Open Access Minireview Article

An Emerging Threat of Dengue and Chikungunya Co-infection: Need of Developing a Pre-diagnostic Screening Tool

Sumit Sohal, Avneet Randhawa, Aanchal Wats, Vedha Sanghi, Arun Yadav

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/29813

Dengue and Chikungunya infections have caused large outbreaks globally and millions of people have been affected worldwide. They are transmitted by Aedes aegypti and Aedes albopictus and can cause potentially severe acute illnesses and or debilitating chronic disease. Coinfection with both diseases is not new and has been reported on patients from Asian, African and Pacific countries. The need to differentiate between two infections is also very important because minute differences in treatment and, misdiagnosis can hamper epidemiological understanding of both diseases.

Use of symptoms differentiation, scoring systems and simple laboratory parameters is discussed in this article which can be used to accurately identify cases of mono and co-infections. The paper emphasizes on development of a pre-screening diagnostic criteria to differentiate between these two diseases which will not only reduce unnecessary testing but will also prevent misdiagnosis.

Open Access Original Research Article

Assessment of the Performance of Out-patient Acute Malnutrition Management in Children under 5 Years in the Northern Benin Setting

Moussiliou Noël Paraïso, Victoire Agueh, Charles Sossa Jerome, Colette Azandjeme, Kokou Pascal Agbehonou, Virginie Mongbo Ade, Michel Makoutode

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2016/27752

Aims: To assess the performance of out-patient acute malnutrition management in children under 5 years.

Study Design: Cross-sectional study.

Place and Duration of Study: Northern Benin, health district of Djougou-Ouake-Copargo, from 1st to 30th June, 2014.

Methodology: Fifteen functional out-patient malnutrition management centres (out the 27 existing) were included in the study. Data on acute malnutrition management were collected in thirty skilled health workers by using questionnaire and observation. Data were also collected in 296 children who suffered from acute malnutrition through medical records, reference documents and supervisions note books. The performance of out-patient acute malnutrition management was assessed through three components “input/resources”, “process” and “results” using predetermined score of two scales seeking for achievement of criterions according to WHO reference for the evaluation of the performance of the health system.

Results: The performance of the out-patient management of acute malnutrition in the health district was rated low.

Conclusion: The performance of out-patient management of acute malnutrition in the health district was suboptimal. Adequate monitoring of malnourished treated child  and a greater mobilization of community volunteers in the active search of drop out patients are required to improve the performance of out-patient management of acute malnutrition in health district of Djougou-Copargo-Ouaké in Benin.

Open Access Original Research Article

The Role of Community Involvement in Malaria Control and Prevention in Abia State, Nigeria

O. R. Ezeigbo, N. G. Agomoh, I. C. Ezeigbo

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2016/28518

Community engagement and participation have played a critical role in successful disease control and elimination campaigns in many countries. Although malaria is endemic in many parts of the country, the knowledge, attitude and practice of the community about the disease prevention and control options are far from perfect, and misconceptions and malpractices are common. The study conducted between January and April, 2016 aimed at evaluating the role of community involvement in malaria prevention and control. A cross-sectional approach was adopted through collection of data using pre-tested structural questionnaire. The information included such variables like knowledge, attitude and practice of malaria control and prevention. Other variables include community involvement in planning, supervision, monitoring, ITN distribution, training and practice of malaria prevention. A total of 2000 fully completed questionnaires were retrieved consisting of 950 (47.5%) males and 1050 (52.6%) females. Majority of the respondents (94.8%) were literate with 64.9% married. The results further revealed a total of 1967 (98.4%) who claimed they have a good knowledge of malaria as a disease. However, only 1657(82.9%) knew infected mosquito bites as the cause of malaria; although, some have misconceptions on the causes of malaria. Almost all the respondents correctly associated malaria with clinical symptoms of the disease. Majority of the respondents have good knowledge of environmental factors predisposing to malaria with 887 (44.4%) for stagnant pool of water, bushes around the house recorded 764(38.2%) while refuse was 185 (9.3%). However, 87 (4.4%) had a misconception that cold weather is one of the factors that predispose to malaria. The result also revealed that community members were not involved in planning, supervision, monitoring and training in malaria control programmes. Only 1.5% of the respondents acknowledged participating in ITN distribution programmes. All respondents affirmed the availability of healthcare facilities in their communities; however only 63.8% claimed they use these facilities. Reasons for non-use include use of herbal medicines (62.0%) and self-medication (29.8%). On preventive measures used, insecticide-treated bed nets (ITNs) had the highest percentage with 29.7%. Despite increased access to this intervention over time, the use of ITNs still remained low. All respondents claimed involvement in the monthly sanitation programme. However, only a little percentage (1.3%) performed this exercise weekly. Although various malaria interventions have emphasized community participation as a vital tool for effective malaria control and prevention, the issue on ground is that community members were not involved in the planning, supervision, monitoring, training and distribution of ITNs. Therefore, existing efforts must be strengthened and health education programmes intensified to improve community participation towards malaria prevention and control.

Open Access Original Research Article

Variation of Mice Immune Responses after Infection with Lethal Strain Plasmodium yoelii: Role of Inflammatory and Anti-inflammatory Cytokines

Hanaa Y. Bakir, Chikako Tomiyama-Miyaji

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2016/29371

Objective: Variability in resistance to infections is a well-known phenomenon that has been ascribed to genetic and immunologic factors. The present study was conducted to identify the mRNA expression pattern for some cytokines in two groups of mice from different genotypes. 

Methods: Two groups of mice were used (C57BL/6 (B6) and DBA/2 mice).  The mice were infected with lethal strain of Plasmodium yoelii 17XL (P. yoelii 17XL). Analysis of mRNA for Th1-type cytokines [Interferon-γ (IFNγ), Interleukins (IL)-12, IL-6, and tumor necrosis factor-α (TNFα)] and Th2-type cytokines [IL-4 and IL-10], was conducted using Reverse Transcription (RT)-PCR. 

Results: The main difference was the significant rise in IL-12 and IL-6 in DBA/2 mice compared to their baseline value in B6 mice. The production of TNFα increased in the severe phase in B6 mice, in sharp contrast to its dominant production in the recovery phase of DBA/2 mice. The expression of anti-inflammatory cytokines, particularly IL-10, increased in DBA/2 mice. The production of immunoglobulin M (IgM) and IgG-type anti-DNA autoantibody was evaluated. 

Conclusion: This study aimed to clarify the complexities of cytokines responses and give valuable evidence about the characteristic pattern of cellular cytokines mRNA expression and their role in controlling malaria in two different strains of mice. Hence presenting necessary data for the development of effective malaria vaccine and new anti-malaria drugs.

Open Access Review Article

Plasmodium knowlesi Infection: Should Africa be Prepared for a New Human Malaria Threat?

Kenneth Ikenna Onyedibe, Michael O. Iroezindu, Emmanuel Tumininu Obishakin, Mark Okolo Ojogba, Emmanuel Olushola Shobowale, Ita Okokon Ita, Ubong Aniefiok Udoh, Samson Ejiji Isa, Daniel Z. Egah

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2016/29180

Background: Human malaria was always believed to be caused by any of four species of Plasmodium namely; Plasmodium vivax, P. falciparum, P. ovale and P. malariae. However, a few years ago, it was observed that Plasmodium knowlesi could naturally infect humans especially in South East Asia. Can we have P. knowlesi infections in Africa? Are we prepared for a new human malaria threat? African institutions might not be searching for this parasite. There is no documented endemic transmission of this parasite in Africa despite many factors that could support its occurrence probably due to clinical and laboratory challenges in the diagnosis of P. knowlesi infections. A misdiagnosis may delay appropriate therapy leading to fatal consequences. 

Methodology: This article reviewed in some details many issues surrounding P. knowlesi malaria diagnosis and infection in other parts of the world and the many factors that could promote transmission and occurrence of this infection in Africa through a database search (PubMed, Google Scholar, Cab direct, and African Journals Online) using terms related to the intended review. This is an area that has not been explored by authors in the past. 

Conclusion: The possibility of transmission of P. knowlesi in tourist sites in Asia and spread through international travel to Africa is a reality. The Zika and Ebola experiences are clear examples of how international travel and interactions between man and vectors could lead to fatal consequences. Subsequently, these consequences can be averted when the scientific and clinical communities are primed to recognize and combat an emergence of P. knowlesi infections in non-endemic regions.