Open Access Original Research Article

Rickettsial Infection in Patients with Acute Febrile Illness at a Tertiary Care Hospital in Bengaluru, India - Serological, Demographic and Clinical Profile

Sneha K. Chunchanur, J. V. Shwetha, R. Ambica

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2018/44504

Background and Objectives: Rickettsial infections are under recognised cause of acute febrile illness (AFI) in India. The reason being low index of suspicion, the absence of specific signs/ symptoms and lack of access to confirmatory laboratory tests. These diseases have a high mortality, which can be averted if diagnosed and treated early. Weil- Felix test is the cheapest and widely used test for diagnosis in India. The present study was undertaken with the objective of evaluating the patients with AFI, for rickettsial infection using Weil- Felix test and study their demographic and clinical profile.

Materials and Methods: One hundred Patients with AFI, from June 2015 to December 2016 were evaluated for Rickettsial infection. Detailed history, signs, symptoms were recorded. The serum samples were analysed by Weil-Felix test.

Results: Of the 100 patients, 69 showed a titre of 1:80/>. The disease was more common in children and in the cooler months. Rash, headache, vomiting, pain abdomen and altered sensorium were common symptoms. Most common signs were hepatomegaly/ splenomegaly (51%), rash (40%), CNS involvement (26%). All 69 patients diagnosed with Rickettsial infection, were started on Doxycycline, however 07% of patients succumbed.

Interpretation and Conclusions: Rickettsial infection should be considered in the differential diagnosis of AFI, especially when associated with rash, gastrointestinal symptoms, seasonality etc. Weil Felix test is useful for initial diagnosis and timely treatment of Rickettsial infection.  Delay in diagnosis and treatment can lead to increased mortality.

Open Access Original Research Article

Changing Patterns and Outcomes of Typhoid Fever in Egypt

Mahmoud Sheded, Mohamed Mosaad, Adel Hassan, Ahmed Faisal, Said Abbadi, Dalia Ghareeb

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2018/44396

Introduction: Typhoid fever is an endemic disease in our country; however, the changing presentation may alter our diagnosis and management.

The Aim of the Work: To improve the management of typhoid fever in Egypt through studying the changes in the clinical picture, laboratory findings, response to antimicrobial treatment & outcomes.

Subjects and Methods: 590 patients were involved in the study, presenting symptoms, laboratory results, responses to medications and the outcomes were registered.

Results: fever was the most prevalent symptom (98.6%) followed by a headache (82.9%) and abdominal pain (71.5%); eating outdoor is the most prevalent risk factor (80.8%); Thirty patients who used quinolone were relapsed (14.4% of cases who used quinolone), while fifty-five patients who used 3rd generation cephalosporin were relapsed (21.1% of cases who used cephalosporins).

Conclusion: Food handlers constitute the major risk factors, while the classical form of the disease is not the common presentation, with a low yield of blood culture and increasingly resistant to fluroquinolone and ceftriaxone.

Open Access Original Research Article

Ocular and Systemic Abnormalities Associated with Paediatric Cataract at Evangelical Church of West Africa Eye Hospital, Kano

A. A. Onua, B. Fiebai, S. O. Abu

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2018/43570

Background: Cataract is a leading cause of childhood visual impairment in developing countries.  Cataract in children causes the blurring of retinal images and therefore disrupts the development of the immature visual pathways in the central nervous system with subsequent development of amblyopia if there is no timely surgical intervention. There are several associations of pediatric cataract- both systemic and ocular which have considerable consequences on the management and post operative outcomes.

Aim: To identify the systemic and ocular associations of childhood cataract presenting in Evangelical church of West Africa (ECWA) Eye Hospital, Kano, Nigeria from 2006 to 2014.

Methods: This was a prospective study of 694 children (1388 eyes) with 881 lens opacity seen at ECWA Eye Hospital, from January 2006 to December 2014. One hundred and eighty-seven children (26.9%) had bilateral cataract. All the patients had comprehensive paediatric review and their parents interviewed.

Results: Seven hundred and thirty eyes (82.8%) had cataract with associated ocular abnormalities: Nystagmus (22.5%), Squint (17.3%), Corneal opacity (8.8%), Microcornea (2.7%), Megalocornea (8.2%), Vascularized cornea (0.8%), Congenital glaucoma (10.4%), Iris coloboma (1.6%), Peripheral synaechiae (3.7%), Abnormal lens anatomy (6.6%). Ninety-eight children (14.1%) had various forms of associated systemic abnormality: Congenital Health Diseases, Deafness, Mentally Retarded, Cerebral Palsy, Down’s Syndrome, Failure to Thrive, Mumps and Asthma.

Open Access Original Research Article

Subperiosteal Mastoid Abscess in the Otolaryngology Practice in Sokoto

Stanley Baba Amutta, Mohammed Abdullahi

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2018/44787

Aims: Audit intent and review of the management.

Study Design: Retrospective descriptive cross-sectional study.

Place and Duration of Study: Ear, Nose and Throat Department of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria between August 2006 and September 2018.

Methodology: The case files of the patients managed for subperiosteal mastoid abscess were retrieved and reviewed. Data extracted from the case files were biodata, symptoms including duration of otorrhoea, signs elicited, radiological findings of the petromastoid bone and brain, microbial isolates, treatment, operative findings, follow-up, and the outcome. The data analysed with IBM SPSS version 21.0.

Results: A total of 11 patients comprising 5 (45.5%) male and 6 (54.5%) female, with a male to female ratio of 1:1.2, had subperiosteal mastoid abscess during the 12 years under review. Mean age was 13 years, and the mean duration of otorrhoea was 8 years. Eight (72.7%) patients had mucopurulent otorrhoea and fluctuant posterior auricular mass which yielded thick pus on tap aspiration. Three patients (27.3%) had a tympanocutaneous fistula. Two of the patients had cholesteatoma. The most common bacteria isolate was Pseudomonas aeruginosa. Six (54.5%) of the patients had initial incision and drainage before the definitive surgery. The definitive surgical intervention was cortical mastoidectomy 6 (54.5%) and modified radical mastoidectomy 5(37.5%). The treatment outcome was the resolution of abscess in 8 (72.7%) and persistent discharging mastoid cavity in 3 (27.3%) patients. The average length of hospitalisation was 12.6 days, and the mean follows up period was 19 months.

Conclusion: Subperiosteal mastoid abscess usually occurs as a complication of chronic suppurative otitis media in children and adults with very long history of otorrhoea. It requires cortical or modified radical mastoidectomy. Early diagnosis and treatment of chronic suppurative otitis media may prevent the development of a subperiosteal mastoid abscess.

Open Access Original Research Article

Persistent Soil-Transmitted Helminth Infections and Associated Risk Factors among Children Aged Between 4 and 12 in Mile 16 Bolifamba, Buea, Cameroon: 6 Months Post-Deworming Campaign

Simon Eyongabane Ako, Anguh Edith, Tankeu Ndassi Vicky, Abiankan Nadesh Abiabia, Helen Kuokuo Kimbi

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2018/44165

Aims: This study aims at determining the prevalence, the soil-transmitted helminths (STH) species, and associated risk factors among children aged between four and 12 in the mile 16 community, Buea, through post-deworming intervention.

Study Design:  The Cross-sectional research design was used, involving a total of 465 children in the aforementioned community.

Place and Duration of Study: The study was carried out in the mile 16 community, Buea, from January to May 2018.

Methodology: Socio-demographic data were collected through the use of questionnaires. Stool samples were collected and analysed using the Kato-Katz technique. Data were analysed using SPSS version 21. Descriptive data were calculated with frequencies (n) and proportions (%); meanwhile, Binary logistic regression analysis was performed to explore significant correlations between risk factors and STH infections.

Results: The overall prevalence rate of soil-transmissible infection in mile 16 Bolifamba, Buea municipality, stood at 27 (5.8%, 95% confidence interval (CI): 3.7 – 7.9). The prevalence rate among children who have been previously dewormed was 18 (3.9 %, 95% CI: 2.1 – 5.6). The most prevalent soil-transmitted helminths being Ascaris lumbricoides recorded 18 (3.9% CI: 2.1 – 5.8), followed by Hookworm 9 (2%, CI: 0.7 – 3.2). Trichuris trichiura recorded 0%. Walking barefoot was significantly associated with STH (χ2= 18.37, p=0.0001), with increased odds of infection (odd ratio [OR] = 3.2; 95% CI: 2.0–5.3). Improper hand-washing was associated with STH infection (χ2= 4.36, p=0.037), with increased odds of ([OR] = 1.7; 95% CI: 1.1–2.7). No awareness on STH and deworming by guardians/parents was significantly associated with increased odds of infection ([OR] = 3.0; 95% CI: 1.7–5.5), P = 0.001. Defecating in bushes and garden showed an association with STH infection (χ2= 5.16, p=0.023), with an increase odd ([OR] = 2.4; 95% CI: 1.2–7.7) and the place of defecation by children showed an association with STH infection (χ2= 13.63, p=0.03).

Conclusion: The findings of this study show that there is an increasingly active transmission of STH at mile 16 Bolifamba, despite the post-deworming campaign. Walking barefoot, improper hand-washing before eating, lack of awareness by guardians/parents on STH, deworming and defecating in bushes and garden increases the likelihood for STH infection. These results suggest among other things that, although community-based deworming programmes have many important benefits, more need to be done to improve on the effectiveness of deworming campaign processes and the combination of other control approaches like education and proper sanitation in the mile 16 Bolifamba community.