Open Access Short Communication

Emergence of Vancomycin Intermediate Staphylococcus aureus (VISA) in Clinical Isolates of Methicillin Resistant S. aureus from South Western Region of Nigeria

D. Olusoga Ogbolu, O. A. Terry Alli, L. A Bello, A. O. Ibrahim

International Journal of TROPICAL DISEASE & Health, Page 1-5
DOI: 10.9734/IJTDH/2015/20642

Aim: Vancomycin has been widely used in the treatment of infections caused by methicillin-resistant Staphylococcus aureus (MRSA). The emergence of vancomycin- intermediate and -resistant Staphylococcus aureus (VISA and VRSA, respectively) in various parts of the world has been reported. The level of vancomycin resistance phenotypically and genotypically in clinical isolates of S. aureus with or without methicillin resistance from south western region of Nigeria was determined.

Methods: A total of 116 non-duplicate S. aureus previously obtained from various clinical specimens were subjected to susceptibility testing using disc and microbroth dilution including polymerase chain reaction amplification of mecA and van genes.

Results: The disc susceptibility testing results depict multiple drug resistance with 100% resistance to co-amoxyclav, erythromycin and gentamicin had intermediate of 39.1 and 65.2% respectively, no strain sensitive. Vancomycin showed 100% susceptibility. The minimum inhibitory concentrations, MICs of 116 S. aureus strains against vancomycin showed the isolates to have MIC50 of 1 µg/ml and MIC90 of 2 µg/ml. Five (4.3%) of the 116 clinical isolates had intermediate MIC of 4 µg/ml. These five strains were from methicillin resistant strains and were isolated from different clinical sites and hospitals. However, none of these strains demonstrated the presence of van genes, vanA; vanB; vanC and vanH by PCR.

Conclusion: There is high level of multiple antibiotic resistance in S. aureus with some MRSA also showing reduced susceptibility to vancomycin resulting in VISA. However, the VISA strains have shown no van gene as their mechanism of acquiring reduced susceptibility.

Open Access Original Research Article

Hookworm Infestations among Pregnant Teenagers in Bungoma County, Kenya

F. A. Mambo, E. K. Mulunji, G. A. Sowayi, R. C. A. Omedo, G. A. Mukoya, D. A. Kokonya

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2015/16330

Hookworm infection (Ancylostomiasis) and its association with hematopoietic micronutrient deficiency, contributes significantly to anaemia in poor countries. In these countries, teenage pregnancy is a major health problem characterized by high prevalence of anemia, exacerbating physiological distress due to increased oxygen demand. In spite of the high prevalence of this problem, no study has been undertaken in Kenya. This is resultant from the combined metabolic needs of a rapidly growing girl and her developing fetus. Anemia increases risks of feto-maternal and child mortality and morbidity, if preventive interventions are not part of antenatal care for prospective teenage mothers. Hookworm infection therefore significantly endangers the health of the teenage antenatal mothers in Kenya. The literature revealed no previous study on the problem in the target population.

Objectives: The objective of this study was to explore the necessity for including treatment for worms in the antenatal care programme for the target population. The study, therefore, aimed at determining the prevalence of anemia, Hookworm infection and the possible etiological role of the latter among teenage antenatal mothers in Kenya.

Methods: A descriptive and cross-sectional survey conducted in 2009 at Bungoma County Hospital and Bumula Health Centre antenatal clinics in West Kenya whose sample population comprised 384 pregnant teenage girls. Diagnosis for anemia was made from hemoglobin concentration (estimated by cyanmethemoglobin spectrophotometry). Hookworm infection was diagnosed based on the presence of ova in stool using Ritchie’s Formol Concentration and Direct stool microscopy. Statistical Package for Social Sciences (SPSS) version 12 was used to analyze data and inference was based on 5% significance level.

Results: The prevalence of Ancylostomiasis was 28% and that of anemia was 61% (Hb<100g/L). Severe anemia (Hb<60g/L) constituted 20%, moderate (Hb≤90g/L) 31.2% and mild (Hb>90<110g/L) constituted 48.3% of the teenage antenatal mothers. There was a significant association between Ancyclostomiasis and anaemia (Chi sq 32.238, p<0.001). Logistic regression (p<0.05) showed that Hookworm infection was a significant predictor of anemia. The teenage antenatal mothers infested with Hookworm were four (4) times more likely to be anemic (OR: 95% CI: 3.703; df 2.287-5.995).

Conclusions: Anemia in pregnancy in the rural Kenya settings is high and that hookworm infections have significant impact on the prevalence, health of teenage mothers and pregnancy outcomes. Based on this evidence and other studies, we suggest that during antenatal acre (ANC) period, there should be routine screening for Ancylostomiasis infections, followed by a single dose of Albendazole after the first trimester along with iron and folic acid supplements. This can cause significant elevation of hemoglobin and serum ferritin levels thereby reducing maternal and perinatal morbidity and mortalities, prematurity and low birth weights in our poor communities.

Open Access Original Research Article

Epidemiology of Hookworm Infection and the Influence of Some Epidemiological Factors on their Prevalence in Some Farming Communities in Ebonyi State, Nigeria

I. A. Nnachi, O. O. Odikamnoro, A. U. Nnachi, O. C. Ani, C. A. Uhuo, C. C. Egwuatu

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2015/19916

Aims: This study was carried out to assess aspects of the epidemiology of hookworm infection and the influence of some epidemiological factors on their prevalence in some farming communities in Afikpo South L.G.A. of Ebonyi State.

Study Design: This was a laboratory-based observational study.

Place and Duration of Study: This study was carried out in the Department of Applied Biology Laboratory, Ebonyi State University, Abakaliki, Nigeria between May, 2013 and November, 2013.

Methodology: A total of 442 stool samples from school children and adults were collected and examined using direct smear and formol-ether concentration techniques for the presence of the parasite eggs.

Results: Out of the 442 examined, 35(7.9%) samples were positive for hookworm infections. Other helminthic infections observed were Ascaris lumbricoides 192(43.4%) and Trichuris trichiura 4(0.9%). The only mixed infections were seen between hookworm and Ascaris lumbricoides which recorded 21(4.8%) prevalence. There was no significant difference in the rate of infection with hookworm between the different age groups (X2=2.68; P>0.05), though 8-14 years age group had the highest infection rate (9.8%) while those between 21-30 had the lowest (3.5%). The sex distribution showed a higher infection rate in females with prevalence of 22(9.0%) while 13(6.6%) cases were recorded among the males, however, there was no significant difference in infection rate between the sexes (X2=0.90; P>0.05).

Conclusion: This study shows that the occurrence and distribution of hookworm and other geohelminth infections were still high in Afikpo South L.G.A. despite the periodic deworming exercises by the governmental and non-governmental agencies. The different epidemiological factors analyzed including farming, use of streams and open defaecation presented the highest risk factors for hookworm infections. Hence, provision of portable drinking water, adequate sanitary disposal of faeces and refuse, health education on the mode of transmission of hookworm and improved personal hygiene should be integrated into the periodic deworming exercises for optimum result.

Open Access Original Research Article

Evaluation of Feeding Practices in Children Aged 6-23 Months in Southern Benin Rural Setting

Charles Jérome Sossa, Flora F. T. Laleye, Victoire D. Agueh, Justine Guedégbé, Colette Azandjemè, Badirou Aguemon, Edgard-Marius Dona Ouendo, Laurent T. Ouédraogo, Michel Makoutodé

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2015/20499

Aims: To assess feeding practices in children aged 6 to 23 months living in rural setting in southern Benin.

Study Design: Population based cross-sectional and evaluative study.

Place and Duration of Study: Southern Benin, from 1st April to 27th June, 2014.

Methodology: Two hundred and fourty children (49.16% girls) aged 6-23 months were randomly selected by cluster sampling technique. Data on breastfeeding and, complementary feeding, food safety and socio-demographic characteristics were collected using a questionnaire. Feeding practices in children were assessed through World Health Organization indicators using predefined scores.

Results: The median age of the children was 13 months and 61.65% children aged 12-23 months. Breastfeeding (82.08%), complementary feeding (37.08%) and food safety (15.94%) were adequate among the children. The overall quality of feeding practices was inadequate among children (73.90%) aged 6-23 months.

Conclusion: Feeding practices was inadequate in children aged 6 to 23 months in southern Benin rural setting. Nutrition education interventions in mothers are needed to improve feeding practices in children aged 6 to 23 months living in southern Benin rural areas.

Open Access Review Article

Promising Therapeutics against Ebola Virus Disease

Elijah Ige Ohimain

International Journal of TROPICAL DISEASE & Health, Page 1-17
DOI: 10.9734/IJTDH/2015/19066

Ebola Virus Disease (EVD) has become a major threat to global peace and security. Since 1976, when Ebola virus was discovered, over 20 outbreaks have been reported. Most of these outbreaks occurred in rural areas of East and Central Africa. But the current 2014 outbreak, which started in Guinea in March 2014, spread to Liberia, Sierra Leone, Nigeria, Senegal and Mali, and traveled beyond Africa into Europe and US. Thus far, there have been no approved therapeutics and preventive vaccines and hence response is limited to supportive care, barrier nursing, and management of patient complications. Spurred by the global threat, research has identified promising drug candidates against the disease. This review presents the current status of promising drug candidates against EVD. The current development status of the experimental drugs ZMapp, TKM-Ebola, Favipiravir (T-705 or Avigan), AVI 6002, BCX 4430 and Brincidofovir (CMX-001) is given. In the absence of licensed drugs, these first generation anti-Ebola virus experimental drugs, which are currently in phase 1 clinical trial, were administered to a limited number of healthcare workers during the current EVD outbreak.