Open Access Original Research Article

Effects of Patients’ Perceptions on Hypertension Treatment in the Cape Coast Metropolis, Ghana

Julius Waamsasiko Adong

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/ijtdh/2019/v35i330122

Background: The rising levels of hypertension related complications in Ghana are perceived to be associated with low anti-hypertensive medication adherence, which is attributable to patient wrong perceptions of hypertension.

Aim: To explore the effects of patients’ perceptions on hypertension treatment in cape coast, Ghana.

Study Design: Cross sectional survey.

Place and Duration of Study: Cape Coast, Ghana. December 2013 to March 2014.

Methodology: Eight out of 350 patients were selected from a baseline quantitative survey conducted at the Cape Coast Metropolis. The purposive sampling technique was used after baseline analysis with the Morisky Medication Adherence Scale, to select four adherents and four non-adherents to anti-hypertensive medication. In-depth interviews were conducted for the eight patients, data was processed using content analysis procedure based on three specific themes.

Results: Perceived appearance of symptoms was misinterpreted as sign of rising blood pressure.  Combination of anti-hypertensive and herbal preparations was prevalent among non-adherents. Perceived side effects of anti-hypertensive particularly, sexual weakness was intense among non-adhering patients.

Conclusion: Hypertensive patients in the Cape Coast Metropolis of Ghana, were at a higher risk of medication non-adherence and uncontrolled blood pressure. The findings underscore the need to change patient orientation about hypertension, by addressing misconceptions of symptoms and medication side effects, whiles discouraging the use of herbal preparations.

Open Access Original Research Article

Analysis of Knowledge Management Practice Studies among the Plasmodium falciparum Positive Patients Attending out Patient Departments in Awka, South Anambra State

Doris O. Obasi, Johnpaul N. Azorji, Nathaniel E. Onyenwe, Obianuju O. Duru

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/ijtdh/2019/v35i330123

Aim: To analyze the Knowledge Management Practice Studies among the Plasmodium falciparum positive patients attending outpatient departments in AWKA, South Anambra state.

Study Design: Blood samples were randomly collected from 210 febrile patients attending the OPD and interviewed on malaria knowledge and management practice, using semi-structured questionnaire from three different clinical laboratories, two of which are hospitals.

Place and duration of Study: This study was carried out in Medical Microbiology and Parasitology unit of Anambra State University teaching Hospital, Awka South, South-East Nigeria between February and August, 2013.

Methodology: Thick & thin blood smears were stained and examined under microscope. At least 100 oil immersion fields were examined for diagnosis and parasite count was done against 200 WBC from thick smear. The questionnaire was analyzed using Statistical Package for the Social Sciences SPSS (P < 0.05).

Results: The national drug policy for malaria treatment during the study period were found to be pyrimethamine, co-trimoxazole, sulphamethaxazole, and in few cases arthemether/lumefantrine. The prevalence rate of P. falciparum was 74.8% (157/210), while those on both sexes were 56.1 % and 43.9 % in females and males respectively. Only 44.3%, 32.4%, 30.5% of the population studied showed good knowledge, attitude and practice respectively towards malaria infections.

Conclusion: The prevalence of P. falciparum were 22.3% and 21.1% in ages 5- 14 and 45- 54 respectively. Studies revealed that most people have good knowledge of malaria but give less attention to its preventive and control measures, thereby presenting very poor attitude and poor practice even when exposed to the infection. These issues may pose a problem, such as drug resistance when proper intervention measures are not followed.

Open Access Original Research Article

Bordetella pertussis: Vaccine Coverage and Immune Status among Children Under Five Years Old in Sana’a City, Yemen

Hassan A. Al-Shamahy, Hana Hassan Mahuob Al-Wafi

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/ijtdh/2019/v35i330124

Aims: This study was made to evaluate the immune response to pertussis among children under five years old by measuring the level of circulating Immunoglobulin G (IgG) antibodies against pertussis toxin (IgG-PT) after immunization with the primary series of DPT (DPT1-3) and then determining the coverage rates of universal childhood vaccines.

Study Design: Cross-sectional laboratory study.

Place and Duration of Study: Department of Medical Microbiology and Clinical Immunology, Faculty of Medicine and Health Sciences, Sana’a University, between June and October 2010.

Methodology: A total of 345 children were randomly selected and investigated for universal childhood vaccination coverage rates; of these, 273 children who had received 3 full doses of DPT were studied for their pertussis immunological status. Blood samples were collected from the latter group and then tested for levels of IgG-PT by ELISA method. For assessment IgG-PT levels more than 24 units/ml were considered protected against pertussis. Data were analyzed according to gender and age groups.

Results: The coverage rate of pertussis vaccine was 79.1%; only 71.4% of vaccinated children responded to the vaccine with mean level of 33 U/ml. A statistically significant difference was observed with respect to sero-protective IgG-PT between males and females (63.8% and 84.8% respectively, with χ2 =15, p=0.0001). Also, a statistically significant difference was observed with respect to sero-protective IgG-PT in different age groups,  with older children (>48 months) having a higher rate of antibodies than younger (13-24 months) (90% and 59.1% respectively, with χ2 =3.87, p=.04).

Conclusion: We conclude that a considerable proportion of vaccinated children with a normal immune status were not serologically immune to pertussis. They remain to be reconsidered for either revaccination or booster doses due to lack of or inadequate response. Also, the rates of vaccine coverage for the main universal childhood vaccines are low.

Open Access Original Research Article

Health Care Seeking Behavior among Caregivers of Sick Children Who Had Severe Malarial Anaemia

Stacey M. O. Gondi, Collins Ouma, Harrysone Atieli, Walter Otieno

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/ijtdh/2019/v35i330125

Aims: The western region in Kenya is holoendemic to malaria and experience stable P. falciparum malaria transmission. The use of health care options has a direct influence on the outcome of severe malaria. As such, the current study will assess the health care seeking behavior among caregivers of sick children who had severe malarial anaemia (SMA) in western Kenya.

Study Design: Cross section study.

Place and Duration of Study: The study was conducted at Jaramogi Odinga Oginga Teaching and Referral Hospital (JOOTRH) between September 2014 to July 2015.

Methodology: It was open to all children ≤10 years (n=271) admitted and diagnosed with SMA (hemoglobin <5.0 g/dl and any density of P. falciparum. Caregivers were interviewed on the health care options before seeking care at a heath facility, when the child started to get sick, if they took child to another health centre/dispensary/private hospital before coming to JOOTRH 

Results: Majority of the caregivers interviewed, 80.07% (217) had attained Primary education.  Majority of the caregivers were in the age category of 19-24 75(27.67%) years and 25-29 years 75 (27.67%). 74.90% (203) of their children were below five years and 25.09% (68) were above 5 years.  61.62% (167. Majority of the caregivers gave some remainder drugs before presenting to a heath facility 32.5% (88). A good number bought drugs at drug stores/pharmacies 27.7% (75). None visited a traditional healer. A minority used herbs 10% (27). There were no statistically significant differences between most of the pre-hospitalization measures taken s with regard to patient’s gender and age, and caretaker’s level of education. Caregivers who chose to give herbs to their sick children took longer in deciding to take their children to hospital. This was however statistically significant between those who used herbs and those who bought drugs only (median 4 days vs. 3 days, respectively, p = 0.0063). There was no significant difference in the delay of child admission at JOOTRH between caregivers who had had primary education only and those with a minimum of secondary education (p = 0.9842).

Conclusion: Self-medication is a common practice before seeking care at a heath facility. There is need for community awareness for correct and comprehensive information about drawbacks associated with self-medication practices. Since safety continues to be a major issue with the use of herbal remedies, it becomes imperative, therefore, that relevant regulatory authorities put in place to ensure that all herbal medicines are safe and of suitable quality.

Open Access Original Research Article

Starvation-induced Changes in Memory Sensitization, Habituation and Psychosomatic Responses

O. N. Ilochi, T. A. Kolawole, B. O. Oluwatayo, A. N. Chuemere

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/ijtdh/2019/v35i330126

Starvation is a global challenge. Nutritional status of an organism may influence its psychosocial behavior and other nervous system processes like motor responses and its ability to learn and memorize.  This study determined the impact of starvation-induced stress on memory sensitization, habituation and psychosomatic responses in an experimental animal design. 25 wistar rats were randomly sampled and grouped into 1-control, 2- feed after 6 hours deprivation, 3-feed after12 hours deprivation, 4-feed after 18 hours deprivation and 5-feed after 24 hours deprivation. Behavioral tests carried out included the multiple maze tests and elevated plus maze test. Grip strength test was performed to determine neuromuscular response and endurance in all groups. Biochemical investigation of brain stress markers was done on the last day of the study. There was a significant (P≤0.05) enhancement in memory processes and anxiolytic behavior after 6 hours feed deprivation. An increase in antioxidants after 6 hours feed deprivation was suspected to be a compensatory response. A progressive decrease in memory facilitation, anxiolytic behavior and muscular strength was reported after 12, 18 and 24 hours feed deprivation. The increase in habituation and decrease in psychosomatic response was observed and appreciated as the duration of feed deprivation was increased. This study provided evidence about a possible link between memory processes and stress-related alterations in calcium, magnesium and nitric oxide. Starvation may impair learning, memory and motor responses, but this tendency is dependent on the extent of feed deprivation and nutrient depletion.