Open Access Systematic Review Article

Nine Years of Malaria Cases in Bangladesh: A Time Series Analysis

Md. Shahidul Islam Laskar, Moktadir Kabir, Shamsun Naher, Md. Akramul Islam, Md. Badrul Hossain Parvez, Md. Ashraf Siddiqui

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/IJTDH/2017/37916

Aims: Bangladesh, a malaria endemic country in South East Asia Region, has successfully decreased malaria over the years through the adoption of different strategies. Still, this is un-notified and no systematic malaria trend analysis has been done. Hence this study assesses the malaria trend through different dimension with consideration of various anti-malarial programmes. 

Study Design and Methodology: Secondary data from National Malaria Elimination Program (NMEP) and BRAC were used to analysis the trend of malaria cases and time series of the data were done to complement the analysis. A comparison of different regions through spatial distribution was also fitted out to determine the present scenario of malaria in Bangladesh. 

Results: The annual malaria incidence declined from 7.77 per 1000 population in 2008 to 1.58 per 1000 population in 2016 [R2=0.712, P-value=0.004, 95% CI:-1.04, -0.29]. Both P. falciparum and P. vivax decreased by 75% and 77% respectively since 2008 though P. vivax is still slightly increased after major shuffling in 2014. Severe malaria gradually decreased by 78% from 2008 to 2016 [R2=0.779, P-value=0.002, 95% CI:- 480.9, -170.7].

A different scenario was found through stratification as malaria infection steadily decreased in both low [R2=0.83, P-value=0.0001, 95% CI:-5.98, -4.87] and medium [R2=0.29, P-value=0.0001, 95% CI:-5.82, - 2.82] endemic districts but the same rate of decrease of malaria infection did not happen in Chittagong Hill Tracts. The study showed that malaria prevalence was higher in males (57.86%) than females (42.13%) and older age group of 15 years and above (59.3%) more than in other younger age groups. 

Conclusion: Though malaria infection has sharply declined in all endemic districts except Chittagong Hill Tracts, a sustained intensified strategy is required in all endemic districts to achieve malaria elimination within 2030.

Open Access Original Research Article

Analysis of Bacterial Meningitis Surveillance Data, 2011-2015, East Mamprusi District, Ghana

Atasige Awin-Irigu Stephen, Emmanuel Jejete Kandoh, Adam Bukari

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2017/38252

Background: Globally meningitis mortality ranges between 2% and 30% and that of in Ghana it is estimated in range between 36% to 50%. The East Mamprusi district in Ghana reports cases due to its location in the meningitis belt. This study assessed the distribution of cases in the district by person, place and time from 2011-2015.

Methods: Meningitis surveillance data in the East Mamprusi district in northern Ghana from 2011- 2015 was analyzed. Case based forms, laboratory tests, results and weekly line lists were reviewed. MS excel was used to analyze the data. We calculated the incidence of the disease and assessed the trend using the alert and epidemic thresholds. We determined the distribution of cases by persons history. Case fatality rates and prevalence of etiological agents were estimated.

Results: The Northern Region recorded a total of 961 suspected meningitis cases from 2011-2015. Numerous subjects are identified, amongst them 205 were confirmed of various organisms with 77 deaths. Between 2011 and 2015, 293 suspected and 83 confirmed meningitis cases were reported from East Mamprusi district. Males are representing 57.5% (216/376) of the total population. About 20% (75/376) of the cases were below one year. The median age of cases was 15 (range 1-77years). The highest numbers of cases were 36.7% (138) reported from Nalerigu Sub-district. Every year, meningitis incidence increased between January and May. The case fatality rate increased from 4.0% in 2012 to 13.3% in 2015. N. meningitides, S. pneumonia were the common etiological agents in the East Mamprusi District. In 2011 nearly 111 and in 2012, 101 cases were recorded respectively. However in 2012 there was a vaccination campaign in the district. Subsequently after the campaign, in 2013, 2014 and 2015 the number of cases declined from 73, 61 and 30 respectively.

Conclusion: Most of the cases were reported among the venerable age group of 1-15 years and from the district capital. There is an observed impact of a 2012 vaccination campaign in the district. There have been reported outbreaks over the period and most outbreaks were reported during the dry and windy season. Case fatality rate is on the increase though incidence is declining of N. meningitides which is the prevalent etiological agent isolated.Meningitis

Open Access Original Research Article

The Influence of Antiepileptic Drugs Alteration as Adjunctive Therapy of Drug Induced Gingival Enlargement among Epileptic Patients in Aseer Region, Saudi Arabia

Mohammed MA. Abdullah Al-Abdaly, Sami Saeed M. AlShahrani, Mohanned Jaber Alwadee

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2017/39039

Background: Drug induced gingival enlargement is a common clinical finding among epileptic patients who are under medical care. This gingival enlargement is generally managed by different methods as scaling and polishing, surgical or substitution of drugs etc. So this study was designed to evaluate the influence of antiepileptic drugs alteration as adjunctive therapy of drug induced gingival enlargement among epileptic patients in Aseer region, Saudi Arabia.

Materials and Methods: The present study was done on thirty epileptic patients (10 patients per group) between the ages of 15 and 52 years with gingival enlargement which were treated using scaling and polishing (SP) alone in group I addition chlorhexidine digluconate 0.2% in group II and alteration of drugs in group III. Plaque index (PLI), gingival index (GI) and gingival overgrowth  (GO) scores were evaluated at baseline, 3 weeks and 6 weeks after therapy, then tabulated and compared statistically using SPSS and the various in proportions was calculated using Chi-square test. Statistical significance (P < 0.05) was detected in PLI, GI, GO score between baseline, 4 weeks, and 6 weeks. Friedman Test and Wilcoxon Signed Ranks Test were carried out to account the significant differences.

Results: There were improvement in all clinical findings among epileptic patients in all study groups in the 1st, 2nd and 3rd visit, but the improvement was most evident among the patients of group III that were treated by SP and alteration of anti epileptic drugs.

Conclusions: Professional and self-plaque control also the alteration of antiepileptic drugs might be a useful in the management of drug induced gingival enlargement, consequently diminishing the necessity of surgical therapy.

Open Access Original Research Article

Paediatric Malnutrition and Associated Factors in the University of Port Harcourt Teaching Hospital

Lucy Eberechukwu Yaguo-Ide, Linus Ndidi Ossai-Chidi

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2017/37926

Aim: Assessment of the occurrence of malnutrition and associated factors in children.

Study Design: Retrospective study.

Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State, Nigeria between June 2015 and June 2016.

Methodology: Data was collected from the medical records of each patient, data collected include; diagnosis, associated symptoms and parent sociodemographic information.

Results: The study showed a 3.6% (37/1017) prevalence of malnutrition among the children. The mean age of the malnourished children was 21.2±10.5 months. There were more underweight children (51.4%), among the malnourished children, while the occurrence of marasmus and kwashiorkor were 29.7% and 18.9% respectively. Malnutrition was mostly common among children that were not breastfed. maternal occupation was shown to be associated with the occurrence of malnutrition in the children, especially among mothers that were civil servants and students. Maternal educational status was also shown to be associated with the occurrence of malnutrition, especially in mothers with no formal education.

Conclusion: The adverse effects of malnutrition span through the lifetime of the children who survive into adolescence and adulthood. Malnutrition is still prevalent in Port Harcourt, underscoring the need to improve on the ongoing efforts to improve the nutritional and physical wellbeing of the children.

Open Access Original Research Article

Awareness and Practice of Pap Smear among Female Hospital Workers in Abia State University Teaching Hospital Aba South East Nigeria

L. Uche Chika, C. Ekeleme Ngozi, C. Iwuoha Ejiro, J. Awa Madu

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2017/35512

Background: Cervical cancer is the fourth most common cancer in females worldwide and the commonest cancer in the female genital tract. Early detection is critical in the diagnosis.

Objective: To determine the awareness and practice of pap smear among female health workers in Abia State University Teaching Hospital (ABSUTH).

Method: This was a cross-sectional descriptive study conducted among female hospital staff of (ABSUTH), About 150 questionnaires were administered out of which 124 responded giving a response rate of 82%. Data was analyzed using SPSS version 20.

Result: A total of 124 female workers; 76(61.3%) health workers and 48(38.7%) support staff participated in this study. Their mean age was 40.7 ±8.7 years. About 76(61.3%) of the respondent had heard of pap smear. However more than half of them 64(52.4%) were not aware that pap smear was being done in ABSUTH. Only 14(11.3%) of the respondents had done Pap smear previously. There was a statistically significant association between cadre of staff and awareness of pap smear (P < 0.001) in addition, health workers were about 4 times more likely to have ever heard of pap smear than support staff (OR 3.92, 95% CI 1.812- 8.45 P 0.00)

Conclusion: The study observed a fair awareness and very poor practice of pap smear among female hospital staff who ought to be at the forefront in enlightening their environment.