 was confirmed by a negative filarial antigen detection test. Cases 2 and 3 had negative filarial smears, but antigen detection kits were not available onsite at the time. However, the altitude at which all three patients live (>1500 masl) makes filarial disease unlikely.
Discussion: Podoconiosis has not been previously reported in the region, and thus may be under-diagnosed due to a low index of suspicion among clinicians. Using adequate footwear is an important component of prevention. However, limited financial resources present a significant barrier to the use of footwear. Understanding community attitudes towards causes and risk factors is also integral to effective prevention.
Conclusion: Podoconiosis has a high potential for elimination, as it is preventable and treatable in the early stages with consistent use of footwear and regular foot-washing. In addition, increased awareness among physicians and clinicians of the presence of the disease in this area can lead to early detection and treatment.

Open Access Original Research Article

Pulmonary Tuberculosis and Its Risk Factors among Inmates of a Ghanaian Prison

Mavis Pearl Kwabla, Donne Kofi Ameme, Priscillia Nortey

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2015/17246

Aims: To determine the prevalence of Pulmonary Tuberculosis (PTB) and its risk factors among prison inmates at the Ho central prison.
Study Design: Cross-sectional study.
Place and Duration of Study: Ho Central Prison in the Ho Municipality of the Volta Region, between May and June 2014.
Methodology: We included 389 prisoners who were screened using the World Health Organization PTB tool. Consenting suspected PTB case-patients were interviewed using a structured questionnaire. Variables collected were socio-demographic and prison-related factors. Spot and early morning sputum samples were collected from suspected case-patients for sputum smear microscopy. Prevalence of PTB and risk factors were determined. Significance level was set at 0.05.
Results: Overall, 173 (44.5%) prisoners were found to have symptoms suggestive of PTB out of which 151(87.3%) were included in the study. Of 151 prisoners included, 111 (73.5%) were able to produce sputum for SSM. Only 1(0.9%) of those tested came out as smear positive PTB. None of the potential risk factors was significantly associated with PTB.
Conclusion: Prevalence of PTB among Ho central prison inmates was low. None of the potential risk factors was significantly associated with PTB. Use of multiple diagnostic methods for PTB in future studies has been recommended.

Open Access Original Research Article

Changing Citizens’ Negative Attitude towards HIV/AIDS in Nigeria: The Policy Thrust and Communications Strategy

Odigbo Benedict Ejikeme, Okonkwo Raphael Valentine, Eneasato Benjamin Onyekachi, Eleje Joy

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2015/17217

In this study, the negative attitude of some Nigerians which inhibits a total successful HIV/AIDS campaigns in the country is critically examined. This was motivated by the reported persistent high national prevalence rate of between 5% to 3.6% of this dreaded health problem over the past ten years. The study objectives were to: ascertain the effectiveness of communications’ media being used in the HIV/AIDS campaigns in Nigeria; and determine the potency of the health policy in the country as tools for successful HIV/AIDS campaigns. The area of study was Port Harcourt city in the Rivers State of Nigeria, reputed as oil producing State with a high momentum of social life. The main instrument for data collection was structured questionnaire. Likert’s 4-points scale and measure of central tendency was used in the presentation and analysis of the data. Results obtained indicate that the communications’ media being used in the HIV/AIDS campaigns in Nigeria are quite effective; the health policy thrust in the country is also adequate for successful HIV/AIDS campaigns, however, some socio-cultural and religious factors, depending on the parts of the country inhibits peoples’ acceptance of some of the anti-HIV/AIDS messages and products like condom. The study then recommended that school heads, corporate organization heads, religious and community leaders should be used to enhance the success of the campaign against stigmatization of people living with HIV in the country.

Open Access Original Research Article

Has Vector-Rodent Relationship Changed in Plague? Experiences of Plague Affected Hilly Terrains of Himachal Pradesh, India

Sonu Goel, Yachna Sharma, Sumeeta Khurana, Harvinder Kaur, Pallab Ray, Sonika Raj, Amarjeet Singh

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2015/18486

Background: The present study was conducted with objectives to elucidate the existence of sylvatic cycle of plague and to document the changing pattern of relationship between rodents and fleas.
Methods: Collection of samples was done from 15 sites (25 locations) from plague affected areas of Shimla district of Himachal Pradesh, India during 5 visits between June 2011 to July 2012, which were thereafter entomologically investigated in a BSL-3 laboratory.
Results: 57 fleas (3 species) from 243 rodents (3 species) were collected in domestic (n=16), peridomestic (n=3) and wild (n=6) locations. Rattus rattus (n=197) and Nosopsyllus fascitus (n=43) was most frequently trapped rodent and flea species respectively. Rattus rattus (domestic rodent species) was also trapped from wild areas and Nosopsyllus fascitus (domestic flea species) was also isolated from Rattus norvegicus (wild rodent species). One rare rodent species Cornilurus albipes was also found. Most common rodent-flea association was Rattus norvegicus-Nosopsyllus fascitus. The recovery of rodents and flea was higher in months of June and December respectively.
Conclusions: The study concluded that sylvatic cycle persisted in study area and rodent and flea mixing was widely prevalent between domestic and wild area. This demands regular and intensive surveillance in plague prone hilly areas of Himachal Pradesh.

Open Access Original Research Article

Burden and Determinants of Hepatitis B Virus Co-infection in a Cohort of HIV Positive Pregnant Women in Jos, Nigeria

F. N. Okoye, A. S. Anzaku, A. N. Ocheke, J. Musa, A. S. Sagay

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2015/18458

Background: Human immunodeficiency virus (HIV) infected pregnant women represent a unique population and co-infection with hepatitis B Virus (HBV) is considered a major health problem worldwide.
Aims: This study was undertaken to determine the prevalence and determinants of hepatitis B infection among a group of HIV positive pregnant women in Jos, Nigeria.
Study Design: Descriptive cross sectional study.
Place and Duration of Study: Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, between December 2011 and May, 2012.
Methodology: A cross sectional study among consecutive HIV positive pregnant women at the antenatal clinic of the Jos University Teaching Hospital (JUTH), Jos, over a 5-month period. Hepatitis B surface antigen (HBsAg) detection was done using in vitro diagnostic kit. Reactive samples were confirmed by Enzyme Linked Immunosorbent assay (ELISA) kit. Information on socio-demographic characteristics and other risk factors associated with the prevalence of HBsAg among HIV positive pregnant women were obtained from participants using pre-tested questionnaires. Data was analyzed using Epi info statistical software version 3.5.1 (CDC, Atlanta Georgia, USA).
Results: Among the 124 HIV positive pregnant women studied, 15 (12.1%) were positive for HBsAg. HIV/ HBV co-infection rates were highest among the age group 31–40 years, unmarried, uneducated, multigravidae, those at third trimester of pregnancies, with multiple sex partners, and those with history of STI, low CD4 count and high viral load. Statistical analysis showed significant association between multiple sex partners (P = 0.017), history of jaundice (P = 0.001), low CD4 count (P = 0.006), high HIV viral load (P = 0.001) and hepatitis B infection among the study population.
Conclusion: Prevalence of hepatitis B virus infection among HIV positive pregnant women among this group of Nigerian women is high. Intensive free hepatitis B screening among HIV positive pregnant women attending ante-natal clinics as a policy especially those with history of multiple sexual partners, jaundice, low CD4 count and high viral load is recommended so as to immunize those without HBV infection.