Open Access Minireview Article

Impact of Refugees and Internally Displaced Persons on International Health

O. Ogbonna Brian, N. Ezenekwe Lizette, N. Nwako Charles, P. Isidienu Chika, C. Ikebudu Chiadichiem, L. Nwankwo Ogechukwu

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2016/28019

The 21st century has been marked with highest distribution of wars and conflicts at local, national, regional, and international levels in world history. This has increased greatly in the last decade with a growing number of internally displaced people (IDP), refugees, and those seeking asylum. This study discussed the growing impact of refugees and IDP’s on global health. Relevant data was extracted from official sites and publications of international aid agencies through electronic search. Electronic search was conducted between January 2015 and March 2016. The sources of information were MEDLINE, PUBMED, and Google search Information was sorted based on merit of relevance to the topic based on selected criteria using identified search words individually and stringed with additional search words where necessary. The trend and dynamics of refugees migration is predominantly from the underdeveloped to the developed nations of the world while that for IDPs is largely from the politically and economically unstable regions to the more economically and politically viable ones. Study showed increasing trend of displacement of people and migration across borders at the national and international level.

Open Access Original Research Article

Modelling the Influence of Covariates of Typhoid Patients at the Tamale Teaching Hospital Using Generalised Linear Models

Alhassan Abdul Latif, Abukari Alhassan, Kaku Sagary Nokoe

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2016/28551

Typhoid fever and typhoid perforation has become a major burden and causes a lot of deaths in the world especially in developing countries. This study considered a total of 418 patients diagnosed of Typhoid fever at the Tamale Teaching Hospital covering the period January 2010 to June 2015.

The data was modelled using the Negative binomial regression model to ascertain the duration (days) of admission cases as well as the effect of some covariates. Preliminary analysis revealed children of school going age as the most vulnerable. Further, collinearity diagnostics did not exhibit interaction among the predictors. The results identified cost of treatment, location of patients and outcome of admission as significant contributing covariates.

Based on the results, it was recommended that policy makers should take keen interest on the cost of treatment of typhoid since rising cost of treatment is likely to increase the number of days spent in the hospital thereby putting pressure on hospital facilities.

Open Access Original Research Article

Study of Neglected Tropical Diseases (NTDs): Gastrointestinal Parasites in School Children of Lolodorf Neighborhood, South Region, Cameroon

Nkengazong Lucia, Ngo Ngué Thérése Nadyne, Nukenine Elias Nchiwan, Ngué Monique, Moyou-Somo Roger

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2016/29273

Background: Intestinal parasitic infections are still endemic in many parts of Cameroon and for effective control measures, epidemiological data are indispensable. This will enable adequate recommendations for the National control program for these infections.

Aim: This study aim to obtain basic data on the epidemiological situation of intestinal infections in school children of Ngovayang health area of Lolodorf neighborhood in the south region of Cameroon.

Methodology: A total of 423 school children were recruited for the study. Stool samples were collected and examined microscopically for the search of helminthes eggs and protozoan cysts using Kato Katz and concentration formol-ether techniques respectively.

Results: Out of 423 children examined, 321 (75.9%) were infected with Ascaris lumbricoides (30.3%), Trichuris trichiura (64.5%), Hookworms (12.5%), E. histolytica/ E. dispar (9.9%) and E. coli (34.0%). Among whom, 117 (36.4%) had single infections, while 204 (63.6%) had multiple infections. Multiple infections were significantly high (P= 0.0001) compared to single infections.  E. histolytica/ E. dispar infection was significantly more prevalent in females than in males (P=0.01), same as in children aged 3-5 years for Hookworms (P= 0.02), 3-5 years and 11-15 years for E. coli (P= 0.04). T. trichura infections occurred more frequently as single infection (P= 0.0001). Interactions between T. trichiura+ E. coli led to a significant increase of E. coli prevalence (P= 0.001). Significant high eggload was observed for T. trichiura (P= 0.00001) and in children between 3-5 years infected by T. trichiura (P=0.0001) and hookworms (P=0.0001). Children with low infection intensity were significantly more compared to those with moderate and high infection intensity (P= 0.0001) for A. lumbricoides, T. trichiura, and Hookworm. T. trichiura density increases significantly when it interacts with A. lumbricoides + Hookworms, A. lumbricoides + E. coli, Hookworms + E. coli, E. histolytica/ E. dispar + E. coli, A. lumbricoides + Hookworms + E. coli and A. lumbricoides + E. histolytica/ E. dispar + E. coli (P< 0.05).

Conclusion: This study has demonstrated that the Ngovayang health area is endemic for intestinal parasites. The protocol of mass drug administration recommended by MINSANTE is not adequate to reduce the endemicity level of these parasites, hence a necessity for a readjustment.

Open Access Original Research Article

Clinicians’ Adherence to Implementation of Test, Treat and Track Strategy for Malaria Control among Children Under-five Years in Ho Municipality, Volta Region, Ghana

Christopher Kankpetinge, Margaret Kweku, Frank Baiden, Eric Agboli, Damian Akapoeh, Wisdom Takramah, Elvis Tarkang, Ishmael Norman, Fred Newton Binka

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2016/29468

Background: The World Health Organization emphasized testing and confirming every suspected malaria case with either Rapid Diagnostic Tests (RDTs) or microscopy before treatment with anti-malarial drugs. Over 80% of cases in endemic countries of Africa are still treated without diagnostic test. This study presented an assessment of the adherence of clinicians to implementation of the Test, Treat and Track (T3) strategy for malaria control among children under-five years in Ho municipality of the Volta region of Ghana.

Methods: A cross-sectional study was carried out in 10 facilities comprising 7 public and 3 private in 2015. The survey was to determine the number of fever cases that were tested before Artemisinin-based Combination Therapy (ACT) was prescribed, if tracking of patients was done by clinicians, and the challenges to implementation of the T3 strategy among children under-five years. Data was collected using a structured questionnaire, and analysed using SPSS version 20, at the level 0.05.

Results: Of the 300 children under-five years, 82% reported to the health facilities with fever. Only 58.5% of these fever cases was tested, out of which 52.8% was confirmed malaria positive, whilst 43.8% tested negative for malaria. All confirmed and unconfirmed cases were treated with ACT. About 61.5% of the cases treated were not asked to return for review. Majority (80%) of the clinicians cited frequent RDT stock-out as the major challenge to their adherence to the T3 policy.

Conclusions: Adherence to the test of fever cases by clinicians was poor. Also, a substantial proportion of the untested fever cases were presumptively treated with ACT as malaria. Adherence to the use of ACT for the treatment of all malaria cases was overwhelming. The Ministry of Health/Ghana Health Service should ensure adequate and sustained supply of RDTs and ACTs to both public and private health facilities. Clinicians should be sensitized on the T3 policy.

Open Access Original Research Article

Identification of Virulence Factors Produced by Candida Isolates from HIV Seropositive and HIV Seronegative Pregnant Women

Blessing Itohan Ebhodaghe, Kwashie Ajibade Ako-Nai, Busayo Roseline Adegun, Winston A. Anderson, Olakunle O. Kassim

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2016/29386

Background: Candida infection has been shown to be a source of morbidity in pregnancy and in immunocompromised individuals due to elaboration of virulence factors.

Study Design: The study was designed to identify various Candida species that were isolated from the vaginal and oropharyngeal cultures of HIV seropositive and HIV seronegative pregnant women in their third trimester of pregnancy as well as the virulence factors of the Candida isolates.  

Methodology: A total of 240 pregnant women were enrolled in the study. They were screened for HIV seropositivity with HIV-1/2 strip and confirmed by Abbott  enzyme-linked immunosorbent assay (ELISA). One hundred and fourteen (114) of the women were found to be HIV seropositive, while 126 were seronegative. Vaginal and oropharyngeal swabs from the two cohorts of pregnant women were cultured on mycological agar that was supplemented with streptomycin. Candida isolates were identified by sugar assimilation and fermentation procedures and further speciated using Candida Ident chromogenic agar. Assays for virulence factors were conducted using standard techniques.

Results: A total of 106 Candida isolates were recovered from the cultures, with 76.4% coming from vaginal cultures and the remaining 23.6% from oropharyngeal swabs. About 59.7% of the vaginal isolates and 92.3% of the 25 oropharyngeal isolates came from HIV seropositive pregnant women. Various Candida species were isolated from 28.9% of 114 seropositive women, compared to 18.3% of 126 seronegative women. Candida albicans and C. glabrata were the two predominant isolates from the two groups of pregnant women. The results show a higher degree of vaginal colonization among the HIV seropositive women. Interestingly, one of the C. albicans isolate from the vaginal cultures from the HIV seronegative women produced haemolysin. However, 55% to 91% of  C. albicans and C. glabrata from the same cultures produced coagulase, phospholipase and biofilm. Bile hydrolysis was the most predominant virulent factor expressed by the Candida isolates recovered from all sites in our study.

Conclusion: C. albicans and C. glabrata were the two most predominant isolates that were recovered from both HIV seropositive and HIV seronegative women in our study. The degree of colonization of Candida isolates recovered from the two anatomical sites was higher in HIV seropositive women (59.7%), compared to 40.3% in HIV seronegative controls. The significant higher rate among HIV seropositive women underscores the potential burden of immunosuppression by HIV infection.