Open Access Original Research Article

Serum Bilirubin Levels in Patients with COPD during Acute Exacerbation

Ali Ali Okaab, Reda Mohamed El Badawy, Ahmed Abd El Sadek Mohamad, Mohamed Abd Allah Hussien

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2018/38864

The Aim of the Work: To study the relationship between levels of serum bilirubin in patients with chronic obstructive pulmonary disease (COPD) during an exacerbation.

Patients and Methods: One hundred fifty (150) patients, including 117 males and 33 females, participated in the study. All patients had been diagnosed with COPD and were experiencing exacerbation; they were admitted to the chest medicine department at Benha University Hospital in Egypt. A full medical history was taken from all patients, and all were given both general and local examinations. The hospital took standard chest x-rays, both posteroanterior (PA) and lateral views. Body mass index (BMI), pulmonary function tests (spirometry) before and after bronchodilation, electrocardiography, a complete blood count, liver function tests, kidney function tests, and fasting blood sugar were also completed. The study excluded patients with any disease that might elevate serum bilirubin, such as hepatic diseases, inflammatory bowel diseases, end-stage renal disease, diabetes mellitus, hypertension, ischemic heart disease, arthritis, cerebral vascular diseases, and any systemic infection or inflammation that could be associated with an increase in the bilirubin level. Also, patients were excluded if they had tuberculosis, bronchiectasis, malignancy, or connective tissue disorders.

Results: The levels of serum total and indirect bilirubin were high in COPD patients with acute exacerbation. Significant negative correlation was observed between serum total and indirect bilirubin levels with the following: the pre-bronchodilator ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC); the pre-bronchodilator FEV1 %, and the forced expiratory flow 25–75 % (FEF25–75%). Non-significant negative correlation was observed between serum total bilirubin levels and the smoking index.

Conclusion: A patient’s bilirubin level may be a helpful indicator of COPD exacerbation, and a COPD patient may receive a beneficial effect from some levels of hyperbilirubinemia.

Open Access Original Research Article

Assessment of Pneumococcal Conjugate Vaccination on Nasopharyngeal Pneumococcal Carriage: A Case Study of Vaccinated and Unvaccinated Children Under-Five Years Attending Mbale Municipality Health Centers, Eastern Uganda

Bournventure Onyango, Kabaka Angurini, Ivan Mugisha Taremwa

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2018/39279

Aims: To determine the nasopharyngeal carriage of Streptococcus pnuemoniae among children under-5 years of age who have been vaccinated with Pneumococcal Conjugate Vaccine (PCV-10) and those unvaccinated in Mbale Municipality, Eastern Uganda.

Study Design: This was a cross sectional study.

Place and Duration of Study: The study was conducted in Mbale Municipality Health Centres, Eastern Uganda during the period of September 2015 and June, 2016.

Methodology: We enrolled 280 children (140 vaccinated with PCV 10 and 140 unvaccinated). Demographic data were obtained from the care givers, and vaccination status from the caregiver and the vaccination card. Nasopharyngeal swabs were tested for Streptococcus pneumonia at least four weeks post immunization. Pneumococcal carriage was defined by a positive culture, with an identification of Streptococcus pnuemoniae.

Results: The overall prevalence of Streptococcus pnuemoniae carriage was 123 of280 (43.93%; 95% Confidence interval: 39.88-47.69) with the rate among the immunized of 14.29% (95%% CI: 11.33-16.73), compared to the 78.57% (95%CI: 81.34-88.61) among the unvaccinated children. The odds ratio of pneumococcal carriage was 7.4 among the unvaccinated children compared to the PCV immunized children.

Conclusion: Vaccination with PCV offers protection to the risk of pneumococcal carriage. This study emphasizes the value of monitoring for the impact of PCV vaccination program in order to reassure health care workers and families.

Open Access Original Research Article

Health-related Quality of Life in Primary Care Diabetes Mellitus Patients with Sexual Dysfunction in Uyo, South-South, Nigeria

Idung, Alphonsus Udo, Jombo, Henry Effiong

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2018/40364

Introduction: Sexual dysfunction complications of diabetes mellitus are major public health problems because of their effects on individuals, families, and communities. The objective of this study was to describe the effects of sexual dysfunction on health-related quality of life in primary care patients with diabetes mellitus in Uyo, South-south, Nigeria.

Methods: This was a prospective cross-sectional study conducted between January and December 2017. Using a systematic sampling techniques, 377 subjects aged 18 -69 years were recruited, data were collected with an interviewer-administered structured questionnaire.

Results: Of the 377 respondents, 176 (46.3%) had sexual dysfunction. The mean age of the respondents was 49.6 ± 5.6 year. The prevalence of sexual dysfunction based on IIEF domains among respondents were as follows: erectile dysfunction 149 (84.7%); impairment in sexual drive  142 (80.7%); impairment in intercourse satisfaction 126(71.6%); impairment in overall satisfaction 106 (60.2%) and impairment in orgasm satisfaction 78 (44.3%).  Respondents also reported impairment in their overall quality of life (p = 0.000); general health satisfaction (p<0.001); as well as physical health (p<0.001); psychological health (p=0.000) and social relationship domains (p=0.000) of their health-related quality of life-based on WHOQOL-Bréf.

Conclusion: Sexual dysfunction is one of the major complications of diabetes mellitus; its effect on health-related quality of life of those affected is often under-estimated.  There is, therefore, need for primary care physicians to develop and execute interventions to address the sexual, social as well as psychological health needs of diabetic patient with sexual dysfunction.

Open Access Original Research Article

Predictors of Unmet Need for Contraception among Urban and Rural Women in Anambra State, Nigeria: A Mixed Method Survey

Ifeoma Iloghalu, Christian Ibeh, Ifeoma Modebe, Nkiru Ezeama, Emmanuel Azuike, Kamtochukwu Obi

International Journal of TROPICAL DISEASE & Health, Page 1-20
DOI: 10.9734/IJTDH/2018/39886

Aims: To assess the levels of unmet need for contraception and the various factors that influence these levels among rural and urban populations of currently married women of reproductive age in Anambra State, Nigeria.

Study Design:  Mixed method survey.

Place and Duration of Study: Anambra State in South-Eastern Nigeria. The study was carried out from March 2017 to July 2017.

Methodology: The study participants were currently married women of reproductive age (15-49 years) who had resided in the Local Government Areas of interest for at least one year prior to the survey and who consented to the study. Excluded from the study were women who were homeless, living in institutional homes or were too sick to participate in the survey. Multistage sampling technique was used to select 208 urban and 210 rural participants and quantitative data obtained using pre-tested, semi-structured, interviewer-administered questionnaires. Qualitative data were obtained from focus group discussions (FGD) among current non-users of contraception and key informant interviews (KII) among Primary Health Care staff in selected Local Government Areas. Binary logistic regression was done for quantitative data analysis using SPSS software and content analysis of qualitative data was done using the Atlas.ti software.

Results: Response rate was 96.8%. There was a significantly higher level of awareness of at least 3 modern methods of contraception among urban (52.5%) compared to rural women (47.5%) (P ˂ 0.001). The overall contraceptive prevalence among participants was 44.5% (29.7% for modern methods and 14.8% for traditional methods). The overall level of unmet need for contraception was very high (26.3%), but much higher was the unmet need for modern contraception (41%). The independent predictors of unmet need for contraception among urban women were health insurance and cost of contraceptives; while that among rural women was perceived the risk of pregnancy. Only 2 rural participants had a form of health insurance. The commonest reasons for contraceptive non-use were side effects-related for urban women and opposition to use for rural women.

Conclusion: The level of unmet need for contraception remains very high and its predictors vary between urban and rural women in Anambra State, Nigeria.

Open Access Original Research Article

Epidemiology of Wheezes and Diagnosed Asthma among School Children Aged 12-17 Years in Three States of Sudan 2016

Siham Ahmed Balla, Sayed Halay, Taha Ahmed Elmukashfi Elsheikh, Heitham Awadalla, Amani Ahmed Burbr, Emtinan Khalid Hamid, Asma Abdelaal Abdalla, Zeinab Swareldahab, Zeinab Ammara, Elfatih Malik, Haieder Abuahmed Mohamed

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2018/39872

Background: There is a dearth of recent information on wheezes and Asthma in Sudan. Asthma is a non-communicable disease that affected more than 300 million persons in 2014 and contributes to more than 15 million disability-adjusted life years (DALYs).

Objectives: This study was conducted to determine the prevalence of wheezes and asthmatic school children in the three states of Sudan.

Materials and Methods: Three states of Sudan were selected for field training of the fifth year medical students as part of the curriculum. A two-stage sampling procedure was carried out. Seventeen rural areas were randomly selected from the three states as the first stage. Thereafter; two primary schools were selected from each area randomly, one for girls and one for boys. The eligible study population was children at 7th and 8th grades of primary schools. A mini adapted questionnaire from the international study of asthma and allergies in children (ISAAC) was used to collect the data.

Results: A total of 1598 school children aged 12-17 years were enrolled in the study. Males children were 162(46.4%) and females were 187(53.6%).Freelancers fathers of children accounted for 259(74.2%) and housewives mothers were 270 (77.4%). Literate fathers and mothers were 1468(92%) and 1377(86%) respectively Children experienced an episode of wheezes during the last 12 months prior to the study were 349(21.8%). School children diagnosed asthmatic prior to the study were 199 (57%) among children suffered from wheezing episodes and the prevalence of diagnosed asthmatic in total study children in the three states was 12.5%. Two hundred children (57.3%) had experienced sleep disturbance among children with wheezing episodes. The difficulty of breath while playing was experienced by 211(60.7%) children. Children experienced difficulties during the speech were 183(52.7%). Those who had a cough without flu or chest infection were 211(60.7%). Presence of smokers and trees in the households of the children were significantly associated with wheezing episodes.

Conclusions: The prevalence of wheezes and Asthma among school children is high in rural Sudan. Smoking and trees were significantly associated with wheezing episodes. Health policy at the state level should include the control of asthma and raise the population awareness