Open Access Case Study

A Case Report of Alloimmunization with Hyperhaemolysis in a Multiple Transfused Known SCD Patient at a Tertiary Hospital South Nigeria: A Challenge in Developing Countries

Kingsley Akaba, Nlemadim Anthony, Hilary Igwilo, Odey Friday, Bassey O. Bassey, Evaristus Chukwudike

International Journal of TROPICAL DISEASE & Health, Page 1-4
DOI: 10.9734/IJTDH/2018/44012

Background: Hyperhaemolysis is a fatal life threatening haemolytic transfusion reaction which is common among sickle cell disease patient.

Aim: The aim is to create the awareness of the increasing trend of hyperhaemolysis among chronic transfused sickle cell patients and to educate medical practitioners on the means of ameliorating this menace.

Presentation of Case: The patient was a 14 years, old male; known sickle cell anaemia (Hbss) diagnosed 13 years ago with Haemoglobin electrophoresis. Patient’s present condition was said to have worsen 4 years ago when patient crisis became so frequent with about 6-8 episode per year, which is so severe that at each episode patient is said to have received between 2-5 unit of whole blood. Further work up revealed a negative direct antiglobulin test (DAT) but Indirect antiglobulin test (IAT) was positive demonstrating the presence of anti-Jka alloantibodies. Patient RBC were phenotyped and was found to be JKa negative, whereas patient blood group is O+ and had received several blood transfusion in our centre where extended phenotyping is not done for the past 3 decades. Each transfusion precipitated a drop in Hb and Hct to levels lower than before transfusion; once transfusions were withheld, the patient slowly recovered.

Summary: Hyperhaemolysis in the setting of alloimmunization is a common complication among multiple transfused SCD which is life threatening requires prompt intervention if taking into consideration among managing physician and also ensure measure to prevent it from occurring.

Conclusion: Transfusions worsens features of hyperhaemolysis in SCD patients. Extended red cell phenotyping may reduce associated risk.

Open Access Original Research Article

Fungal Pollution of Indoor Air of Some Health Facilities in Rivers State

S. I. Douglas, V. K. Robinson

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2018/44134

Aims: Investigating the fungal pollution within the indoor air of two government health facilities.

Study Design:  The study sites (wards) were the four most used wards. One hundred and ninety-two air samples were collected in two sampling periods (morning and evening).

Place and Duration of Study: Samples were collected from four study sites (wards) each of two different primary Health centres; the Orowurukwo Primary Health centre and the Rumuigbo Primary Health centre. The GPS of these areas are 4.806°N, 6.992°E and 4.850°N, 6.991°E respectively. The study sites were the postnatal, children, injection and outpatient wards. This was a three months study (January-March).

Methodology: The plate exposure technique was used in the collection of air samples. Freshly prepared Sabouraud Dextrose agar plates in duplicates were left open above one meter in the various study sites for 15 minutes. Collected samples were transferred to the Microbiological Laboratory and incubated at 20-25°C for 3-7 days. After incubation, fungal populations were enumerated and distinct isolates were purified by subculturing onto fresh SDA plates. The purified isolates were used for characterization.

Results: Five fungal genera which include Aspergillus, Candida, Penicillium, Rhizopus, and Mucor species were isolated and identified. The fungal loads in log10sfu/m3 ranged from 2.42 to 2.51 and 2.23 to 2.55 for morning and evening sampling hour in the Oroworukwo Health centre respectively. While those of the Rumuigbo ranged from 2.23-2.39 and 2.37-2.50 in the morning and evening sampling hours respectively. The statistical insignificant difference was reported in the sfu/m3 of the two sampling hours at P=0.05.

Conclusion: The fungal load in this study was very high when compared with other studies. Also, the species of fungi in this study are pathogenic and could cause delay recovery especially in immuno-compromised patients.

Open Access Original Research Article

Atherogenic Triad in Overweight and Obese Adults in Benin-City, South-South Nigeria

Tomisin Matthew Adaja

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2018/43715

 

International Journal of TROPICAL DISEASE & Health, ISSN: 2278-1005,Vol.: 32, Issue.: 2

Original-research-article

 

Atherogenic Triad in Overweight and Obese Adults in Benin-City, South-South Nigeria

 

 

 

Tomisin Matthew Adaja1*

1Department of Chemical Pathology, University of Medical Sciences, Ondo City, Ondo State, Nigeria.

 

Article Information

Editor(s):

(1) Dr. Arthur V. M. Kwena, Professor, Department of Medical Biochemistry, Moi University, Kenya.

Reviewers:

(1) Arthur N. Chuemere, University of Port Harcourt, Nigeria.

(2) Wagih Mommtaz Ghannam, Mansoura University, Egypt.

(3) Mra Aye, Melaka Manipal medical College, Malaysia.

(4) Brijesh Mukherjee, Hi-tech Medical College, Rourkela, India.

Complete Peer review History: http://www.sciencedomain.org/review-history/26432

 

Abstracts

 

 

Context: Atherogenic triad is a constellation of lipid abnormalities characterised by elevated small, dense low- density lipoprotein particles, decreased high- density lipoprotein particles and hypertriglyceridaemia.

Aim: This study determined the prevalence of atherogenic triad among the overweight and obese adults in Benin-City, South-South, Nigeria.

Setting and Design: Study was conducted among overweight and obese adults in Benin City. It is a cross-sectional study.

Materials and Methods: This study was conducted among 138 overweight and obese adults in Benin- City, Nigeria between July and September 2016. The concentration of small, dense LDL-cholesterol was determined using precipitation method involving sodium-heparin and manganese II chloride as described by Hirano et al. Subjects were categorised into three groups (ideal weight, overweight and obese) based on their body mass index.

Results: The mean small dense LDL-cholesterol levels in the three groups were 0.79 ± 0.16, 0.96 ± 0.15 and 1.33 ± 0.26 mmol/l respectively which were statistically different, triglyceride levels were 1.41±0.73, 1.33±0.61 and 1.31±0.73 mmol/L in the ideal weight, overweight and obese categories respectively, while plasma HDL-cholesterol were 0.85±0.20, 1.05±0.34 and 0.94±0.30 mmol/L in the ideal weight, overweight and obese groups respectively. Elevated LDL-cholesterol was seen in more than 80% of the normal weight and the obese subjects and; 57.8% of the overweight subjects. Two (3.6%) obese subjects had elevated sdLDL-C with LDL-C within the reference interval. Reduced HDL-C was found more in the normal weight and obese subjects while atherogenic triad was detected in 7 (15.2%) of the obese.

Conclusion: The prevalence of atherogenic triad among the obese adult was 15.2%. The prevalence of the atherogenic triad components was higher among the obese individuals than the overweight. There is an urgent need for the introduction of therapeutic lifestyle modification among overweight and obese individuals in Nigerian population.

Open Access Original Research Article

Otomycosis among Patients Presenting with Ear Discharges at a Tertiary Hospital in South Western Uganda

Herbert Itabangi, Victoria Katawera, Victoria Nyaitera, Jacob Stanley Iramiot, Martha Nakaye, Bashir Mwambi, James Mukasa Kiguli, Joel Bazira, Fredrick Byarugaba

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2018/44070

Aims: To the determine prevalence, mycology profile, associated symptoms and risk factors of otomycosis among patients that present with an ear discharge.

Study Design:  This was a cross-sectional study in which survey data was analysed.

Place and Duration of Study: Departments of Microbiology and ENT, Faculty of Medicine, Mbarara University Teaching Hospital, between 2013 and 2015.

Methodology: We recruited 117 patients (52 men, 65 women of age range 1-69 years) presenting with a discharging ear. Both newly enrolled and follow-up patients were included in the study. Clinically, patients were assessed for symptoms, possible predisposing factors, and treatment history. For laboratory diagnosis, ear swabs were aseptically collected and mycology profile determined using both direct examination and culture techniques. Fungal identification was through stimulation of fruiting bodies such as conidia or chlamydospores and biochemical identification.

Results: Of the 117 participants enrolled, fungal infection was detected in 24 (20.51%) with direct microscopy and confirmed in 16 (13.68%) by culture.  Otomycosis was more common among the youth (54%). There were no statistically significant symptoms associated with otomycosis. However, HIV/AIDS and mastoidectomy were significant predisposing factors (38%, p = 0.001 and 25%, p = 0.002, respectively). Aspergillus species (76.47%), Candida albicans (17.65%) and Cladosporium species (5.88%) were the agents commonly associated with otomycosis in this region. 

Conclusion: Otomycosis can be common and is an important disease of the external ear, especially in at-risk individuals. In southwestern Uganda, the disease is common among young males and aetiology is mainly due to Aspergillus and Candida albicans but other opportunists such as Cladosporium species may also be implicated. Thus, there is a need for routine checks followed by robust diagnostic approaches as a means for evidence-based patient management.

Open Access Original Research Article

Presence of an Unmapped Focus for Urogenital Schistosomiasis in the Tiko Health District in Cameroon: Implications for Control

Edith Anguh, Simon Ako, Emmanuel Numfor, Z. Bimabam Josiah, Vicky Ndassi

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2018/43575

Background: Schistosomiasis is known to be endemic in all the 10 regions of Cameroon.  In the South West Region, it is concentrated in Meme Division [1] and Bafia health area, [2]. Treatment coverage has been limited to the areas known to be foci for the disease. We studied an area (Likomba) where no infected persons were recorded in the past but recently (June 2017), individuals infected with Schistosoma haematobium were identified at a hospital in that area.   

Methodology: Demographic, socioeconomic and environmental information were collected via a validated questionnaire. In order to establish the prevalence of, and risk factors for infection with S. haematobium in the Tiko health district, urine samples were collected into dry containers from 264 children between the ages of 5 and 20 after administration of structured questionnaires. The samples were preserved appropriately and using the sedimentation technique of microscopy, samples were analysed for the presence of S. haematobium ova.                   

Results: It was established that all the subjects had been resident there for at least five years and most of them, their whole lives. Out of 264 individuals, 101 persons were positive for S. haematobium. This gave a prevalence of 38%.  The prevalence of schistosomiasis was significantly higher (p=0.01) among children aged 5-8 and 17-20 years compared to those aged 9-12 and 13-16 years (P<0.05). A very significant difference was also seen in infection between males and females with males having a prevalence of 48% and females having a prevalence of 27%. Multivariate analysis confirmed that using unsafe sources for household chores and drinking water (P = 0.001), bathing in the stream (P = 0.00001) and visiting the stream more often (P = 0.0001) were the key factors significantly associated with schistosomiasis infection among these children.

Conclusion: There is obviously an active transmission of urogenital schistosomiasis in the Tiko health district. Since the sedimentation method of diagnosis is less sensitive than the syringe filtration method, which is the gold standard, the prevalence is likely to be underestimated in this area. This health district should be included in any future control program in the country.