Open Access Short Research Article

H1N1 Pandemic – One Year Follow up Study

Abhijit Biswas, Faisal Alam, Karen Hartery, Aidand O. Brien, Saad Mahdy, Phillip Hodnett, James O’Driscoll O’Driscoll, Catherine Motherway

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/20420

Objective: We performed a one year follow up case series study to evaluate any residual systemic diseases in the patients who presented to our intensive care unit with H1N1pdm09 infection during the 2010/2011 flu epidemic. Twelve patients were admitted with H1N1pdm09 infection over a period of two months. Most of them had multi organ failure and needed various supports. All needed respiratory support varying from, non invasive ventilation, conventional ventilation and high frequency oscillation with some requiring extracorporeal support. Six patients suffered acute renal failure due to the infection and received renal replacement therapy.

Aim: This is a one year follow up case series study to evaluate any impairment in respiratory, cardiac, renal and neurocognitive function in this cohort of patients, who had suffered and were treated for H1N1 infection.

Study Design: Case Series study.

Methods: We assessed seven patients, one year after they had suffered from H1N1pdm09 infection. They were evaluated for pulmonary, cardiac, renal and neurocognitive function in our clinic. Rest of the five patients were interviewed over phone.

Results: Three of the seven patients had poor pulmonary function, indicating significant parenchymal lung injury. Two had moderate to severe restrictive lung disease. Few patients reported a significant impaired quality of life and cognitive impairment. Five patients had impaired phonological fluency, which could be due to hypoxic brain injury, post H1N1pdm09 ARDS. One of the patients, who had suffered acute renal failure, still had renal impairment.

Conclusion: Though all of these patients had survived and were discharged home, a number of them in this small cohort still suffered from quantifiable sequel of the disease.

Open Access Original Research Article

Analysis of Reported Cases of Lassa Fever in Plateau State and the Need for Strategic Action Plan

Solomon Chuwang Chollom, Sophia Osawe, Patricia Lar, Daniel Zanyu Egah, Ille Mamman, Alash’le Abimiku

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/20568

Background: Lassa fever is a fatal haemorrhagic disease endemic in West Africa. Following the index case in Lassa, Nigeria in 1969, outbreaks of Lassa fever have become common in Nigeria. This study sought to review and document recent trends in Lassa related mortality in Plateau State.

Methodology: We targeted the State Ministry of Health (SMoH) and tertiary hospitals in the State. Ethical approval was obtained from the SMoH and Plateau State Specialist Hospital (PSSH), Jos. Data on Lassa fever cases was obtained from the targeted health institutions and analysed using simple percentages.

Results: Fifty nine suspected cases were reported within the period under review (2012-2014). Majority 48(81.3%) were from Northern Plateau, 5 (8.5%) from Central Plateau, 2(3.4%) from Southern Plateau while 4(6.8%) were from States bordering Plateau. Percentage mortality of cases in 2012, 2013 and 2014 stood at 70.0% (7/10), 36.4% (8/22) and 18.5% (5/27) respectively.

Discussion: Although reported cases are on the rise, prompt administration of ribavirin by experienced health care workers may be responsible for the decline in mortality over the years. Improvement on intervention strategies, training, diagnostic facilities should continue to be prioritized.

Open Access Original Research Article

Prevalence and Risk Factors of Primary Postpartum Hemorrhage after Vaginal Deliveries in the Bonassama District Hospital, Cameroon

Gregory Edie Halle-Ekane, Francine Ketchem Emade, Ndemazie Nkafu Bechem, John N. Palle, Duplex Fongaing, Henri Essome, Nelson Fomulu

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2016/23078

Background: Approximately 800 women die from pregnancy-related conditions daily with 99% of these maternal deaths occurring in low resource countries. Primary postpartum haemorrhage accounts for 25.7% of maternal deaths in Africa. In Cameroon, primary postpartum hemorrhage remains the leading cause of maternal death.

Objective: The aim of this study was to determine the prevalence, risk factors, and the maternal and fetal outcomes of primary postpartum hemorrhage in the Bonassama District Hospital, Douala, Cameroon.

Methods: This study was a cross-sectional study. Of the 556 women interviewed regarding their willingness to participate in the study, 550 consented. Quantification of blood loss was done over the 24 hours using a 700cc measuring cylinder, an electronic weighing balance and the Pathfinder International wall chart for visual estimation of blood loss. The well-being of the neonates was evaluated by a pediatrician. Data was collected using a structured questionnaire and analyzed using EPI-INFOTM version A P-value <0.05 used to determine association between variables was considered statistically significant.

Results: The prevalence of primary postpartum hemorrhage was 23.6%. The risk factors of primary postpartum hemorrhage were: previous postpartum hemorrhage (aO.R=6.50; 95% C.I=4.60-9.20), multiparity (aO.R=7.02; 95% C.I=5.27-8.02), prolonged labor (aO.R= 1.1; 95% C.I=1.01-6.61) and macrosomia (aO.R=8.18; 95% C.I= 5.53-8.51). The main causes of PPH were uterine atony and obstetrical lacerations (P-value<0.01). Two (1.5%) maternal and 2 (0.4%) perinatal deaths were recorded.

Conclusion: The prevalence of postpartum hemorrhage was high. The main cause of primary post-partum hemorrhage was uterine atony. Primary PPH was associated with uterine hypotonia, placenta retention and genital lacerations. The maternal and perinatal mortality were high. These findings highlight the pressing need for good quality emergency obstetric care and the availability of more accurate techniques of postpartum blood loss measurement. Secondly, hospitals need blood banks to manage patients with severe hemorrhage.

Open Access Original Research Article

Comparative Analysis of Cervical Human Papillomavirus DNA Testing and Cytological Findings among Women Presenting for “Pap” Smear in a Tertiary Health Centre in Northern Nigeria

M. M. Manga, A. Fowotade, Y. M. Abdullahi, A. U. El-Nafaty, S. Adamu, A. D. Bojude, H. U. Pindiga, R. A. Bakare, A. O. Osoba

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2016/23084

im: This study was conducted to compare different cytological findings with cervical HPV infection among women presenting for cervical cancer screening in Gombe north-eastern Nigeria.

Study Design: It is a hospital based cross-sectional study.

Place and Duration of Study: Departments of Obstetrics/Gynaecology and Histopathology Federal Teaching Hospital Gombe (FTHG) Nigeria, between August 2013 and May 2014.

Methodology: Two hundred and nine (209) women were subjected to liquid-based cervical cytology and HPV DNA testing.

Results: Of the 209 participants, cytological findings were normal in 126 (61.6%) women while 80 (39.0%) had abnormal features. Three (1.4%) respondents had unsatisfactory smears. The observed abnormal cytological features include HPV changes 30 (14.4%), HPV changes with inflammation 2 (1.0%), inflammatory changes alone 36 (17.3%), Low Squamous Intraepithelial Lesion; LSIL 3 (1.4%), High Squamous Intraepithelial Lesion; HSIL 5 (2.4%) and malignant changes 3 (1.4%). Positive HPV DNA testing was detected among 100 (48.1%) of the participants. Almost half 60 (47.6%) of the women with normal cytology were positive for HPV. Among women with cytologically detected HPV changes, only 16 (50%) were also HPV DNA positive. The sensitivity and specificity of cervical cytology in detecting HPV infection was 16.2% and 85.0% respectively.

Conclusion: This study reports a very low sensitivity but relatively high specificity of cytology in detecting cervical HPV infection. It further justifies the need for introduction of HPV DNA testing to improve efficiency and maximise the sensitivity of cytology based cervical cancer screening for women above 30 years.

Open Access Original Research Article

Breastfeeding and Association with Diarrhoeal Diseases: A Tale of two Councils in South-Eastern Nigeria

E. C. Azuike, U. C. Anyanwagu, S. A. Nwabueze, K. M. C. Obi, I. R. Nwagalaku

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2016/22830

Background: Diarrhoeal diseases remain the second global leading cause of infant mortality accounting more than the combined effects of AIDS, Measles, and Malaria. It remains the leading cause of under-5 mortality, in poor underdeveloped regions. The protective effects of good breastfeeding practices among infants against diarrhoeal diseases are well known, but its practice among nursing mothers remains a subject of concern.

Aim: This study aimed to determine the prevalence of diarrhoeal diseases and its association with breastfeeding amongst breastfeeding infants attending Primary Healthcare Centres (PHC) in two area councils in South-Eastern Nigeria.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Selected Primary Healthcare Centres in two area councils- Nnewi-North and Nnewi-South in Anambra State of Nigeria between June and August, 2014.

Methods: Multi-staged sampling technique was applied in selecting the Health Centres and study participants. The mothers were interviewed using pretested self-administered questionnaire. Data analysis was done using STATA statistical software version 13 and the level of significance was determined at a p-value of less than 0.05.

Results: The prevalence of diarrhoeal diseases among the infants was 27%. Above half (55.0%) was within the 0-3 months age bracket, while 23.8%, 21.8% and 33.33% of exclusively, predominantly, and mixed fed infants respectively had diarrhoea. Following adjustment for maternal education and past history of diarrhoea,  babies not on any form of breastfeeding were three-folds (OR: 2.93, 95%CI: 1.02-8.40) more likely than their breastfeeding counterparts to develop diarrhoeal disease. Similarly, exclusively breastfed babies were 73% (OR: 0.27, 95%CI: 0.09-0.86); and those predominantly-breastfed: 78% (OR: 0.22, 95%CI: 0.06-0.77) less likely to develop diarrhoeal diseases.

Conclusion: Exclusive breastfeeding and healthy breastfeeding and weaning practices should be encouraged amongst mothers in developing countries as a good protective measure against diarrhoeal diseases among infants.