Open Access Original Research Article

Atherogenic Index of Plasma and Visceral Adiposity Index among Healthcare Workers in University of Benin Teaching Hospital, Benin City, Nigeria

Tomisin Matthew Adaja, O. E. Onovughakpo-Sakpa

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2018/39493

Background: The healthcare workers are prone to various diseases; most especially cardiovascular diseases by virtue of the nature of their work. The use of traditional lipid profile in the evaluation of cardiovascular risk among health care workers; most especially atherogenic index of plasma [log (triglyceride /HDL-Cholesterol)] and visceral adiposity index, has been advocated among the clinicians. In this cross-sectional study, atherogenic index of plasma and visceral adiposity index are assessed among healthcare workers.

Aim of the Study: This study aims to determine the level of the atherogenic index of plasma and visceral adiposity index among the healthcare workers in the University of Benin Teaching Hospital, Benin City. The relationship between these parameters was also determined.

Materials and Methods: A total of 325 healthcare workers in the age range of 21-69 years, comprising medical doctors, nurses and the other health professional were recruited using a structured questionnaire. One hundred and sixty (160) of the subjects were males while 165 were females. Subjects were categorised based on their gender and body mass index. Their anthropometrics and blood pressure were measured using standard techniques. Biochemical assays done include fasting serum lipid profile (total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol) using standard enzymatic methods. Atherogenic index of plasma and visceral adiposity index were calculated.

Results: Approximately 32% of the subjects were overweight while 26% were obese. Average serum lipids were: Total cholesterol (5.06±1.33 mmol/L), triglycerides (0.91±0.54 mmol/L), HDL-cholesterol (4.08±1.37 mmol/L). Atherogenic index of plasma (AIP) and visceral adiposity index (VAI) were 0.27±0.23 and 1.52±0.91 respectively. Low atherogenic index of plasma and visceral adiposity index were found in the obese healthcare workers. The higher biochemical profile was seen among the female healthcare workers while AIP and VAI were more elevated in the males. A strongly positive correlation was found between triglycerides and visceral adiposity index (r= 0.784; p=0.000) and atherogenic index of plasma (r=-0.223; p=0.000). Approximately 56% of the subjects were at high risk of cardiovascular diseases using atherogenic index of plasma while 23% of the subjects had elevated visceral adiposity index. Triglyceride and HDL-cholesterol were good predictors of levels of atherogenic index of plasma while  triglyceride, HDL-cholesterol and waist circumference were good predictors of visceral adiposity index.

Conclusion: In this study, we demonstrated that a high percentage of health care workers have elevated atherogenic index of plasma and visceral adiposity index. There is an urgent need for a more aggressive screening programme to detect and reduce the scourge of dyslipidaemia among healthcare workers. Moreso, there is a strong relationship between AIP and VAI.

Open Access Original Research Article

The Use of Paper Based Obstetrics Wheel and Electronic Applications for Calculation of Estimated Date of Confinement and Gestational Age, Which is More Accurate?

Ikobho Ebenezer Howells, Ikeanyi Eugene Maduabuchukwu

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2018/39959

This study demonstrates that the USS EDD is more in agreement with the date of spontaneous delivery than the EDD estimated from LMP. This highlights the importance of dating USS in all pregnancies which would be helpful in the management of pregnancy in late stages.

Background: During antenatal care, accurate determination of the gestational age and expected date of confinement are mandatory, for management decisions and birth plan. This could be achieved by the traditional Naegle’s rule, the mechanical obstetrics wheel, and recently the electronics applications.

Objective: To compare the accuracy and consistency of the mechanical or paper-based obstetrics wheel to that of electronics applications in calculating expected date of confinement and gestational age.  It would also recommend the application that is most suitable for use in our environment, for the benefit of the patients and the health personnel.

Materials and Methods: An analytical study of 1200 pregnant women who presented for antenatal care on their booking visit. The study was carried out from May 2010 and April 2013, at the antenatal clinic of the department of obstetrics and gynaecology, Niger Delta University Teaching Hospital, Southern Nigeria. Women who presented in the antenatal clinic on the booking visit were identified, and consent was obtained from them. Relevant information concerning the first day of the last regular menstrual period and patient's bio-data were obtained for those who accepted to participate in the study. Using Naegle's rule as control, the expected date of confinement and gestational age were calculated using the mechanical obstetrics wheel and the electronics application. The results were then analysed.

Results: Using the mean gestational age by Naegle’s rule 27.6 ± 7.6 as control, the mean gestational age obtained by mechanical obstetrics wheel 28.4 ± 7.6, and electronics application 27.8 ± 7.6 were compared respectively using the student's t-test. The difference was statistically significant for the paper-based wheel, t = 2.62, p = 0.008 [0.21, 1.43], while that for the electronics applications was not significant, P = 0.48. Also, there was a higher tendency for the paper-based wheel to deviate from +1 to +5 days beyond the normal duration of pregnancy of 280 days, when used to calculate expected date of confinement.

Conclusion: The electronics applications are more accurate in calculating expected date of confinement and gestational age than the mechanical or paper-based obstetrics wheel. The mechanical wheel is less precise, with a high tendency to deviate when used to calculate expected date of confinement. The electronic applications are hereby recommended as first-line tools in all antenatal clinics.

Open Access Original Research Article

Plasmodium falciparum Malaria Clinical and Parasitological Outcomes after In-vivo Artemether-Lumefantrine (AL) Treatment at Bushenyi District Uganda

Josephat Nyabayo Maniga, Adamu Almustapha Aliero, Ntulume Ibrahim, Matilda Angela Okech, Mugasa Claire Mack

International Journal of TROPICAL DISEASE & Health, Page 1-17
DOI: 10.9734/IJTDH/2018/39642

Aims: The aim of this study was to determine the Plasmodium falciparum malaria clinical and parasitological outcomes after in-vivo Artemether-Lumefantrine (AL) treatment at Bushenyi District Uganda.

Study Design: This was a one-arm prospective longitudinal health point survey.

Place and Duration: This study was carried out in Bushenyi District Uganda as from May 2017 to August 2017 for a period of four months at the selected four health centers.

Methodology: A cohort of 283 human participants who had been confirmed of Plasmodium falciparum malaria was followed for a period of 28 days after treatment with Artemether-Lumefatrine (AL) drug. The follow up was done at fixed check up visits i.e. day 0, 1, 2, 3, 7, 14, 28. Parasitological and clinical evaluations were done at each subsequent follow up days. Consequently they were requested to fill a questionnaire which had aspects of malaria infection.

Results: Out of the 283 participants recruited to this study 194 (68.6%) participants completed the follow up schedules while 89 (31.4%) were withdrawn from the study. There was adequate clinical and parasitological response (ACPR) among 53(27.3%) participants. There was late parasitological failure (LPF) among 43 (22.2%) participants. There was late clinical failure (LCF) among 23(11.9%) participants and there was early treatment failure (ETF) among 75 (38.7%) participants

Conclusion: There was suspected Artemether- Lumefantrine (AL) poor response to Plasmodium falciparum malaria in the study area after 8 years of introduction to Uganda as a drug of choice for treatment of uncomplicated malaria. Those aged 5 years and below were 2.28 times more likely to present LCF as a clinical treatment outcome compared to other age groups when other factors were held constant. Molecular confirmation of the suspected resistance needs to be conducted in the collected Plasmodium falciparum isolates.

Open Access Original Research Article

Prevalence of Helicobacter pylori in Students with Stomach Ulcer Attending School of Health Technology Gwadabawa, Sokoto

M. L. Jidda, Aiki Gambo, K. K. Ibrahim, A. A. Ngaski, Abubakar Ibrahim, A. I. Umar, C. Nwachukwu

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2018/32600

This present study was conducted with the aim of determining the prevalence of Helicobacter pylori, (H. pylori) among students of Sultan Abdurrahaman School of Health Technology Gwadabawa, Sokoto State. The study included 147 subjects, made up of 45(30.6%) males and 102 (69.4%) females. Randox G6PD quantitative in vitro test screening was used for screening for H. pylori infection. 116 (78.9%) patients were positive and 31 (21.1%) were screened negative and of the 45 male subjects studied, 38 (25.9%) were positive compared to females 80 (54.4%). The Prevalence of H. pylori  among the subjects was 78.9%, and the frequency was higher in females than males and much higher in those that are married than singles. Symptoms of abdominal pains and ulcer were strongly associated to infection of H. pylori. There is a need for the routine screening of subjects on a much wider scale for H. pylori to allow for evidence-based management of subjects the infection and also educate them on the factors that will predispose them to infection, as well as good water sources and proper sanitation in our environment especially in the rural areas where personal and environmental hygiene is poor.

Open Access Original Research Article

Studies on the Level of Selenium in Pregnant Women with Malaria (A Case Study of Nnewi South East Nigeria)

C. P. Ozougwu, M. O. Aniagolu, S. N. Ekoh

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2018/40362

Malaria in the tropics has continued to be a threat to public health despite all efforts curb it, more so in pregnancy. The clinical consequences of this disease as it concerns mother and child have always been grievous sometimes leaving death in its wake. This work is aimed at examining the relationship between the trace element selenium and malaria density in pregnant women with malaria. A total of 460 subjects were recruited for the study, comprising 160 pregnant women with malaria attending the antenatal clinic of Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra, South East, Nigeria. The controls are 100 pregnant women without malaria attending the same clinic, 100 non-pregnant women with malaria and 100 non-pregnant women without malaria. The concentration of selenium was determined by atomic absorption spectrophotometry while the malaria density was determined by counting the parasites against white cells. From the results selenium showed a significant decrease in pregnant women with malaria 55.68±16.69 µg/L (p<0.05) compared to non-pregnant women without malaria  64.83±13.27 µg/L and a significant increase compared to pregnant women without malaria 32.94±14.41µg/L and non-pregnant women with malaria 36.44±9.59 µg/L ((F=42.91; p<0.05). Selenium showed a weak positive correlation with parasite density (r=0.27; p=0.004).