Open Access Original Research Article

Prevalence of Latent Tuberculosis Infection among Health Workers Resident in Akwa Ibom State, South-South Nigeria

Anthony Nathaniel Umo, Anne Ebri Asuquo, Lydia Nyong Abia-Bassey, Anietie Effiong Moses

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/20380

Background: Tuberculosis (TB) remains a Public health problem in Nigeria and Healthcare workers (HCWs) are at risk of Latent Tuberculosis Infections (LTBI) and TB disease. There has been no available information on the prevalence of LTBI in HCWs in Akwa Ibom State especially in hospitals for pulmonary diseases. With Interferon-gamma release assays (IGRA), a new method for diagnosis of LTBI, accurate data on prevalence of LTBI among HCWs could be obtained for infection control measures.

Objectives: The study was designed to estimate prevalence of LTBI among 609 HCWs in hospitals for Pulmonary Diseases that routinely screen for TB infection.

Methods: LTBI was assessed by the QuantiFERON-Gold In-Tube (QFT-IT). Information on gender, age, workplace, job title, BCG vaccination and history of both for potential risk factors for LTBI were obtained from standard questionnaires and analysed using SPSS version 17 (SPSS Inc, Chicago, Illinois).

Results: The prevalence of LTBI was 24.8% and 45.8% as assessed by QFT-IT and TST respectively. In HCW younger than 30 years LTBI prevalence was 9.1% and in those older than 50 years, it was 51.3%. Ward Orderlies and Laboratory staff showed higher prevalence rate than other HCWs (31.4% to 33.8%). The putative risk factors for LTBI were age (>50 year OR 10.53, 95% CI 4.77–23.23), working for ≥ 11 years (OR 11.27% CI 3.5–36.34) and working as Ward Orderly and as Lab staff.

Conclusion: Prevalence of LTBI assessed by QFT-IT is high. This indicates a high infection risk especially in health care workers. Laboratory staff and ward orderlies as well as being in service for >10 years, were more significantly associated with LTBI. The higher LTBI prevalence rate in older HCWs might be due to the cohort effect or the longer time at risk. The difference in prevalence of LTBI between TST and QFT may be due to non-tuberculous mycobacterium (NTM). This may have grave implications of drug toxicity and development of resistance to anti-TB drug among individuals harbouring NTM, but receiving anti-TB medication.

Open Access Original Research Article

Factors Associated with Intestinal Parasite Infections in a Resettled Indigenous Community in Malaysia

Mehru Nisha, Verasingam Kumarasamy, S. Ambu, Fabian Davamani, J. W. Mak

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/21902

In Malaysia, the Orang Asli community (the indigenous people of Malaysia) are prone to intestinal parasite infections (IPIs) due to their living environment, socio-cultural and personal hygiene practices. The prevalence and potential risk factors for infection among the indigenous community in Kg. Serendah in Malaysia was investigated. Stool samples were collected from 110 participating villagers who were then interviewed to obtain information on socio-demographic, behavioural, and environmental sanitation. The stool samples were processed and the parasites were identified by microscopy. To identify risk factors associated with intestinal parasite infection univariate and multivariate analysis were done. The level of significance was set at p<0.5 and for each statistically significant factor, odd ratios and confidence interval was computed. The prevalence for IPIs in the community was 67% and the intestinal parasites detected were Trichuris trichiura (50%), Ascaris lumbriocides (39%), Blastocystis hominis (10%), Cryptosporidium parvum (7.2%), Taenia spp (2.7%) and Microsporidia (2.7%). Forty five percent among them had a single infection while 46% had double infections with triple infections constituting 9.5%. Overall the prevalence of IPIs was slightly higher for females (68%) compared to males (66%). Higher IPIs prevalence was observed among children below 7 years compared to the adults. Univariate analysis showed that not using sanitary latrine, source of water supply and not boiling water before drinking and not using footwear were potential risk factors for intestinal parasite infection. However multivariate analysis indicated that not using the toilet and drinking unboiled water was predictive of intestinal parasite infection in this community.

Open Access Original Research Article

Knowledge, Attitude and Practice Regarding Hepatitis B Infection among Nurses in Public Hospitals of Niger State, Nigeria

Abubakar Amali Muhammad, Bisallah Chindo Ibrahim, Abubakar Mohammad Ramadan

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2016/18663

Aim: This is a cross sectional descriptive study that evaluated knowledge, attitude and practice regarding HBV infection among nurses in public hospitals in Niger State North Central part of Nigeria.

Study Design: The study consisted of 1085 nurses working in 23 secondary health care facilities in the state. Distribution of nurses was based on the size and workload of each hospital. Ethical clearance was obtained from ethical committee of the Ministry of health Niger state.

Methodology: A multi stage probability sampling method was used in selecting participants for the study. 283 nurses of the 350 questionnaires distributed were used. Data were analyzed using SPSS version 22.

Results: The results of the study showed that, the mean Age of respondents was 45± S.E 0.6 years with 35.7% males and 64.3% females. Significant percentage (82.3%) of the respondents had diploma as their highest qualification. And 58.3% had adequate knowledge of HBV. Majority (96.5%) used hand gloves and 70.1% do not recap needles after injection compared to 27.9% that still recap needle after use. However, no significant difference was observed between knowledge of HBV and use of hand gloves or re-capping of needle [X² (3) =1.727, P value = 0.911 and X²(1) = 1.191, P value = 0.285. There were 65% of respondents that had HBV screening and 6% were HbsAg positive. As much as 35% of respondents never had HBV screening. Furthermore, 62.9% of the respondents had vaccination while 37.1% remained at risk for not been vaccinated. No significant relationship between knowledge of HBV and screening or vaccination {X²(1) = 1.781, P value = 0.182 and X²(1) = 2.692, P value = 0.105}.

Conclusion: Educational programmes based on hepatitis B - its causes, mode of transmission, prevention, adherence to universal precautions and complication like wise adherence or compliance to infection control policy in the hospital are essential to nurses and other health care workers to prevent risk of contact and spread of hospital acquired HBV infection.

Open Access Original Research Article

Laboratory Evaluation of Clinical Bacterial Isolates for Detection of Carbapenemases-Producing Enterobacteriaceae in Kano, North West, Nigeria

Y. Mohammed, N. T. Dabo, M. K. Umar

International Journal of TROPICAL DISEASE & Health, Page 1-5
DOI: 10.9734/IJTDH/2016/18956

The spread of carbapenemase-producing Enterobacteriaceae is a global problem; however, no exact data on the epidemiology of carbapenemase in Kano, Northern Nigeria is available. The study was aimed to detect the occurrence and prevalence of carbapenemase production among clinical bacterial isolates in Aminu Kano Teaching Hospital, Kano, Nigeria. From March to August 2014, a total of 94 clinical bacterial isolates comprising of E. coli (44), Klebsiella pneumoniae (27), Proteus mirabilis (19) and Proteus vulgaris (4) were screened for susceptibility to 3rd generation Cephalosporins using Kirby-Bauer disc diffusion method and for carbapenemase production using Modified Hodges Test. Result obtained showed that 7(7.4%) of the isolates were found to produce carbapenemase. Highest prevalence of carbapenemase production was found in E. coli (9.09%) followed by Klebsiella pneumoniae (7.40%) Proteus mirabilis (5.26%) and none were found in Proteus vulgaris (0%). Urine samples were found to be with the highest prevalence of 57.1% when compared with sputum (42.9%). This showed that carbapenemase-mediated resistance occurred in Kano state and uncontrolled spread may lead to treatment failure.

Open Access Review Article

Global Epidemiology of EBOLA Disease: A Review

Adekunle Sanyaolu, Chuku Okorie, Olanrewaju Badaru, Alex Adler, Michelle Boucher, Kurtis Carlson, David Johnson, Myriam Jolicoeur, Aleksandra Marinkovic, Philip Mead, Delini Sivakumar, Madison Stewart, Alexander Stirpe

International Journal of TROPICAL DISEASE & Health, Page 1-15
DOI: 10.9734/IJTDH/2016/22284

EVD is a disease of humans and other non-human primates caused by Ebola viruses, which was first discovered in 1976. Between 1976 and 2013 there had been 24 outbreaks of the disease. The recent outbreak is the 26th and has seen more deaths than all other outbreaks from the disease combined. This outbreak in West Africa occurred in five countries: Guinea, Liberia, Nigeria, Senegal and Sierra Leone. In the present research article, the authors reviewed various studies and current research on EVD. EVD was initially restricted to West Africa when the outbreak was first identified, but later was reported in several countries around the world, including the USA. Researchers have begun to use mathematical analysis from previous outbreaks to construct the Atangana's Beta Ebola System of Equations (ABESE), which is being used to predict the spread of future outbreaks.  The pathophysiology and transmission factors, including the basic and effective reproduction numbers, R0 and Re are discussed in detail. Prevention and control measures, such as proper hygiene techniques (both preventative and post-exposure), education (including educating communities on proper burial techniques), reduction in the consumption and exposure to bushmeat, and controlled prevention of the spread of the disease (proper personal protective equipment and protocol upon exposure or in high-risk environments), are outlined. The history and current outbreak are reviewed in detail, which compare the differences in previous outbreaks compared to the current. Earlier (and less deadly) outbreaks have also been traced to the ZEBOV strain, and researchers suggest that the evolutionary rate of gene mutations was accelerated in this current outbreak. Death occurs in approximately 40% of affected individuals within 7-12 days after the onset of initial symptoms and is most often associated with multi-organ failure. Researchers outline the WHO’s criteria for screening and diagnosis, including primary, secondary and entry screening.  There is currently no cure for EDV, only supportive treatment. There are current drug trials on the following vaccinations: ZMapp, TKM-Ebola, Favipiravir, cAd3 and VSVΔ-EBOVGP12. This review article will attempt to summarize the current state of understanding on EVD and explore the most recent and accepted information including epidemiology of the disease, etiology and pathophysiology, transmission, prevention and control, history, recent outbreaks, clinical manifestations, screening and diagnosis, and treatment and clinical trials.