Open Access Original Research Article

Use of Long-Lasting Insecticidal-Bednets among People Living with HIV/AIDS Accessing Care in a Tertiary Health Facility in Southwest, Nigeria

H. A. Edogun, G. O. Daramola, T. E. Adeleye, A. O. Ojerinde, A. A. Agbaje, O. Ogunbola, O. O. Ajala, A. Egbebi, E. F. Akerele

International Journal of TROPICAL DISEASE & Health, Page 1-5
DOI: 10.9734/IJTDH/2018/41025

Co-infection of HIV with certain diseases like pulmonary tuberculosis and malaria increases the morbidity and mortality of people living with HIV/AIDS. HIV-malaria co-infection has been regarded as having a synergistic effect on the patient. The former increases the patient’s vulnerability to parasitic and microbial infections, due to compromised immunity, while malaria on its part, further lowers an already diminished immunity by negatively impacting CD4 lymphocytes. In a nutshell, HIV-malaria co-infection is a collaboration that must not be allowed to take place in persons living with HIV/AIDS. One way to do this is to encourage HIV infected persons to sleep under long-lasting insecticidal nets (LLIN). In this retrospective study, covering a decade at a tertiary health facility in the southwest, Nigeria, requisite data on 303 confirmed HIV positive subjects were retrieved and reviewed. Two hundred and twenty-one (73%) of the subjects were females, while 82 (27%) were males. The mean age of the subject was 41.7 while 42 was the modal age. Ten (3.3%) of the subjects fell within 16-25 years age-bracket, 74 (24.42%) fell within 26-35 age-bracket, while, 118 (38.94%), 71 (23.43%), 26 (8.58%) and 4 (1.32%) respectively fell within 36-45, 46-55, 56-65 and 66-75 age-brackets. Only 6 (2%) of the cases were new HIV infections, whereas, 70 (26%) had been infected for upwards of 9years and had been on HAART (highly active anti-retroviral therapy) ever since then. About half 147 (48.5%) of the subjects didn’t disclose at enrolment into the free treatment scheme if they used LLIN or did not use it. However, out of the remaining 156 who did make a disclosure, 148 (94.9%) used LLIN, while 8 (5.1%) did not. The study also revealed that male subjects were likelier than the females to use LLIN. 

Open Access Original Research Article

Estimated Burden of Premature Death and Morbidity from Low Birth Weight Infants in Thailand

Ei Ei Aung, Nuttapat Makka, Kanitta Bundhamchareon

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2018/41821

Aims: The aim of this study was to estimate the burden of premature death and morbidity consequences due to infants born with a low birth weight (LBW).

Study Design:  This study was a secondary data analysis and part of the study of the burden of diseases and injuries in the Thai population in 2014.

Methodology: Data were collected from national public health statistics, a vital registration database, and the morbidity burden from the LBW consequences was analysed according to the Global Burden of Disease (GBD) study 2000. The burden was estimated by the disability-adjusted life years (DALYs). DALYs are the combination of two components: years of life lost (YLL) and years lived with disability (YLD).

Results: Among the registered live births in 2014, 10.4% were born with a birth weight less than or equal to 2500 g accounting for 180,853 healthy lives lost. The number of deaths resulting from LBW was 2.4 per 1000 live births for both genders, and LBW was the leading cause of death in children under five years of age. Cerebral palsy and mild permanent disabilities were the highest attributed morbidity burden among children with a disability. The estimated burden of LBW attributed to 16.1% of the total DALYs loss from the burden of all causes among children under five years old. 

Conclusion: LBW remains a burden in Thailand. Premature death was the primary driver for the total DALYs loss. The current study revealed the need to develop appropriate interventions for the developmental delay and children with a disability, as well as to conduct a long-term follow-up study concerning infants born with LBW.

Open Access Original Research Article

Radiation Protection: What do the Nigerian Paediatric Residents Know?

Ighodaro Osaigbovo Emmanuel, Ehigiamusoe Oghanina Festus

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2018/41814

Knowledge of radiation protection is pertinent to the paediatric doctor as some radiological investigations requested for a sick child use ionizing radiation with some deleterious effect in the future. A sound knowledge will help the doctor to make the right and appropriate choice of radiological investigations in this age group.

This was a questionnaire-based prospective study involving 89 paediatric resident doctors who came for an update course at the University of Benin Teaching Hospital. Thirty-nine (43.8%) of the 89 were males and 50 (56.2%) were females.

The mean age of the study population was 34.0 ± 4.6 years (range 25 - 51 years).  Majority of the study participants 78 (87.6%) had been in residency training for at least 6 years. Eighty (90.0%) of the respondents had poor knowledge of radiation protection, 7 (8.0%) had the fair knowledge, 1 (1.0%) each had good knowledge and excellent knowledge respectively. A lower proportion of male residents (36, 45%) demonstrated a lower level of knowledge of radiation protection compared to their female counterparts (44, 55%) although the difference was not statistically significant. Those younger in the residency training had poorer knowledge of radiation protection compared with the older residents. The level of knowledge was not associated with the previous lecture on radiation protection or the geopolitical location of the resident doctor.

In conclusion, this study has documented the level of knowledge of radiation protection among resident doctors training in paediatrics in Nigeria.

Open Access Original Research Article

Phenotypic and Genotypic Antimicrobial Resistance Profiles of Escherichia coli O157 Isolates from Cattle in Cameroon

Elvis Achondou Akomoneh, Seraphine Nkie Esemu, Gilbert Karngong Nfor, Roland N. Ndip, Lucy M. Ndip

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2018/42423

Background: Escherichia coli O157, a Shiga toxin-producing serotype of E. coli implicated in severe foodborne diseases, is a major public health concern worldwide. Most human infections are attributed to the consumption of infected beef and contaminated bovine products. The burden of E. coli O157 disease is compounded by the extensive use of antibiotics in the animal production line which might lead to the selection for antibiotic resistance. The aim of this study was to describe the antibiotic resistance patterns of E. coli O157 isolates from cattle in Cameroon.

Methods: Fifty-six E. coli O157 isolates previously obtained were subjected to antibiotic susceptibility testing using the Kirby-Bauer disc diffusion technique. Polymerase chain reaction was used to screen the isolates for the presence of eight antibiotic resistance genes.

Results: Antibiotics susceptibility profiling of the 56 isolates showed ofloxacin was the most active drug (55; 98.2%), followed by gentamicin (51; 91.1%). Ampicillin was the least active drug with only 7 (12.5%) isolates susceptible. Multidrug resistance was a common phenomenon exhibited by 33 isolates comprising 17 phenotypic profiles (A8-A24). The most frequent phenotypic profile was TETRSTRRAMPRTRIRERYR (tetracycline, streptomycin, ampicillin, trimethoprim, and erythromycin resistance) which accounted for 17.0% of the resistant strains. All the 8 resistance genes investigated were observed in one or more isolates and genotypic resistance was generally consistent with the resistant phenotypes observed. The most commonly observed resistance genes were tetA (73.2%) and aac(3)-IV (57.1%). Five isolates had none of the resistance genes investigated while 25 carried at least three different resistance determinants.

Conclusions: Cattle in Cameroon are infected with multidrug-resistant E. coli O157 and are a potential risk to consumers. Hence adequate animal food production measures should be prescribed and implemented to minimize the development and spread of antibiotic resistant E. coli O157.

Open Access Original Research Article

Risk Factors of Mortality Related to Severe Malaria among Children in Referral Hospitals of Kisangani

B. G. Mande, K. V. Muyobela, O. Alworong’a

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2018/40898

Aims: This study aimed at determining the factors associated with mortality in childhood severe malaria in Kisangani. For Democratic Republic of Congo is one of African countries with highest mortality rate of under-five children.

Study Design:  cross-sectional study.

Place and Duration of Study: Data were collected from medical folders of all children of 6 months to 16 years-old, hospitalized in 4 general reference hospitals (GRH) of Kisangani town, from January to December, 2015.  We selected only children with severe malaria confirmed by a positive thick blood smear and/or positive rapid diagnostic test. 

Methodology: Sociodemographic and clinical data of deceased children were compared to those of alive or controls. Association of severity criteria and other factors to fatal prognosis was assessed by chi-square or Yate’s adjustment. Bivariate analysis used odds ratio to evaluate the risk of dying. Means were compared by test t of student.

Results: Among 3410 children hospitalized for miscellaneous causes, 1194 had clinical and 845 confirmed severe malaria. The sex ratio M/F was 1.34. Most of children were under 5 years old (73.1%) and the most frequent severity criterion of malaria was pallor, followed by respiratory distress, icterus and coma. Quinine was used in 84.3%. Twenty-nine out of 845 children died (3.43%) and factors associated to this fatality were male sex (P= .04), age under 5 years-old (P =.002). The risk of dying was high when children had circulatory collapse or shock (P < .001), coma (P = .0008), icterus (P = .003), and ≥ 2 severity criteria (P = .005). Sixty-six percent received antibiotics without any microbiological exam.  

Conclusion: The malaria-related mortality is still high and associated with avoidable factors. Supervising health workers in GRH and providing them with more technical assistance to address complications in severe malaria can help to save more children.