Open Access Short Research Article

Magnitude of Prior Teenage Pregnancy among Women Aged 18–67 Years in Rural Southwestern Uganda

Edgar Mugema Mulogo, Moses Ntaro, Jessica Kenney, Palka Patel, Andrew Wesuta, Peter Chris Kawungezi, Shem Bwambale, Michael Matte, Fred Bagenda, Geren Stone

International Journal of TROPICAL DISEASE & Health, Page 46-52
DOI: 10.9734/ijtdh/2020/v41i530278

Objective: Teenage pregnancy is a growing health challenge among adolescents in Uganda with its magnitude varying across the different regions of Uganda. This study evaluated the magnitude and factors associated with prior teenage pregnancy among women aged 18-67 years in a rural community of Kasese district, Uganda.

Results: Fifty-two percent (52%) of the 138 women interviewed, had a prior teenage pregnancy. Having experienced a teenage pregnancy was independently associated with; occupation of current household heads (adjusted odds ratio, aOR= 0.2, 95% confidence interval, CI: 0.1 – 0.9), whether or not the current household could adequately meet their food needs (aOR= 0.1, 95% CI: 0.01 – 0.8), and whether the current household shared toilet facilities (aOR= 4.7, 95% CI: 1.0 – 21.8).

Conclusion: The findings suggest that magnitude of prior teenage pregnancy among women in this rural community is much higher than the national average. Socio economic factors at household level are contributory to prior teenage pregnancy. A multi sectoral approach integrating household livelihood improvement with health interventions targeting the girl child is proposed to curb teenage pregnancy in this context.

Open Access Original Research Article

Covid 19: Determination of the Relationship between Sex, Having Handkerchief or Staying Indoor and Facial Touch

S. A. Aderoju, S. S. Ajewole, O. S. Balogun

International Journal of TROPICAL DISEASE & Health, Page 1-6
DOI: 10.9734/ijtdh/2020/v41i530273

Background: Covid-19 outbreak is the current pandemic confronting nations in the world. The virus had caused so much loss of lives, loss of jobs and serious damages to global economy. One major way of preventing the spread of the virus and guide against being infected is to avoid face touching with unwashed hand(s).

Objective: The objective of this study is to investigate the association between sex, having handkerchief or staying indoor and number of time a person touches face (mouth, eyes or nose). 

Methodology: A sample size of n = 130 people were randomly selected and observed obliviously for 120 seconds. The number of times they touched their faces were recorded with other variables like sex, having handkerchief and staying indoor or outdoor. Since the response variable is count, appropriate models for such data were used.

Results and Conclusion: The Poisson results shown that there exist overdispersion, hence, a model that can account for the dispersion parameter was used to obtain accurate results. The results of the analysis shown that there is no association between the number of time a person touches face and sex, having handkerchief or staying indoor. The expected number time people touch their faces within 120 seconds is twice while the minimum and maximum number of times are zero and eight respectively.

Recommendation: It is recommended that there ought to be adequate public enlightenment and sensitization on the peril of the novel COVID-19 pandemic and the reason why individuals ought to stick carefully to the exhortation of abstaining from touching of faces (without washing with soap and water) so as to forestall its spread. If a person's hands are contaminated with the virus, he/she isn't infected until he/she touches the face (nose, eye or mouth) with the hands unwashed.

Open Access Original Research Article

Fever Cases Associated with Plasmodium falciparum Malaria Infection among Children Attending a Tertiary Health Facility in Imo State, Nigeria

C. I. Okoro, F. C. Ihenetu, K. E. Dunga, K. Achigbu, C. C. Obasi, K. K. Odinaka, E. S. Anikwo

International Journal of TROPICAL DISEASE & Health, Page 7-14
DOI: 10.9734/ijtdh/2020/v41i530274

Background: Malaria is a major cause of fever in endemic countries, although the prevalence of malaria has been declining across Sub-Saharan Africa, the proportion of clinical presentation attributable to febrile illness due to malaria to febrile illnesses have remained high. It is therefore important to determine the proportion of fever cases attributable to malaria.

Methods: A descriptive cross sectional study was conducted among children aged 1-72 months presenting at a tertiary facility in Imo state Nigeria from 1st March, 2014 to 31st October, 2015.

Children between 1-72 months of age with documented fever at presentation or history of fever in the last 24 hours without signs of severe malaria and those without any history of anti-malarial drugs administration were considered eligible. Fever was regarded as axillary temperature of ≥37.5°C. For all subjects (febrile and afebrile), the presence of Plasmodium falciparum was assessed microscopically by a WHO Certified malaria microscopist. Malaria parasite density was grouped as 1-1000, 1001–10000, and >10,000 parasites/µl respectively according to World Health Organization guidelines for grouping malaria parasitamae while data was analysed using SPSS 20.1v.

Results: Overall malaria prevalence of both febrile and afebrile at point of assessment but with history of fever in the last 24 hours was 24.3%. Prevalence by microscopy was 26% among the 289 children who were febrile as at point of examination. There was no significant difference (p>0.05) between malaria prevalence in males as against females.

Age group 49-72 months had the highest prevalence (42.6%), while age groups 25-48 and 1-24 months recorded prevalence of 35.7% and 25%, respectively (P<0.05). About 22.5% of afebrile patients had positive Plasmodium parasitaemia. The Geo-mean (range) of parasitaemia was 1427(8-180,000) parasite/µl while mean body temperature ± SD was 37.0±0.9°C. About 8% of the children had high parasite density.

Conclusion: Plasmodium falciparum although linked with majority of fever is not the cause of fever in all instances. Healthcare providers should make more effort to correctly diagnose non-malaria febrile cases so as to optimize clinical outcomes for the patients and minimize possible over diagnosis and overtreatment of malaria.

Open Access Original Research Article

Prophylactic Effect of Ethanol Extract of Azadirachta indica Leaf in Streptozotocin-induced Diabetic Rats

O. C. Ezeigwe, C. J. Ononamadu, M. E. Onuegbu, O. R. Ikpeogu, I. C. Agugom, F. A. Ejiofor, U. E. Ezeokoye, U. H. Cornel-Ilokolobia

International Journal of TROPICAL DISEASE & Health, Page 15-27
DOI: 10.9734/ijtdh/2020/v41i530275

Background: Medicinal plants are now becoming indispensable in the treatment and management of many ailments. The unaffordability, unavailability and adverse effects of conventional therapy in the treatment and management of many diseases have geared keen interest in the use of herbal medicine. This work was carried out to investigate the prophylactic effect of the ethanol extract of Azadirachta indica leaf in streptozotocin-induced diabetic rats.  

Methods: A total of one hundred (100) rats were randomized into four (4) groups (n=25) and used for the study. Each group of 25 rats was sub-divided into five (5) groups (n=5). The sub-groups comprise: Group A-normal control that was not treated, group B-100 mg/kg body weight of metformin and groups C to E - graded doses (100 mg/kg, 200 mg/kg and 400 mg/kg body weight) of the ethanol leaf extracts of A. indica leaves. The standard drug and the extracts were consecutively administered to groups B-E for 7, 14, 21 and 28 days before the induction of diabetes. Diabetes was induced intraperitoneally using 50 mg/kg bodyweight of streptozotocin.

Results: The groups that were administered 100, 200 and 400 mg/kg bw of ethanol extract of A. indica showed a significant (p<0.05) increase in their weight after 21 and 28 days of pre-treatment compared with the control group that was not treated. The graded doses of the extract also have a remarkable effect in the fasting blood glucose levels which was made visible by the significant (p<0.05) reduction recorded in the fasting blood glucose levels compared with the control group that was not pre-treated and the group pre-treated with metformin.

Conclusion: The results obtained in this research suggest that ethanol extract of A. indica has the potential to protect against diabetes by delaying its onset. However, the longer the period of pre-treatment, the better the condition of the animals pre-treated as well as the protection as can be seen from the results of the weight and fasting blood glucose levels.

Open Access Original Research Article

Potential Risk Factor for Malaria Infection in Banjarnegara, Indonesia: A Matched Case-control Study

Sulistyawati Sulistyawati, Rokhmayanti Rokhmayanti, Maririn Devi Pradita

International Journal of TROPICAL DISEASE & Health, Page 28-35
DOI: 10.9734/ijtdh/2020/v41i530276

Context: This research is performed in Banjarnegara, an endemic malaria area in Indonesia. Considering the incidence of malaria in Indonesia in the last ten years, it is essential to assess the potential risk factors to maintain the cases and to accelerate malaria elimination.

Aims: This study examined the potential risk factors from the human socio-economic aspect and human behavior for malaria cases.

Settings and Design: This is a match case-control study conducted in 34 cases and 34 controls in Banjarmangu Subdistrict, Banjarnegara, Indonesia. The subjects for the two groups were based on the routine report of Banjarmangu I public health center from July 2017–March 2018. Inclusion and exclusion criteria were applied to select the subject.

Statistical Analysis: Logistic regression was used to seek the association among the variables.

Results: This research found that installing wire netting, not sleeping under a bed net, and consuming higher transportation costs were significant protective factors for malaria cases. Having lower family income was significant as a potential risk factor for malaria cases (OR=10.68, CI = 1.01-112.59).

Conclusions: This study may explain that economic income was the essential aspect of malaria prevention as it contributed to the other health issues, such as health-seeking behavior.

Open Access Original Research Article

Update of the Evolution of SARS-CoV-2 Infection, COVID-19, and Mortality in Mexico Until May 15, 2020: An Ecological Study

Nicolás Padilla-Raygoza, Cuauhtémoc Sandoval-Salazar, Luis-Antonio Díaz-Becerril, Vicente Beltrán-Campos, Daniel Alberto Díaz-Martínez, Efraín Navarro-Olivos, María de Jesús Gallardo-Luna, Francisco J Magos-Vazquez, Ma Guadalupe León-Verdin

International Journal of TROPICAL DISEASE & Health, Page 36-45
DOI: 10.9734/ijtdh/2020/v41i530277

Aims: Disease for a novel coronavirus has been a big public health challenge around the world in the past several months. The aim of this study is to describe the epidemic and report the number of confirmed cases and deaths of disease for a novel coronavirus in Mexico until May 15, 2020.

Study Design:  Ecological study.

Place and Duration of Study: Registries of confirmed cases for disease for a novel coronavirus in Mexican population during January and until May 15, 2020, from National System of Epidemiological Surveillance/ General Direction of Epidemiology/ Secretary of Health, Mexico.

Methodology: Based on the database of confirmed cases of disease for a novel coronavirus by Secretary of Health in Mexico, we collected data on age, gender, and deaths, and co-morbidities. As of May 15, 2020, 45,032 cases have been identified in Mexico. 

Results: The first confirmed case in Mexico has been identified on January 8, 2020 and the incidence has been rising from the end of February and throughout March. The early confirmed cases were imported cases resulting from travel to USA, Italy, Germany, Spain, France and Singapore. No one travelled to China. No cases of community transmission have been reported. The cause-specific mortality rate was 10.59% and the possibility to death is three times more if comorbidities are in the patient.

Conclusion: The frequency of confirmed cases of disease for a novel coronavirus in Mexico are concerning and the health authorities in Mexico are waiting for the peak of the epidemiological curve to occur in May. The mortality is high with co-morbidities.

Open Access Original Research Article

Chronic Nonhealing Ulcers ‒ Garhwal Region (Etiopathology, Microbiology with Susceptibility, Managements & Outcomes)

Keshri Amit, Mukul P. Bhatt, Santosh Kumar, K. Punita

International Journal of TROPICAL DISEASE & Health, Page 53-64
DOI: 10.9734/ijtdh/2020/v41i530279

Introduction: Chronic nonhealing ulcers, with varied etio-pathologies, are difficult to manage and warrant meticulous, early and prolonged directed treatment to prevent their development and complications.

Methods: Patients of chronic ulcers (>3 months’ duration), having undergone surgical management at our Institute, VCSGGMS&RI-UT, between January 2018 – August 2019, numbering one hundred twenty five (N= 125), were included in this concurrent observational study, aimed at identifying implicated microrganism (s) and their antibiotic susceptibility, for promoting wound healing, along with surgical measures.

Results: Male patients (M:F :: 87:38; 69.6% males) in the “20-50 year” age-group (74; 59.2%), with diabetic ulcers (35;28.0%), burns etc. (21;16.8%) and traumatic ulcers (18;14.4%) etc. predominated in the chronic non-healing state. Gram positive (68; 54.4%) organisms (including Staphylococcus) were the major isolates from the ulcers; organisms showing higher sensitivity to the newer generations/groups of antibiotics. Uncontrolled Diabetes, other prolonged illnesses &/or under-nutrition were important causative factors, requiring their remediations and also debridements ± skin/flap coverage (45; 36.0%) with prolonged course of antibiotics and occasional amputations (18; 14.4%) for adequate treatment.

Conclusion: Skilled intensive multidisciplinary effort is essential to achieve satisfactory healing and prevent disfigurement and to limit disability and death (11; 8.8%) among the patients.

Open Access Original Research Article

Association of Foetal Outcome with Maternal Body Mass Index (BMI)

Tanzina Iveen Chowdhury, Tasrina Rabia Choudhury

International Journal of TROPICAL DISEASE & Health, Page 65-76
DOI: 10.9734/ijtdh/2020/v41i530280

Background: The worldwide obesity epidemic continues to be a major public health challenge, particularly in women of childbearing age. There is a need to understand the associations between maternal BMI and perinatal outcome.

Objectives: To evaluate recent trends in maternal body mass index (BMI) and to quantify its association with foetal outcome.

Methodology: It is a cross sectional study including a total of 384 pregnant women who were primi gravida and carry singleton pregnancy admitted at term in the department of Obstetrics and Gynaecology of DMCH for the management of labour. All the mothers were chosen by purposive sampling. The study populations were classified into four groups according to BMI. Group-I stands for 44 mothers who are underweight, Group-II consists of 234 mothers who are normal weight, Group III represents to 81 mothers who are overweight and Group IV signifies for 25 mothers who are obese. The women with multiple pregnancies, preterm labour and hypertension or diabetes were excluded from the study. Data regarding socio demographic, clinical, obstetrical and foetal outcome were recorded, afterwards the data were edited, managed and analyzed. The observations were plotted into tabular and figure form. The categorical variable was analyzed by chi square test and the quantitative variables were analyzed by ANOVA test. At all level 95% confidence interval & level of significance was p <0.05. The statistical analysis was done by SPSS version 23.

Results: The mean BMI of mothers in different groups (Group I, Group II, Group III and Group IV) were 18.37±1.06 kg/m2, 23.77±2.03 kg/m2, 26.54±2.47 kg/m2 and 32.15±1.17 kg/m2 respectively. The average BMI of total 384 mothers was 22.75±4.56 kg/m2. The highest 84% newborn had birth weight >2.5 kg in Group IV whereas 72.7% had ≤2.5 kg birth weight in Group I. Maximum (57%) mothers underwent NVD in Group I as long as the paramount (71%) mothers endured LSCS in Group III. Out of 384, total 180(46.9%) mothers had NVD and 204(53.1%) mothers deferred LSCS. APGAR score ≤7 was found 31.8%, 12.8%, 38.3% and 20% in Group I, Group II, Group III and Group IV independently. The P-value showed statistically significant of the groups (P=0.00016). Among 204 LSCS, 167(81.9%) mother sustained emergency and 37(18.1%) undertook elective LSCS. 52.9% of mothers went through LSCS were due to meconium staining liquor in Group IV which was subsequently followed by 46.6% in Group-III. 25.0%, 9.8%, 32.1% and 16% neonates required NICU admission in Group I, Group II, Group III and Group IV severally. There was a moderately positive significant correlation between maternal BMI and neonatal birth weight (r=+.383, p<0.001). All the statistics of requirements of NICU between one another group showed statistically significant difference.

Conclusion: Our study shows that maternal BMI has an effect on foetal outcome. Low BMI is associated with adverse perinatal outcome in terms of low birth weight while high BMI is associated macrosomia, LSCS and neonatal NICU admission. Regarding NICU requirements overweight mothers had more association with foetal outcome rather than obese. Therefore, definitely there is a role of pre pregnancy counseling regarding maintenance of weight of women especially during reproductive age group to maintain normal BMI as to have better perinatal outcome.