Open Access Original Research Article

An Eight-Year Review of Morbidity and Mortality among Adult Patients with Tetanus at a Tertiary Hospital in Zaria, Northern Nigeria

O. R. Obiako, D. Ogoina, E. I. Akase, S. A. Abubakar, J. A. Kehinde, E. U. Iwuozo, P. I. Chukwuma

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2015/16368

Background: Tetanus infection is a major cause of morbidity and mortality in many developing countries. The infection results from contamination of wound by Clostridium tetani in unimmunized individuals. The morbidity is mainly due to sustained skeletal muscle spasms from unopposed action of tetanospamin on excitatory neurons in the central nervous system. The clinical presentation and outcome depend on both patient and disease factors. Health education and immunization would contribute to prevention and eradication of the infection.  This review studied morbidity and mortality patterns among adults treated for tetanus at a tertiary hospital in Zaria from January 2006 to December 2013.

Materials and Methods: Medical records of adults admitted with the diagnosis of tetanus were retrieved and reviewed. Information on socio-demography, clinical presentation, complications, co morbidities and outcomes were obtained and analysed using the Statistical Package for Social Sciences version 17.0.

Results: Forty-seven patients were admitted during the period, with an average of 6 patients per year. Male (70.2%): female (29.8%) ratio was 2.4: 1. Their ages ranged from 15 years to 65 years, the age group 20-39 years constituting 76.6% of the population. 51.2% were students. The lower limbs were portal of entry in 70.6% of cases, and 52.9% of the wounds were dirty. 82.4% of the patients were unimmunized and overall mortality was 40.4%. Predictors of mortality were short incubation period, short onset time, severe muscle spasms, non-immunization and presence of complications.

Conclusion: Tetanus remains a major preventable disease among unimmunized and low income people. Therefore, immunization of people at risk would prevent tetanus infection and its associated complications.

Open Access Original Research Article

Diabetes Mellitus and Cerebrovascular Accident among North African Population (Libya) Community Based Survey

Mohamed Kaled A. Shambesh, Taher Mohamed Emahbes, Fayroz Ahmed Kamal, Zeinab Elmehdi Saleh, Iman Mohamed Shambesh

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2015/19028

Diabetes mellitus (DM) is a very common medical disorder and a major health problem in North Africa including Libya. DM is associated with an increase in the risk of stroke and hospitalization.

Objectives: To estimate the importance of DM as a stroke risk factor among people living in Libyan community.

Methodology: The study was community based descriptive cross-sectional study used CHADS2 Questionnaire, as well a local Libyan classification of stroke risk factors called Community Stroke Risk Classification (CSRC).

Area: North Africa (North of Libya, the capital Tripoli).

Time: Five years from 2010-2014.

Population: Sampling was done from a large cohort of individuals living in the community, 7497 individuals were screened looking for risk factors of stroke.

Results: The prevalence of DM among our participants (7497 individuals) was 39% (2908 patients), among males and females was 54.1% and 45.9% respectively (P =0.0001). Among different age groups, males have higher rates compared to females except in very young (10-19) and very old (>80) where females dominated. The male to female ratio among total population screened was 21%: 17.8% (1573:1335 respectively).

DM prevalence increased with age, with higher rates among age over 40 (P <0.0001).

53% of DM patients had hypertension (1538 patients), 21.3% had Congestive Heart Failure (CHF) (618 patients), 13% had Atrial Fibrillation (AF) (382 patients), 22% had Transient Ischemic Attach (TIA) (643 patients), 12.3% had Prior Stroke (PS) (359 patients), All those risk factors accompanying DM increased with age increase (P<0.0001). 

100% of DM patients had risk of stroke on CHADS2 and CSRC scores, which mainly concentrated in intermediate and high scores.

Conclusion: DM is a major risk factor of stroke among Libyan population and had very high risk scores in CHADS2 and CSRC.

Open Access Original Research Article

Antifungal Activity of Phytochemicals against Samples of Penicillium

Tassiana Barbosa Dantas, Sávio Benvindo Ferreira, Lilian Sousa Pinheiro, Camilla Pinheiro de Menezes, Felipe Queiroga Sarmento Guerra, Janiere Pereira de Sousa, Edeltrudes de Oliveira Lima

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2015/19210

Aims: The incidence of fungal infections has increased over the last ten years and fungi of the genus Penicillium can be found in various substrates and affect immunocompromised people, hospitalized patients, many animals and plants, as well as compromise the quality of air indoors. The current situation of indiscriminate use of antibiotics and the consequent resistance of microorganisms to conventional antimicrobial therapy has been stimulating researchers to seek alternative sources of antimicrobial compounds, among them the medicinal plants. The tendency of getting phytochemicals from extracts, fractions, fixed or essential oils obtained from plant species is currently observed. In this context, the present study aims to evaluate the in vitro antifungal activity of seven phytochemicals (geraniol, carvacrol, thymol, linalool, p-cymene, terpinolene and citral) against twelve samples of Penicillium.

Place of Study: Laboratory tests were carried out at the Mycology Laboratory Department of Pharmaceutical Sciences, located in the Health Sciences Center (CCS) of the Federal University of Paraíba (UFPB).

Methodology: Firstly, screening was carried out to find the phytochemical with the best activity by determining the minimum inhibitory concentration (MIC) by the broth microdilution technique. Following, the tests were proceeded with thymol to determine of minimum fungicidal concentration (MFC).

Results: Through analysis of results, it is observed that carvacrol, thymol and citral showed the best activities of the samples of Penicillium studied. The MIC values were 256 mg/mL, for carvacrol and citral, and 128 mg/mL, for thymol (compound showed better results). The thymol had its MIC 90 established at 128 mg / mL, inhibiting, at this concentration, 92% of the tested samples. Analyzing compared to MIC and MFC, it was observed that thymol presented CFM values similar to CIM values for 1/3 of the samples, showing also values greater than 1024 mg/mL for only two samples. The CFM value ranged from 128 µg/ml to 1024 µg/ml.

Conclusion: The thymol is a promising new possibility among the products with antifungal activity against Penicillium, however if the performance is needed further studies, deeper, about their mechanism of action and toxicity, as well as in vivo tests, aiming a possible application therapy.

Open Access Original Research Article

Asymptomatic Blastocystis-infected Persons as Potential Carriers of Disease in Thailand

Sompong Mingmongkol, Surong Prasartpan, Suwannee Aumkhayan, Dorn Watthanakulpanich

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2015/19299

Aim: Blastocystis spp. is currently classified as a gastrointestinal protozoan parasite and has become quite a controversial organism. This study was aimed to obtain information about the prevalence of Blastocystis infection among an otherwise healthy, asymptomatic Thai population.

Study Design: Retrospective study.

Place and Duration of Study: The study areas were the Border Patrol-police station (Subdivision 12), Sa Kaeo Province; the Home for Mentally Handicapped Childcare, Ban Rajawadee, in Nonthaburi Province; Silpakorn University, Nakhon Pathom Province and the Intercity Motorway Division, Department of Highways, Bangkok. The study was carried during 2010-2013.

Methodology: Fecal examination was performed by direct simple smear test on 3,940 out of 6,537 Thais of different genders, ages, occupations, and residential locations who joined the annual health check-up program serviced by the Faculty of Tropical Medicine, Mahidol University.

Results: It was found that 1.0% (40/3,940) presented with Blastocystis infection was asymptomatic of clinical symptoms at a male to female ratio of 2.3:1.0. Blastocystis infection was predominantly found in the age group 41-50 years (47.5%, 19/40). Border Patrol-policemen (Subdivision 12), who resided and worked in rural areas of Sa Kaeo Province near the border between Thailand and Cambodia had significantly higher prevalence of Blastocystis infection (2.8%) than the staff of the Intercity Motorway Division, Department of Highways, in urban Bangkok (0.1%). Other occupations located in suburban areas, such as workers at the Home for Mentally Handicapped Childcare, Ban Rajawadee, in Nonthaburi Province, who worked closely with mentally handicapped children, and officials and lecturers at Silpakorn University, Nakhon Pathom Province, also had significantly higher prevalence rates than Intercity Motorway Division staff in urban Bangkok, with prevalence rates of 4.20% and 2.55%, respectively. Food handlers and cooks who prepared and sold food in Silpakorn University had similar prevalence rates of Blastocystis infection as Intercity Motorway Division staff.

Conclusion: This study revealed that Blastocystis infected patients probably did not show obviously clinical symptoms in asymptomatic carriers, who can spread infections to others and environments.

Open Access Original Research Article

Treatment Outcomes of Tuberculosis Patients Managed at the Public and Private Dots Facilities in Lagos Nigeria

Olusola Adedeji Adejumo, Olusoji James Daniel, Esther Ngozi Adejumo, Esther Oluwakemi Oluwole, Odusanya O. Olumuyiwa

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2015/19933

Setting: Public and private tuberculosis (TB) treatment facilities in Lagos State, Nigeria

Objective: This study compares the treatment outcomes of tuberculosis (TB) patients managed at the public and private treatment facilities in Lagos Nigeria.

Methods: A descriptive comparative cross-sectional study. Four hundred and seventy smear positive adults TB patients were consecutively recruited from 23 public and 11 private directly observed treatment short course (DOTS) facilities and followed up till completion of treatment after which their treatment outcomes were compared.

Results: The prevalence of TB/HIV co-infection among patients managed at the public and private DOTS facilities was 10.0% and 10.7% respectively (P = 0.68). There was no significant difference in the treatment success and defaulter rates of TB patients managed at the public and private DOTS facilities (P > 0.05). Supervision of treatment by a treatment supporter (OR 2.98, 95%CI 1.59 – 5.56) and not interrupting treatment (OR 21.27 95% 8.86 - 51.07) were predictors of treatment success.

Conclusion: Treatment outcomes of TB patients treated at the public and private DOTS facilities were comparable. There is need for strategies to effectively track patients lost to follow up.