Open Access Original Research Article

A Retrospective Review of Rifampicin-Resistant Mycobacterium tuberculosis between 2015 and 2017 in Port Harcourt, Nigeria

R. M. Nwalozie, O. E. Agbagwa, G. Mac-Fiberesima

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/ijtdh/2019/v35i230117

Background: The diagnosis and treatment of drug resistant tuberculosis (TB) is a significant challenge for the control of TB in Nigeria.

Aim: The study was carried out to assess the prevalence of rifampicin-resistant TB at the point of initial diagnosis among subjects suspected of TB.

Methods: A retrospective review of Mycobacterium tuberculosis (MTB) and rifampicin resistance detected by GeneXpert™ analysis between 2015 and 2017 in Braithwaite Memorial Specialist Hospital was carried out.

Results: A total of 6733 samples were received and analyzed in the period under review, 1252 (19%) were positive for Mycobacterium tuberculosis and 5841 (81%) were negative. The prevalence of Mycobacterium tuberculosis was 24.56%, 20.11% and 16.86% from 2015 to 2017 respectively. There was a significant decline in the prevalence of MTB from 2015 to 2017 (c2 = 33.59, p = 0.0001). Rifampicin (RIF) resistance was 5.42%, 5.86% and 6.22% respectively from 2015 to 2017; but the trend was not statistically significant (c2 = 0.21; p = 0.6418).

Conclusion: The study showed that despite a decrease in the prevalence of tuberculosis infection there was an increase in rifampicin resistance from 5.42% to 6.22% between 2015 and 2017. There is an urgent need to improve the management of TB in the Port Harcourt metropolis to improve treatment outcomes and to prevent the proliferation of drug resistant strains.

Open Access Original Research Article

Tuberculosis-Candida Co-Infection in Patients having Pulmonary Tuberculosis Attending DOTs Clinic in Rumuigbo Model Primary Health Centre in Port Harcourt, Nigeria

Asikiya Hanson, Amala Smart Enoch, Gloria N. Wokem

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/ijtdh/2019/v35i230118

Introduction: Some pulmonary tuberculosis subjects were some co-infected with Candida such as C. albicans, C. tropicalis, C. kruezi and C. paraspsilosis which were initially thought to be normal floras of the oral cavity. The percentage of tuberculosis patients co-infected with Candida is becoming a concern and might complicate the treatment of tuberculosis.

Materials and Methods: A total of 400 sputum samples were collected and subjected to Ziehl-Neelsen staining technique and Genexpert system, Gram’s stain, Germ tube test and examination in KOH preparation were conducted. Culture on Sabouraud Dextrose Agar with gentamicin, and cultured on CHROMagar Candida and sugar fermentation were carried out for Candida.

Results: Out of the 400 sputum samples examined 93(23.3%) had TB and 32(8.0%) were positive for Candida. By gender the prevalence of tuberculosis were females 51(22.4%), males 42(24.4%) while the prevalence of Candida were females 18(35.3%) and males 14(33.3%). The percentage occurrences of Candida sp. isolated were C. albicans which was the predominant species 10(21.5%), C. tropicals 5(5.4%), C. krusei 4(4.3%) and C. Parapsilosis 3(3.2%) respectively.

Conclusion: Candida albicans remains the most predominant species of Candida in patients suffering from pulmonary tuberculosis and colonization by Candida sp should not be ignored. The presence of Candida sp. might contribute to in one way to the progression of the disease.

Open Access Original Research Article

Evaluation of Integrated Child Development Services Program in Kashmir, India

Tawheeda Yasin, Hummara Azim

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/ijtdh/2019/v35i230119

Aims: Evaluation of Integrated Child Development Services (ICDS) program in the vale of Kashmir in terms of status of Anganwadi workers, facilities at Anganwadi centers, delivery of services to beneficiaries including children, pregnant women, lactating women and adolescent girls.

Study Design: Study based on facility at Anganwadi centers.

Place and Duration of Study: The present study was conducted by visiting Anganwadi centers in Kashmir Division of Jammu and Kashmir during the year 2017-2018.

Methodology: The valley of Kashmir was divided into three zones; North Kashmir comprising of three districts Baramulla, Bandipora, Kupwara, Central Kashmir comprising of three districts Srinagar, Ganderbal, Budgam and South Kashmir comprising of four districts Anantnag, Kulgam, Pulwama, Shopian. Lottery method was used to select two districts for each zone. Through multistage sampling a total of 48 anganwadi centers were evaluated.

Results: The coverage of supplementary nutrition was almost complete for all the beneficiaries. All the other services were not delivered properly. 31.51% children reported to receive pre-school education, 13.54% reported of having had health check-ups and 1.82% reported of being immunized at anganwadi centre (AWC). 94.79% of the pregnant and lactating women are covered under supplementary nutrition. Immunization and health check-ups were not available for pregnant and lactating women, however, 53.3% received iron and folic acid (IFA) tablets and 4.17% were provided with referral services. 71.53% of adolescent girls received IFA tablets. Health check-ups and basic skills programmes were not conducted for adolescent girls, however, 5.56% were provided with referral services.

Conclusion: The performance of ICDS in Kashmir in terms of coverage is very low and almost all the services except supplementary nutrition are not delivered properly.  There are many reasons for the underperformance of the scheme including socio-economic and other aspects of the grassroot workers including anganwadi workers (AWWs) and anganwadi helpers (AWHs), inadequacy of equipment for proper implementation, undesirable condition of AWCs, lack of professionalism in implementing staff, lack of co-ordination between AWCs and other associated personals like Lady Health Visitor (LHV)/Auxiliary Nurse Midwife (ANM).  In Kashmir the political environment makes the implementation of ICDS scheme even more complicated and difficult. A realignment is the need of hour and the state government must identify the specific problems faced by the scheme and convey them to all the stake holders so that a better and modified version of the scheme is implemented.

Open Access Original Research Article

Prevalence of Intestinal Parasitic Infections among Inmates of the New-bell Central Prison, Cameroon

Thomas Kuete, Hugues Ghislain Mbwang, Catherine Menengue Nguele, Albert Same Ekobo

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/ijtdh/2019/v35i230120

Intestinal parasitic infections (IPIs) remain a public health issue in developing countries where overcrowded settlements and poor sanitation are general rule. Due to paucity of IPIs data in known overcrowded Cameroonian prisons, this cross-sectional study conducted in 2015 in the New-Bell Central Prison (NBCP) aimed to establish biodiversity, prevalence and risk factors of intestinal protozoan and helminthe infections among inmates.

Fresh stool samples collected from the NBCP volunteered inmates were laboratory examined microscopically as fresh mounts plus iodine, Kato-Katz smears, formalin-ether concentration and modified Ziehl-Nelseen stained sediments.

Of a total 374 inmates who participated in the study, overall IPIs prevalence was 39.3%. Helminthe and protozoa prevalence was 16.6% and 24.6% respectively. Parasites species were recorded at following prevalence: Ascaris lumbricoides (10.4%), Trichuris trichiura (5.1%), Schistosoma mansoni (0.5%), Entamoeba histolytica/dispar (14.2%), Entamoeba coli (16.6%), Giardia intestinalis (7.2%), Chilomastix mesnili (2.4%), Blastocystis spp (2.1%) and Cryptosporidium sp (4.3%). Co-infections by two or three parasites were recorded among parasitized inmates.

Overall IPIs prevalence was not significantly influenced by gender, age, detention duration, education level, handwashing practices, sanitation and drinking water source. However, highest IPIs prevalence occurred in males aged 30 to 49 years old, less than one year detainees, latrine users and those who drank borehole water. Systematic handwashing practices and education level did not influence significantly IPIs prevalence. All helminthe infections were of light intensities.

Inmates in the New Bell central prison were parasitized by several species of protozoa and intestinal worms in varying prevalence depending on the detention period, the sex, the age and hygiene. A regular IPIs control among prison inmates was recommended to the NBCP managers to prevent related morbidity.

Open Access Original Research Article

Age Related Pattern of Awareness and Basic Knowledge on Zika Virus Disease among Women Visiting Children Immunization Unit in Enugu State University Teaching Hospital, Southeast Nigeria

Edmund O. Ndibuagu, Innocent I. Okafor, Sussan U. Arinze-Onyia

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/ijtdh/2019/v35i230121

Background: Zika virus is an infective agent of significant Public Health importance, which re-emerged  in 2015. It is transmitted through mosquito bite, and associated with microcephaly and some other neurological malformations in some babies of infected mothers.

Objectives: The objective of this study was to assess the age-related pattern of the awareness and basic knowledge of Zika virus infection among women who bring children for immunization, in a teaching hospital, southeast Nigeria.

Materials and Methods: The study was conducted in the Immunization unit of a Teaching Hospital, Southeast Nigeria, between November 2016 and February 2017. It was a quantitative, observational, descriptive, cross-sectional study, involving randomly selected 256 women who brought children for immunization. Pre-tested, interviewer-administered, structured questionnaire was used; and data was analyzed using SPSS version 20.0 for windows.

Results: Highest number of respondents [112 (43.8%)] were from 30 to 39 age group, followed by those aged 20 to 29 years [108(42.2%)]. Up to 38.3% of respondents had never heard about Zika virus, though this was not statistically significant when compared to the 61.7% that were aware of Zika Virus Disease (P = 0.92).  Highest number heard it through television [57(36.1%)]. Overall, respondents that were 20 to 29 years of age recorded mean percentage basic knowledge score of 54.6%, while those in the 30 to 39 years age range recorded 49.8%.

Conclusions: Many respondents either had never heard about Zika virus, and also many exhibited poor basic knowledge on Zika virus disease. It is therefore important to develop good strategies aimed at addressing these awareness and knowledge gaps among women of child-bearing age, who are mostly affected by Zika virus disease.