International Journal of TROPICAL DISEASE & Health

The “Type of Article” of this paper is “Letter to the Editor”. This paper discuses about: “Challenges of Indian Health System Supporting Migrant Healthcare during a Pandemic”. No formal abstract is available. Readers are requested to read the full article.

Pneumonia continues to be the leading infectious cause of death among children under the age of five worldwide. Diagnosis of this disease is primarily dependent on physical examination, clinical history, and radiographic studies. Microbiological studies of the lower respiratory tract secretions have proven to be futile, however, sputum gram staining and culturing methods often aid in the diagnosis and management of these infections. Aspiration pneumonia often occurs in a community setting and primarily involves anaerobes like Staphylococcus aureus or gram-negative rods such as Klebsiella pneumonia, and other Enterobacteriaceae and Pseudomonas species. The total number of cases taken in the study of acute pneumonia was 22 (15 male subjects and 7 female subjects). Biochemical tests were conducted for identifying different organisms present in the samples collected from patients suffering from acute pneumonia. Distribution of bacteria in the case of acute pneumonia was as follows: Staphylococcus aureus was recorded to be the highest (36.36%) followed by Streptococcus pneumonia (18.18%) and Klebsiella pneumonia (18.18%), Pseudomonas pneumonia (13.63%), Haemophilus influenza (9.09%) and lastly Chlamydia pneumonia (4.45%). A maximum number of laboratories proven acute pneumonia cases (36.36%) belonged to 61-70 years. The distribution of cases was marginally more in urban areas (63.63%). By occupation largest group (36.36%) was of others in case of acute pneumonia were as farmers, housewives and others were the largest groups (22.73%) each. The microbial etiology derived from the present study found that Klebsiella pneumonia was an independent risk factor for mortality in severe community-acquired pneumonia. Moreover, two important findings were drawn from this study. K. pneumonia was identified as the causative pathogen in 22% of cases, second to S. pneumonia.

Aims: This study aimed at determining the prevalence, infection intensities and risk factors associated with Schistosomiasis (SCH) and Soil transmitted helminthiasis (STH) among school aged children (SAC) in Tiko Health District (THD).

Study Design: A community-based cross-sectional study was conducted in three health areas (Likomba, Holforth and Tiko town) in Tiko Health District.

Place and Duration of Study: The study was carried out in THD from July to October, 2018.

Methodology:  The study included 464 children of both sexes aged between 4 – 15 years. Stool and urine samples were collected from 464 children and processed using the Kato Katz and Urine filtration techniques respectively. Information on socio-demographic characteristics and risk factors were collected using structured questionnaires. Data was analyzed using SPSS version 25 with statistical significance set at p< 0.05.

Results: Of the 464 SAC examined, the overall prevalence of Schistosomiasis, STH and Schistosomiasis/STH co-infection rate in THD was 16.16%, 14.44% and 0.43% respectively. Females (18.98%; 14.81%) were more infected with Schistosomiasis when compared to STH than males (13.71%; 14.11%). The order of STH prevalence observed was Ascariasis (9.27%) > Hookworm disease (3.88%) > Trichuriasis (1.29%). The mean infection intensity for Urinary Schistosomiasis and STH was 4.36 eggs per 10ml and 11.74 eggs per gram (EPG) respectively. SAC residing in Likomba HA were significantly at higher risk of Schistosomiasis (aOR: 4.40, P=0.008) and STH (aOR: 2.14, P = 0.031). Use of tap water was associated with STH.

Conclusion: Tiko Health District can be considered as a moderate-risk zone for Schistosomiasis and a low risk zone for STH infection according to WHO classification.

Background: Schistosomiasis and Malaria are among the most prevalent afflictions of humans who live in areas of poverty in the developing world. The present study was aimed at determining the socio demographic characteristics and prevalence of schistosomiasis and malaria in children living in Suburb of Malentouen Health District and analyzing the effect of co-infection on haemoglobin level, mean corpuscular volume and platelet count.

Methods: Questionnaires were distributed to parents or guardians of children attending public primary school in the area. A total of 429 pupils aged 6-15 years old were screened for urinary schistosomiasis and 228 out of the 429 were tested for. Prevalences of the two parasites were calculated; Haemoglobin level, Mean Corpuscular Volume and platelets count of the 228 participants were recorded.

Results: The prevalence of malaria was 26.75%, where as that of schistosomiasis was 43.82%. 31(13.60%) of the participants were co-infected with the two parasites. Mean haemoglobin level obtained was 11.01± 1.19 G/dL, that of MCV was 84.50±5.31/fl and the mean platelet count was 255.13±96.99/µl. In malaria single infected and co-infected participants, low haemoglobin level (c² = 50.315, p = .000), low MCV (c² = 27.448, p = .000) and low platelets count (c² = 37.253, p = .000) were observed with significant variations.

Conclusions: The three haematological parameters analysed in this study (Hb, MCV, Platelets count), showed low level or amount in malaria and malaria-schistosomiasis infected participants. Moreover, thrombocytopenia in children in this endemic area may be useful as supportive diagnostic criteria for malaria in case with low level of parasite number.

The WHO fascicule “Information systems for the evaluation of malaria control programmes” identified as outcome target “the proportion of households targeted for use of nets using at least one impregnated bednet” [1].

The parasitological evaluation of the efficacy of vector control programme is mainly based on the plasmodial prevalence rate evaluated by cross sectional or longitudinal surveys on representative sample of the human population targeted.

For the new “House plasmodial” index we decided to combine the 2 indicators: the classical human plasmodial prevalence and house considering as positive any house with “at least one symptomless inhabitant having at least one positive thick film during the survey”. We used this new indicator when analyzing data gained during 24 regularly done parasitological surveys during 5 years in Capango village where a vector control (VC) programme was implemented using both Long Lasting Nets PermaNet© 2.0 and deltamethrin treated wall lining called ZeroFly© inside every house. Surveys were done during 2 years before VC and 3 years after.

It appeared that the House Plasmodial positive index showed the same trends and level as the classical human plasmodial prevalence and clearly indicated the impact of vector control in reducing the overall plasmodial prevalence in the targeted village.

On the other hand it appeared repeating surveys identified “frequently positive houses” (=found positive in some 50% of surveys) and therefore to be prioritized for control and those “scarcely positive” (20% of surveys).

The House Plasmodial Prevalence index appeared relevant and reliable, interesting to be used in vector control programme while easy to get and should be considered in other epidemiological situation.

Aims: To establish the prevalence and concurrent diseases in outbreaks presenting with respiratory signs, major associated clinical signs and postmortem lesions and proportions of those diseases in clinically and autopsied small ruminants for a proper diagnosis and control strategies.

Study Design: Purposive outbreaks investigation.

Place and Duration of Study: Department of Global Health, School of Life Science and Bio-Engineering (LiSBE), Nelson Mandela Institution of Science and Technology (NM-AIST) between September 2016 and December 2018.

Methodology: We included investigations of outbreaks of diseases presenting with respiratory signs in small ruminants reported from five agro-ecological zones in Tanzania. Small ruminats with clinical signs or postmortem lesions suggestive of respiratory involvement were subjected to clinical or postmortem examination. Samples from all examined animals were tested in the laboratory using conventional polymerase chain reaction (PCR) to confirm the tentative diagnosis.

Results: A total of 205 small ruminats were examined and tested, of these 72.2% and 20.8% were goats and sheep respectively. In goats, 79.1% (117/148) and sheep, 28.1% (16/57) were confirmed to have concurrent infections, and pneumonic pasteurellosis and peste des petits ruminants (PPR) for goats, and PPR for sheep being mostly involved diseases. Contagious caprine pleuropneumonia (CCPP) was detected in 16.1% (n=205) of the animals, and was significantly high in goats (p=0.003, OR=7.3) than sheep. Pneumonic mannheimiosis (prevalence = 9.3%) was less likely to affect goats than sheep (p=0.047, OR=0.38). In goats (n=148), detection of all diseases was significantly (p<0.05) low in clinically examined animals except pneumonic pasteurellosis and PPR, (p =0.056, OR=2.1) and (p=0.096, OR=2.15) respectively, though the difference was not significant. In sheep (n=57), CCPP was significantly (p=0.005, OR=0.17) more likely to be detected in clinically examined animals.

Conclusion: In investigations of outbreaks presenting with respiratory signs in small ruminants, it is important to consider concurrent infections in the interventions and control strategies to be deployed, which may include development and use of multivalent vaccines.

Objectives: This study aims to investigate in secondary databases the prevalence of TB / HIV co-infection in the elderly in the metropolitan region of Belém-Pará, Brazil, in the 2001-2018 historical series.

Methodology: This is an epidemiological, retrospective study with a quantitative approach. Data collection was carried out in the database of SINAN/TB (Notifiable Information System/ Tuberculosis) of the State Secretariat of Public Health (SESPA), using records of confirmed cases of tuberculosis in the elderly in the metropolitan region of Belém, between 2001 and 2018, available for public consultation.

Results: 110 cases of co-infection were found in the elderly between 2001 and 2018 in the Metropolitan Region of Belém, with a predominance of males, aged between 60 and 69 years, mixed race and ignored/blank education. The clinical-epidemiological variables resulted in the prevalence of new cases and in the pulmonary clinical form, in addition to the absence of information in the extrapulmonary form.

Conclusion: The elderly are more vulnerable to pulmonary tuberculosis and HIV infection, and the presence of co-infection in this population is extremely harmful and even fatal. Therefore, conducting early detection is essential for disease prevention, in addition to educational activities aimed at promoting information about the two pathologies, promoting self-responsibility for health, higher rates of appropriate treatment and better cure rates.

Leishmaniasis has spread beyond the traditional areas of the Rift Valley and North Eastern provinces. There is more evidence of emergence and spread of leishmaniasis in Western Kenya. However, there is currently no comprehensive study on knowledge, attitude and prevention practices on leishmaniasis among the risk populations in the endemic Mount Elgon region of western Kenya. This has hindered the protocol for understanding the epidemiology of leishmaniasis. The descriptive survey design study was carried out from April to June, 2019 and it sought for information on KAP related to cutaneous leishmaniasis (C.L) in Mount Elgon region. Using stratified simple random sampling technique, a total of 340 household participants were selected in the study area. Structured questionnaire was used to collect the data. Regarding the responses given to knowledge, attitude and practice, a score of 1 was given for each right response and 0 for unsure responses. Data analysis was conducted using IBM SPSS version 23 statistical software. Descriptive statistics that include frequency and percentage were used to analyze the results. Out of 340 individuals were participated in our study 214 (62.9%) of the participants were males and 126 (37.1%) were females. The result of the present study in terms of knowledge showed that most of the respondents scored less than four items out of six correctly, hence described as having poor knowledge of CL. With regard to attitude respondents believed that CL was a problem in their area and had positive attitude towards the treatment of the disease. The study also found out that majority of the respondents practiced well, as indicated by scoring positively in more than three items. In terms of plants used in the treatment of the disease, Olea europaea, Kigelia Africana, Terminial mollis, Croton macrostachyus, Tylosema fassoglense and Bridella micrantha were mentioned. It was concluded that, people were less knowledgeable, had positive attitude towards the treatment especially using plant extracts could act as the basis for future research on alternative drugs against the disease.

Aims: Explore national and international literature about mortality in elderly caused by COVID-19.

Methodology: An integrative literature review was performed using the databases: Virtual Health Library (VHL), PubMed/Medline (National Library of Medicine and National Institutes of Health/Medical Literature Analyzes Sand Retrieval System Online) and Cochrane Library. The selection of articles occurred from the combination of the descriptors: “Coronavirus Infections”; “Aged” and “Mortality” mediated by the Boolean operator “AND”. After evaluating and synthesizing the articles, the data were analyzed using the IRaMuTeQ software, a program that is anchored in the R software.

Results: After analyzing the identification of textual domains and interpretation, 4 classes emerged: 1) The importance of tests for the control and good prognosis of infection in the elderly; 2) Predictors related to high mortality in the elderly; 3) Comorbidities associated with a high mortality rate; 4) The reasons for the transmission of the virus are more worrying in the elderly.

Conclusion: The elderly population presents different risks for mortality, an example of physiological changes such as immune senescence, critical, social and psychological factors and the presence of comorbidities.