Open Access Original Research Article

Study on Cutaneous Leishmaniasis among Clinically Suspected Patients in Taiz City, Taiz Governorate, Yemen

Talal Alharazi, Ibtesam Alasbahi, Nada Saif

International Journal of TROPICAL DISEASE & Health, Page 1-5
DOI: 10.9734/IJTDH/2016/28536

Aims: To determine the prevalence of Cutaneous leishmaniasis (CL) among clinically suspected patients in Taiz city, Taiz governorate, Yemen and its correlation with age, sex, site and lesions sites and number.

Study Design: Cross-sectional study.

Place and Duration of Study: This study was conducted among clinically suspected patients in Taiz city, Taiz governorate, Yemen during March to August 2014.

Methodology: A Hundred of skin scraping were collected randomly from clinically suspected patients and stained with Giemsa stain for microscopic analysis. Furthermore, epidemiological data including sex, age, residences, place of lesion, and number of ulcer/s or scar/s had been collected using semi-structured questionnaires.

Results: Out of 100 patients, 87 were found positive. The majority of infected patients 69 (79.3%) were coming from rural areas. Males are more infected (57.5%) than females (42.5%). The prevalence of CL was highest in the 1-15 years group (62.1%) than the older age group. The most lesions were recorded on the face (48.3%) than the other sites of the body. The majority (78.2%) had single lesion, 17.2% had two lesions, while three lesions were developed in 4.6% of patients.

Conclusion: Prompt and effective measures will be required to prevent CL.

Open Access Original Research Article

Co-occurrence of Free-living Amoebae and Amoebae-resisting Bacteria in Hospital Drinking Water System: Evaluation and Comparative Analysis

Lamia Galal, Omnia El-Badawy, Mona H. M. Abdel-Rahim, Eman Mossad, Hanaa Y. Bakir

International Journal of TROPICAL DISEASE & Health, Page 1-15
DOI: 10.9734/IJTDH/2016/28815

Aims: Conventional routine water analysis does not search for free-living amoebae (FLA) and Amoebae-Resisting Bacteria (ARB) in spite of their morbid impact on human health especially towards patients in health care services. In Egypt, very limited data are available in FLA, existing in the treated drinking water and the ARB naturally inhabits them. Therefore, this study was to elucidate the obscure side of this problem trying to find their actual co-occurrence and strength of such relations in nature.

Study Design: Cross-sectional study.

Place and Duration of Study: This study was conducted between June and December 2014 at six of Assiut University Hospitals (AUH) buildings.

Methodology: A total of 54 samples (27 water and 27 biofilms) were collected from the drinking water system (DWS) of AUH. The samples were filtered and processed to Fluorescent In-situ Hybridization (FISH) using specific oligonucleotide probes for Legionella spp., Legionella pneumophila, Parachlamydiaceae, and eukaryote-specific probes for Hartmannella spp. and Naegleria spp.

Results: Forty-four out of 54 samples (81.4%) were positive for FLA, 45% Hartmannella species, 27.27% Naegleria spp. and 27.27% (co-occurrence of both amoebae). Legionella spp. was the most detected ARB within their FLA host 84% (37/44) in contrast to 54% (24/44) Parachlamydiaceae. Co-existence of Legionella spp. and Parachlamydiaceae in both amoebae within the same sample was observed. The number of Hartmannella harboring Legionella spp. was higher than Naegleria spp., but the number of FLA decreased when both amoebae coexisted and harboring Parachlamydiaceae.

Conclusion: It is worth mentioning it could be the first comparative study in Egypt pointing to the relation between FLA and ARB in their natural environment and not from in vitro culture using FISH. New strategies are to be implemented for efficient infection prevention and control to restrict the spread of nosocomial infections through hospital water systems.

Open Access Original Research Article

Neonatal Outcomes of Mothers with Hypothyroidism in the Third Trimester

Ehimen Phyllis Odum, Ngozi Clare Orazulike

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/27963

Aims: To determine the relationship between maternal hypothyroidism and preterm birth, neonatal low birth weight and neonatal thyroid stimulating hormone (TSH) levels.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Obstetrics and Gynaecology in a tertiary hospital in Rivers State, Southern Nigeria from June 2014 to November 2014.

Methodology: Serum TSH and free thyroxine (FT4) were analyzed in pregnant women before delivery and cord blood TSH was analyzed in their babies immediately after delivery. Maternal hypothyroidism was defined as serum TSH > 3.0 mIU/L in the third trimester according to the American Thyroid Association (ATA) recommendation.

Results: Out of 168 pregnant women, 25 (14.9%) women had subclinical hypothyroidism. None had overt hypothyroidism. They had babies with lower birth weight (P = .037) and lower Apgar scores at 1 minute (P = .003) and 5 minutes (P = .001) compared to mothers without hypothyroidism. A total of 17 (10%) babies had low birth weight. Fourteen (8.3%) babies were preterm. Thirteen (7.7%) babies were admitted into the neonatal intensive care unit (NICU) and among them babies born to mothers with hypothyroidism had a higher frequency of admission into NICU (P = .002), lower gestational age (P = .006) and higher mean TSH (P = .015) than babies born to mothers without hypothyroidism.

Conclusion: Maternal subclinical hypothyroidism was associated with neonatal low birth weight, low Apgar scores, preterm birth and high neonatal TSH. Timely detection and treatment of maternal hypothyroidism could reduce the burden of adverse neonatal outcomes.

Open Access Original Research Article

Socio-demographic, Clinical and Laboratory Predictors for the Diagnosis of Visceral Larva Migrans in Children - Upper Egypt

Lamia A. Galal, Abeer E. Mahmoud, Rasha A. H. Attia, Azza Eltayeb, Dalia G. Mahran

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/IJTDH/2016/28780

Visceral larva migrans (VLM) is a worldwide neglected disease, prevalent among children from socio-economically disadvantaged populations in temperate and tropical regions. Infections may go undiagnosed as the required diagnostic tests; serological, molecular and/or imaging examinations are expensive, which may not be affordable or available. We aimed to establish predictors useful in the diagnosis of VLM in children in Upper Egypt. A one year cross-sectional study was conducted at Assiut University Children's Hospital and eighty-one children aged between 6 months to 13 years old (mean± SD 5.7 ± 3.2 years) were eligible to our inclusion criteria, 55.6% of them were males. Socio-demographic risk factors, clinical, laboratory and imaging tests were collected. ELISA (anti-T. canis IgG) results were positive in 60.5%. By using the bivariate analysis, a significant association was found between seropositive ELISA and younger age less than four years (p-value <0.0001), having underground water at their homes (p= 0.004), previous history of parasitic infection (p= 0.003) and positive liver ultrasonographic findings (p=0.001). In a multivariate logistic regression model with positive and negative ELISA results as a dependent factor, younger age (<4 years), history of parasitic infestation and positive liver ultrasonographic findings were found  to be significant predictors, while no significant association with other factors was identified. Thus, clinicians should consider the positive liver ultrasonographic changes with the earlier history of parasitic infection in children under four years as predictors for VLM infection, according to which they should undergo ELISA or other tests to confirm their diagnosis.

Open Access Review Article

Dengue Prevalence and Diagnosis in Pakistan

Nazia Haider, Atia Iqbal

International Journal of TROPICAL DISEASE & Health, Page 1-14
DOI: 10.9734/IJTDH/2016/13961

Dengue virus, a positive sense RNA virus, involve in spreading dengue infection worldwide, consists of four related but genetically different serotypes. The present study depicts the outbreak and prevalence of dengue infection in different parts of Pakistan from 1982 to 2013. In addition to this most commonly used diagnostic techniques in the world and in Pakistan have been also discussed. Since 1934, the availability of vector (Aedes aegypti) into various parts of Pakistan served as a risk factor for dengue infection and transmission to other parts of the country resulted into several mini and major outbreaks of different intensity. Later on, factors such as the geographical growth of the vector, seasonality of unknown reasons in transmission patterns and increased rainfall in area extended the degree of infection. After the first documented outbreak of dengue illness in 1994 in Karachi, the situation remained more or less unchecked therefore, dengue illness started to appear in the Northern part of the country in 2007. In 2013, a new trend has been observed regarding dengue prevalence in Pakistan, when cases were reported from areas other than endemic belt such as Balouchistan and Khyber Pakthunkhwa provinces. The analysis of available data showed the major threat of this viral infection that need to be considered and preventive measures should be taken accordingly.