Open Access Case Study

Can Malaria Interfere with the Diagnosis of HIV Infection?

Martin E. Ohanu, Michael O. Iroezindu

International Journal of TROPICAL DISEASE & Health, Page 1-4
DOI: 10.9734/IJTDH/2016/26995

A 40 year old woman presented to the medical outpatient clinic of University of Nigeria Teaching Hospital Enugu with an acute febrile illness. She had blood film malaria parasitaemia of 2,400 parasites/μl, and tested positive to human immunodeficiency virus (HIV) 1 & 11 using rapid test kit. She was counseled and offered HIV confirmatory test which turned out indeterminate. She was treated for malaria using artemisinin-based combination therapy and advised to come back after three months for repeat HIV test. Three months later, the patient now asymptomatic with negative malaria parasite film was re-screened for HIV using enzyme linked immunosorbent assay (ELISA) technique which turned out negative. Our findings suggest that malaria may interfere with diagnosis of HIV infection especially when using the rapid test kit and hence give wrong epidemiological data – this also has grave implications for the individual patient. This observation is important in populations where both malaria and HIV are endemic.

Open Access Original Research Article

Work-Related Musculoskeletal Disorders: A Case of Office-Based Civil Servants in Rivers State, Nigeria

Ify L. Nwaogazie, ThankGod C. Omuruka, S. S. Adaramola

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/IJTDH/2016/27544

This study was carried out to investigate Work-Related Musculoskeletal Disorders (WRMDs) among office-based civil servants in selected ministries (Ministry of Education and Health) –Min-C and local government areas (Ikwerre and Obio/Akpor) LGA-C of Rivers State using 200 office-based civil servants as the study population. A lykert model response questionnaire was used as the instrument of primary data collection to investigate prevalence of WRMDs among the study population. The data obtained were analyzed using Kendall’s coefficient of concordance (w). The w-values for general office ergonomic awareness were 0.271 (27.1%) for LGA-C and 0.739 (73.9%) for Min-C while that of workstation ergonomics awareness were 0.297(29.7%) and 0.323(32.3%) for LGA-C and Min-C, respectively. When Workstation Ergonomic Practice was considered the w-values for LGA-C were 0.771 (77.1%) and 0.9896 (99%) for Min-C while that of Musculoskeletal Disorder/Pain complaints were 0.995 (99.5%) for LGA-C and 0.992 (99.2%) for Min-C. These values suggest that there is low level of ergonomics awareness and practice, and high prevalence of musculoskeletal disorders/pains among the study population. The study also indicates that the most affected body regions were waist, back, and neck.

Open Access Original Research Article

Fecal Calprotectin in Assessment of Ulcerative Colitis Activity

Badawy A. Abdul Aziz, Enas Sh. Khater

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2016/26984

Background: It is important to evaluate the activity of inflammatory bowel disease (IBD) for the treatment. Fecal Calprotectin has been shown to be excellent marker of intestinal inflammation because it is simple, rapid, sensitive, specific, inexpensive and noninvasive to detect and monitor intestinal inflammation.

Aim: The aim of this prospective study was to evaluate the role of fecal calprotectin in diagnosis and assessment of activity of ulcerative colitis.

Methods: Prospective cross sectional study was conducted to involve thirty patients with UC and five as control. The included patients attended the gastrointestinal endoscopy clinic of the departments of internal medicine in AL-Quwayiyah General Hospital, Riadh, KSA. The study was carried out for six months from August – 2015 to January – 2016. All patients underwent lower GI fiberoptic endoscopy (proctosigmoidoscopy, ES450WE5- Fujinon and colonoscopy, EC 530 WL-Fujinon) with multiple biopsies from each patient and sent to histopathology laboratory. The patients’ disease activities were assessed according to Montreal classification and Mayo subscore. Calprotectin was measured by enzyme linked immuno-sorbentassay (ELISA) method (Calprotectin ELISA Kit, Immundiagnostik AG, Bensheim, Germany). CRP and ESR were measured in the clinical laboratory, AL-Quwayiyah General Hospital, Riadh, KSA, based on the instructions provided by the reagent manufacturer.

Results: Of the patients 25 presented by active UC ranging from mild to severe picture and 5 patients were in remission. According to endoscopic Mayo score: 5(16.67) showed Mayo score 0(remittent patients); 8(26.67%) showed Mayo score 1; 13(43.33%) showed Mayo score 2; 4(13.33%) showed Mayo score 3. The extent of UC according to Montreal classification was total (extensive) colitis 6(24%); left-sided colitis, 12(48%); and proctitis, 7(28%). There was a high significant difference in the fecal calprotectin concentration between the patients with active UC and the patients with inactive UC (P < 0.001). The FC concentration was significantly greater in the patients with inactive UC than in the controls (P < 0.001). As regard CRP and ESR; the patients with active UC had higher levels of CRP and ESR than the patients with inactive UC and the controls (P < 0.001), but there was no significant difference between the patients with inactive UC and the controls Calprotectin had a good correlation with the disease activity that the concentration was greater in severe cases than in moderate and mild cases and this difference was highly statistically significant (P<0.001).

Also CRP concentration in severe cases was greater than in moderate and mild cases and in comparison the difference was statistically significant (P<0.002). ESR concentration was higher in severe cases than moderate and mild cases but there was only statistical significant difference as regard severe and mild cases not between moderate and mild cases.

Conclusion: Fecal calprotectin is a biomarker that could differentiate active from inactive UC and our results suggest that FC can be used as a valuable, simple, noninvasive diagnostic tool for UC compared with other markers such as CRP and ESR. Keywords: ulcerative colitis, fecal calprotectin and enzyme linked immunosorbentassay (ELISA).

Open Access Original Research Article

Socio-demographic and Environmental Factors Affecting the Prevalence and Spread of Tuberculosis in South West Region of Cameroon

Irene Ane-Anyangwe, Jerome Fru-Cho, Julius Awah Ndukum, Anong Damian Nota, Henry Dilonga Meriki, Fritz Roland Fonkeng Nsongomanyi, Theresa Nkuo-Akenji, Vincent P. K. Titanji

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/26827

Aims: To carry out a household based study in the South West Region of Cameroon to evaluate the effects of selected environmental and social factors affecting the prevalence and spread of tuberculosis.

Study Design: This study was a cross-sectional one.

Place and Duration of Study: From May to September 2006, a team of 6 including 2 laboratory technicians and one nurse visited 309 randomly selected households in five different localities within Fako Division.

Methodology: Three major overcrowded and two major affluent quarters peculiar for high and low TB prevalence respectively were visited. We used a standard questionnaire to get demographic information. A poverty index based on type of toilet, salary scale, educational level and number of persons sleeping in a room was calculated. Sputum samples were collected from 1000 participants in 309 household and Mycobacterium tuberculosis identified by the standard Ziehl Nelsen staining technique.

Results: The overall prevalence of TB was 3% (30/1000). A significantly higher prevalence (1.62%) was recorded in individuals with primary level of education when compared with the prevalence rate (0.20%) for those with tertiary education (p=0.034) TB prevalence was significantly higher in people who earned between $100-200/month compared with those who earned >$200 (p<0.0001). A significant majority of TB positive patients (16, 53.33%) had never been vaccinated compared with those vaccinated (p<0.0001). Polygamists recorded the highest TB prevalence (12.37%) compared with monogamists (3.56%) and singles (0.93%) (p<0.0001).

Conclusion: Illiteracy and polygamy were some of the social factors significantly related to TB in our study. These findings would be used in redesigning strategies for effective control of TB in the study areas.

Open Access Original Research Article

Study on the Prevalence of Onchocerca volvulus Infection among the Inhabitants of Awgu and Oji-River Local Government Areas of Enugu State, Nigeria

A. U. Ikpo, J. l. Mbanugo, C. A. Anukwuorji, I. K. Ugwuanyi

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2016/27369

This study was conducted to determine the prevalence of Onchocerciasis among the inhabitants of Awgu and Oji River Local Government Areas from October 2012 to March 2013. Simple random sampling method was used to select three communities in each Local Government Area. The prevalence of O. volvulusinfection was determined by microscopic examination of skin snip samples for O. volvulus microfilaria. The subjects were selected from the communities by systematic random sampling method. Seven hundred and eighty six samples were collected and 250 (31.38%) were positive. Two hundred and ninety-five (295) individuals were sampled in Awgu Local Government Area and 36 (12.20%) of them were positive. In Oji River Local Government Area, 491 individuals were sampled and 214 (43.58%) were positive for O. volvulus. Higher prevalence of Onchocerciasis was observed in males {108(48.43%)} compared to females {106(39.55%)} in Oji river Local Government Area. In Awgu Local Government Area, females had a higher prevalence of 19 (13.38%) as against 17 (11.11%) by the males. The highest prevalence of onchocerciasis was seen among the age group 41-50 years in both Local Government Areas. Farmers had the highest prevalence in both Awgu (15.49%) and Oji River (50.43%) Local Government Areas. The highest prevalence was seen among the illiterates in Awgu (16.87%) and Oji River (54.66%) Local Government Areas. Despite efforts aimed at controlling Onchocerciasis infection in the two Local Government Areas of Enugu state, the infection is still hypoendemic (<40%) in Awgu and mesoendemic (>40% but less than <60%) in Oji River Local Government Area.