Open Access Original Research Article

Major Diseases among Underserved Population of Ogun State, Nigeria

A. K. Adeneye, B. Adewale, A. Z. Musa, E. E. Afocha, S. M. C. Ezeugwu, J. Yisau, T. Y. Raheem, D. O. Akande, A. O. Akinremi, O. A. Runsewe, M. A. Sulyman, O. O. Adewoyin, M. A. Mafe, I. A. O. Ujah

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2016/25886

Aim: To assess major health challenges of underserved communities.

Study Design: This descriptive cross-sectional study conducted in May 2014 probed into major health challenges of underserved communities where community-based health insurance scheme (CBHIS) was to be implemented.

Methodology: Semi-structured questionnaires were administered in two Local Government Areas of Ogun State selected using multi-stage sampling technique on consented 419 out of 442 randomly selected household heads from 10 communities. In-depth interviews and focus group discussions were also held with community members, community and opinion leaders, to complement the quantitative data. The quantitative and qualitative data were analysed using Statistical Package for Social Sciences (SPSS) version 20 and Textbase Beta software respectively.

Results: A total of 419 household heads were interviewed, of whom 50.4% were males and 49.6% females with ages ranging from 20 to 87 years and with an average age of 51 years (SD ±16.75 years). Trading (37.5%) and artisanship (23.9%) accounted for the major occupations of the respondents. Two hundred and twenty-five (53.7%) had a minimum of secondary education. At the household level, the major health challenges mentioned were communicable diseases (CDs) that included malaria (58.0%) and vaccine-preventable diseases such as typhoid (4.1%), measles (2.4%), chicken pox (1.9%) and cholera (1.0%) while non-communicable diseases (NCDs) mentioned included rheumatism/arthritis (6.2%) and hypertension (2.9%). Similar result were obtained for the community level [malaria (58.2%), typhoid (17.4%) and measles (6.7%) and NCDs included hypertension (7.9%) and rheumatism/arthritis (7.2%)]. A cumulative of diseases mentioned showed that 45.5% of the diseases mentioned in the study were NCDs.

Conclusions: The findings from this study provide useful policy insights for the improvement of health service provision to these rural populations. The CBHIS if effectively implemented will ensure access by the underserved to quality and affordable health care.

Open Access Original Research Article

Prevalence of Transfusion Transmissible Infections among Blood Donors in a Tertiary Care Hospital of Mysuru District – A Six Years Study

Pallavi Prakash, Shreedevi S. Bobati, Vijaya Basavaraj

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2016/25449

Introduction: Blood transfusion remains a substantial source of transmissible infection in India. The prevalence of transfusion transmissible infections (TTIs) like Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), syphilis and malaria in blood donation is important for evaluating blood safety and potential risks to the population.

Aims: To determine the prevalence of HIV, HBV, HCV, syphilis and malaria among blood donors in a tertiary care hospital.

Study Design: A retrospective review of donor record over a period of 6 years between 2009 to 2014 was done at the regional blood transfusion centre (RBTC) in a tertiary care hospital of Mysuru, Karnataka, India.

Methodology: A total of 50,279 healthy donors were screened for HIV, HBV, HCV, syphilis and malaria. Screening for HIV, HBV and HCV was done by ELISA. Screening for syphilis and malaria was done by Rapid Plasma Reagin (RPR) method and rapid immunochromatographic test respectively.

Results: Among 50,279 donors screened, 768 (1.52%) were positive for the TTI. The overall prevalence of HIV, HBV, HCV and syphilis among the blood donors in the present study was 0.26%, 0.96%, 0.15% and 0.13% respectively. No blood donor showed positivity for malarial parasite. Majority of seropositive donors (43.35%) were in the age group of 26 to 35 years followed by 27.60% in 18 to 25 years age group.

Conclusion: The prevalence of TTIs among blood donors in Mysuru district was 1.52% with male dominated donor pool. Continuous improvement and implementation of strict donor selection criteria, sensitive screening tests and establishment of strict guidelines for blood transfusion can ensure the elimination, or at least reduction, of the risk of acquiring transfusion transmitted infections.

Open Access Original Research Article

Evaluation of Fine Needle Aspiration Cytology Technique for Early Diagnosis of Tubercular Lymphadenitis in Patients Presenting at a Primary Care Setting in India

Pradeep Tandon, Winie Gautam

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2016/25716

Aims: The aim of the present study is to evaluate whether FNAC helps in detecting tubercular lymphadenitis (TB LAN) at an early stage in a primary care setting. Demographic and cytomorphological profile of TB LAN in this part of the country is also analyzed.

Study Design: The study is a retrospective analysis of all FNAC procedures carried out in patients of lymphadenopathy (LAP). Cases diagnosed as TB LAN are analyzed further.

Place and Duration of Study: All patients of LAP presenting at Ama Diagnostic Centre, Lucknow, Uttar Pradesh, India, between August 2008 to December 2015.

Methodology: FNAC procedure was carried out on 780 patients of whom 762 cases yielded adequate material. Of these, 245 cases were diagnosed as TB LAN based on cytomorphological details and Zeihl Neelsen staining.

Results: TB LAN is the second most common cause of lymphadenitis. Lymph nodes of head and neck region are involved most frequently in TB LAN. Majority of TB LAN patients are in 2nd and 3rd decade of life. The disease tends to occur at a younger age in this part of the country.

Conclusions: Cytomorphological profile of the aspirates indicates that use of FNAC helps in detecting TB LAN at an earlier stage of the disease. Majority of the cases of TB LAN are seen between 10-30 years of age. It also occurs at an earlier age in this part of the country. In about 90% of cases TB LAN tends to involve lymph nodes of the head and neck region.

Open Access Original Research Article

Soil-Transmitted Helminth Infections and Associated Risk Factors in a Neglected Region in the Upper Nkongho-mbo Area, South-west Region, Cameroon

Ngum Helen Ntonifor, Irene Ule Ngole Sumbele, Tabot Joseph Ebot

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2016/26048

Introduction: Soil-transmitted helminth (STH) infections are among the most prevalent chronic human infections worldwide and affect the poorest and most deprived communities.  Few studies have been carried out to evaluate the state of STH infections in the Upper Nkongho-Mbo region of Cameroon; hence levels of infection remain unknown.

Methodology: A cross-sectional study on the prevalence and intensity of soil-transmitted helminth infections as well as the influence of risk factors was carried out in the Upper Nkongho-Mbo area, South-West Region, Cameroon, between November 2012 and July 2013. Faecal and soil samples were collected and analysed using the formol-ether concentration technique and the sucrose floatation centrifugation technique respectively. Information on hygienic standards was also obtained.

Results: Results obtained showed that out of 327 people sampled, 145 were infected with one or more STHs giving an overall prevalence of 44.34%. The prevalence of round worm infection (39.14%, 128) was significantly higher (χ2 = 26.95; p ≤0.001) than that of whipworm (8.26%, 27) and hookworm (13.46%, 44). The prevalence of infection varied with age group (p ≤0.001). The 21-50 years age group had the highest prevalence (55.44%) while the 6-12 years age group had the lowest prevalence (30.38%). Intensity of infection also varied significantly with age groups (p < 0.001). The highest intensity was observed in the 21-50 years age group (113.5±24.8), and the lowest in the 6-12 years age group (20.95±9.33). Soil samples examined had a prevalence of 26.79% (30) compared with 44.34% observed in the faecal samples. The proportion of soils contaminated was statistically different from the proportion of faecal samples contaminated (χ2 = 4.307; p = 0.038). Age and toilet type were found to be important predictors of infection (p = 0.041and p= 0.01).

Conclusion: These findings provide evidence for the high risk of acquiring STH infections from the middle age group in the Upper Nkongho-Mbo region of Cameroon. Effective measures are therefore necessary to reduce contamination of the region.

Open Access Original Research Article

Clinical Manifestations and CD4 Counts of Tuberculosis in Human Immunodeficiency Virus-infected and Un-infected among Newly Diagnosed Patients in Mombasa, Kenya

Shadrack A. Yonge, Michael F. Otieno, Rekha R. Sharma, Sarah S. Nteka

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/IJTDH/2016/25263

Background: Tuberculosis is a disease with protean manifestations. The clinical presentation of tuberculosis can mimic several diseases and can be a diagnostic problem even in endemic areas. Virulence and dose of the infecting mycobacterium, the immune status of the host, the organ systems(s) involved, all influence the clinical manifestations of tuberculosis.

Aim: This study was at aimed assessing clinical manifestations and CD4 counts of TB patients with or without HIV co-infection.

Study Design: Hospital and laboratory based cross-sectional study was carried between May 2011 and November 2013 in Coast General Referral hospital, Tudor, Port-Reitz, Mlaleo, Likoni and Mikindani districts and Sub-districts hospitals.

Methodology: Tuberculosis was diagnosed following standard clinical bacteriological and radiological procedures. Sputa from 500 tuberculosis suspects underwent mycobacteriologic evaluation using Ziel-Nelsen smear microscopy, Lowestein and Jensen and BACTEC MGIT 960 culturing. Consenting participants were screened for HIV infection by enzyme -linked immunosorbent assay. Data collected from group were compared using univariate and multivariate analysis. The level of significance was set at p<0.05 and for each statistically significant, odds ratios and confidence interval were computed.

Results: A total of 210/500 (42%) of the tuberculosis suspects had mycobacterial disease and 78/210 (37.1%) were HIV co-infected. Most presenting symptoms in TB patients with or without HIV was cough 50%, constitutional symptoms 42.3%, fever 29.5% and weight loss 31.4% and night sweats (90.9%). Regarding clinical signs, pallor 50.4%, night sweats 35.2% and respiratory signs 16.7% were common and significantly associated with HIV -positive serology. Oral thrush (OR=11.04; 95% CI: 3.01-17.20), Gastro intestinal symptoms (OR=8.97; 95% CI: 3.45-23.41) and constitutional symptoms (OR=7.17; 95% CI: 2.24-15.2) were independent predictors of HIV-positive serology. Majority of the patients with TB-HIV co-infection had CD4+T cell count <200 cells/mm3 accompanied by night sweats. Tuberculosis patients had statistically significant higher mean CD4+T cell counts (t=5.6, df=461, p<0.05) and higher leukocyte counts (t=3.8, df=472, p<0.05) than HIV/AIDS tuberculosis co-infected patients.

Conclusion: Co-infection with HIV was very high in patients with TB. The presence of chronic cough more than one month, night sweats, fever and pallor may assist in identify TB patients with HIV infection. Physicians should be aware of this pattern of presentation and the atypical findings on investigation for early diagnosis and treatment. CDT+T cell counts were significantly elevated in TB patients than TB-HIV co-infection.