Open Access Case Report

Fatal Human Babesiosis in a Nine-Year Old Nigerian Girl

Murtala Muhammad Ahmad, Yahaya Mohammed, Nma Muhammed Jiya, Baba Jibrin, Sabitu Muhammad Zainu, Joy Fatima Legbo, Fatima Abubakar, Ahmed Kolawole Jimoh

International Journal of TROPICAL DISEASE & Health, Page 26-30
DOI: 10.9734/ijtdh/2020/v41i1030326

Background: Babesiosis is a rare emerging opportunistic disease in humans. It is a zoonotic disease caused by protozoan parasites of the genus Babesia and transmitted by Ixodid tick vector. It is often incidentally diagnosed because of its rarity but may be severe or fatal in presentation, particularly in immunocompromised hosts.

Aim: To reportthe clinical presentationof a fatal case of human babesiosis in a nine-year old girlwith retroviral disease, in Sokoto, Northern Nigeria.

Case Report: A nine-year old girl presented with a month history of unremitting fever, cough and weight loss, There was no history of contact with someone with chronic cough and no diarrhoea. She was diagnosed to have retroviral disease (RVD) at age of three (3) years consequent to her mother’s positive test but only the mother was on antiretroviral treatment, due to the claim that the child had remained healthy. Review of her blood film during third week of admission revealed characteristic tetrads (maltese-cross formation) pathognomonic of babesial infection. She was started on anti-babesial treatment with quinine and clindamycin. She succumbed to the illness within second week of anti-babesial treatment.

Conclusion: This report suggested that babesiosis should be a high index of suspicion especially in immunocompromised patients with persistent fever.

Open Access Short Communication

Experience in Prevention and Control Work of Anti-COVID-19 in People's Hospital of Tongchuan City in China

Hu Guizhong, Liu Wanqing, Wang Jianhua, Guo Chunli, . Xiaoli, Bao Yanqi, Liu Xiaohui, Yang Yonghong, Jiao Fuyong

International Journal of TROPICAL DISEASE & Health, Page 22-25
DOI: 10.9734/ijtdh/2020/v41i1030325

Objective: To explore the prevention and control strategies and effects of COVID-19 in People's Hospital of Tongchuan so as to provide evidence for prevention and control of COVID-19 in Tongchuan.

Methods: The measures taken by People's Hospital of Tongchuan from the aspects of sound organization, new coronavirus knowledge training, prevention of nosocomial infection, establishment of elite medical team, scientific and precise treatment and internet application as well as medical treatment were reviewed.

Results: Between 23 January 2020 and 15 April 2020, the hospital had received a total of 6 patients with confirmed COVID-19, among which 3 patients have been discharged. More than 31,000 persons were given pre-examination triage, 2,605 persons were treated for fever at clinics, 596 persons were under isolation and observation, and 184 persons had nucleic acid test, so as to achieve the requirements of no missed diagnosis, no death and no infection goal, which were prioritized by the national, provincial and municipal health inspection teams.

Conclusion: The effective prevention and control strategies against COVID-19 in People’s Hospital of Tongchuan have significantly achieved the "three zeros" goal namely zero infection, zero transmission and zero death.

People's Hospital of Tongchuan, founded in 1949, is a comprehensive level-III first-class hospital. It has two hospitals located in the north and the south, with 1,700 beds and 2,044 employees. It is the first designated hospital for treatment of COVID-19 [1] in the province.

Open Access Original Research Article

Studies on Comparative Hematological and Biochemical Changes in Yankasa Sheep Experimentally Infected with Trypanosoma vivax and Trypanosoma congolense Field Isolates of Nigerian Origin

Christopher Igoche Ogbaje, Idris Alao Lawal, Joseph O. Ajanusi

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/ijtdh/2020/v41i1030323

Background: African Animal Trypanosomosis is one of the key hindrances to full livestock development in most parts of sub-Saharan Africa, despite years of efforts to eradicate the disease. It is an important parasitic disease of human and animals. Control of the disease relies majorly on chemotherapy of one of the three trypanocidal drugs. The severity of haematological indices depends on parasite species, host involved and nutrition. Hence, there is need to assess the pathogenicity and compare their effects on some of our local breeds of livestock.

Methodology: Field isolates Trypanosoma vivax and Trypanosoma congolense of Nigerian origin were used. Thirty sheep were acquired and preconditioned for two weeks in arthropod- proofed pens before the commencement of the experiment. The sheep were divided into five groups (A- T. vivax infected-treated, B- T. vivax infected-untreated, C- No infection, no treatment, E- T. congolense infected-treated and F- T. congolense infected-untreated. Packed Cell Volume, serum protein, WBC, DLC were monitored weekly for 8 weeks.

Results: There was gradual decreased in PCV of all the infected animals which was an indication of anaemia but more severe in T. vivax groups. Also decreased in plasma protein that was more pronounced and prolonged in T. vivax than the T. congolense groups, this was similar with WBC. Neutrophils had initial increased in all the groups before dropping and low value of monocyte at the early period of infections which later disappeared. There was no basophil seen in all the T.vivax groups but few were observed in T. congolense groups.  

Conclusion: Anaemia is a general feature of most parasitic infections especially in trypanosomosis. Trypanosoma vivax used in this study is more pathogenic than the T. congolense, hence may have more negative effects in sheep production in author’s environment.

Open Access Original Research Article

Analysis of HIV/Malaria Coinfections among HIV-1 Infected Individuals in Two Tertiary Hospitals in Old Cross River State, Nigeria

Ugochi Immaculate Ejike, Tochi Ifeoma Cookey, Hope Chioma Innocent- Adiele, Iheanyi Omezuruike Okonko

International Journal of TROPICAL DISEASE & Health, Page 31-41
DOI: 10.9734/ijtdh/2020/v41i1030327

Aims: Human Immunodeficiency Virus (HIV) and Malaria are the two main global public health threats that dent development in low and middle-income countries. This study evaluated the immunological marker and HIV/Malaria co-infection among individuals infected with HIV-1 in old Cross River State, Nigeria.

Study Design: Cross-sectional study.

Place and Duration of Study: University of Calabar Teaching Hospital (UCTH) and University of Uyo Teaching Hospital (UUTH) between March 2018 and August 2019.

Methods: A total of 417 individuals infected with HIV-1 partook in this study. The age of these individuals ranged from 4-72 years (average age = 39.1 years). Plasma samples were analyzed for HIV and Malaria using Enzyme-Linked immunosorbent Assay. The CD4 count was enumerated using the Partec CyFlow® Counter. Plasma viral loads (PVL) were determined using the Abbott Real-Time HIV-1 assay.

Results: Results showed that 230(55.1%) of the participants were in the 31-45 years age range. The majority (67.4%) of the HIV-1 infected individuals were females. An overall prevalence of HIV/Malaria coinfection in Old Cross River State, Nigeria was 14.3%, of which Uyo was 6.3% and Calabar was 3.0%. A higher prevalence of HIV/Malaria coinfection was observed among age groups <25 years (17.5%), males (5.1%), singles or divorced/widow/widower (7.7%), those with primary education (7.5%), and students (10.0%). Higher HIV/Malaria coinfection was also observed among those with CD4 cell count <200 cells/μl and 350-499 cells/μl (5.7%) and PVL >5000 copies/mL (7.9%) compared to others with 2.0% prevalence. Of all variables evaluated only marital status (p= 0.033), educational background (p= 0.000) and occupations (p =0.000) were significantly associated.

Conclusions: This study further confirmed the presence of HIV/Malaria coinfection in old Cross River State, Nigeria. This study has added to the voices on the ground to give a better view on the frequency and the pattern of distribution of HIV/Malaria coinfection since limited studies have been done on this in old Cross River State, Nigeria. This, therefore, highlights the need for a well-structured approach to the management of HIV/Malaria coinfection in Nigeria.

Open Access Original Research Article

Socio-demographic, Economic and Health Profile of Diabetic Patients Attending Some Primary Care Units in the City of Bukavu, Democratic Republic of Congo

Ombeni Mahano Aladin, Ziruka Ntaboba Rachel, Asima Katumbi Florentin, Akonkwa Byamungu Brigitte, Salama Matumaini Béatrice, Birindwa Mulashe Patient, Ahana Bagendabanga Jean, Feza Bianga Viviane, Mushagalusa Kasali Félicien

International Journal of TROPICAL DISEASE & Health, Page 42-53
DOI: 10.9734/ijtdh/2020/v41i1030328

Introduction: Diabetes is a serious health problem; its prevalence is increasing in developing countries. This study aims to describe the socio-demographic, economic and health profile of diabetics attending the primary care units for the management of diabetes mellitus (DM).

Methods: We carried out a cross-sectional study in 2019 on 257 diabetics in seven primary care units (Maendeleo, Funu, Uzima, CBCA-Nyamugo, 8th Cepac-Buholo, Lumu and Charles-Mbogha).To collect the data, we used the survey questionnaire, medical tools and documents; anthropometric tools and statement of the prices (for drugs, laboratory exams and public transport). Results: Most of respondents were female (79.4%), aged ≥ 45 years old (90.27%), with a level of study below secondary education (63.0), without paid employment (71.1 %) with a monthly income < $ 37.5 US (59.92%). Most of them had type-2 diabetes mellitus (93.3%). With family history (48.25%) and comorbidities (hypertension and stroke). All participants were on medication (77.0% on oral glucose-lowering drugs). Once a week glycemic control was assessed in six primary care units, we noted hyperglycemia in the majority of female 68.5% (OR = 2.25; P = 0.02); aged 55 or older 54.9% (OR = 2.62; P = 0.02), not respecting the diet 45.5% (OR = 2.09; P = 0.04) and ate the family meal on a common plate 40.5% (OR = 2.32; P = 0.007). Their monthly expenses covered the assessment of fasting blood sugar, medication, and food purchases. Body Mass Index has represented the increased (31.5% with overweight) and high (23.8% with obesity) disease risk. The waist circumference represented the abdominal obesity mainly in women.

Conclusion: Diabetes is an economic and health burden for the patient, family and community. Primary care units lacked human, material and financial resources to care for diabetics.

Open Access Original Research Article

Demographic Factors Associated with Dengue in Saint Lucia

Brendan Lee

International Journal of TROPICAL DISEASE & Health, Page 54-70
DOI: 10.9734/ijtdh/2020/v41i1030329

Aims: To identify demographic variables associated with dengue in Saint Lucia.

Study Design:  Retrospective quasi experimental study of secondary data.

Place and Duration of Study: Data was accessed from the Ministry of Health Saint Lucia, the Saint Lucia Tourism Authority and the Central Statistics Office Saint Lucia, 2011-2017.

Methodology: This study included 1869 cases tested for dengue between 2011 and 2017 identified through regular surveillance in Saint Lucia. There were 1310 confirmed cases, of which 667 were male and 643 were female. Data on education, employment, and unemployment levels, population density, hospital access and tourist arrivals were accessed from local Saint Lucian agencies to determine their relationships with the occurrence of dengue.

Results: The largest prevalence of dengue from the sample was found in the district of Castries (29.6%) and 25% of the cases occurring in the adult group (19-44). It was found that over 40 % of the dengue cases occurred in the population when between 12500 to 14000 persons (medium level) had tertiary education. Logistic regression of the data allowed the demonstration of strong significant relationships between age, the 13-18-year age group (P<.001, OR 4.091 [CI 2.628-6.369]) and tertiary education (P<.001, OR 4.785 [CI 2.896- 7.905]) and occurrence of dengue.

Conclusion: Age and education, along with other variables such as location, tourist visitor arrival, employment status, and population density were found to be associated with dengue in Saint Lucia. Further research is warranted to better characterize these relationships and understand how they could be used to develop predictive models for use in public health prevention programmes.

Open Access Review Article

A Novel Corona Virus (COVID-19) Pandemic, Pathogenesis, Clinical Features and Management Options, Public Health Measures

Mukoro Duke George

International Journal of TROPICAL DISEASE & Health, Page 11-21
DOI: 10.9734/ijtdh/2020/v41i1030324

Introduction: SARS-CoV-2 is an unknown corona virus causing COVID-19 disease responsible for the ongoing pandemic affecting over 190 countries, with a mortality rate of about 5%. The high mortality rate resulted from its ability to elicit cytokine storm via non-specific immune response with delay in specific immune response, notably worst in the elderly, HIV, immunocompromised and cancer diseased patients. The article therefore provides frontline health care workers, the opportunity to understand and equip themselves with management options, public health measures used in coping with COVID-19 infections and enables personnel to make quick preparation for Symptomatic COVID-19 infection in-order to reduce mortalities in health facilities. It also provides a summarised teaching material for medical and allied health students around the world.

Methodology: Credible data and information were obtained from the World health organization situation report, Johns Hopkins University Corona Virus resource centre and other notable journal publications. Most information was on public domain.

Results: Clinical features reported include pneumonia, renal dysfunction, hepatobiliary dysfunction and residual tissue damage, especially in the lungs in those that survive. The literature highlights the blood work-up picture (Leucopenia, increased cytokines IL-6, ferritin, Serum creatinine, urea, AST, GGT, ALT and Viremia) and radiological features of the disease. ELISA and RT-qPCR test are required for diagnosis using sputum, or pharyngeal swab, blood, serum, urine and faecal samples which lead to faeco-oral transmission. ELISA/RT-PCR is also required for disease exclusions in co-existing epidemics such as MERS-CoV, SARS-COV and other viral diseases. Treatment modalities employed thus far are trials that have produce results including targeted therapy, anti-retroviral, Favipiravir, Remdesivir, antibody-serum and antimalaria drugs such as chloroquine and quinine which are found among some protocols in African setting and other developing countries. Currently, ongoing preventive measures (face mask, social distancing and hand hygiene, community testing, isolation of confirmed cases and tracking of the exposed, remain the key corner-stone in the management of COVID-19 pandemic.

Conclusion: COVID -19 disease still remain unclear to many scientists and its pandemic still ongoing. There are many research and clinical trials ongoing while some drugs are used off-label in-order to mitigate the damage caused by the virus in Human body. Cytokine storm needs immunomodulators and viral targeted therapy as discussed in-order to reduce tissue damage, and eventually morbidity and mortalities from COVID-19 infections.