Open Access Original Research Article

Screening for Syphilis among Third Trimester Pregnant Women in a Low Resource Setting: A Missed Opportunity?

G. E. Halle-Ekane, A. R. Ojong, N. Bechem, T. E. Obinchemti, N. M. Halle-Ekane, P. N. Nana

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2018/43973

Syphilis accounts for a significant morbidity and mortality especially in the sub-Saharan Africa, where it remains a public health problem. Studies have demonstrated its deleterious effects on pregnancy and its association with HIV/AIDS. The aim of this study was to determine the prevalence of syphilis, its associated factors, and its relationship with HIV, among third trimester pregnant women in the Buea Health District (BHD), Cameroon. This was a cross-sectional study involving 250 third trimester pregnant women. Serum obtained from 5 ml of venous blood from each participant was tested for syphilis using VDRL antigen and Treponema pallidum hemagglutination assay (TPHA). The data on some socio-demographic, clinical characteristics and the results of tests were collected using a pretest questionnaire and analysed using the statistical software Epi-info version 7. P-values less than 0.05 were considered statistically significant. The mean age of the participants was 26.9 (SD 5.2) years. There was a high prevalence of syphilis of 6.4% in Buea Health District. No risk factor was identified to have a significant association with syphilis but there was a significant difference between the prevalence of syphilis among HIV positive and the HIV negative groups (p<0.001). Apart from screening for syphilis during the first trimester; sensitization, screening, treatment and proper follow-up should also be encouraged in the third semester to prevent adverse foetal outcomes.

Open Access Original Research Article

Prevalence and Factors Contributing to Non-adherence to Diabetes Treatment among Diabetic Patients Attending Government Hospitals in Addis Ababa

Alemayehu Hailu Jufar, Zewdu Jima, Debela Gemeda

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2018/43867

Background: Non- adherence to diabetes treatment regimen is possibly the most common reason for poor health outcomes among people with diabetes. Non-adherence in chronic disease is claimed as a patient taking less than 80% of the prescribed treatment. The rates of non-adherence to diabetes regimen tasks are highly variable but have significant consequences on the outcome & the effectiveness of treatment.

The objective of this study was to determine the prevalence & factors associated with non-adherence to diabetes treatment among diabetic patients attending diabetic clinics at a governmental hospital in Addis Ababa.

Methods: Institutional based cross-sectional study was conducted on 308 diabetic patients attending diabetic clinics at a governmental hospital in Addis Ababa. Study subjects have been selected by using systematic random sampling technique. A pre-tested structured questionnaire was used to collect the data. Data were entered by using Epidata-3.1 & then exported to SPSS version 20 for analysis. Frequency distribution was used to organise the data. Multivariate logistic regression was used to predict the factors which affect adherence.

Results: The prevalence of non-adherence to diabetes treatment was found to be 68.1%. In multivariate logistic regression age(>= 60,(AOR=1.21)), educational status(illiterate (AOR= 1.62)) , duration of treatment(> 5yeras(AOR= 4.032)) & presence of co-morbidity (AOR= 1.796)) were significantly associated with non adherence to diabetes  treatment

Conclusion: The result of this study had shown a high prevalence of non-adherence to diabetes treatment with age of the patient, educational level, duration of treatment & presence of co-morbidity having a significant association with non-adherence.

Open Access Original Research Article

Prevalence of Soil-Transmitted Helminths among School Pupils in the Upper East Region of Ghana Using Direct Wet Mount Technique and Formol-Ether Concentration Technique

Yaw Sam, Fred Jonathan Edzeamey, Enock Henebeng Frimpong, Ansah Kofi Ako, Kwaku Appiah-Kubi

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2018/43809

The prevalence of soil-transmitted helminths has been reported to be high among residents especially school pupils in small communities located in Ghana and Sub-Saharan Africa as a whole. Gia is one of the communities in the Kassena-Nankana district of the Upper East Region of Ghana where the prevalence of soil-transmitted helminths was reported in 2007 to be 10% by the direct wet mount method. The study sought to determine the current prevalence of soil-transmitted helminths among primary school pupils in Gia and Kajelo communities in the Kassena-Nankana district using direct wet mount and the formol-ether concentration techniques and also to compare the performance of the two techniques employed in the study.

Methods: Three hundred and ninety-four (394) pupils were recruited from the primary schools in the Gia and Kajelo communities for the study. The study was carried out from October 2010 to March 2011. Stool samples were collected from subjects and processed within two hours after collection using the direct wet mount and the formol-ether concentration techniques.

Results: Out of the 394 stool samples examined in the study, 2.79% (Hookworm 0.25 %, Strongyloides stercoralis 2.54%, Ascaris lumbricoides 0.00% and Trichuris trichuira 0.00%) prevalence was observed with the direct wet mount method whilst 9.40%  (Strongyloides stercoralis 5.08%, Hookworm 3.30%, Ascaris lumbricoides 1.02% and Trichuris trichuira 0.00%) prevalence was observed with the formol-ether concentration technique. The formol-ether concentration technique demonstrated a higher sensitivity as compared to the direct wet mount technique.

Conclusion: There is high soil-transmitted helminthic infection among primary school pupils in Gia and Kajelo communities in the Kassena-Nankana district of the Upper East Region of Ghana. However, it has been underdiagnosed due to the use of the direct wet mount technique in clinical laboratories in these communities.

Open Access Original Research Article

Seasonal Outbreak of Dengue Fever in Northern India - A Clinical Perspective and Predicting Length of Hospital Stay

Aparna Chakravarty, Anuja Krishnan

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2018/44585

Aims: India reports frequent outbreaks of dengue fever every year. Scarcity of hospital beds during these outbreaks can be fatal to some. In this study we looked into the clinical and laboratory features of dengue fever in children and predictors of prolonged hospital stay.

Study Design: Prospective cross-sectional descriptive study

Place and Duration of Study: Department of Pediatrics, Hamdard Institute of Medical Sciences and Research from September to December 2017.

Methodology: This prospective study was conducted in admitted patients in the Pediatric department of a teaching hospital in Delhi to determine the clinical and laboratory features of all children admitted with dengue fever and find out any predictive factor for prolonged hospital admission. All clinical and laboratory confirmed dengue cases were included in the study. Patients were divided into dengue fever without warning signs (DF), dengue fever with warning signs (DWS) and severe dengue (SD) as per WHO Classification.

Results: Of the 92 cases, 78 had positive IgM ELISA/NS1 Ag, 14 were clinical cases. The M:F is 1.7:1, the mean age is 7+ 4.2 years. The common clinical features were fever (94%), abdominal pain (61%), vomiting (53%) and lethargy (52%). 61% patients were categorised as DWS, 30% as DF and 9% SD. The mean duration of hospital stay was 5 ± 2.8 days. 43% were hospitalised for > 5 days. Prolonged hospital stay (>5days) was significantly associated with high grade fever (>102°F) and lethargy (p<0.05).

Conclusion: A high proportion of patients with DWS required hospitalisation. Admission during the critical phase of dengue is essentially life-saving.  For clinical practice, the doctors working in the front line should be aware of the factors significantly prolonging LOS in the management of dengue fever. This can identify the patients at highest risks and help focus time and resources during seasonal outbreaks.

Open Access Original Research Article

Outcome of Pregnancy in Patients with Pre-Pregnancy Obesity in Douala, Cameroon

Gregory E. Halle-Ekane, Jacqueline B. Nsom, Ndemazie N. Bechem, John N. Palle, Fulbert N. Mangala, Phillip N. Njotang

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2018/44002

Introduction: The prevalence of obesity is increasing worldwide, especially in women of child-bearing age with deleterious effects during pregnancy. This study sort to determine the prevalence of pre-pregnancy obesity, its risk factors, socio-obstetrical profile and obstetric outcomes in Douala, Cameroon.

Methods: A prospective cohort study was carried in Doula from 1st December, 2014 to 28th February, 2015. An interviewer-administered questionnaire was used to collect data from women at their third trimester of pregnancy. Pre-pregnancy body mass index (BMI) was computed and the women classified according to their BMIs as obese (BMI ≥30kg/m2) or non-obese (BMI<30 kg/m2). These two groups of cohorts were followed up during pregnancy and delivery and the obstetric outcomes were recorded. Logistic regression analysis was used in determining factors associated with pre-pregnancy obesity.

Results: Three hundred and fifty participants were enrolled into the study. The prevalence of pre-pregnancy obesity was 14.7% (95% CI: 11.1-18.8). It was associated with a family history of obesity [RR= 2.2 (CI: 1.15-4.43)] and increasing maternal age [RR=4.3(CI:1.59-11.41)]. Meanwhile marital status and parity were related to pre-pregnancy obesity, however, there was no statistically significant associations. Pre-pregnancy obesity was associated with an increased rate of Caesarean section (P=0.04), nonetheless adverse fetal outcomes.

Conclusion: The prevalence of pre-pregnancy obesity in Douala was high. Advanced maternal age, parity, marital status and a family history of obesity were associated with pre-pregnancy obesity. Pre-pregnancy obesity was associated with increased caesarean section rate. Therefore, screening for pre-gestational obesity should be encouraged to decrease the rate of caesarean section.