Open Access Original Research Article

Are We Treating the Right People? Are We Treating the People Right? Health Status, Knowledge and Quality of Life amongst Patients with Diabetes at a Specialized Clinic at Kamuzu Central Hospital, Malawi

Ali T. Yassin, Yohannie Mlombe, Claudia Beiersmann, Thomas Bruckner, Martin Zeier, Florian Neuhann

International Journal of TROPICAL DISEASE & Health, Page 1-14
DOI: 10.9734/IJTDH/2016/25601

Aims: To describe health status, knowledge and quality of life among patients with diabetes mellitus attending a tertiary hospital in the capital of Malawi.

Study Design: A cross-sectional observational study among randomly selected adult patients with diabetes.

Place and Duration of Study: Diabetes clinic, outpatients department, department of Medicine, Kamuzu Central Hospital, Lilongwe, Malawi between April 2014 and May 2014.

Methodology: We included 271 randomly selected patients (82 men, 189 women; age range 18-86 years) with diabetes mellitus. Socio-demographic characteristics, clinical status, glycosylated hemoglobin (HbA1C), comorbidities and medical history were assessed beside diabetes specific knowledge and subjective quality of life (QoL).

Results: There were 77% classified as having type 2 diabetes vs. 23% type 1 diabetes. In 4% tuberculosis (TB) was suspected and prevalence of human immunodeficiency virus (HIV) was 13.6%. Level of education was high in 52%. Mean HbA1C was 7.1% and 15.9% had an HbA1c <5.5%. HbA1C was significantly higher in type 1 vs. type 2 diabetes (<.001). Mean body mass index (BMI) was 30.1 kg/m2. The mean BMI for females 31.4 kg/m2 (SD 5.9) was significantly higher than that for males 26.9 kg/m2 (SD 4.6), (P = .001). Arterial hypertension was diagnosed in 61% and 52% had a systolic blood pressure >= 140 mmHg and/or diastolic blood pressure >= 90 mmHg. Among all participants, 23% had estimated glomerular filtration rate (eGFR) corresponding to stage 3 and above chronic kidney diseases (CKD). The majority of patients (62%) could not name their diabetes type or causes; 75% of participants expressed a significant fair overall QoL.

Conclusion: The clinic was dominated by well-educated adipose females with relatively adequately controlled HbA1c and patients, who might have no diabetes. Patients with acute metabolic diabetes complications were underrepresented. Subjects showed a fair subjective QoL. Clinic function and focus as a specialized tertiary care center require re-definition.

Open Access Original Research Article

Preparation of Inactivated Trivalent FMD Vaccine and Determination of Antibody Titre in Vaccinated Cattle

M. M. R. Chowdhury, M. L. Hossen, S. Ahmed, K. H. M. N. H. Nazir, M. Rahman, M. F. R. Khan, K. B. Amin, M. T. Rahman, M. B. Rahman

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2016/25870

Aims: This research work was conducted for isolation and molecular detection of Foot and Mouth Disease (FMD) virus from the field samples, development of inactivated trivalent FMD vaccine, and determination of antibody titer in vaccinated cattle.

Methodology: A total of 10 samples (tongue epithelium) were collected from FMD affected cattle from Gazipur, Mymensingh, and Pabna districts of Bangladesh during May 2014. Inoculum was prepared from the sample and the associated FMDV was propagated in BHK-21 cell lines. Besides, viral RNA was extracted for molecular detection (RT-PCR) of the serotypes involved. The isolated serotypes were used as seed virus in preparation of binary ethyleneimine (BEI) inactivated trivalent FMD vaccine using saponin and oil adjuvants. For the determination of antibody production in response to our trivalent FMD vaccine, a total of 25 cattle aging 11-22 months were used. Sera of vaccinated cattle were collected on day 0, 21, 35, 49, 63. The sera were subjected for the determination of antibody level using enzyme-linked immunosorbent assay (ELISA). The titer values were statistically analyzed using one-way ANOVA to see immune response against the serotypes.

Results: Three serotypes of FMDV were detected; these were FMD serotype-O, A and Asia-1, of which serotype-O was mostly prevalent, followed by serotype-A and Asia-1. The highest mean antibody titer was found on day 63 in all serotypes. Sixteen cattle (80%) out of 20 vaccinated cattle obtained protective antibody titer. The titer values of the vaccinated cattle were statistically significant against O, A and Asia-1 serotypes.

Conclusion: FMD serotype-O, A, and Aisa-1 are prevailing in Bangladesh. A trivalent inactivated FMD vaccine has been prepared successfully using circulating virus of Bangladesh. The vaccine can be used to combat FMD in Bangladesh.

Open Access Original Research Article

Microhabitat Assessment of the Breeding Sites of Simulium damnosum Theobald Complex in Oji River Basin, Enugu State Nigeria

Ugwuanyi Ifeoma Kosisochukwu, Eneanya Christine Ifeoma, Onyido Angus Ejikeme, Okonkwo Nnaemeka Joe, Aribodor Dennis Nnanna, Nwankwo Edith Nonye, Ukonze Chikaodili Blessing, Okoye Chukwuebuka Kingsley

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/25858

Aims: Blackflies of the Simulium damnosum complex are the principal vectors of Onchocerca volvulus, the causative agent of Onchocerciasis (river blindness) in Nigeria and other West African countries. They therefore constitute serious public health and socio-economic problems in the areas that they occur. The study was undertaken to assess some physical and chemical factors affecting the distribution of Simulium damnosum complex in Oji river basin, Enugu state, Nigeria.

Study Design: Larval prospection was carried out in eleven riverine breeding sites in Oji river basin and physico-chemical parameters these breeding sites were evaluated.

Place and Duration of Study: A one year study was carried out between December 2011 and November 2012 in four communities in Oji river Local Government Area, Enugu state.

Methodology: Physical and chemical parameters of the breeding sites such as water temperature, velocity, turbidity and pH were determined. Measurements were taken between 10:00 and 11:00 hours local time on each visit. The features of the sites were also assessed by visual observation and scored as either presence or absence of rocks, logs and trailing vegetation and presence or absence of human and animal activities.

Results: A total of two hundred and ninety-one (291) S. damnosum complex larvae were collected. Of the microhabitat characteristics measured, water velocity and turbidity (P<0.05) were the only parameters showing significance with the distribution of S. damnosum complex larvae at the breeding sites.

Conclusion: This study provides information on prevailing microhabitat characteristics of breeding habitats of S. damnosum s.l., which may have implications in predicting vector distribution and disease transmission. This knowledge is crucial for accurate planning of onchocerciasis elimination programs.

Open Access Original Research Article

Comparison of Two Survey Methods Based on Response Distribution of Pediatricians Regarding Immunization for Children in India: Mail versus Telephone

Roy L. Zhang, Naveen Thacker, Panna Choudhury, Karen Pazol, Walter A. Orenstein, Saad B. Omer, James M. Hughes, Paul S. Weiss, Lisa M. Gargano

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2016/24051

Introduction: The use of telephone and mail surveys raises the question to what extent the results of different data collection methods deviate from one another.

Aim: To determine if there is any difference in the response distribution between telephone and mail surveys of vaccination related-attitudes.

Methods: A random sample of 400 pediatricians who are members of the India Academy of Pediatrics and work at various locations in India was selected. Mantel-Haenszel chi-square test was applied; significance level was alpha=0.05. Difference in percentage points of the majority response was calculated in the following way ∆=telephone% - mail%.

Results: Only 36% responded to mail surveys and 57% responded to telephone surveys. Pediatricians in both telephone and mail surveys agreed for the majority of survey questions but to a different degree on particular items. More pediatricians in the telephone arm responded that measles eradication is important with a p=0.001 and ∆=8.3. More mail than telephone respondents reported that it is parents’ responsibility to ensure child is vaccinated (∆= -7.9, P=0.002) and that they would refer parents to a facility of their choice to get vaccines (∆=14, P=0.008).

Conclusion: The results show evidence of the interviewer and/or social desirability bias and its influence on response choices. This suggests that mode of administration should be standardized or carefully adjusted for during analysis. Alternatively, further question development may minimize the sensitivity of items to mode of data collection.

Open Access Review Article

Hepatocarcinogenic Properties of Hepatitis B Virus

R. K. Obi, B. O. Oke, A. A. Anjorin, I. K. Bidmos, O. B. Salu, S. A. Omilabu

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2016/17067

Approximately two billion people are infected with hepatitis B (HBV) worldwide. Infection due to the virus can be influenced by host immune status, age, and vigorosity of viral replication. Majority of patientsre cover from acute infection while a larger percentage of new infections, contracted mostly in utero, advance to a chronic form of the disease and therefore stand thechance of developing complications. The mechanisms through which chronic HBV infection causes hepatocellular carcinoma (HCC) are however unclear, though evidence exist to show that the virus itself is hepatocarcinogenicin action. With an estimated 85% worldwide cases of HCC attributed to HBV, the virus is said to be one of the leading causes of cancer-related deaths. Althoguh several discoveries have been made in the physiology and pathology of cancer in relation to disease progression, mortality rate of HCC is still high due to late diagnosis. This occurence is however low in developed countries than developing countries where the endemicity of HBV strongly predisposes to the development of chronic liver disease and subsequent progression to HCC. It is indeed necessary to encourage HBV vaccination as well as treatment of chronic hepatitis B, to facilitate the application of many of the advances that have been made in the understanding, prevention, and treatment of hepatocellular carcinoma.