Open Access Original Research Article

Knowledge of Chikungunya Disease among Academic Population in Private Universities, Khartoum State, Sudan - 2019

Ghalib Nashaat El Hunjul, Siham Ahmed Balla

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/ijtdh/2020/v41i430265

Introduction: Chikungunya is a viral disease that could lead to chronic symptoms. It has no approved treatment or vaccine to date.

Objective: To assess the level of knowledge about Chikungunya viral disease following an outbreak in Kassala Sudan among the academic population in private universities in Khartoum State.

Methods: A cross-sectional study was carried out in three private universities in Khartoum State during April-August 2019. A sample of 376 individuals (346 medical students and 30 teaching staff) was determined. A self-administered questionnaire was distributed to the target population. It included eleven variables about the information regarding Chikungunya disease. Data was imported into SPSS program version 20 and descriptive statistics were presented.  Knowledge variables were categorized into scores as adequate, moderate and poor. Chi square test was used to test the knowledge levels among the study population at the confidence level of 95%.

Results: Out of 376 study population, 66 (17.6%) had never heard about the Chikungunya disease. Therefore, the knowledge variables were analyzed among 310 individuals who heard about the disease. Out of 310 individuals, 235 (75.8%) knew that the disease is viral and 245 (79.0%) knew that fever is the common symptom. Individuals who did not know the mode of transmission were 200 (64.5%). Individuals who did not know the diagnostic methods of the disease and management methods accounted for 228 (73.5%) and 174 (56.1%) respectively. One hundred seventy-five individuals (56.5%) did not know the prevention by vector control and 174 (56.1%) did not know if a vaccine is available or not. Out of 310 individuals, 60 (19.4%) had adequate knowledge about Chikungunya disease. Moderate to poor knowledge were significantly high among the study population, p value = 0.0002.

Conclusion: Most of the study population heard about Chikungunya disease but the majority had moderate to poor knowledge about the disease. Private universities should open channels with Ministries of Health to facilitate field training of students during outbreaks.

Open Access Original Research Article

Viral Hepatitis B Screening among Asymptomatic Patients of Liver Pathology in a Secondary Health-care Facility in Nigeria

Stephen Oluwasegun Adetunji, Emmanuel Donbraye, Blessing Ifeoluwa Adetunji, Olutayo Busola Olaniran

International Journal of TROPICAL DISEASE & Health, Page 9-16
DOI: 10.9734/ijtdh/2020/v41i430266

Background: HBV infection is a serious ailment which damages the liver yet not well known and hence not given adequate attention. Many are infected but are not aware because they do not manifest any sign and symptom.

Aim: The purpose of this study was therefore to evaluate the prevalence of HBsAg among asymptomatic hospital attendees.

Study Design: A cross sectional study.

Place and Duration of Study: St Mary’s Catholic Hospital, Ibadan, Nigeria, between November 2017 and August 2018.

Methodology: 1328 consecutive patients who attended the hospital were enrolled into this study after obtaining their consent. Their blood samples were aseptically collected and assayed for HBsAg using conventional method.

Results: A total of 1,328 participants were enrolled, out of which 421 (31.7%) were male and 907 (68.3%) were female with a gender ratio of 1:2.2 - male to female. 5.9% (25/421) of the males tested positive to HBsAg while 5.4% (49/907) of the females tested positive to HBsAg (p=0.692). Of the overall 1328 individuals screened, 5.6% tested positive to HBsAg. The age group with the highest prevalence of HBsAg were those between 51 and 60 years with 13.1% followed by 41 - 50 years (7.2%) while > 70 years had the lowest prevalence.

Conclusion: This study showed that HBsAg infection is high among asymptomatic hospital attendees in Ibadan, Nigeria. More public sensitization and awareness programmes are strongly advocated for.

Open Access Original Research Article

Self-Medication with Antibiotics and Its Predictors among the Population in Khartoum Locality, Khartoum State, Sudan in 2018

Osman Kamal Osman Elmahi, Siham Ahmed Balla, Hiba Ahmed Khalil

International Journal of TROPICAL DISEASE & Health, Page 17-25
DOI: 10.9734/ijtdh/2020/v41i430267

Background: Self-medication is a personal self-initiated behaviour of diagnosis of a disease and self-treatment of its symptoms and signs.

Objective: To identify the prevalence of self-medication with antibiotics and the diseases commonly treated with antibiotics, the most commonly used antibiotics, the sources of obtaining it and the predictors of self-medication with antibiotics.

Study Design: This was a cross-sectional, descriptive study.

Place and Duration of Study: This study was conducted in Khartoum Locality, Khartoum State, Sudan during April 2018.

Methods: 246 adults (130 males, 116 females) over 18 years were included in the study. A closed-ended, pretested and pre-validated questionnaire was used to interview the participants.

Data was analysed using SPSS Version 23.0. Descriptive statistics were presented in tables and figures. Logistic regression was conducted to identify the predictors of self-medication with antibiotics. Ethical approval and voluntarily signed consent were obtained prior to embarking on the study.

Results: 148(60.2%) participants practiced self-medication with antibiotics, 111(75%) of whom obtained the antibiotics over the counter in community pharmacies. The most commonly used antibiotic was amoxicillin/clavulanic acid (38.5%). The major reason behind taking antibiotics without prescription was long distances to healthcare facilities (43.2%). The commonest symptom which encouraged self-medication with antibiotics was abdominal pain (27%). Females were 3.55 times more likely to use self-medication with antibiotics than males. Participants who lacked health insurance cards were 2.65 times more likely to practice self-medication with antibiotics.

Conclusion: The prevalence of self-medication with antibiotics is alarmingly high in Khartoum Locality. Over the counter purchase of antibiotics was the main route of self-medication. Gender and lack of health insurance were significant predictors of self-medication. Mass education through different media and policy reform are recommended.

Open Access Original Research Article

The Burden and Socio-demographic Differentials of Malaria Infection among Asymptomatic School Children in Gombe State, Nigeria

Mela Danjin, Solomon O. Adewoye, Henry O. Sawyerr

International Journal of TROPICAL DISEASE & Health, Page 26-42
DOI: 10.9734/ijtdh/2020/v41i430268

Background: As a foremost disease of public health significance, malaria has wrecked untold havoc among children and pregnant women in developing countries with Africa and Nigeria being worst affected.

Objective: This study was aimed at documenting the prevalence and socio-demographic differences in the pattern of malaria infection among asymptomatic primary school children in Gombe state, Nigeria.

Methodology: Using a cross sectional study design 745 pupils aged 6 to 15 years were assessed from March to June 2019. The subjects were selected from 12 public and 6 private schools in 6 Local Government Areas (LGAs) of the state, using multi-stage sampling technique. Malaria rapid diagnostic test (mRDT) kits were deployed in screening the subjects for malaria parasites positivity or otherwise. Data was analyzed using IBM SPSS version 21 analytical software. And the findings were presented in tables and charts. Proportions were compared using chi square, with alpha significance level set at 0.05.

Results: The mean age of the participants was 9.96±2.26 and 379 (50.9%) of them were boys while the rest 366 (49.1%) were girls (about 1:1 male-female sex ratio). A total of 101 (13.6%) of the 745 school children screened yielded positive to malaria rapid diagnostic test (mRDT), with children from the public primary schools being significantly (p=0.000) more affected than their counterparts in the private schools (18.2% vs. 4.1%). Though male children were more affected by malaria, the difference was not statistically significant (15.0% vs. 12.0%, P=0.229). Similarly, significantly higher proportion (p=0.000) of pupils from the rural schools were affected  and were about three times more at risk of malaria (OR=3.362, CI: 2.169-5.212) than their urban counterparts (22.4% vs. 7.9%). Low academic performance was found to be associated with malaria infection (p=0.012). Other socio-demographic factors associated with malaria  infection among the pupils include; senatorial district, family size, source of parental care, tribe etc. However, from the evidence of this study there was no significant association between  the prevalence of malaria infection and birth order, age group and gender of the school children.

Conclusion: In view of the high and disproportionate distribution of the burden of malaria among the subjects, it is hereby recommended that concerned authorities should include primary schools in the design and implementation of malaria control/ elimination programmes.

Open Access Original Research Article

Emerging Threat of Salmonella typhimurium in Extraintestinal Infections: Cases from a Tertiary Care Hospital in North India

Ashima Jain, Aparna Pandey, Nirupama Chatterjee, Santosh Kumar Giri, Saurabh Anand, Ragesh Radhakrishnan Nair, Pawan Kumar Singh, Namita Jaggi

International Journal of TROPICAL DISEASE & Health, Page 43-51
DOI: 10.9734/ijtdh/2020/v41i430269

Purpose: Infections due to invasive non-typhoid salmonella can be dangerous and fatal. The mode of infection and the severity varies from the typhoidal fevers. It is important to find the association between clinical features and the infecting serovar to understand the pathophysiology and course of treatment.

Methods: In the present study, extra-intestinal specimens (blood, cerebrospinal fluid and pus) from three patients suffering from septicaemia, meningitis and osteomyelitis were received. Micro-biological and biochemical test for species identification and antibiotic susceptibility was done as per standard protocol. Further, PCR based amplification and sequencing of a portion of the flagellin gene (FliC) was done to confirm the serovar.

Results: Salmonella enterica was identified from all the three by microbiological and biochemical examination.The sequence of the Flic gene confirmed the serovar to be S. typhimurium. All the patients were treated successfully for the infection by appropriate antibiotic therapy.

Conclusion: The study highlights that serovar Typhimurium is common in invasive non-typhoidal salmonellosis and its pathophysiology and virulence factors expression should be understood in various organ types for better treatment options and outcomes.

Open Access Original Research Article

Comparison of Three Parasitological Stool Examination Methods with the Formalin-Ethyl Acetate Procedure for the Diagnosis of Intestinal Parasites in Humans

A. L. Madriz-Elisondo, M. L. Galván-Ramírez, D. A. De la O-Carrasco, A. R. Eufracio-Maciel, M. A. Cardona-López, J. J. Romero-Rameño

International Journal of TROPICAL DISEASE & Health, Page 52-63
DOI: 10.9734/ijtdh/2020/v41i430270

Aims: The objective was to compare the sedimentation spontaneous in tube technique (SSTT), the direct smear, the zinc sulfhate (surface film and sediment analyzed) methods with the formalin-ethyl acetate method as the reference standard.

Study Design: This a cross-sectional study performed in two populations around Chapala lake, Jalisco, Mexico.

Place and Duration of Study: Sample Department of Medical Sciences and Life, University Center of the Ciénega, University of Guadalajara, Ocotlán, Jalisco, Mexico.

Department of Physiology, Health Sciences University Center. University of Guadalajara, Jalisco. México, between June 2018 and July 2019.

Methodology: Sample: We included a total of 297 samples and were analyzed by the direct smear, the zinc sulfhate (surface film and sediment analyzed), the SSTT and formalin-ethyl acetate methods.

Results: The SSTT was able to detect 40% of intestinal parasites, very good agreement for Entamoeba complex, Entamoeba coli, and Ascaris lumbricoides kappa index=0.697, 0.791, 0.696, respectively and excellent agreement for Giardia lamblia kappa index = 0.843. Regarding the isolation of Blastocystis spp, only a poor agreement was found among all techniques. The SSTT was able to detect multiple parasites with a sensitivity of 82.90% and specificity 83.80 kappa index= 0.649.

Conclusion: The SSTT showed a very good agreement for the diagnosis intestinal polyparasitism which could represent another alternative for the concentration and identification protozoans and intestinal helminthes in low-resource settings.

Open Access Original Research Article

Evolution of COVID-19 Infection in Mexico until 28 March, 2020: A Descriptive Ecological Study

Nicolás Padilla-Raygoza, Efraín Navarro-Olivos, María de Jesús Gallardo-Luna, Francisco J. Magos-Vazquez

International Journal of TROPICAL DISEASE & Health, Page 64-69
DOI: 10.9734/ijtdh/2020/v41i430271

Aims: To describe the number of confirmed cases of COVID-19 in Mexico.

Study Design: Ecological descriptive study.

Place and Duration of Study: Registries of confirmed cases for COVID-19 in Mexican population during February and until 28 March 2020, 13:00 PM, from National System of Epidemiological Surveillance/ General Direction of Epidemiology/ Secretary of Health, Mexico.

Methodology: Accord to database of confirmed cases of COVID-19 by Secretary of Health in Mexico, it was collected data on age, gender, source of infection (travel to USA, European or Asian countries). It was included 848 registries.

Results: The first confirmed case in Mexico was 20 February 2020 and the frequency is arising at the end of February and throughout March. The early confirmed cases were imported cases for travel to USA, Italy, Germany, Spain, France and Singapore. No one travelled to China. Now, there are confirmed cases infected for contact with a case.

Conclusion: The frequency of confirmed cases of COVID-19 is higher and the health       authorities in Mexico are waiting that the peak of the epidemiological curve is in late March and early April.

Open Access Original Research Article

Comparative Diagnosis of Latent Tuberculosis Infection amongst HIV and Diabetic Patients Attending Tertiary Hospitals in Anambra State

Ugwu Kenneth Chukwudi, Ene Paschal Chuka, Orji Nkeiru MaryAnn., Umedum Chinelo U., Umetiti Chukwuemeka Nnamdi, Ikeanumba Michael Okwudiri

International Journal of TROPICAL DISEASE & Health, Page 70-79
DOI: 10.9734/ijtdh/2020/v41i430272

Aims: The aim of this research work was to survey the epidemiology and diagnosis of Latent Tuberculosis Infection (LTBI) amongst HIV and Diabetic patients in Anambra state of Nigeria using Tuberculin Skin Test (TST) and Interferon Gamma Release Assay (IGRA).

Study Design: This was a multicenter study covering three tertiary hospitals in Anambra State involving 480 adult HIV positive and Diabetic patients with 240 normal participants as control.

Place and Duration of Study:  This study conducted from February 2016 to April 2018 involved the general hospitals chosen from the three senatorial zones in the state. 

Methodology: IGRA using T spot TB as well as TST were done for all the participants. HIV screening, CD4 count and Fasting Blood Sugar were also done accordingly.

Results: Overall prevalence of Latent Tuberculosis Infection (LTBI) was 24.4% and 22.5% for IGRA and TST respectively, of the two health groups, HIV group had 35% and 20% for IGRA and TST respectively in their overall prevalence, this was significant (P<.05) compared with the controls which had 2.5% and 4% respectively to IGRA and TST. The diabetics group on the other hand had 13.8% and 25% for IGRA and TST respectively, this also was significant (P<.05) in comparison to its control group with 1.6% each for both IGRA and TST. Out of the 480 patients, 74(15.4%) of them had concordant result, this was 63.2% of the total positive value in the two groups worked on while 43(8.95%) and 34(7%) patients constituted the discordant figures for IGRA and TST respectively.CD4 count was inversely proportional to the presence of LTBI amongst HIV patients using the TST method. Age and duration of illness were significantly associated with LTBI in diabetics (P<.05). Participation rates were higher among males, though females recorded a non significant higher prevalence on the two test methods.

Conclusion: There was a high prevalence of latent tuberculosis infection amongst HIV and Diabetic patients in Anambra State. IGRA and TST diagnostic results were not concordant with each other but IGRA appeared to be more specific than TST in diagnosing LTBI.