Open Access Case Study

Unilateral Mediothoracic Exanthem – Report of the Third Patient in the Literature

Antonio Chuh, Vijay Zawar

International Journal of TROPICAL DISEASE & Health, Page 1-4
DOI: 10.9734/IJTDH/2016/22992

Background: We have previously described two patients with a paraviral exanthem known as unilateral mediothoracic exanthem, which we believe to be intimately related to asymmetric periflexural exanthem and/or unilateral laterothoracic exanthem.

Presentation of Case:   A 20-year-old male presented with an erythematous belt of erythema and papules on the left anterior aspect of the thoracic cage. The lesions jumped across the dermatomes from T4/T5 laterally to T6 medially, and stopped abruptly at the midline. Vesicles were not seen for the entire course of the eruption. Lesional histopathology revealed perisudoral lymphocytic infiltrates, which is a characteristic, though not pathognomonic, feature of asymmetric periflexural exanthem / unilateral laterothoracic exanthem. Complete rash remission was noted in two weeks.

Conclusion: The rash distribution and the lesional histopathological changes are compatible with unilateral mediothoracic exanthem, a variant of two paraviral exanthems. This is the third reported patient with unilateral mediothoracic exanthem.

Open Access Original Research Article

Spatial Modelling of Fever Prevalence and Suspected Malaria Cases among Children: A Cross-sectional Study

Aklilu Toma Shamenna, Ayele Taye Goshu

International Journal of TROPICAL DISEASE & Health, Page 1-17
DOI: 10.9734/IJTDH/2016/13191

Background: Disease morbidity, mortality and speed of spread vary substantially spatially. These have important implications for effective planning and targeting intervention strategies. The purpose of this study was to model the spatial dependence of fever prevalence and suspected malaria cases among children in Ethiopia.

Methods: Data were obtained from 2011 EDHS collected for 144 districts at SNNP and Oromia Regional States. Explanatory spatial data analysis and spatial lag and error models were applied.
Results: The results showed that the spatial lag model better fitted to the data. Prevalence rate of each of the events in a district was shown to be affected by that of its neighbors status. It was revealed that altitude, access to piped water, proportion of children under five, vaccination coverage, child wasting core, proportion of children born below average size and toilet availability were significant risk factors of fever rate. Moreover, altitude, proportion of children born below average, vaccination overage, stunting score, wasting score, proportion of children under five, mother education, and access to mass media were found to have significant effects on the rate of suspected malaria cases.

Conclusion: There is spatial dependency for both variables -childhood fever prevalence and suspected malaria cases. The hot spot areas are at the center of each region. Several risk factors need attention. Interventions to mitigate occurrence of malaria infection among children would take in to account the nature of spatial variability and the identified risk factors.

Open Access Original Research Article

Isolation and Identification of Some Microbial Pathogens Associated with the External Body Surface of Periplaneta americana in Umuahia, Abia State

E. O. Nwankwo, K. N. Onusiriuka, B. J. Elesho, O. G. Pipi

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2016/22891

Aim: This study was carried out to isolate and identify the microbial pathogens of medical importance on the external body surfaces of Periplaneta americana collected from toilet areas, residential/hostel areas and health facilities in Umuahia metropolis, Abia State, south-eastern Nigeria.

Study Design: Cross sectional study.

Place and Duration of Study: The study was carried out in Umuahia metropolis, Abia State, south-eastern Nigeria between October-December, 2014.

Methodology: A total of 100 cockroaches from toilets (30), residential/hostel areas (46) and health facilities (24) in Umuahia were collected and their external body parts screened for bacterial, fungal and parasitological carriage. Sterile physiological saline used as washing fluid of the external surface of each cockroach was cultured by the streak plate method. The isolated bacteria were identified using standard bacteriological methods. Antibiotics susceptibility tests were done by the disc diffusion method.

Results: Results showed that all the cockroaches were positive for different species of medically important bacteria and fungi.  Escherichia coli were the most common bacteria in the cockroaches’ from toilet (21.14%) and residential/hostel areas (22.37%) while, Staphylococcus aureus (21.74%) was the most frequent isolate obtained from cockroaches obtained from health facilities. Aspergillus species (33.16%) was the most prevalent fungal group. Quantitative analysis of the total viable count and microbial loads of the bacterial and fungal isolates from the three sites revealed that the isolates obtained from toilet areas were high as compared to those from residential areas.

Antibiotic susceptibility of all the bacteria isolates revealed a common pattern of multiple drug resistance amongst isolates from health facilities when compared to those from toilet and residential areas.

Conclusion: The result indicated that Periplaneta americana is a possible reservoir of several pathogens via their bodies and thus may spread multiple drug resistant species.

Open Access Original Research Article

Bacterial Contamination of User Interface of Automated Teller Machines (ATM) of Various Banks in Umuahia Metropolis, Abia State, Nigeria

E. O. Nwankwo, J. C. Offiah

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2016/22812

Aims: To evaluate the bacterial diversity and degree of contamination obtainable on the ATM buttons as money is being collected and antibiotic susceptibility pattern of the isolates.

Study Design:  Cross-sectional study including all ATM user interface in the banks within Umuahia metropolis.

Place and Duration of Study: Department of Microbiology, Michael Okpara University of Agriculture, Umudike, Abia state, between August 2015 and September 2015.

Methodology: A total number of sixty-eight (68) samples were collected from 14 different commercial banks in Umuahia metropolis. Isolation and identification of bacteria were done by standard microbiological techniques. Antibiotic susceptibility testing was carried out by disc diffusion technique.

Results: Nine (9) different organisms were isolated which include- E.coli (26.5%), S. aureus (17.6%), Bacillus spp (4.9%), Klebsiella spp (6.9%), Proteus spp (8.8%), Pseudomonas aeruginosa (9.8%), Streptococcus spp (13.7%), Salmonella spp (4.9%) and Coagulase Negative Staphylococcus (6.9%). Most of the isolates were sensitive to Ceftriaxone, Ciprofloxacin, Amoxicillin/Clavulanate and Gentamicin and resistant to Cotrimoxazole, Ampicillin and Cephalexin.

Conclusion: The result of the study reveals that high levels of bacterial contamination were detected on ATM hardware user interface. This is of public health importance.

Open Access Review Article

Clinical Profile of Cysticercosis in Head and Neck

Alok Rathi, Ashok K. Gupta, Ramandeep Virk, Sandeep Bansal, Shweta Gupta

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2016/23606

Objectives: Review of the various clinical presentations of cysticercosis in head and neck and its diagnosis.

Materials and Methods: Data Sources: PubMed was searched with MeSH terms Cysticercosis, Oral cavity, Tongue, Buccal, Lip  Cheek, Neck, Muscle neck, Muscle head, Parotid, gland, Fnac, Larynx, Pharynx, Nose, Ear, Orbit, Ocular. The results were extensively reviewed to select relevant articles of isolated lesions of head and neck (other than brain) which present to clinician as a diagnostic dilemma.

Review Methods: Articles generated were oral cavity(98), Tongue(128), Buccal(12), Lip(20), Cheek(9), Neck(58), Muscle neck(21), Muscle head(26), masseter(29), Temporalis(6), Parotid(11), gland(38), Fnac(19), Larynx(3), Pharynx(6), Nose(9), Ear(20), Orbit(59), Ocular(166). Out of these, 118 unique articles were selected, accessed, references reviewed to finally study 109 relevant articles. These have been studied for clinical presentation and how clinical problem was solved.

Implications for Practice: Cysticercosis is usually a diagnostic dilemma in head and neck, and the diagnostic tools used in such clinical scenario, are well known, easily available and dependable. These tools like fine needle aspiration cytology and sonography, however are not the part of diagnostic criteria. Their accuracy, utilisation, and vast availability suggest their role needs addition in present diagnostic criteria.

Conclusion: Cysticercosis is the major neglected tropical disease. High vigilance and prompt diagnosis is required for adequate management of this eradicable disease. Various presentations in head and neck have been described. Diagnosis based on present criteria is not always possible. Well known investigations are helpful in early and accurate diagnosis.