Open Access Original Research Article

Bacterial Meningitis: A Review in the Upper East Region of Ghana 2010-2014

Joseph K. L. Opare, John Koku Awoonor-Williams, John Kofi Odoom, Edwin Afari, Abraham Oduro, Baba Awuni, Dorcas Kyeiwa Asante, Olivia Serwaa Opare, Patricia Akweongo

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2015/19398

Introduction: Meningitis is an acute inflammation of the protective membranes covering the brain and the spinal cord. It can cause severe brain damage and is fatal in 50% of cases if untreated. The Upper East Region (UER) of Ghana recorded 70 case-patients in 2014 with a case fatality of 10%. Furthermore, there have been series of out outbreaks of bacterial meningitis in the region. The study reviewed meningitis surveillance data to assess the progress towards interruption of meningitis transmission and identified opportunities for surveillance improvement in the UER.

Methods: This involved records review and secondary data analysis of all reported meningitis cases in the Region from 2010 to 2014. Data quality was assessed: described by person, place, time, causative agents involved and identified opportunities for system improvement.

Results: Of 1142 suspected cases of meningitis recorded at the health facilities and communities in the UER, 352(30.8%) were confirmed cases of various forms of Bacterial meningitis. Majority of the cases (50.7%) were males. The age group 0-9 years was mostly 491(43.0%) affected. There were 146 deaths, giving a case fatality rate of 13.0%. The identified etiological agents were Neisseria meningitides (Nm W135) 50.3%, Streptococcus pneumonia (41.7%), Neisseria meningitides (Nm A) 1.7%, Neisseria meningitides (Nm Y 5%), Haemophilus Influenzae Type B1.5%. Majority of the case-patients were observed in 2010 (34.7%) and 2012 (44.2%) between February and April (%). The Kassena Nankana Municipal recorded the highest number of cases 234(20.5%) and the Bulsa South District recorded no case of bacterial meningitis cases.  69 (6%) of case-patients had no lumber puncture done. Time spent  before presentation of case-patients to the health facilities had no significant association with the outcome of the infection (p= 0.319).

Conclusions: There has been a consistent outbreak of Bacterial meningitis in the Upper East Region that involved many cases-patients with some mortality. More bacterial meningitis cases were recorded in children compared to adults. Lumber puncture was not performed in all case-patients. Many case-patients were recorded in the first quarter of the year with the majority in the Kassena Nankana District. There is an urgent need to review the management of meningitis, coupled with enhanced strategies in prevention of occurrences of the disease in the Upper East Region of Ghana.

Open Access Original Research Article

Tuberculosis Burden -In Non-HIV Patients at a Tertiary Care Hospital in Hyderabad Telangana State

S. Fatima, N. M. Aleemuddin, Fakeha Firdous

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2015/19094

Introduction: The revised national tuberculosis control program of India has been able to reduce the disease burden significantly. Despite; TB continues to affect 40% of our population. To achieve the desired goal of NSP {national strategic plan} 2012-2017 we need to have a focused approach on the disease prevalence and the most vulnerable.

Aim: To estimate the burden of tuberculosis both pulmonary and extra pulmonary in non HIV patients at a tertiary care hospital in Hyderabad Telangana state South India.

Materials and Methods: Over a period of two years from Jan.2013- Jan.2015 a total of two hundred and twenty six specimens, seventy eight from pulmonary and one hundred forty eight from extra pulmonary tuberculosis suspects were processed by various methods to achieve diagnosis.

Results: Microbiologically the disease was observed in 25% of the studied subjects. Pulmonary tuberculosis accounted for 10% and extra pulmonary in 15%. Overall smear by ZN stain was positive in 17% and culture in 20%. Cytology could detect disease in 67% of the suspects. Biochemical findings were insignificant. Drug resistance was noted in 4.4% of the cases. Drug resistance and MDR tuberculosis was more common in pulmonary form than in extra pulmonary. Females dominated both in the suspect’s and culture confirmed cases as 53% & 76% respectively. The most affected age group for extra pulmonary disease remained as 6-35 years for both the sexes. In case of pulmonary tuberculosis it was noted as 36-50 years for men.

Conclusion: TB affects one third of the suspects. In the present study EPTB has exceeded PTB in the proportion of the laboratory confirmed suspects of tuberculosis. Both the forms of disease are more common in females and young age which needs to be prioritized in the control program to achieve the desired target of NSP.

Open Access Original Research Article

Cryptosporidial Diarrhoea in Children at a Paediatric Hospital in Accra, Ghana

Isaac Anim-Baidoo, Charles Narh, Dorotheah Obiri, Christabel Ewerenonu-Laryea, Eric S. Donkor, David N. Adjei, Uri S. Markakpo, Richard H. Asmah, Charles A. Brown, George E. Armah, Ben A. Gyan, Andrew A. Adjei, Patrick F. Ayeh-Kumi

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/IJTDH/2015/18532

Background: Diarrhoeal diseases are common among children in developing countries, and are caused by several aetiological agents including Cryptosporidium sp.  Several species of this parasite exist which may belong to either anthroponotic or zoonotic forms. With recent application of molecular tools, species involved in human transmission in any locality and sources of infection can now be determined. 

Aim: We screened children with acute diarrhoea at a paediatric hospital in Accra, Ghana for enteric parasites to determine frequency of cryptosporidial diarrhoea. Cryptosporidium isolates were then characterized by molecular methods to determine the genetic species in transmission.

Methodology: A total of 365 diarrhoeic children of age ≤ 5 years were used in this cross-sectional study. Stool samples were collected and tested for enteric parasites by microscopy and ELISA. Cryptosporidium isolates were subsequently genotyped by PCR-RFLP and confirmed by sequencing of the 18S rRNA gene. Demographic and clinical data were obtained by a structured questionnaire and data analysed for possible association with cryptosporidial diarrhoea.

Results: Enteric parasites detected were Cryptosporidium sp. (22.2%), G. lamblia (5.8%) and E. histolytica (0.8%). Neither gender nor breastfeeding habits, presence of domestic animals, source of children’s food, seasons (dry or rainy) appeared to be associated with infection of Cryptosporidium sp. However, age of children, source of drinking water, and education level of mother seems to have association with infection of the parasite. Genotyping results show that C. parvum is the only species involved in transmission.

Conclusion:  Cryptosporidium parvum is the commonest enteric parasite causing diarrhoea among children with acute diarrhoea. Children ≤ 3 years and those who drank sachet water were most affected. A carefully planned health education among illiterate mothers and improved sanitary conditions could reduce rate of infections. Further sub-genotyping of C. parvum is needed to determine whether source of infection is zoonotic or anthroponotic.

Open Access Original Research Article

Prevalence of Anemia among Human Immunodeficiency Virus Infected Patients Accessing Healthcare in Federal Medical Center Keffi, Nigeria

Grace Rinmecit Pennap, Khadijah Abubakar

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2015/19657

Background: Anemia is an underestimated but important condition to reckon with among HIV infected people especially as it affects their morbidity and mortality. Aim and Objective This study was therefore aimed at determining the prevalence, burden and risk factors associated with anemia in this group.

Methodology: A cross sectional study was carried out among 300 consenting HIV positive adults between April–August 2014. A blood sample was obtained from each participant by venipuncture and the hemoglobin concentration was determined by an auto-analyzer. The World Health Organization definition and classification of anemia toxicity and severity were used to interpret the results.

Results: An overall anemia prevalence of 64% was observed with 7.8% of them categorized as having severe anemia. The association of anemia with age, gender, CD4 counts, HAART and occupation was not statistically significant.

Conclusion: The 64% prevalence of anemia reported in this study was high. There is a need for routine evaluation of HIV infected people for anemia.

Open Access Original Research Article

Environmental and Public Health Aspects of Solid Waste Management at the Lemna Dumpsite in Calabar, Cross River State, Nigeria

I. U. Bassey, A. A. Brooks, B. E. Asikong, I. E. Andy

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/IJTDH/2015/20023

This study is aimed at investigating the level of environmental pollution and the potential impacts of municipal solid wastes on public health. The health risk assessment was determined through a survey of the present facilities used for solid waste management in the metropolis. Waste bins, types of depots, modes of transportation of wastes to disposal sites and methods of disposal were amongst the facilities investigated. The microbiological and physicochemical analysis of decomposing solid waste, leachate, soil, air at dumpsite, stream and Ikot Effanga Mkpa river waters were carried out using standard microbiological procedures. The prevalent bacteria besides fungi isolated from decomposing solid waste, soil, leachate, stream and river water samples were Escherichia coli 55 (13.31%) and 48 (14.33%) Chromobacterium spp 36 (18.18%), Staphylococcus spp 37 (17.70%), Salmonella spp 45(16.85%) and Klebsiella spp (17.06%) respectively. Statistical analysis of the bacterial and fungal counts showed significant difference (p<0.05) between the sources of sampling, months of sampling and seasons of sampling. Decomposing solid wastes followed by soil and leachate had the highest counts at 5% level of probability. The high bacterial counts coupled with these findings are indicative of the possible high risk of microbial infections and a potential destruction of biodiversity from the toxic chemicals of the wastes. The results of the physicochemical analysis showed that virtually, most of the parameters determined are above the WHO permissible limits for drinking water. It is recommended that a fit for purpose strategy be developed for waste management with control measures that are health and eco-friendly.