Open Access Original Research Article

Daytime Sleepiness among Healthy Adults in South West Nigeria

Ogunkeyede Segun Ayodeji, Fasunla Ayotunde James, Arulogun S. Oyedunni, Lasisi Olawale Akeem

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/22210

Aims: Obstruction of the upper airway during overnight sleep is associated with non-refreshing sleep and daytime sleepiness. This may be an antecedent to accidents, declining quality of life, poor concentration, as well as poor academic and work performance. This study determined the prevalence and risk factors for daytime sleepiness among healthy adults in a rural community of South-west Nigeria.

Study Design: A prospective, cross sectional community based study.

Place and Duration of Study: Oyo town, Nigeria between August 2012 and June 2013.

Methodology: Households and adults in the community were selected by multistage random sampling technique. Data on demographics, snoring, and subjective sleepiness (using Epworth Sleeping Scale) were obtained. Mallampati score, tonsillar grade and body mass index of each participant was determined. Statistical analysis was done and level of significance was p < 0.05.

Results: There were 408 participants consisting 202 (49.5%) males and 206 (50.5%) females, age ranged from 18 to 82 years with mean of 37 years ±15.2. Only 191 (46.8%) participants snored while daytime sleepiness was observed in 113 (27.70%) participants. Forty two (10.30%) participants had enlarged tonsils. Only 165 (40.4%) participants had high Mallampati score. Mean Body Mass Index for male was 23.79 kg/m2 ±3.93 and female was 24.86 kg/m2 ±4.90. Daytime sleepiness was significantly associated with increased age (p = 0.0018), female gender (p = 0.048), enlarged tonsils (p < 0.013), snoring (p < 0.001), high Mallampati score (p < 0.001) and high body mass index (p = 0.014), but no association with overnight sleeping duration (p = 0.138).

Conclusion: There prevalence of excessive day time sleepiness is high among the adults in Oyo community, Nigeria and factors associated with narrowed upper airway predispose to daytime sleepiness. Therefore, there is a need for public awareness on its implication on health, productivity and safety.

Open Access Original Research Article

Treatment Outcome of Tuberculosis at One Year: A Single Centre’s Experience in Niger Delta, Nigeria

Ikenna Desmond Ebuenyi, Peter Ogie Ikuabe, Johnbull Jumbo

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2016/22079

Background: Monitoring the outcome of tuberculosis treatment and evaluating the reasons for unsuccessful treatment outcome are important in assessing the effectiveness of tuberculosis control program. This study investigated tuberculosis treatment outcomes and predictors for unsuccessful treatment outcome in a tertiary hospital in the Niger Delta Region of Nigeria.

Methods: The medical records of patients registered in the DOTS clinic of the Niger Delta University Teaching Hospital between September 2013 and August 2014 were retrospectively reviewed. Tuberculosis treatment outcomes were assessed according to WHO guidelines. Multivariate analysis was used to determine the relationship between selected variables and treatment outcome.

Results: Out of the 166 PTB patients (54 males and 112 females) aged 15 years and above, 78.3% had good treatment outcome while 36 had poor treatment outcome. In the final multivariate logistic model the odds of poor treatment outcome was higher among patients older than 30 years of age (OR 1.33, 95% CI 0.580 – 3.049) female (OR 0.83, 95% CI 0.342-1.994).

Conclusion: The treatment outcome among patients with pulmonary tuberculosis was satisfactory in Okolobiri, South – south, Nigeria. However, high risk patients for poor treatment outcome should be identified early and given social support.

Open Access Original Research Article

Lesion Aspirate Isolation, Culture, Diagnosis and Molecular Identification of Cutaneous Leishmaniasis in District Kohat, Khyber Pakhtunkhwa, Pakistan

Hamid Iqbal, Sultan Ayaz, Baharullah Khattak, Ali Rehman, Muhammad Ishfaq, Muhammad Naseer Abbas, Abdul Wahab, Azra Azam

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/20450

Leishmaniasis is a poverty-associated zoonotic tropical disease transmitted by the bite of infected female sand fly. Diagnosis and recognition of clinical manifestation and morphological features of Leishmania parasites involved in the spread of disease is mandatory to design appropriate strategies for ecologic control and preventive plans. Although clinical investigations are necessary to estimate and help define about epidemiological findings but they are not sufficient for identification and characterization of the particular parasite, as the transmission of the disease especially in endemic areas is manifested by various Leishmania species. Samples from 41 patients of both gender (22 males and 19 females) with variable age groups (median age was 27) irrespective of location and immune status suggested with suspected cutaneous leishmaniais lesions fulfilling the inclusion criteria were enrolled and examined. Aspirate smears and skin scrapings collected from the active edge of the lesion were stained with Giemsa and confirmed via microscopy using fine needle aspirate biopsy and/or lancet. Productivity and potential isolates of Leishmania samples inoculated in Biphasic Novy-MacNeal- Nicolle (NNN) and cultured in Monophasic Roswell Park Memorial Institute (RPMI) 1640 media were used in evaluating the efficiency for each sample under study. In order to identify Leishmania specie a definite molecular technique, Polymerase Chain Reaction (PCR) product analyzed by gel electrophoresis using 2% agarose was adopted. Genomic DNA was extracted using proteinase k and amplified by specific primers of kinetoplast DNA. Gel staining was performed using ethidium bromide. The presence of 186bp fragment indicated L. tropica confirming it as the prevalent species in Khyber Pakhtunkhwa, Pakistan, which has immense importance from an epidemiological, transmission and treatment point of view. PCR is a very reliable and sensitive method to detect Leishmania DNA as compared to Giemsa and culture techniques.

Open Access Original Research Article

An Audit of the Use of Renal Function Tests among Paediatric Mortalities

Adanze Onyenonachi Asinobi, Adebowale Dele Ademola, Oluwatoyin Oluwafunmilayo Ogunkunle

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2016/21837

Background: Acute kidney injury is a frequent and serious complication encountered in critically ill children and is an independent risk factor for mortality.  Major causes of childhood mortality in our environment are conditions frequently complicated by kidney failure, yet kidney failure is conspicuously absent in many of the reports.  The actual proportion of these critically ill children subjected to renal function tests is not known. In view of the low representation of kidney failure as a cause of mortality in our environment, we sought to know what proportion of critically ill/dying patients had renal functions tests done and to identify any cases of missed diagnosis.

Methods: This was a descriptive study of the mortalities in the Department of Paediatrics, University College Hospital, Ibadan, between August 2004 and May 2006, particularly those due to kidney failure. Data from the departmental mortality database collected on a weekly basis were analyzed.

Results: Out of 4,941 admissions, there were 542 mortalities (age 1day -13 years) giving a mortality rate of 11%. Low birth weight, malaria, severe perinatal asphyxia, meningitis and neonatal tetanus were the leading five causes of death. Over 80% of the mortalities were under-fives.

Serum urea and creatinine levels were documented in only 217(40%) and 49 (9%) of the mortalities respectively. Primary analysis using ante-mortem data showed that 1.8% died from kidney failure; re-analysis based on available results of renal function tests, many obtained post-mortem, ascribed deaths related to kidney failure to at least 6%. 

Conclusion: There is a low rate of utilization of renal function tests in the management of critically ill patients in our setting, which might have contributed to the under-reporting of kidney failure. There is an urgent need to improve the monitoring of renal function in at-risk and critically ill patients in order to institute/expedite appropriate treatment. Failure to apply these measures will continue to affect the under-five mortality rate in Nigeria adversely. As cerebrospinal fluid analysis is important in ruling out meningitis in Paediatrics practice, so is serum creatinine monitoring for ruling out AKI at the present, and should be ensured.

Open Access Original Research Article

Comparative Assessment of Dogs Experimentally Infected with Single Trypanosoma brucei, Ancylostoma caninum and Conjunct Trypanosoma brucei and Ancylostoma caninum Infections and Treated with Diminazene Aceturate and Mebendazole

R. I. O. Nwoha, B. M. Anene

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2016/21722

A comparative serum biochemistry assessment of experimental infection with single and conjunct Trypanosoma brucei (T. brucei), and Ancylostoma cannium (A. caninum) was carried out in a total of sixteen mongrel breed of dog. The dogs were randomly assigned into 4 groups with 4 animals in each group as follows: GP I:  Uninfected (control), GP II: Ancylostoma caninum infected, GP III: Trypanosoma brucei infected, GP IV: Conjunct Trypanosoma brucei and A. caninum infection. Post acclimatization Ancylostoma caninum infection was done on GPII and GPIV alone. Two weeks later, Trypanosoma brucei infection was done on GPIII and GPIV. Three weeks post trypanosome infection; GPIII and GPIV were treated with diminazene aceturate. Mebendazole was used only on GPII and GPIV and a repeat treatment given 2 weeks later. The serum biochemistry parameters showed a significant (p< 0.05) increase in Total protein in GPIII and GPIV. A significant (p< 0.05) decrease in Total protein was recorded in GPII. Conversely, there were significant (p< 0.05) decrease in albumin in all the infected groups (GPII, GPIII and GPIV). Significant (p< 0.05) increases in the levels of cholesterol and bilirubin were observed in GPII, GPIII and GPIV. However there was no significant (p > 0.05) alteration in calcium level in all the infected groups compared with control.