Open Access Original Research Article

How different is the Dietary Intake of Individuals with Metabolic Syndrome?

Chee Huei Phing, Hazizi Abu Saad, Barakatun Nisak Mohd Yusof, Mohd Nasir Mohd Taib

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2016/20063

Background: Metabolic syndrome has turned out to be a chief public health concern, but the role of diet in the etiology of metabolic syndrome is not well understood.

Aims: This study aimed at assessing whether individuals with metabolic syndrome had a specific dietary intake and how it compared with the Recommended Nutrient Intakes for Malaysia and the Medical Nutrition Therapy Guidelines by the Malaysian Dietitians’ Association.

Study Design: Cross-sectional study.

Place of Study: Putrajaya, Malaysia.

Duration of Study: Eight weeks.

Methodology: Waist circumference, systolic blood pressure, diastolic blood pressure, triglycerides, HDL cholesterol and fasting plasma glucose were collected in 659 randomly selected subjects. A total of 275 out of 322 subjects with metabolic syndrome completed the self-administered three-day food record. Data were analysed with Nutritionist Pro, and were compared with the Recommended Nutrient Intakes for Malaysia (2010), based on age and gender. Metabolic syndrome was defined according to the ‘Harmonized’ criteria.

Results: Subjects’ mean age was 34.51±8.30 years, 202 Females: 73 Males. Comparison of subjects’ food records with the Recommended Nutrient Intakes for Malaysia revealed that protein consumption was significantly higher among study subjects compared to the Recommended Nutrient Intakes for Malaysia (62 g/day for males; 55 g/day for females), P<.001. All subjects (100%) had low fibre (<20 g/day) intake. Conversely, most subjects (72.0%) had high sodium intake (≥2400 mg/day).

Conclusion: This study highlights the importance of assessing the dietary intake of each individual with metabolic syndrome. There is a discrepancy between the dietary intake among individuals with metabolic syndrome and the Recommended Nutrient Intakes for Malaysia or Medical Nutrition Therapy Guidelines by the Malaysian Dietitians’ Association. Notwithstanding, our study cannot declare that diet induces the disease, yet it definitely sheds more light on the need for appropriate and professional dietary measures to be integrated in the management of individuals with metabolic syndrome.

Open Access Original Research Article

Clinical Spectrum of Severe Plasmodium falciparum Malaria in a Tertiary Care Centre of Eastern India

Prasanta Purohit, Pradeep Kumar Mohanty, Siris Patel, Snehadhini Dehury, Satyabrata Meher, Kishalaya Das, Ashutosh Rath, Jagannath Hati, Ashok Kumar Behera

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2016/22387

Introduction: Plasmodium falciparum malaria is one of the major public health problem presented with varied clinical severity. This study was carried out to observe the clinical spectrum of severe falciparum malaria in a tertiary health care centre.

Methods: This study was undertaken in hospitalized adults with suspected severe malaria. Confirmation of falciparum infection was done by ICT/QBC and single-step-PCR. Diagnosis of severe malaria was done by WHO- guideline 2010.

Results: 450 adult cases with falciparum infection were studied. Maximum number of cases was from 15-25 years age group depicting the high exposure to malaria. In these patients, acute renal failure (ARF) was the most common (36.2%) complication followed by cerebral malaria (35.3%), jaundice (27.8%), hepatic dysfunction (21.8%), respiratory distress (18.4%), severe malarial anemia (15.8%), thrombocytopenia (15.1%), and hypoglycemia (9.3%). Mortality was found in 6.0% of cases. Cerebral involvement and ARF were the common cause of death in these patients. 

Conclusion: ARF is the most common type of clinical severity followed by cerebral malaria in adults and both are equally responsible for death along with other complications. Looking into the matter of varied clinical severity, accurate diagnosis, effective anti-malarial treatment along with supportive therapy is necessary to triumph over this deadly severe falciparum malaria.

Open Access Original Research Article

Performance of Rapid Diagnostic Test for Malaria Diagnosis at the Different Specialized Hospitals in Wad Medani, Gezira State, Sudan

Bakri Y. M. Nour, Magid A. A. Almobark, Albadawi A. Talha, Elgaili M. Elgaili, Dafallah Abuidris, Ali B. Habour, Kamal Osman, Yassir M. Elhassan, Ahmed Bolad

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/22677

Background: Malaria may be overestimated if the diagnosis is based solely on clinical signs. Therefore, laboratory confirmation is essential. Rapid diagnostic tests (RDTs) have become an essential tool in malaria control and management programmes in the world. RDTs can offer a good alternative with the advantage that it is an easy and rapid method, and may assist in diagnosis and improving the practices prescription. This study aims to evaluate the performance of RDTs for malaria diagnosis.  

Methods: In Wad Medani, Central Sudan. 931 patients with symptoms of malaria attended the outpatient clinics at the different specialized hospitals were enrolled in this study, RDT and blood smears methods were performed to diagnose Plasmodium falciparum malaria and blood drop spot were collected in filter paper for nested PCR technique as a confirmative diagnostic tool.

Results: The results obtained by this study revealed that, 131/931 (14.1%) and 63/931(6.7%) were positive when performed by microscopy and RDT respectively. While the result of the 131 microscopy positive samples showed that 63/131(47.3%) were positive by RDT and 68/131(52.7%) were negative. The 68 samples subjected to nested PCR, 6 samples gave an insufficient amount of DNA after extraction while all the 62 samples confirmed that  they were infected with P. falciparum malaria, indicating that there is a significant difference between the rates of malaria cases diagnosed by microscopy and RDT (P  = 0.001).  

Conclusion: This study concluded that the implementation of RDT as a diagnostic tool could not be a merely an alternative method to diagnose malaria, and it does not replace malaria microscopy.

Open Access Original Research Article

Childhood Cerebral Malaria in Nigeria: Clinical Features, Treatment and Outcome

Samuel O. Oninla, Paul S. Ogunro, Olumayowa A. Oninla, Olamide V. Kayode

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2016/22447

Aims: The study aimed at reviewing the clinical features, treatment and outcome of childhood cerebral malaria in a Nigerian health facility, to improve its management and outcome.

Study Design: It is a retrospective study of cerebral malaria patients.

Place and Duration of Study: Department of Paediatrics, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria, between September 2011 and August 2012.
Materials and Methods: Hospital records of children managed for cerebral malaria during the study period were retrieved and assessed. Information extracted from the records was: bio-data, anthropometric values, clinical and laboratory findings, treatment modality, outcome and duration of hospital stay. SPSS version 19 software was used to analyze the data.

Results: We studied 20 patients. The age range was 7 to 99 months (mean 43.3±25.2), and under-five children accounted for 75% of the patients. Mean admission weight was 12.8±4.0, with percentage weight for age mean of 84.5% ±11.2. More well-nourished (normal weight) patients (12) than underweight (8) were affected, and the difference of their means percentage weight for age was significant (P = .00). The principal complaints were: fever, convulsion and loss of consciousness. The mean packed cell volume at presentation in the hospital was 23.9%±8.0, and nine patients (45%) had blood transfusion. A large proportion of the patients had electrolytes, urea and glucose abnormalities. Plasmodium falciparum was the only parasite specie found in the blood films of all the patients, and all cerebrospinal fluid results were normal. Nineteen (95%) patients received parenteral artemisinin derivatives. Five (25%) patients had their antimalarial changed to quinine. Fifty-five percent had a full recovery, 30% were discharged with neurological deficits, 10% discharged against medical advice, and 5% died. Neurological sequelae were found to be more among underweight children and those who were given artemisinin and amodiaquine combination. The outcome appeared to depend on the age of the patient, sex, type of antimalarial given, nutritional status, abnormal laboratory results and illness duration before presentations at the hospital. Mean hospital stay was 10.4±7.9 days.

Conclusion: The use of parenteral artemisinin derivatives or quinine infusion only, rather than artemisinin and amodiaquine combination drugs at the outset of CM management, improvement in children nutrition and regular malaria parasitaemia monitoring during therapy will go a long way to reducing morbidity and mortality among CM patients in Nigeria.

Open Access Review Article

Water and Waterborne Diseases: A Review

Nwabor Ozioma Forstinus, Nnamonu Emmanuel Ikechukwu, Martins Paul Emenike, Ani Ogonna Christiana

International Journal of TROPICAL DISEASE & Health, Page 1-14
DOI: 10.9734/IJTDH/2016/21895

Despite numerous efforts by government at various levels and other agencies interested in water and its safety, waterborne diseases are still a major public health and environmental concern. The huge investment towards water research, although worth the spending, has not yielded the much expected result as waterborne diseases continue to plague developing countries with Africa and Asia having the worse hit. The unavailability of pipe-borne water and the dependence of rural dwellers on surface waters which are often contaminated with faecal materials are undoubtedly the major causes of the rising prevalence of waterborne diseases. Water availability and poor hygienic practices amongst these rural dwellers are also of paramount concern as they play significant roles in the spread of water-washed diseases. Also, poor environmental practice which encourages the breeding of insects and other forms of vectors within residential areas contribute to the increasing prevalence of waterborne diseases. This review focuses on waterborne diseases, its classification and the various methods employed in the bacteriological analysis of water.