Open Access Original Research Article

Prevalence of Candida albicans among Female Patients in Two Selected Hospitals in Owerri Metropolis, Imo State Southeastern Nigeria

M. O. Nwachukwu, J. N. Azorji, P. C. Onyebuagu, L. A. Adjeroh, S. N. Nmezi

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/ijtdh/2020/v41i930313

The incidence of candidiasis in the female reproductive tract is a serious threat to public health. This study assesses the prevalence of Candida albicans among female patients in the two selected hospitals in Owerri metropolis. A systematic random sampling technique was used to select 120 female patients between the ages of 16-56 years. Only patients who showed no symptoms of urinary tract infections and who were not on anti-fungal therapy at the time of the study were included in the study. A well-structured interview questionnaire was used to source information on socio-demographic characteristics of the respondents as well as the risk factors of Candida albicans infections. High Vaginal Swab (HVS) was aseptically collected from each of the patients, using a sterile swab stick. The collected samples were labeled appropriately and immediately sent to the microbiology/mycology lab for analysis. The HVS samples were respectively streaked directly into sabouraud agar plates and incubated anaerobically at 37oC for 48 hours. Yeast growth characteristics were noted. Positive colonies were sub-cultured in Macconkey agar to obtain pure isolates. The Candida albicans were properly identified and confirmed by germ tube test, gram staining and biochemical tests. The results showed that the overall prevalence of Candida albicans among the women was (53.34%). The prevalence was highest among the patients in the age group 16-25 (44.17%), lower education qualification (n=65, 54.17%) and pregnant women (n=44, 36.67%). The possible risk factors for the infection include use of antibiotics (n=85, 70.83%), use of nylon underwear (n=78, 65.00), use of public toilet (n=90, 75.00%), use of squat WC (n=59, 9.17%) and use of oral contraceptive (n=59, 49.17%). The results call for preventive measures to protect women. Therefore public health education and campaign should be adopted.

Open Access Original Research Article

Pregnancy Malaria: Predisposing Factors, Burden and Management in Agrarian Settlements Southeast Nigeria

Emmanuel Ikechukwu Nnamonu, Obiageli Constance Ejilibe, Pamela Amarachi Ndukwe- Ani, Godwin Chigozie Nwosu, Cyril Ali Imakwu, Kingsley Chukwujindu Ezugwu, Casmir Chiebuka Ekwueme

International Journal of TROPICAL DISEASE & Health, Page 22-33
DOI: 10.9734/ijtdh/2020/v41i930315

Aim: To evaluate predisposing factors, burden and management of malaria amongst pregnant women in some agrarian settlements southeast Nigeria.

Study Design: Cross-sectional survey conducted in 4 randomly selected agrarian communities was conducted.

Place and Duration of Study: Isi-Uzo Local Government Area (Eha-Amufu, Ikem, Mbu, Neke and Umualor). The study lasted six months.

Methodology: A total of 385 respondents participated. A cross-sectional survey was conducted in 4 randomly selected agrarian communities was conducted. Data were collected using a structured questionnaire.

Results: Obstetric and socio-demographic characteristics of the participants showed that majority were age-bracket 25-34 (42.6%), 1st trimester (56.4%) and multigravidae (52.8%), primary education group (32.2%), secondary education group (55.6%), farmers (73.1%) and Christians (93.5%). All the respondents (100%) agreed to the presence of overgrown bushes in their environs, many farming activities which is the main source of income and staying out late at night for relaxation. A high percentage of the women experienced fever (57.9), headache (61.6), cough & catarrh (54.5) and anorexia (53.8) monthly reflecting high malaria frequency in the locale. 20.3% had experienced stillbirth, 82.6% neonatal death and 65.5% infant mortality once, twice or more. And according to (58.7%) and (38.7%) of respondents, malaria moderately and highly affects their productivity during pregnancy respectively. Respondents that seek health/treatment in hospitals (50.9) differ insignificantly from those that seek health through traditional remedies (49.1). Cost of treatment was reported to be high and moderate by 31.9% and 65.5% respondents respectively. Poor health care delivery was implicated as major dissatisfaction with treatment by 76.4% of respondents.

Conclusion: Malaria is a major health problem encountered by pregnant women in agrarian locales. Hence, girls should be exposed to malaria awareness programs an earlier stage of life.

Open Access Original Research Article

Determinants of Anemia, Diabetes and Hypertension among Urinary Tract Infected Pregnant Women Attending in a Selected Hospital, Kathmandu

Shikha Thakur, Komal Lata Nagpal

International Journal of TROPICAL DISEASE & Health, Page 34-40
DOI: 10.9734/ijtdh/2020/v41i930316

Aims: Urinary tract infection (UTI) occurs in all age groups, more common in women due to short urethra and its close proximity to anus and vagina. UTI is defined as “microscopic finding of >10 pus cells/high power field (40x) in urine”. The purpose of the study is to find the risk factor associated with pregnancy and the different non-communicable diseases (Anemia, Diabetes and hypertension) of UTI.

Study Design: A cross-sectional comparative study.

Place and Duration of Study: The study was carried out under the supervision of OPJS University and field study was carried out in Kathmandu, Nepal from March 2019 to October 2019.

Methodology: An analytical cross-sectional study was done among UTI pregnant 510 women aged 18 years to 45 years. A convenient sampling technique was used. A structured questionnaire was designed to collect the data. Descriptive statistics along with unadjusted Odds Ratio (95% CI) and a P < 0.05 was considered significant for data analysis.

Results: Anemia, diabetes and hypertension among UTI infected pregnant women was 62.7, 32.9 and 30.2 respectively. There were significant associations between educational status, ethnicity, age and occupation of UTI infected pregnant women with anemia, diabetes and hypertension. Similarly, there was a significant association between gestational period, gestational age at the beginning of prenatal care, the gender of the infant, history of delivery and Anemia, diabetes and hypertension.

Conclusions: Based on the findings the study concluded that, anemia, diabetes and hypertension remain a prevalent problem of UTI infected pregnant women.

Open Access Original Research Article

Value Addition on Trend of Tuberculosis Disease in India- The Current Update

Praveen Kumar Gupta, Mohammed Haseeb Nawaz, Shyam Shankar Mishra, Roshmee Roy, E. Keshamma, Shreya Choudhary, Apoorva Saxena, Ryna Shireen Sheriff

International Journal of TROPICAL DISEASE & Health, Page 41-54
DOI: 10.9734/ijtdh/2020/v41i930317

Tuberculosis (TB) is infectious diseases were the lungs are mostly affected. It is caused by the Mycobacterium tuberculosis bacteria and is spread when a person already affected with TB coughs, sneezes, spits, laughs, or talk. Even though it’s is contagious does not easily catch i.e. chances of catching TB are much higher with someone you live with or work than from a stranger. Multidrug-Resistant TB (MDR-TB) arises when the antibiotic fails to kill bacteria. MDR-TB can be treatable and curable with specific anti-TB drugs but unfortunately, these are limited in quantities or not readily available. As per WHO around 4,50,000 people developed MDR-TB in the year 2012. People with a weak immune system are at maximum risk of active TB development. For instance, HIV conquers the immune system, making it harder for the body to control TB bacteria. People infected with both HIV and TB are 20-30% more probable to develop active TB than those who do not have HIV. Besides, WHO estimates, every year 9 million people get sick with TB and 3 million with these are “missed” by health systems. Among the top 3 causes of death in women between 15- 44 TB is one the major cause. The symptoms of TB may be mild for many months and can infect 10-15 other people through close contact. This study involves a comparative evaluation of the presence of Tuberculosis concerning factors such as socioeconomic status, sex ratio, age, addiction of nicotine or alcohol, etc. All the screenings were based upon various methods of diagnosis used in pulmonary tuberculosis such as Ziehl Neelsen staining, culture on L.J media, Petroff’s concentration method, and DNA PCR method.

Open Access Original Research Article

Prevalence of Human Intestinal Helminthic Infections among School-Age Children in Calabar, Cross River State, Nigeria

Usang Anok Ukam, Imalele Edema Enogiomwan, Effanga Emmanuel Offiong, Osondu-Anyanwu Chinyere

International Journal of TROPICAL DISEASE & Health, Page 55-63
DOI: 10.9734/ijtdh/2020/v41i930318

Aims: The study aimed at determining the prevalence and risk factors for intestinal helminth infection among school-age children in Calabar, Cross River State, Nigeria.

Study Design: Cross-sectional observational study was conducted in two Local Government Areas (Calabar South and Calabar Municipality) in Calabar.

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

Methodology: Faecal samples were collected from pupils in sterile dry specimen bottles with the use of applicator sticks and analyzed using sedimentation and floatation techniques. Data obtained was analyzed using Statistical Package for Social Sciences (SPSS) version 21.

Results: Overall prevalence of intestinal helminth was 18.5%. Parasites recovered were Ascaris lumbricoides (9.3%), Trichuris trichiura (4.0%), Hookworm (2.6%), Taenia solium (0.9), Enterobius vermicularis (0.9), Strongyloides stercoralis (0.4%) and Schistosoma mansoni (0.4%) (P = 0000). Males (22.1%) were more infected than females (14.0%) in the study area (P = 0.031). Prevalence of intestinal helminths was lowest in age group 11-15 years (14.4%) and highest in age group 6-10 years (23.5%) (P = 0.005). After multivariate analysis, source of water [OR=3.355, 95% CI 1.448 – 7.770], type of sewage system [OR=7.547, 95% CI 5.011 – 8.358], hand washing before meal [OR=4.069, 95% CI 1.719 – 9.631] and hand washing after defecation [OR=2.281, 95% CI 1.059 – 4.917] were statistically associated with the detected intestinal helminthic infections in faecal samples (p = .05).

Conclusion: The presence of these intestinal parasites in these schools is a public health problem and there is therefore a need to prevent these infections by improving individual personal hygiene through health education, general sanitation and provision of adequate social amenities.

Open Access Original Research Article

Malaria Prevalence in Rice Farm Settlements South East Nigeria

Emmanuel Ikechukwu Nnamonu, Ogonna Christiana Ani, Felix Joel Ugwu, Simeon Ikechukwu Egba, Ifeanyi Oscar Aguzie, Obiageli Panthe Okeke, Christian Enyi Dialoke, Lilian Obinna Asogwa, Solomon Ikechukwu Odo

International Journal of TROPICAL DISEASE & Health, Page 64-74
DOI: 10.9734/ijtdh/2020/v41i930319

Aim: Agrarian settlements in Nigeria possess a lot of factors that predisposes the populace to malaria. The present study focused on the evaluation of three-year prevalence of malaria in rice farm settlements, South-East Nigeria.

Study Design: The study was a retrospective descriptive survey designed to evaluate the prevalence of malaria infection between January 2015 and December 2017. A total of 29, 458 records were examined, 21, 559 and 7, 899 from Ebonyi and Enugu States respectively for three years (2015 – 2017). Male comprises 11, 453 of the records while the female was 18, 005.

Place and Duration: Southeastern Nigeria \ three years

Methodology: Preparation of thick films blood smears for microscopy following standard methods.

Results: Overall, 12, 746 (43.3%) were positive for malaria parasites, 7, 651 (35.4%) and 5, 115 (64.8%) from Ebonyi and Enugu respectively.  Prevalence of the infection was similar between male and female in Ebonyi State (35.5% vs. 35.3%, χ2 = 0.044, df = 1, p = 0.834); but significantly higher in female compared to male in Enugu State (69.7% vs. 55.7%, χ2 = 154.808, df = 1, p = 0.0001).

Conclusion: There was high prevalence of malaria infection in rice farm settlements, south-east Nigeria.

Open Access Original Research Article

Estimation of Cardiovascular Risk Factors & Their Relative Impact in Diabetic Mellitus-2 Adult Patients’ in Mnazi Mmoja Hospital - Zanzibar

Mohammed S. Juma, Chukwuma J. Okafor, F. A. Dida, Said Ali Yusuf, Salum S. Salum

International Journal of TROPICAL DISEASE & Health, Page 75-83
DOI: 10.9734/ijtdh/2020/v41i930322

Diabetes is characterized by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. We aimed to estimate the cardiovascular risk factors and their correlation with type 2 diabetes mellitus (T2DM) in Zanzibar (Mnazi MMoja Hospital) hypothesizing that early detection and treatment of lipid abnormalities can minimize the risk for atherogenic cardiovascular disorders and cerebrovascular accident in patients with T2DM.

Methods: The study populations were those patients who presented themselves at Mnazi Mmoja hospital with T2DM, and who are within the age bracket of 18 to 45 years. Fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels were evaluated. Pearson’s correlation studies were performed between the variables of blood glucose and serum lipid profiles and also within the lipid profile parameters.

Results: TC, TG, LDL-C mean levels were significantly higher in diabetics compared with the control subjects p< 0.05. The HDL-C was however lower in diabetics compared with the controls. Also, the mean FBG, TC, TG, and LDL-C were significantly higher in female diabetic subjects compared to the male counterparts p< 0.05. A positive correlation was observed between FBG and TC, TG and LDL-C (r=0.643 p=0.0021; r=0.679, p=0.0001; r=0.534, p=0.0091 respectively) while HDL-C showed a negative correlation (r= -0.799, p= 0.0021). TC also showed a positive correlation with TG and LDL-C (r=0.590, p=0.0021; r= 0.628, p=0.0001) and negative correlation with HDL-C ( r=-0.670, p=0.0041).

Conclusion: There is an influence of gender on cardiovascular disease risk factors with more of the females seriously at risk. Measurement of serum lipid profile should be introduced to the management plan of diabetes mellitus. There is an urgent need for the establishment of regional and national training courses for diabetic educators and also the creation of new evidence-based management plan for diabetics in Zanzibar for a better healthcare.

Open Access Review Article

Effectiveness of Community Based Interventions in Reducing Maternal Mortality in Sub-Saharan Africa: A Systematic Review

O. Orjingene, J. Morgan

International Journal of TROPICAL DISEASE & Health, Page 9-21
DOI: 10.9734/ijtdh/2020/v41i930314

Background & Aim: Maternal mortality ratio for sub- Saharan Africa in 2010 was estimated to be about 600 per 100,000 live births, which is approximately higher than what is obtainable in advanced countries. To this end, several community-based interventions have been put in place by governments and developmental partners in the region to address the situation. This review aimed to seek evidence from existing literature on the level of effectiveness of these interventions in improving maternal health outcomes in the region. The literature search process resulted in retrieval of six full text studies that were written in English, published between 2000 and 2019 and were focused on intervention based at the community level which resulted in the reduction of maternal deaths in some sub-Saharan African countries. The Critical Appraisal Skills Programme (CASP) tool was used to critically review retrieved literature.

Findings: Findings from the articles reviewed show that community based interventions with direct reduction on maternal mortality were implemented in Ethiopia and Nigeria and were effective since maternal mortality declined by 64% and 43.5% respectively. Other community based interventions did not directly address reduction in maternal mortality but rather addressed leading causes of maternal mortality such as home and unskilled birth attendance, low Ante-Natal Care (ANC) & Post-Natal Care (PNC) services utilization, Eclampsia, delay in accessing care  and Postpartum Hemorrhage (PPH). Such interventions were implemented in Nigeria, Zambia, Tanzania and the Democratic Republic of Congo and were proved to be effective in reducing maternal mortality.

Conclusions and Recommendations: Based on the literatures reviewed, it was concluded that community based interventions were effective in reducing maternal mortality in Sub-Saharan Africa. The following recommendations were made based on gaps observed in the implementation of some interventions. Introduction of emergency transport scheme in countries where they do not exist as despite the existence of maternity waiting homes and dedicated maternity ambulances in Zambia, many expectant mothers still had difficulty reaching the health facilities in time to deliver, Engagement and training of more health workers so as to avoid human resources challenges that may be associated with increased demand for health facility deliveries.