International Journal of TROPICAL DISEASE & Health

Medicinal plants, also called herbal medicine, have been used in traditional medicine practices since prehistoric times. The phytochemical screening of root and shoot extracts of Euphorbia hirta plant commonly known as asthma weed was evaluated using soxhlet and aqueous extract as a solvent to determine the active components. Maceration method was used in extracting the active properties/component. Phytochemical screening of root and shoot extracts revealed presences of saponins, anthranoid anthroqunione, phenol, alkaloid, tannins, phylobatannins and cardiac glycoside. Antibacterial screening of clinical isolates of Staphylococcus aureus, Salmonella typhi, Escherichia coli and Streptococcus pyogenes, using disk diffusion method, showed that in both the aqueous root and shoot extract Streptococcus pyogenes has the highest zone of inhibition of 120 mg with 12mm while least is Escherichia coli that had no inhibition at all. The aqueous extract the root and shoot were more active than the soxhlet solution. Using the aqueous shoot extracts, Streptococcus at 120 mg with 12mm zone of inhibition of Staphylococcus at 90 mg with 9mm. While in the aqueous root extract, Staphylococcus aureus at 100 mg with 10mm, Streptococcus pyogenes at 90 mg with 9m and Salmonella typhi at 80mm with 8mm. Antifungal screening with clinical isolate of candida albicans had highest zone of inhibition 130 mg with 13mm at root aqueous extract while penicillium spp, Aspergillus, spp and Microsporium spp showed no zones of inhibition at both root and shoot extracts. The results obtained suggested that Euphorbia hirta plant can be used in the treatment of ailments caused by the test microorganisms, with particular attention being paid to its aqueous extract.

Background: Soil transmitted helminth infections are Neglected Tropical Diseases (NTD) affecting mostly pupils in developing countries. They seem to lose more and more interest due to the fact that resources and research are being justifiably diverted to more recent priorities such as HIV/AIDS, cancers, tuberculosis and malaria. As a result, specific data on STH infections is often lacking.

Aims: To evaluate the prevalence and intensities of STH parasites among pupils in Penka-Michel Sub-division, West-Cameroon in order to refresh information for a better management of these parasitic diseases.

Settings and Design: A cross-sectional analytic study was conducted from October to December 2018 in Penka-Michel Sub-division.

Methods and Materials: To evaluate the prevalence and intensities of STH parasites among pupils, seven hundred and twenty nine (729) stool samples were collected from pupils aged 4 to 14 years old in 23 randomly selected primary schools. The samples were analysed using the concentration method of Willis and the Mc Master technic.

Results: Out of 729 pupils enrolled, 107 (14.7%) were infected with one or more STH parasite species. The nematodes species identified were Ascaris lumbricoides (9.9%), Trichuris trichiura (5.3%) and hookworms (2.2%). Pupils aged from 8 to 11 years were the most infected (17.3%). Statistically females were more infected with hookworms (2.2%). These parasites occurred as monospecific (84.11%), bi-specific (13.0%) and tri-specific (2.80%) infections. The mean fecal eggs count was 3652.78±8715.93, 266.67±273.81 and 118.75±72.74 for A. lumbricoides, T. trichiura and hookworm respectively. According to faecal concentration of eggs, 88.18% of infections were light.

Conclusion: These results show the necessity of sustainable application of regular deworming, health education and improvements in sanitation among pupils in Penka-Michel Sub-division.

Background: Urinary tract infections (UTIs) are among the most common infections in outpatients in Nigeria. However, antimicrobial drug resistance is a challenge in the treatment of UTIs and therefore, there is need for drug resistance surveillance to guide treatment.

Aim: This study assessed the prevalence and antimicrobial susceptibility patterns of UTIs in a Nigeria population.

Study Design: This was a cross-sectional study involving hospital outpatients.

Place and Date of Study: The study was conducted between September 2012 and February 2013 at Madonna University Teaching Hospital, Elele, Nigeria.

Methodology: Urine sample collected from 115 randomly selected patients was screened by microbial culture for the presence of microbial pathogens. Antimicrobial susceptibility testing was done for the identified isolates to assess the effectiveness of some selected routinely used antibiotics.

Results: Among the 115 subjects, bacteria growth was observed in 49 subjects giving a prevalence of 42.6%. UTI was slightly higher in females (44.8%) than in males (40.4%). A total of 9 bacteria isolates of the following genus; staphylococcus, klebsiella, pseudomonas, Escherichia, enterococcus and proteus species were identified among which Staphyloccus aureus was the most prevalent. Ampicillin was the most effective antibiotics, followed by ciprofloxacin and erythromycin. Staphylococcus aureus, other Staphylococcus species and Escherichia coli were the most susceptible isolates. Most microbial pathogens were resistant to Nitrofurantoin, amoxicillin-clavulanic acid and amoxicillin.

Conclusion: Urinary tract infection showed a high prevalence of 42.6% which was predominant in females. Staphylococcus aureus was the most prevalent bacterial isolate. Ampicillin was the most effective antibiotics followed by ciprofloxacin while most pathogens were resistant to nitrofurantoin, amoxicillin-clavulanic acid and amoxicillin.

Aims: This study compares the sexual behaviour of the residents of Bonny kingdom, Rivers State in pre-intervention and post-intervention periods of a comprehensive HIV/AIDS prevention program carried out by the African Health Project in collaboration with independent research consultants and members of the Ibanise HIV/AIDS initiative in the community for three years from 2009-2012.

Methodology: This is a quantitative survey that used a structured questionnaire among a representative sample of the general population aged 15 – 49 years. Post-intervention survey was conducted three years after the pre-intervention survey. The data obtained include the demographics; age, sex, education, occupation, marital status and sexual related information. Data were analyzed using SPSS version 25.0.

Results: This study comprised 1021 (53.3%) males and 895 females (46.7%) in the pre-intervention survey and 659 (54.2%) males and 556 (45.7%) in the post-intervention survey, mostly aged 15-34 years and had secondary education. More females have ever had sex in both surveys but there was a significant reduction in the percentage of males who have ever had sex from 70.8% to 42.0% in pre-intervention and post-intervention surveys respectively. The rate of sexual activities was very high before intervention among unmarried males (51.6%), age 15-24 years (69.6%), secondary education (50.7%) and graduates (65.9%). However, there was a drastic reduction in these values after the interventions. During pre-intervention survey, 9.4% of females and 13% of males had ever accepted or given gifts exchange for sex while the post-intervention survey showed a decrease into 8.0% among females and 5.5% among males. This proportion was 13.0% among adolescents 15-24 years in the pre-intervention survey and 4.7% in the post-intervention survey. Also, there was 65.0% decrease in the proportion of singles who had ever received gifts in exchange for sexual intercourse after the intervention. A high proportion of the males had multiple sexual partners during the pre-intervention survey (34.6%) but the value reduced to 3.2% after the intervention. Similarly, the percentage of the adolescent who had multiple sexual partners reduce from 22.2% to 2.5% due to the intervention. The pre-intervention survey showed that about 56.0% of males and 81.0% of females had sex with non-marital partners while the post-intervention survey showed that about 71.0% of males and 76.0% of females did same.

Conclusion: The study has shown a significant positive impact of health interventions in improving the sexual behaviour of Bonny residents. However, more and regular interventions are needed in this environment to further prevent the spread of HIV and STIs due to the vulnerability of the residents, especially the adolescents to sexually transmitted infection.There is also need for more study to evaluate the impact of sexual and reproductive health programs for adolescence and adult that already exist in Nigeria in comparison with the HIV intervention outcome.

Background: Gastric cancer accounts for many cancer-related deaths, is one of the top leading cause of cancer-associated mortality. Tumor staging and classification depends upon histological, immune histochemical tests along with the radiological imaging. In the preoperative T staging of gastric cancer, Magnetic Resonance Imaging (MRI) has become principal attention in recent years.

Aim: Evaluating the accuracy of MRI in the preoperative T staging of gastric cancer vis-a-vis post-operative pathological staging.

Methods: A total of 37 patients were initially taken in our study, out of which 13 patients were excluded as they underwent neo adjuvant chemoradiotherapy for the down staging of the tumor. The 24 patients became the sample size of our study and their magnetic resonance imaging (MRI) T stage was correlated with pathological T-stage.

Results: The diagnostic accuracy of T₁ stage by MRI was 87.5%, with 94.7% specificity and 60% sensitivity (n=24, κ -value = 0.58; P-value<0.05). The diagnostic accuracy of T₂ stage by MRI was 87.5%, with 88.2% specificity and 85.7% sensitivity (n=24, κ- value= 0.69; P-value<0.05). The diagnostic accuracy of T₃ stage by MRI was 91.7% with 93.3% specificity and 88.9% sensitivity (n=24, κ -value= 0.82; P-value<0.05). The diagnostic accuracy of T₄ stage by MRI was 95.8%, with 100% specificity and 75% sensitivity (n=24, κ- value= 0.80; P-value<0.05).

Conclusion: Because of high accuracy and specificity in determining the depth of invasion of gastric cancer, MRI proves to be an invaluable diagnostic tool in the preoperative T staging of gastric cancer and therefore is very useful in sidestepping unnecessary surgery by supervising the selection of treatment decisions.

The major problem threatening the continued success of antimicrobial drugs is the development of resistant organisms. This study was designed to determine the occurrence and prevalence of carbapenem resistance among enterobacteriaceae isolated from in-patients attending Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, and also to determine the antimicrobial susceptibility patterns of the organisms isolated. The Methodology involves the use of trypticase soy broth containing 10 μg of carbapenem (imipenem) for primary isolation. The secondary isolation involves the use of MacConkey agar and biochemical (Simmon citrate Agar) for identification, and then antimicrobial susceptibility testing by the disk diffusion method. A total of 191 stool samples from male and female in-patients within the range of 2-60 years were screened for the gastrointestinal colonization of Carbapenem Resistance Enterobacteriacea (CRE). Data were analysed using Statistical Package for Social Sciences (SPSS) windows version 21. The overall prevalence was 15.7% The prevalence rate was found exclusively in males. The highest prevalence was found within the age group of 30-40 years. Escherichia coli, Klebsiella species, Pseudomonas species and salmonella species were the bacteria isolated. The most predominant bacteria isolated were Escherichia coli, accounting for 85 (9.4%) resistant strains, Klebsiella species accounting for 50 (8%) resistant strain, Pseudomonas aeruginosa 21% and Salmonella species accounting for 42 (0%) no resistant strain isolated. The misuse of antibiotics is a major factor responsible for the high rate of bacterial resistance. Improvement on the management and personal hygiene, as well as the appropriate use of antibiotics would reduce the prevalence of Nosocomial Carbapenem Resistance (NCR) especially among prolonged hospitalized patients.

Aim: To uncover information gap on the health extension program contribution in improving access, the study explored the lived experiences towards creating enabling environments for contraceptive service provision and use in light of the health extension program.

Methods: Interpretative phenomenological design was employed for the study. Data were collected using focus group discussions, individual in-depth interviews and key informant interviews. Analysis was done using an interpretive phenomenological analysis framework including phases of data immersion, transcribing, coding, theme development and phenomenological interpretation through the hermeneutic circle.

Results: The finding captures the contribution of the health extension program in accelerating/decelerating contraceptive use in the study area. Contraceptive services organization, access and extension in the era of the health extension program were presented. Since the beginning of the program, contraceptive use has alarmingly improved as witnessed by both the service users and providers. The linkage of primary health care with the community organization, a women development army and the one-to-five network are among the major contributed factors for the outcomes.

Conclusion and Recommendation: The study concludes that the health extension program has given a special momentum in shaping the principles of PHC. The study revealed that women witnessed encouraging involvements in contraceptive service access and use. Hence, the study recommends that the experiences of women development armies and other networks have to be strengthened. Moreover, the existing community networks should be strengthened through proper evaluation and feedback.

Aim: To determine spectrum of bacteria infecting burn wound and its antibiotic susceptibility at Benue State University Teaching Hospital (BSUTH).

Study Design: A one year prospective study of the microbial profile in burn wound infection at BSUTH, Makurdi.

Methodology: All patients admitted from August 2018 to July 2019 with burn wound who had wound swab microscopy culture and sensitivity (MCS) after thorough cleaning of the wound were included in the study. Data collected included the Age, Sex, Occupation, Total Body Surface Area (TBSA) of burn, injuring agent, type of burn, bacteria cultured from the wound, antibiotic susceptibility, number of days of admission and outcome of treatment.

Results: Out of the 63 patients admitted, flame was the predominant injuring agent seen in 54 (85.7%) patients. The age group 21 – 30 years was the most affected, 27 constituting 42.9%. Burn wound infection occurred in 25(39.7%) patients from whom 33 bacterial isolates were recovered. Gram negative organisms Pseudomonas species and Proteus species were the commonest bacteria isolated constituting 21.21% each. Other isolates were Staphylococcus aurous 36.36%, Escherichia coli 15.15%, Klebsiella species and Staphylococcus saprophyticus (each 3.03%,). There was multiple bacteria colonization of wounds and antibiotics resistance. There was no gender difference in the burn wound infection, P =0.7819.

Conclusion: The sensitivity pattern showed many of the bacteria to be resistant to commonly administered antibiotics but sensitivity patterns got are important for empirical antibiotics prescription when patients come with glaring sepsis and are waiting for wound swab microscopy culture and sensitivity. Studying the microbial profile with antibiotic resistance pattern in burn’s wound infection should be a continuous process in all burn units/departments. This will help to formulate and modify at regular intervals, a hospital/departmental antibiotic policy according to the present microbial pattern in the respective burns unit.