International Journal of TROPICAL DISEASE & Health

Introduction: Primary Hydatid cyst of pancreas is a rare entity even in endemic countries. These cases usually present with non specific symptoms such as pain abdomen, vomiting or feeling of vague lump in abdomen.

Presentation of Case: A 55 year old lady presented to GI surgery department, GB Pant institute of Postgraduate Medical Education and Research (GIPMER), India with complaints of lump in abdomen and pain abdomen which was evaluated with imaging studies (Computed tomography scan Abdomen and Magnetic resonance imaging Abdomen). Initially considered as cystic lesion pancreas, Endoscopic ultrasound (EUS) confirmed diagnosis of Hydatid cyst and patient underwent open deroofing and drainage of cyst with uneventful post operative period.

Aim: The 2018 World Health Organization Global Tuberculosis Report enlisted Nigeria as one of the seven countries worldwide that accounted for 64% of all new cases of tuberculosis. The aim of this study was to assess the magnitude and determinants of tuberculosis treatment outcomes at a Tertiary Hospital in South East, Nigeria.

Study Design: Retrospective cohort.

Place and Duration: The Enugu State University Teaching Hospital Directly Observed Treatment Center, between April 2009 and March 2013.

Methods: Completely filled data were extracted from tuberculosis treatment cards and registers of 445 clients (255 males, 190 females; age range 0-90 years) who assessed care at the DOTS clinic.  Tuberculosis treatment success outcome is defined as cured or completed TB treatment.

Results: Of 445 registered patients, majority was males (57.3%), lived in urban areas (68.1%), and were newly diagnosed (97.8%). Of the 93.7% with pulmonary tuberculosis, 62% were smear negatives cases (62%). While the male to female ratio of the clients was 1.3:1, their mean age was 42 ± 16.7 years. About half (50.6%) had chest x-ray findings that were not diagnostic of Tuberculosis. While TB/HIV co-infection rate was 32.8%; 16% and 19.3% had commenced anti -retroviral and co-trimoxazole preventive treatment respectively. Treatment success was reported in 67.9% of all clients and was associated with being older than 14 year (AOR=12.0, 95% CI: 2.5 – 58.0) and having positive chest findings (AOR = 2.6, 95% CI: 0.3-0.6).

Conclusions: The TB success rate in was 67.9% Being older than 14 years, having PTB and positive chest x ray findings were the predictors of good treatment outcome in this study. There is an urgent need to track and report the treatment outcome of patients who are lost to follow up since they constitute 20% of missed cases in this center.

Aim: The aim of this study was to describe temperature, precipitation pattern and the occurrence of maternal urogenital schistosomiasis (UGS) in Munyenge in 2017.

Study Design: It was a twelve-month cross-sectional study.

Study Site and Duration: The study was carried out in Munyenge from January to December 2017.

Materials and Methods: Volunteer pregnant women attending antenatal care clinic were enrolled consecutively on a monthly basis from January to December 2017. A semi-structured questionnaire was used to obtain information on socio-demographic data and water contact behaviour. Urine samples were analysed for presence of microhaematuria and/or Schistosoma haematobium ova using filtration method. Monthly land surface temperature (LST) and precipitation were sourced from MODIS and CHIRPS satellite data respectively. Statistical analyses performed were analysis of variance, student t- test and correlation analysis. 

Results: The mean annual temperature was 27.18 ± 0.74°C. Monthly temperatures were fairly constant (range: 26.12 to 28.82°C). Precipitation varied greatly (range: 0.26 - 12.75 mm) with a mean of 6.58 ± 4.5mm. A marginal negative correlation (r = -0.586; P = .04) was observed between stream usage and precipitation where stream usage reduced with increase in precipitation. Generally, there was high dependence on the stream as source of water (60.9 - 90.6%) in the  study area. Dependency on the stream was associated (r = 0.603; P = .03) with domestic and bathing activities. The annual prevalence of maternal UGS was 24.1% (77/320) with a high occurrence during the rainy season (16.6%; 53/320) than the dry season (7.5%; 24/320) but the difference was not significant (χ² = 2.26; P = .13).  There was no significant difference between months.

Conclusion: Our findings show no seasonal variation in the occurrence of maternal UGS in Munyenge. Transmission of infection may be perennial.

Self-medication is very common especially in developing countries and is documented to be associated with many health risks including antibiotic resistance. Antibiotic resistance is shrinking the range of effective antibiotics and is currently listed as a global health problem. This study investigated the perceptions of self-medication with antimicrobials (SMWA) after community mobilization intervention among the households in Nyalenda B, an informal settlement, within Kisumu County, Kenya. This enabled the study to establish the magnitude of SMWA and the perceptions that persist given such intervention within the region. Data was collected through structured questionnaires administered to 380 households. Focus group discussions (FGDs) were also facilitated and targeted purposively-selected 30 CHVs.  Descriptive and binary logistic regression analyses were used to determine the association between socio-demographic characteristics and the perceptions influencing SMWA. The study established that 316 households had used antimicrobials of which 20.9% were self-medicating with antimicrobials. Age (OR=0.647, 95% CI=0.431, 0.973, P=0.037) is significantly related to SMWA, use of NHIF for outpatient services (OR=1.772, 95% CI=0.652, 2.887, P=0.133) and use of Universal Healthcare Services (OR=1.165, 95% CI=0.922, 1.472, P=0.201) may have contributed to SMWA reduction but not significantly as compared to other socio-demographic factors. Likewise, sources of information or advice on self-medication (OR=0.732, 95% CI=0.613, 0.873, P=0.001) and illness or symptoms of illness (OR=1.324, 95% CI=1.129, 1.554, P=0.001) may significantly influence SMWA as compared to other SMWA perceptions. Community mobilization using empowerment as a strategy and implemented through participatory learning and action is a successful method for reduction of SMWA level and development of SMWA perceptions with an experiential value especially when strengthened with structural modification. SMWA is a serious problem in developing countries and so such intervention should be prolonged and continuous to offer sustained changes in public perception and attitudes towards the misuse of antimicrobials.

HIV/AIDS continues to be a major global public health issue, having claimed more than 32 million lives so far. There were approximately 37.9 million people living with HIV/AIDS (PLHIV) at the end of 2018. Anti-retroviral therapy (ART) has significantly reduced morbidity and mortality and improved quality of life among people with HIV infection.

Aims: The study was conducted to improve the knowledge and adherence to anti-retroviral therapy among PLHIV in Enugu state, southeast Nigeria.

Study Design: Interventional study.

Place and Duration of Study: Anti-retroviral Therapy clinics within Enugu metropolis in Enugu state Nigeria between June to December 2018.

Methodology: A health education intervention was carried out among 312 PLHIV receiving ART in Enugu metropolis to improve their perception and adherence to antiretroviral therapy. A structured questionnaire was used to collect data from 312 PLHIV (156 each in the study and control groups), who were selected by multistage sampling. Subsequently, health education was conducted among the study group. Three months after this intervention its effects were assessed through a survey using the same structured questionnaires employed in the baseline survey. 

Results: The most frequently occurring reason given by the respondents for poor adherence to ART was forgetfulness (65.4% for study and 69.9% for control groups). Knowledge of the factors and consequences of poor adherence to treatment was significantly higher among the study group than the controls post-interventions p<0.001. Adherence to ART improved from 42.3% pre-intervention to 81.4% post-intervention.

Conclusion: Intensive health education effectively improved adherence to ART among persons living with HIV/AIDS and this should be carried out regularly.