Open Access Clinical Practice Article

Low Body Mass Index Helps Detect HIV Infection in Uganda

Eichi Takahashi, Kazuo Inoue

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2017/36718

Background: According to the most recent study of World Health Organization (WHO), 36.7 million people were living with HIV by the end of 2016 world-wide, and almost two-thirds of them are residing in Sub-Saharan Africa. Especially Sub-Saharan Africa is one of the most effected regions. UN statistics states that 65% of the population is infected with HIV.  Although the Uganda Ministry of Health (MOH) has implemented the “Nutritional Education Program” at a hospital level, the actual nutritional condition of HIV positive people has not been documented yet.  Therefore, we executed this investigation to examine the nutritional condition, and the eating habits, of HIV positive people compared to HIV negative people in Uganda.

Place and Duration of Study: Kampala, Busia, Mbende, Mbende General Hospital HIV Clinic, and Masafu General Hospital HIV Clinic in Uganda. 24th August 2013 and 2nd September 2013.

Methods: Eighty HIV positive patients visited two hospitals, and one hundred and eleven individuals who self-reported as HIV negative in Kampala, Mbende and Busia. Participant’s weight, height and body size were measured using an electric weight scale, and a measuring tape were used to calculate BMI using standard equations. After calculating BMI scores for low BMI were filtered according to the WHO criteria (BMI<18.5). BMI scores were categorized by gender.

Results: There was a significant difference in BMI mean values between HIV positive and negative people. Although HIV positive and negative subjects consumed a similar amount of food every day, the mean BMI of HIV positive people is lower than that of HIV negative people. We saw similar results for all age groups.

Conclusion: HIV infection in the non-symptomatic carrier stage may influence the nutritional condition and eating habits for people in Uganda. Therefore, BMI measurement could be a very useful method for assessing chronic malnutrition.

Open Access Systematic Review Article

Ebola Outbreaks Public Health Emergencies in Fragile Conflicts Zones and Displaced Populations in Africa

Ernest Tambo, Oluwasogo A. Olalubi, Chryseis F. Chengho, Isatta Wurie, Jeannetta K. Jonhson, Marcel Fogang, Jeanne Y. Ngogang

International Journal of TROPICAL DISEASE & Health, Page 1-15
DOI: 10.9734/IJTDH/2017/35541

Little is documented on conflict and displacement impact on West Africa Ebola Virus disease (EVD) outbreaks. The paper revisits Ebola outbreaks public health emergencies in fragile conflict zones and displaced populations across Africa. Findings showed that the duration of conflict/war events varied one to forty three years. Notably, Darfur war in Sudan and South Sudan lasted between 18-23 years, RD Congo and Guinea incessant political and ethnical or mining conflict instability repeatedly ranging between 2-6 years, Liberia and Sierra Leone 5 and 12 years conflict/war events associated Ebola outbreaks were documented following seven and four years of conflicts from 1989-1996 and 1999-2003 prior to a democracy nation era in Liberia respectively. Worldwide, there have been 28,639 cases of Ebola virus disease and 11,316 deaths as at December, 2016 compared to recent Zika virus outbreaks in Latin America. Ebola outbreak public health emergencies advocacy, community social mobilization and engagement, Ebola awareness, effective and culturally dignified communications, social media and mass media risk communication, community literacy and preparedness, emergency response engagement and participation, access and deployment of digital technology applications (Health map) in surveillance, tracking and monitoring and key traditional burial practice behaviours changes were being translated into positive successes and benefits that geared rapid and effective prevention of further spread and containment activities of West Africa Ebola outbreak. Inter-humanitarian organizations, institutions and other stakeholders including government cooperation and coordinated leadership, commitment and investment were laudable in supporting accountability and transparency in the overall objectives of public health emergency preparedness planning, care management systems in Ebola outbreak centres, public awareness, epidemic early detection and rapid response as well as effective immunization programs implementation to outwit Ebola virus. Sierra Leone conflict lasted from 1991-2002, Guinea recorded frequent relentless instability than Liberia with two major conflict periods from 1989-1996 and 1999-2003. For the first time, we established a statistical significant correlation between duration of war/conflict events and Ebola outbreaks onsets in Africa (P<0.05).Unexpectedly; the total fatality rate in Liberia or Sierra Leone only was greater than the previously reported cumulative EVD cases across Africa since 1976. It is crucial to intensify advocacy on conflicts/wars resolutions to disaster risk reduction framework evidence practice implementation of peace building in fostering health and socioeconomic development and growth. Authors call for the urgent need for concerned commitment and engagement of all stakeholders to develop, implement and strengthening local, national, regional and global public health emergencies evidence practice approaches and strategies including national public health disaster emergency situations insurance models and schemes integration is paramount in disaster high risk prone settings and particular in Africa.

Open Access Original Research Article

Effectiveness of Sulphadoxine Pyrimethamine in Intermittent Preventive Treatment of Malaria in Pregnancy at Federal Medical Centre, Abeokuta

D. O. Awonuga, S. O. Omoya, M. O. Alao, K. I. Hunyinbo

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2017/35015

Objective: To determine the effectiveness of sulphadoxine – pyrimethamine (SP) in intermittent preventive treatment of malaria in pregnancy at Federal medical centre, Abeokuta.

Design: Randomized controlled trial.

Setting: Antenatal Clinic, Department of Obstetrics and gynaecology, Federal Medical Centre, Abeokuta.

Population: Pregnant women presenting for antenatal booking that met the inclusion criteria for the study.

Methods: Patients were randomized into two groups. Blood film for malaria parasite was collected from all the patients before administering sulphadoxine – pyrimethamine to the first group. A repeat sample for malaria parasite was collected from all the patients after two weeks before administering SP to the second group. The maternal biodata, Pre and Post SP blood film analysis results were compared within the two groups.

Main Outcome Measures: Prevalence of malaria parasitaemia and parasite reduction or clearance rate with use of SP.

Results: The result of 358 patients were analysed; 203 in the case group and 155 in the control group. The prevalence of malaria in pregnancy in the study population was 43.9%. The mean parasite density at booking was 1049.7 parasites/µl in the case group and 1183.4 parasites/µl in control group. Prevalence of parasitaemia in the case group reduced by 67.4% and in the control group by 32.4% (P=0.015). The mean parasite density reduction was 59.3% and 37.9% in the case and control group respectively (P=0.021).

Conclusion: The study findings revealed that sulphadoxine-pyrimethamine is effective for the intermittent preventive treatment of malaria in pregnancy.

Open Access Original Research Article

Perceived Training Needs of Butchers and Meat Retailers Regarding Meat Handling Practices in Jammu District of Jammu and Kashmir

Rayees Ahmed Bafanda, S. A. Khandi, Sheikh Umair Minhaj, Rohan Sharma, Farzana Choudhary

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2017/36797

The hygienic meat handling practices of the butchers and meat retailers, and hygienic status of slaughterhouses and the surrounding are of great importance for both the meat handlers and the consumer. In order to enhance the viability and safety of current consumer protection systems in the region, a significant increase of investment by abattoir/meat business operators in suitable equipment for hygienic slaughtering and proper meat inspection as well as in waste treatment facilities is an urgent requirement. Insufficient skills and knowledge in meat handling practices are a key constrain to ensuring food safety of animal products. Training in the abattoir sector is urgently needed for personnel at abattoirs carrying out slaughtering, sanitary, meat hygiene and technical operations. The present study analyses the perceived training needs of butchers and meat retailers regarding meat handling practices in Jammu district of Jammu and Kashmir. Three Major slaughter houses of Jammu district situated at Nagrota, Old Rehari and Gujjar Nagar were selected for the study. A list of butchers in the selected slaughter houses was prepared. Ten butchers from each slaughter house were selected randomly. After preparing the comprehensive list of meat markets operating in Jammu district, three meat markets were selected, and from each selected meat market ten retail meat shops were randomly chosen. From each randomly selected retail meat shop, one person was selected purposively who was actively involved in animal slaughter and sale of meat at retail meat shop. Thus, a total of thirty butchers and thirty retailers were selected in all. Data was collected through interview schedule as well as through observations. The data was coded, classified, tabulated and analyzed using the software; Statistical Package for the Social Science (SPSS 16.0). The presentation of data was done to give pertinent, valid and reliable answer to the specific objectives. Frequencies, percentage, mean and standard deviation were worked out for meaningful interpretation. It was found that all meat handlers (100%) emphasized about the need of basic training provided through either family members or colleagues, whereas 78.33% meat handlers also felt the need for formal training provided through an institutions. Efficient slaughtering, cutting of carcasses, display of carcass/meat, proper packaging of meat and preparing different meat products were the specific area where the majority of meat handlers perceive the need for trainings. Few meat handlers were also willing to receive training about meat associated disease identification and reporting of animal diseases respectively. Result also revealed that majority of meat handlers were willing to undergo short duration training at their own workplace and funded by government.

Open Access Review Article

How Useful is the Widal Test in Modern Clinical Practice in Developing Countries? A Review

Abiodun Christopher Jemilohun, Adebukola Temilade Adeyanju, Modupeola Maria Bello

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2017/36691

Background: It has been over a century since the Widal test was developed for diagnosing typhoid fever. Yet, the test remains the major means of diagnosing the disease in many of the developing countries where it remains endemic. This review appraises the Widal test in regard to its performance techniques, its various drawbacks and the available alternative diagnostics methods.

Methods: The study was a non-systematic review. A literature search was conducted for relevant original and review articles primarily in MEDLINE database through PubMed. Relevant references in the articles at hand were searched manually with Google search engine. Related articles during the manual search were also reviewed. Inclusion criteria were the date of publication from 2,000 to 2017, original research conducted on human subjects and publication in the English Language. All articles that did not meet these criteria were excluded.

Results: The Widal test is a relatively cheap and readily available test in developing countries where more sophisticated tests like culture and polymerase chain reaction are either not available or unaffordable where available. It is, however, difficult to interpret the result because of various reasons that may cause either a false positive or a false negative result. Although several alternative rapid diagnostic tests are now available, there is still no sufficiently reliable one that can replace the traditional diagnostic gold standard, which is culture isolation of the organism.

Conclusion: The Widal test is grossly inadequate to be relied upon as a diagnostic tool for typhoid fever in an endemic area, culture isolation of the causative organism remains the gold standard for diagnosing the disease, and the quest to develop highly effective rapid diagnostic tests for the disease should continue.