Open Access Case Study

Nocardiosis –A Series of Four Case Reports

Sukanya Sudhaharan, Padmaja Kanne, Lakshmi Vemu, K. S. Sandhya Devi, B. Aparna

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2017/32403

Aim: Nocardia spp are ubiquitous soil organisms that often infect patients with underlying compromised immunity, pulmonary disease or history of surgery or trauma. The diagnosis of nocardiosis can be missed because there are no characteristic symptoms. Pulmonary nocardiosis is a major cause of  morbidity and mortality in immunocompromised patients

Presentation of Case: We present 3 cases of pulmonary nocardiosis and one case of disseminated nocardiosis, that were culture proven

Conclusion: With increase in immunocompromised patients, early recognition and initiation of appropriate treatment can lead to successful outcome.

Open Access Case Study

Leptospirosis – A Rare Cause of Acute Acalculous Cholecystitis: Successfully Treated with Antibiotics and Cholecystectomy

Hemanth Kilaru, Satish Chandra Kilaru, John Israel Pulukuri, Chandrika Reddy Abbadi, Venkat Mohan Reddy Abbadi

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2017/33459

Aim: Leptospirosis is a rare cause of Acute acalculous cholecystitis (AAC), reported as a presenting feature, hitherto. The present report suggests that it can complicate leptospirosis during its treatment and rapidly deteriorate warranting prompt surgical intervention. The aim of this case report is to consider leptospirosis in evaluation of acute febrile illness and be vigilant for the possibility of AAC.

Presentation of Case: We present a case of 30-year old male driver with Leptospirosis, complicated with AAC during the inpatient period of management. Diagnosis of Leptospirosis was made based on fulfilment of modified Faine’s criteria & unequivocally positive IgM (ELISA) titers for Leptospirosis and was managed with antibiotics. During the inpatient period, however, the patient developed signs of AAC for which he underwent cholecystectomy during which gangrene of the gallbladder was noted. He showed complete recovery and was doing well during the three months of follow up.

Discussion: Leptospirosis is a rare cause of AAC and the latter has the propensity for progressing to gangrene and perforation and might go undiagnosed unless a high index of suspicion is shown. Hence, prompt and aggressive management with antibiotics and surgery when needed (as in our case) is imperative.

Conclusion: A high index of suspicion of leptospirosis in a patient with acute febrile illness, especially in tropics and constant vigil for the said complication, apart from personal hygiene and preventive public health measures will not only prevent such infections but also reduce associated morbidity and mortality.

Open Access Original Research Article

Investigating the Prevalence and Intensity of Plasmodium falciparum Infection and Two Methods of Malaria Diagnosis in North-Western Nigeria

M. H. Ruqayyah, I. H. Nock, I. S. Ndams, B. D. J. George

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2017/28884

Aims: The study was undertaken to estimate the prevalence and intensity of Plasmodium falciparum infection, in randomly selected areas of north-western Nigeria and to evaluate the efficiency of microscopy and rapid diagnostic test (RDT) in detecting and determining intensity of   P. falciparum infection.

Study Design: The study was conducted in public health facilities from five out of the seven states of north –western Nigeria between April and August, 2013.

The states are Kano, Kaduna, Katsina, Kebbi and Jigawa states, respectively.

Methodology: A total of one thousand four hundred and seventy (1,470) blood samples were collected. Patients were asked to sign consent form after which 2-5 ml of blood was drawn (venepuncture) into EDTA sample bottles. Rapid one step malaria HRP2 Rapid test was carried as described by (Cheesbrough, 2016), to determine presence of Plasmodium falciparum and stained in Giemsa and examined by thick and thin blood smears under light microscope (X 40 objective ) in oil immersion.

Results: A total of eight hundred and thirty four 834(56.5%) cases were positive microscopically while two hundred and eighty seven 287(19.52%) were positive with the RDT which showed high significance (P<0.05) in the efficiency of the diagnostic methods. Low intensity (+) was higher in 542 (36.87%) and different significantly within the states (P<0.05).The RDT showed high specificity of 68.21% while a higher sensitivity of47.68% was observed from the microscopy results which differed significantly (P<0.05) when the two methods were compared.

Conclusion: The results of the study established that P. falciparum malaria was endemic in the states evaluated with certain level of intensity. Microscopy was the most specific method of falciparum malaria diagnosis. However discordance between microscopy and RDT requires further investigations.

Open Access Original Research Article

Prevalence and Atherogenic Index of Plasma as a Predictor of Cardiometabolic Syndrome amongst Road Transport Workers in Owerri

Charles C. Onoh, Ify L. Nwaogazie, Ernest I. Achalu

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/IJTDH/2017/32392

Cardiometabolic Syndrome is a constellation of cardiovascular risk factors which include diabetes, hypertension, obesity, dyslipidaemia amongst others. This study was designed to determine the prevalence and predictors of cardiometaboic syndrome among road transport workers. The Study was a work – site based cross sectional study carried out on one hundred and twenty (120) workers at Imo Transport Corporation, Owerri. The Questionnaires were designed to address the background information of the respondents with respect to gender, age, job title, departments and address. The respondents were anthropometrically examined. The prevalence was calculated as a ratio and reported in percentage. Principal Component Analysis (PCA) and Multinomial Probit Regression Model were employed to determine the degree of relationship between the Atherogenic Index of Plasma (AIP) and cardiometabolic parameters and their order of importance. The prevalence of cardiometabolic syndrome was found to be 19.17%. AIP was shown to be statistically significant and positively correlated with waist circumference (WC) and body mass index (BMI). Atherogenic Index of Plasma (AIP) was shown to be a principal dominant predictor of cardiometabolic syndrome. AIP as a calculated factor can be used in the clinical setting for assessing cardiometabolic syndrome beyond the routinely done lipid profile.

Open Access Original Research Article

Prevalence of Intestinal Protozoan Infections and the Associated Risk Factors among Children in Bushenyi District, Western Uganda

Ibrahim Ntulume, Julius Tibyangye, Adamu Almustapha Aliero, Barugahare John Banson

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2017/33255

Aims: To determine the prevalence of intestinal protozoan infections and the associated risk factors in children.

Study Design: A cross sectional study.

Place and Duration of Study: The study was conducted in four selected health facilities in Bushenyi District, Western Uganda, between June 2016 and January 2017.

Methodology: A total of 200 children aged below one year to 12 years were enrolled. Stool samples were collected and analyzed according to the established standard methods.

Results: Of the 200 children enrolled, 73(36.5%); CI = 0.000-0.015, had intestinal protozoan infections. The prevalence of Giardia lamblia was the highest (16%) followed by Entamoeba histolytica/dispar (13%) compared to Cryptosporidium spp (4%) and Cyclospora spp (3.5%).The highest prevalence was in the age group 1-4 years (26.8%, OR; 2.601, P = .015), mothers with no formal education (44.4%, OR; 3.240, P = .002) and those with primary level education (23.5%, OR; 1.812,P = .027) were significantly associated with intestinal protozoan infections. There was no significant difference in the prevalence of infections between the females (22.3%) and males (16.5%).

Conclusion: The overall prevalence of intestinal protozoan infections was 73(36.5%), Giardia lamblia (16%) was the most prevalent intestinal protozoan infection in the study. The intestinal protozoan infections were most prevalent among children aged 1-4 years whose mothers had no formal education. Prevention strategies need to be tailored to the respective levels of education.