Open Access Articles

Efficacy and Safety of Up-scaled Dosage of 60 mg/kg Praziquantel in Control of Schistosoma mansoni in School Going Children in Kirinyaga County, Kenya

E. Kirubi Muthoni, E. Mumbi Kigondu, D. Kiboi, I. N. Mwangi

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2018/44929

Aim: The aim of this study was to determine efficacy, safety and morbidity of increased dosage of praziquantel (PZQ) of 60 mg/kg compared to the standard dosage of 40 mg/kg of PZQ in the treatment of S. mansoni in school going children in Kirinyaga County, Kenya.

Background: Chemotherapy with PZQ has been the core treatment strategy for schistosomiasis. Due to recent concerns on tolerance and resistance to praziquantel, efficacy studies of up-scaled dosage are warranted. Socio-economic activities in Kirinyaga County exposes the community to fresh water snails that harbour the schistosome parasite. Various studies have reported the increased prevalence and high infection intensity in the area despite ongoing mass drug administration (MDA) interventions.

Methods: Study area was in Kirinyaga County, Kenya where the prevalence of schistosomiasis in school going children was first determined. A sample size of 192 subjects of 4-17 year old infected with S. mansoni were randomly allocated in Group A (40 mg/kg) and Group B (60 mg/kg).  Stool samples were examined by Kato Katz technique to determine baseline infection intensity. Cure rate and egg reduction rate were also determined at 21 days post-treatment in both groups. Comparison of the frequency and severity of adverse events (AE) at 4 and 24 hrs post-treatment were also determined. Peripheral blood was collected to study disease morbidity by measuring haemoglobin (Hb) and eosinophil levels.

Results: Prevalence of S. mansoni infection was 52.8%. Baseline intensity of infection was 40% representing light infection while 41.58% and 18.42% representing modereate and heavy infections respectively. Cure rates at 21 days post-treatment were 92% for 40 mg/kg while that of 60 mg/kg was at 94%, a slight variation which did not represent any significant difference between the two treatment groups (p˃0.05). Mean haemoglobin levels for male and female at 21 days post-treatment were 11.26 g/dl and 11.34 g/dl respectively representing a non-significant difference (p>0.05). Eosinophil levels implied a significant decrease after treatment in both treatment groups although no difference was observed between the treatment groups (p>0.05). Adverse events recorded in the 60 and 40 mg/kg groups showed that mild abdominal pain was the most frequent AE for the 2 dosages while anoxia was the least occurring AE at 4 hrs and 24 hrs post-treatment.

Conclusion: The upscaled dosage of 60 mg/kg PZQ offers substantial cure to S. mansoni infected individuals. Efficacy tests in comparison with 40 mg/kg showed the difference in cure rates to be insignificant. The 60 mg/kg dosage was also associated with slightly higher mild adverse events.

Open Access Short Research Article

Sickle Cell Disease and Severity of Malaria

Maman Daou, Ibrahim Alkasoume, Mahamadou Doutchi, Samaila Boubacar, Mansour Maman Anou, Mahamane Moustapha lamine, Ramatoulaye Hamidou Lazoumar, Kamayé Moumouni, Djibo Yacouba Hamadou, Ibrahim Maman Laminou

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/IJTDH/2018/45337

Background: The relationship between sickle cell disease and malaria remains controversial and the hypothesis that sickle cell disease protects against malaria is widespread.

Methodology: A descriptive and retrospective study over a two-year period (2014-2016) was conducted in pediatric departments of the National Hospital of Niamey (NHN). The objective is to assess the relative risk between sickle cell disease and the severity of malaria.

Results: Nine hundred and seventy four (974) patients infected with Plasmodium falciparum were included in this study. Thirteen point twenty four percent (129/974) of patients had sickle cell disease, of which 93.8% (121/129) had SS form and 6.2% (8/129) SC form. Seventy-nine point eight percent (103/129) of sickle cell patients had severe malaria (RR = 0.9, p = 0.17). Ninety six point one percent (99/103) of patients with severe malaria were homozygous SS versus 3.8% (4/103) who were heterozygous SC (RR = 0.6, p = 0.05). Eleven point forty three percent (4/35) of sickle cell patients died of malaria (RR = 0.1, p = 0.4). Seventy-five percent (3/4) of the deceased sickle cell were homozygous SS versus 25% (1/4) who were heterozygous SC (RR = 5, p = 0.2).

Conclusion: Heterozygous sickle cell patients have less severe malaria than homozygotes. Malaria is more severe and more lethal in homozygous sickle cell patients. A strategy for the prevention of sickle cell malaria should be developed during periods of high transmission.

Open Access Original Research Article

HIV Prevalence and Intimate Partner Abuse in TIV Land, North Central Nigeria

Godwin Aondohemba Timiun, Stella Saror, James Aan

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2018/45170

Background: Several attempts have been made to document the relationship between HIV prevalence and partner violence. However, the relationship is still not clear. This present study adopted mixed methods to examine the relationship between HIV prevalence and violence amongst intimate partners in Nigeria.

Methods: The multi-stage and purposive sampling methods were used to obtain 1,621 (864 women; 757 men) respondents in four different locations for the study. Structured interviews using questionnaires and in-depth interviews (using a guide) were utilised for data collection. SPSS (version 21) was used for quantitative data analysis while the qualitative data was analysed thematically.

Results: The factors associated with multiple partnerships are location (P < 001; OR =.300; 95% CI = .210- .428); sex (P < 001; OR = 1.710; 95% CI = 1.391 -2.103 );  the desire for children (P = .024; OR = .735; 95% CI =.565-.952); receiving family support (P =.002; OR = .706; 95% CI = .565-.882) and the laws guiding sexual relationship that provide the ground for intimate partner abuse (P < 0.001; OR= 0.513; 95% CI = 0.375-0.700).  Intimate partner abuse is carried out by both men and women using phones, informants, deprivations, tactics and antics. 

Conclusion: The evidence suggests that there is a relationship between intimate partner abuse and HIV prevalence. Intimate partner abuse indicates another manifestation of the impact of HIV on human health.  This study draws the attention of public health and clinical practitioners, policy makers and researchers to the co-existence of HIV prevalence and intimate partner abuse for possible intervention.

Open Access Original Research Article

Prevalence of Diarrhoea and Associated Sociodemographic Factors among Children Receiving Care in the Paediatrics Department of Federal Medical Centre (FMC) Yenegoa, Bayelsa State, Nigeria

Efealukwu, Andy, Ordinoha, Best

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2018/46321

Background: The environmental problem that has been of great concern to inhabitants at the local, state and federal government levels is the generation and disposal of waste. The aim of the study was to assess the prevalence of diarrhoea and the associated sociodemographic factors among children receiving care in the paediatrics department of Federal Medical Centre (FMC) Yenegoa, Bayelsa State, Nigeria.

Methods: This was a descriptive cross-sectional study among caregivers attending the paediatrics department of the Federal Medical Centre Yenagoa, Bayelsa, State Nigeria. The sample size of 303 participants was recruited for this study. A systematic random sampling technique was used. The inclusion criteria was all caregivers of out-patients seen in the paediatrics department and have agreed to participate in the study. Thus, Care-givers of seriously ill children and caregivers that are not adults were excluded from this study. An interviewer-administered questionnaire was used to collect relevant information. Data was analysed using Statistical Package for Social Science (SPSS) version 23 software. A descriptive analysis, chi-square test were performed, and inferential analysis was also performed, statistical significance was set at p ≤ 0.05. Ethical approval for the study was sought and obtained from the Research and Ethics Committee of the University of Port Harcourt, Nigeria. Also informed consent was obtained from the prospective participants before recruitment.

Results: The mean age of the children was 8.56 ± 5.785 years old, with 176(58.1%) of the children being females. It showed that 172(56.8%) of the caregivers were females. A greater percentage age of the respondents was within 36-45 years with 119(39.3%) of respondents being in this age group. The overall prevalence of diarrheal disease among children aged 1month-18years was 53(17.5%). There was no significant association between age and sex of child with episodes of diarrhoea. Knowledge, attitude and practice on domestic waste management with proper washing of hands after defecating was significantly associated with episodes of diarrhoea.

Conclusion: This study concluded that the prevalence and period prevalence (2 weeks prior to the study) of diarrhoea was relatively low among children a month-18 years, who received care. Age and sex of child have no influence on episodes of diarrhoea. Thus, knowledge, attitude and practice on domestic waste disposal with proper washing of hands after defecating have influence on episodes of diarrhoea. The Government should minimize the magnitude of childhood diarrhoea by implementing various strategies, such as health education, improved child care, improved immunization services especially rotavirus and improved collection of waste from dump sites by the environmental sanitation authorities are quite essential.

Open Access Original Research Article

Trends in Breastfeeding Practices among Women of Childbearing Age in Nigeria: (A Review of National Demographic Health Survey 1999, 2003, 2008)

Akinola Temitope, M. D. Dairo, Adekunle Olajide

International Journal of TROPICAL DISEASE & Health, Page 1-16
DOI: 10.9734/IJTDH/2018/44461

Background: Breastfeeding is the appropriate method recommended by World Health Organization (WHO) for feeding infants. The recommendations includes initiation of breastfeeding within the hour of life, exclusive breastfeeding for the first six months then the introduction of complimentary foods and continued breastfeeding for at least twelve months of age, breastfeeding on demand as often as the child wants. Despite these recommendations, compliance with breastfeeding recommendations in developing countries is still low. This study, however, describes breastfeeding pattern among women of childbearing age and identifies the factors associated with the pattern over the years (1999, 2003, 2008).

Methods: This study is a comparative cross-sectional population based study in which a secondary data review and analyses of NDHS 1999, 2003 and 2008 data were done. Frequencies, proportions and chi-square for trends were used to investigate and describe the pattern of initiation, frequency and duration of breastfeeding over the years. All analyses were done at 5% level of significance.

Results: Few women initiated breastfeeding immediately and this proportion decreases over the years; 1999(40%), 2003(31.7%) and 2008(39.2%), X2=6.132, p=0.013. There was no much change in the proportion of women that breastfed for at least one year over the years. A higher percentage of women breastfed during the day (X2=8.725, p=0.003) than those that breastfed in the night (X2=33.211, p=0.000) over the years, with an increasing trend over the years. Age of the mothers, religion, marital status and education amongst others have been observed to be significantly associated with increasing trends in breastfeeding practices over the years.

Conclusion: Breastfeeding practices significantly increased over the years (1999, 2003, 2008) only amongst women aged 30-34 years, married women, women with primary and secondary education, Urban dwellers, Christian women, women from the south region amongst others.