Open Access Original Research Article

A Five Years Retrospective Study on Etiology and Clinical Analysis of Meningitis in St. Paul’s Hospital Millennium Medical College Pediatric Ward from 2012-2016

Ermias Getaneh Ayele, Zebenay Workneh Bitew, Kibir Temesgen Assefa, Teshome Gishu Tura, Rahel Mezemir

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/ijtdh/2019/v36i430147

Meningitis is the sever CNS pyogenic infections which primarily affects infants and children. Ethiopia is one of the countries where meningitis is endemic and frequent episodes of meningococcal epidemics are very common in the dry season (December to June).

The main purpose of this study was to identify determinants and clinical analysis of meningitis in pediatrics ward admitted to St.Paul’s hospital millennium medical college pediatrics wards from 2012-2016.

A retrospective study on etiology and clinical analysis of meningitis was conducted at the pediatric unit. The study population was all pediatric patients admitted with meningitis that were presented in ward during the study period. Those fulfilling the mentioned inclusion criteria were included. The data were collected using a structured format in September /2016.

From the study population 95 cases fulfilled the inclusion criteria and 64 & 31 of them were males and females, respectively making a male to female ratio of 2:1. The most significant seasonal variation was observed for N. meningitidis having high incidence in the 2nd quarter (April to June). In the dry season 18 cases were diagnosed using the culture results. Culture findings also revealed that S. pneumonia was one of the commonest causes of bacterial meningitis. The most common symptom was fever with high grade fever (>38oC) recorded in 84 (88.4%) of cases. Most (65.5 %). of clients were recovered from meningitis at the end of the treatment where as death was the second outcome with 17(20.2 %) cases ended up with death. Neurological or other complications  were seen  in 9(10.7 %) cases.

Open Access Original Research Article

The Impact of Human Genetic Factors (G6pd and Type of Hemoglobin) on the Course of Uncomplicated Malaria Infection in Children Aged from 2 to 10 Years Living in the Banfora Health District in Burkina Faso

Salif Sombié, Emilie S. Badoum, Samuel Sindié Sermé, Aïssatou Diawara, Amidou Diarra, Sam Aboubacar Coulibaly, Noelie Henry/Béré, Mame Massar Dieng, Aissata Barry, Désiré Kargougou, Alfred Sababeni Traoré, Alfred B. Tiono, Bienvenu Sodiomon Sirima, Youssef Idaghdour, Issiaka Soulama

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/ijtdh/2019/v36i430148

Aims: The aim of this study was to assess the impact of hemoglobin polymorphisms and G6PD deficiency on the course of uncomplicated malaria infection in children aged from 2 to 10 years in Burkina Faso.

Study Design: The study was conducted as a longitudinal study in Banfora health district. A total of 150 children aged from 2 to 10 years was enrolled and followed up between May 2015 and February 2016. Blood samples were collected at four different time points: before infection (Visit 1), during asymptomatic parasitemia (Visit 2), during symptomatic parasitemia (Visit 3) and three weeks after treatment (Visit 4). Clinical examination, hematology parameters and malaria diagnosis using microscopy were performed. Hemoglobin and G6PD typing were done using PCR-RFLP. Hemoglobin AA genotypes were defined as normal hemoglobin while Hemoglobin AC, AS and SS were defined as abnormal hemoglobin (hb non-AA).

Results: The prevalence of hemoglobin (hb) genotypes was 81.21% for AA while hb non-AA genotypes were estimated at 18.79% (12.08% for hbAC, 6.04% for hbAS and 0.67% for HbSC). The prevalence of G6PD genotypes was 89.26% and 10.74% for normal G6PDn and G6PD deficiency respectively. The prevalence of asymptomatic carriers of P. falciparum was not affected neither by the genotypes of Hemoglobin, nor by the G6PD deficiency. Conversely, the risks of developing uncomplicated malaria in G6PD deficiency (G202A) group, was significantly lower (p = 0.04).

The results showed a significant difference (p˂0.0001) in the means of P. falciparum parasite densities between asymptomatic and symptomatic phase in Hemoglobin AA genotypes carriers while the means of parasite density was comparable in non-Hemoglobin AA carriers.   

Conclusion: Our study showed that G6PD deficiency protects against clinical malaria while P. falciparum parasite density increasing was correlated with carrying hemoglobin genotypes AA.

Open Access Original Research Article

Prevalence of Pulmonary Tuberculosis among Presumptive Cases in Rivers State, Nigeria

N. Gabriel-Job, Paul Ni

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/ijtdh/2019/v36i430149

Background: Tuberculosis (TB) is a leading cause of death in children but it is underdiagnosed and underreported in children.

Objective: To determine the prevalence of pulmonary TB in children among presumptive cases of TB and to compare the diagnostic efficacy of different screening tool for TB in children. 

Materials and Methods: This study was a descriptive prospective study carried out over one year in nine general health facilities that can provide diagnosis and treatment for tuberculosis in Rivers State, Nigeria. Children aged 0 – 18 years with presumptive TB were explored. They were explored by carrying out a clinical assessment with chest radiograph, sputum or gastric aspirate for AFB microscopy and XpertMTB/RIF screening. Sociodemographic data and results of the screening tests was retrieved from their case records as well as the National Tuberculosis registers. Ethical approval for the study was obtained from the Rivers state Ministry of Health. Those with confirmed pulmonary TB were commenced on anti TB medications and followed up for at least 6months. Obtained data was analysed by SPSS version 20 and expressed as percentages, proportions and frequencies. A test of significance (chi square and t-test) was conducted between proportions and means as appropriate. In all a p value of less than 0.05 was considered significant. 

Results: Nine hundred and sixty three patients aged 0-18 years had presumptive diagnosis of TB,   394 (40.9%) were males while 569 (59.1%) were females. The commonest presenting symptom was chronic cough which occurred in 735 (76.5%) of the patients. The prevalence of pulmonary TB was 19.1%. Significantly more males (60.9%) than female (39.1%) had confirmed tuberculosis (X2= 37.431, p-value <0.001). Significantly more children (54.3%) from the low socioeconomic class had confirmed pulmonary. Seventy two (39.1%) and 29 (15.8%) of the patients were AFB and XpertMTB/RIF positive respectively. Children aged 0-5 years were neither AFB nor XpertMTB/RIF positive. Of the children with confirmed TB, 98 (53.3%) had suggestive clinical features while 86 (46.7%) had suggestive X-ray features. More than a third (33.2%) of the children aged 0-5 years had their TB confirmed by suggestive X-rays and Clinical features. All the patients with TB were commenced on anti TB medications, 40 (21.7%) were lost to follow up (LTFU), 21 (11.4%) were transferred to other centres while 123 (66.8%) completed the treatment. 

Conclusion: The prevalence of pulmonary TB among presumptive TB cases in this study was comparable to findings from other studies and clinical diagnosis of Pulmonary TB remains very relevant in its management. Improving the clinical skills of physicians involved in TB care and treatment and the need for community/ facility collaboration to reduce cases of LTFU is advocated.

Open Access Original Research Article

Perception and Management of Fever in Children, by Mothers in Port Harcourt Nigeria

Yaguo Ide, Lucy Eberechukwu, Shorinwa Olusayo Aderonke

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/ijtdh/2019/v36i430150

To determine mother’s perception and management of fever in their children. It was a descriptive cross-sectional study, carried out at the children outpatient clinic of the department of Paediatrics, University of Port Harcourt Teaching Hospital, over a one-year period, January to December, 2012. Every mother who presented with her child to the children outpatient clinic was recruited and interviewed using a structured questionnaire after obtaining written informed consent, as they presented their children to the children outpatient clinic of the University of Port Harcourt Teaching Hospital until   we recruited 324mothers, whose children aged between 0-16 years into the study.  A little over half of these mothers had completed secondary education. The thermometer was used by 209(64.50%) mothers and the preferred route was by mouth 135(41.67%). 175(54.01%) mothers  reported temperature <35ºC as fever. 49.07% of the mothers were worried about the consequences of the fever.  43(13.3%) would give paracetamol. 24(7.4%) would tepid sponge. 15(4.6%) would give a cold bath. 6(1.9%) expose the child to air with reduced clothing. 4(1.2%), wrap the child with warm and thick cloth. 2(0.6%) gave antibiotics. 11 (3.4%) gave antimalaria.  6(1.9%) gave teething drugs. 1 (0.3%) gave nothing. Most mothers got their information on knowledge of fever management from doctors and nurses-164(50.62%). Paracetamol was the most commonly used drug by mothers for the treatment of fever at home-217 (67%). 87(26.852%) would take the child to hospital if fever persisted. This study found a significant association between using physical methods such as giving cold bath to reduce fever, and tepid sponging to reduce fever with no formal education P < 0.0001 and P< 0.0165 respectively. Data was analyzed using Epi-info version 7. Mothers awareness of fever in Port Harcourt is low and Paracetamol is commonly given to children with fever.

Open Access Original Research Article

Estimation of Malaria Parasite Densities by Different Formulas in Thailand

Kyaw Swar Oo, Polrat Wilairatana, Noppadon Tangpuckdee, Kittiyod Poovorawan, Srivicha Krudsood, Shigeyuki Kano, Nalinrat Wilairat, Pichayapat Wilairat, Pimjira Thebpatipat

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/ijtdh/2019/v36i430151

Introduction: Although there are many methods in malaria diagnoses e.g., quatitative buffy coat (QBC), rapid diagnosis tests (RDTs), serological tests and molecular diagnosis methods such as PCR, but microscopy still remains the gold standard for malaria diagnosis. Estimation of malaria parasite density can be carried out by using assumed white blood cells (WBC) and red blood cells (RBC) counts.

Objective: The aims of this study were to determine malaria parasite densities calculated by assumed WBC and RBC counts; and to compare their reliability with absolute WBC and RBC counts.

Methods: The clinical presentations and laboratory findings of specimens collected from 512 uncomplicated falciparum and vivax malaria patients admitted to Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand were utilized and analysed for estimation of malaria parasite densities by using different formulas.

Results: Parasite densities calculated by WHO recommended assumed WBC of 8,000 /µL, and assumed RBC counts of 4.7x106-6.1x106 /µL and 4.2x106-5.4x106 /µL for males and females respectively led to overestimation, and resulted in low reliability when compared to the absolute WBC and RBC counts. Parasite densities calculated by assumed WBC of 5,900/µL in thick blood; by assumed RBC of 4.8x106/µL for males and 4.3x106/μL for females in thin blood film respectively gave more precise estimation.

Conclusion: Assumed WBC and RBC counts for calculating malaria parasite densities have to be adjusted to use in Thailand for more precise estimation. Parasite densities calculated by assumed WBC and RBC used in other malaria endemic countries might need further re-evaluation.