Open Access Short Research Article

Efinaconazole 10% Topical Solution: Treatment of Mild to Moderate Toenail Onychomycosis in Japanese Subjects

Theodore Rosen, Tina Lin

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2018/36283

Objective: To evaluate efficacy, safety, and tolerability of efinaconazole topical solution, 10% in a cohort of Japanese patients with mild to moderate toenail onychomycosis.

Methods: A subgroup analysis of patients, aged 22-70 years, randomized to receive efinaconazole topical solution, 10% or vehicle from a multicenter, double-blind, vehicle-controlled 48-week study evaluating safety and efficacy. The primary end point was complete cure rate (0% clinical involvement of target toenail, and both negative potassium hydroxide examination and fungal culture) at Week 52.

Results: The primary end point, complete cure, was achieved in 30.6% of patients treated with efinaconazole compared to 12.3% with vehicle (Observed case, P=.006), and was significantly better than that seen in the non-Japanese patients (P<.001). Treatment success (percent affected target toenail ≤10% at week 52) for efinaconazole was 60.6% compared to 33.3% with vehicle (P<.001). The majority of adverse events (AEs) were mild (16.6%) or moderate (81.1%) and few (7.8%) associated with efinaconazole. Eleven patients (6.0%) treated with efinaconazole discontinued the study due to AEs.

Conclusions: Once daily efinaconazole topical solution, 10% may provide a useful topical option in the treatment of mild to moderate onychomycosis among ethnic Japanese patients.

Open Access Original Research Article

Epidemiology of Malaria Using LED Fluorescence Microscopy among Schoolchildren in Douala, Cameroon

Léopold Gustave Lehman, Loick Pradel Kojom Foko, Calvin Tonga, Hervé Nyabeyeu Nyabeyeu, Else Carole Eboumbou, Larissa Kouodjip Nono, Lafortune Kangam, Arlette Linda Ngapmen, Peguy Brice Assomo Ndemba, Isabelle Matip, Nicolas Policarpe Nolla

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/IJTDH/2018/38804

Aims: Determine factors associated with malaria infection, the prevalence of asymptomatic carriage of malaria parasites and fevers of non malarial origin.

Study Design: This was a cross-sectional study.

Place and Duration of Study: The study was carried out in three districts of the town of Douala, Cameroon in 2013.

Methodology: Seven hundred and eighty five (785) schoolchildren aged 3 to 17 years were enrolled upon parental consent and tested for the presence of malaria parasites in capillary blood. In addition, sociodemographic and clinical data were also documented.

Results: The overall prevalence of malaria parasite infection was 45.47% and significantly varied with respect to age, health district and body temperature. Asymptomatic infections accounted for 89.61% of all malaria infection cases. Fevers of non malarial origin were found in 10.73% of the pupils. The overall ITNs use rate found was 45.74% with value significantly lower in males compared to females (20.70% versus 25.03%; P = .04).

Conclusion: There is an urgent need for the implementation of interventions based on active detection and treatment of all cases of malaria infection in community especially in children who pay the heaviest tribute to the disease. CyScope fluorescence microscopy could be a valuable diagnostic tool to achieve this objective.

Open Access Original Research Article

Prevalence and Predictors of Tuberculosis Treatment Default in Abakaliki, Nigeria: An Implication for Patient Centred Education and Treatment Follow-Up

B. N. Azuogu, N. C. Eze, V. C. Azuogu, A. Emegoakor, A. Osuagwu, A. N. Inya, E. C. Ede

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2018/39170

Introduction: Tuberculosis (TB) treatment is the most effective strategy for preventing the spread of the disease. Default in TB treatment remains an important contributor to treatment failure, resurgence of multidrug resistance (MDR-TB), prolonged infectiousness, relapse and death. TB treatment default increases the disease burden and poses a threat to its elimination. This study determined the prevalence and predictors of tuberculosis treatment default. 

Methods: Records of 686 patients from TB treatment register at Federal Teaching Hospital Abakaliki from year 2012 to 2016 were analysed. Key informant interviews were conducted with nurses to elicit the factors associated with default. Ethical approval and permission were obtained respectively from the ethics committee and TB unit chief nurse. Records of treatment follow-up were grouped as “defaulter” and “non-defaulter”. Data analysis was done using SPSS software, version 20. Chi squared test of statistical significance was done at P = .05, and thematic analysis was done for the qualitative data.

Results: Mean age of the patients was 34.9 ± 5.7 years, and prevalence rate of default was 10.6% for the five-year period. Majority (73.1%) defaulted within the intensive phase of treatment. Common reasons for defaulting were: ‘well feeling’, ‘distance to health facility’, and high pill burden. Among the defaulters, 25% were ≤ 29 years, 52.8% were males, and 68.1% lived in rural areas. Predictors of TB treatment default were male gender (AOR =2.1; 95% CI: 1.4-7.5), and rural residence (AOR=1.8; 95% CI: 1.3-5.7).

Conclusion: Default rate was high among the patients, and it was mostly associated with the distance from the health facility. We recommend decentralization of treatment centres to rural areas; together with individual patient-centered education and counseling on treatment duration as measures to reduce defaulter rate.

Open Access Original Research Article

Geohelminth Infections and Associated Risk Factors among Children Living in Selected Shanty (Batcher) Settlements in Port Harcourt Metropolis, Rivers State, Nigeria

G. Nwokeocha Chinenye, N. C. Eze, Florence O. Nduka

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2018/39180

Aim: To determine the prevalence of intestinal parasites and their associated risk factors among children living in some selected shanty settlements in Port Harcourt Metropolis, Rivers State, Nigeria.

Study Design: A cross-sectional descriptive study.

Place and Duration: The study was carried out in Port Harcourt Metropolis Rivers State Nigeria, between March to September 2015.

Methodology: Concentration Method (Sedimentation) was used to examine the stool samples according to Cheesbrough (2005). Questionnaire was also used to assess the associated risk factors.

Results: Of the 414 randomly surveyed children 27.1% had parasitic infections, four types of helminths, Ascaris lumbricoides (15.0%), Hookworm (10.9%), Trichuris trichiura (1.0%) and Strongyloides stercoralis(0.2%) were recovered.  Multiple parasitic infections were not recorded, and result showed a significant difference in the occurrence of species of geohelminths (p=0.000). The highest prevalence of 39.4% was observed among children living in Diobu II location. Difference in location prevalence was found to be statistically significant (p<0.05). The males showed a higher prevalence of intestinal parasite infections (29.1%) than the females (25.0%). However, this was not statistically significant (p>0.05). Age distribution of the prevalence of infection did not show a definite pattern, but infection rate was highest among 9 – 10years. This observed difference in prevalence by age was statistically significant (p<0.05). Comparing the distribution of parasites within the age groupings, hookworm infection was most encountered among 9-10 years while Ascaris lumbricoides infection was most frequent among children aged 7-8 years. Risk factor assessment showed that children who defecate on ground/field recorded the highest prevalence followed by those that use the pit latrine. The study also documented a very high prevalence of intestinal parasites amongst children who do not wear footwear.

Conclusion: Ascaris, hookworms and trichuris were recorded in the study; these parasites are found prevalent in Nigeria and associated with poor infrastructure and unsanitary habits. Males showed a higher prevalence of intestinal parasite infections than the females and multiple parasitic infections were not recorded. Open defecation and non-usage of footwear were associated risk factors in the acquisition and distribution of geohelminth infections among the children.

Open Access Original Research Article

Caregivers’ Knowledge and Perception of Accidental Childhood Poisoning in Selected Hospitals in South-South Nigeria

Blessing I. Abhulimhen-Iyoha, Ikponmwosa Owie, Ujiro Igbudu

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2018/39099

Background: Accidental poisoning is a monumental challenge internationally and a major cause of morbidity and mortality among children in Nigeria. There is a paucity of data on the knowledge and perception of primary caregivers with regards to accidental childhood poisoning in the study locale. This study sets out to ascertain these so as to aid the development of suitable educational programmes.

Objective: To assess the knowledge and perception of accidental childhood poisoning among caregivers of under-five children in Edo and Delta States of Nigeria.

Methods: The study subjects included caregivers with children less than five years of age attending the Well-baby Clinics of four major hospitals in Edo State and Delta States, South-south Nigeria, between February and April 2016. A structured questionnaire served as an instrument to extract information on their biodata and their knowledge and perception of accidental childhood poisoning.

Results: Of the 632 caregivers studied, 38.8%, 36.2% and 25.0% had low, moderate and high levels of knowledge of accidental childhood poisoning respectively. The primary caregivers had poor knowledge on first aid following ingestion of a poisonous agent as the majority (90.2%) of them responded that palm oil is a good antidote for most poisons. The higher the level of education of the caregiver, the more likely it is that she would possess the correct knowledge on childhood poisoning and its prevention. The level of perception of accidental childhood poisoning among the caregivers was positive in 447 (70.7%) and negative in 185 (29.3%). The caregivers had the negative perception to some specific statements on the scale; for instance indicating that it is safe to take one's medicines in the presence of the young child.

Conclusion/Recommendation: Caregivers with a high level of knowledge were few. The need for public enlightenment programmes on poisoning prevention, on appropriate first aid should poisoning occur, as well as disabusing caregivers’ minds of certain negative perceptions of accidental childhood poisoning are again emphasized. The establishment of Poison Control Centres (PCCs) to aid in the achievement of this goal would be a step in the right direction.