Open Access Case Study

Multiple Viral Co-infections in a Pediatric Patient of Acute Encephalitis Syndrome (AES) - An Unique Case Report

Maneesh Kumar, Roshan Kamal Topno, Binod Kumar Singh, Major Madhukar, Bheemarao Kamble, Ganesh Chandra Sahoo, Pradeep Das, Krishna Pandey, Alka Singh

International Journal of TROPICAL DISEASE & Health, Page 22-27
DOI: 10.9734/ijtdh/2020/v41i1930384

The occurrence of viral co-infection is always a challenging issue in pediatrics which indicates underestimation of causal viral pathogens. A 6-year-old girl child from Patna had diagnosed a rare case of multi-viral co-infection in February 2020. She was manifested with oblivion along with high-grade fever, weakness, nasal bleed, headache, and body ache. She had altered sensorium with mildly dilated pupils. Her three classical meningeal sign i.e. Kernig's sign, Brudzinski's sign, and nuchal rigidity were found positive. She clinically investigated with a strong suspicion of viral infectivity. Awfully, she was diagnosed with multi-viral co-infection including Japanese Encephalitis, Dengue, Chikungunya, Cytomegalovirus, and Rubella where as HSV and VZV detected borderline. The IgM detection for JE using the CSF sample was found equivocal. The infection was also confirmed by CECT brain scanning. She got proper medication including antiemetic, antipyretic, antiepileptic drugs, antibiotics, anti-viral drugs, and 20% Mannitol for reducing the intra cranial pressure. After medication under proper clinical supervision, she improved completely with any seizures and viral infections. She advised for follow-up after a month. Such occurrences of multi-viral co-infections deserve proper attention and awareness among the healthcare experts about the severity of drugs.

Open Access Policy Article

Policy Brief: Ending Open Defecation in Nigeria

Mary Obidiya Okuku

International Journal of TROPICAL DISEASE & Health, Page 47-54
DOI: 10.9734/ijtdh/2020/v41i1930387

The purpose of this paper is to present a policy brief on ending open defecation in Nigeria. The briefing notes the burden of open defecation (OD) in Nigeria, its causes, the impact of OD practices, successes achieved so far, as well as the failures encountered and offers recommendations to end the practice in order to achieve the sustainable development goal (SDG) 6.2 of ending open defecation globally by 2030 as proposed by the United Nations.

      Key Recommendations:

  • Strong Political Will to uphold and implement policies on sanitation
  • Building more latrines
  • Establishing monitoring team
  • Capacity building
  • Sustainable job creation
  • Improved communication strategy

Open Access Original Research Article

Dietary Enrichment with Omega -3 Fatty Acid Potentiates Leptin Permeability through the Blood-Brain Barrier in Wistar Rats

Ebuehi, Osaretin Albert Taiwo, Oyegoke, Enioluwayan, Ajagun-Ogunleye, Olufemi Mulkah, Olu-Taiwo, Adebola

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/ijtdh/2020/v41i1930382

Obesity is an excessive accumulation of fat which causes several health implications. It is a risk factor for most disabilities and non-communicable diseases such as cardiovascular diseases, diabetes, cancer, neurodegenerative diseases, etc. The present study aimed to show the effect of short and long-term supplementation of an enriched diet with different concentrations of omega-3 fatty acid on cerebrospinal fluid (CSF), and serum leptin ratio, adiposity and lipid profile in albino Wistar rats. Serum-leptin ratios and indicators such as lipid profile, feed consumption, and adiposity index were obtained to ascertain the effect of the enriched diet on health and wellness. Forty Wistar rats divided into four groups of ten were used, comprising of five males and females; Groups A, B, C and D. The group A, the control, was fed with rat chow and water alone. Groups B, C and D were fed with rat chow supplemented with 10%, 20% and 40% omega-3 fatty acid respectively. The permeability of the blood-brain barrier (BBB) with leptin significantly increased across the experimental groups in a concentration-dependent manner.

Practical Applications: Omega-3-fatty acids, also called polyunsaturated fatty acids are well known for their cardioprotective properties. ALA, α-linoleic acid, eicosapentanoic acid (EPA), and docosahexanoic acid (DHA) have been collectively referred to as omega-3 fatty acids. ALA, an essential fatty acid, can be converted into EPA and DHA. These polyunsaturated fatty acids (PUFA) are obtained from fish-oil and other kinds of seafood. Dietary consumption is essential for a better blood lipid profile and reduced risk for cardiovascular disease. In the present study, supplementation with omega-3 fatty acids improved blood-lipid profile, increased HDL which are essential in preventing obesity. Equally reported here is that concentrations of serum-leptin and CSF were used to derive the leptin ratio. There was also a significant decrease in the adiposity index across the groups. The feed consumption and CSF leptin were given as r=-0.46 for the short term diet, while r=0.34 for the long term diet group. Data of the study indicate that omega-3 fatty acid enrichment had a diminishing effect on both adiposity and appetite, but enhanced the permeability of leptin through the blood-brain barrier in the Wistar rats. The relevance of this study is that omega-3-fatty acid food supplementation could aid in weight management and assist in the prevention and control of obesity.

Open Access Original Research Article

Pattern of Ocular Manifestations among People Living with HIV/AIDS on Highly Active Anti Retroviral Therapy

Catherine U. Ukponmwan, Evaristus Oseiwe Oboh, Odarosa M. Uhumwangho, Benson U. Okwara

International Journal of TROPICAL DISEASE & Health, Page 11-21
DOI: 10.9734/ijtdh/2020/v41i1930383

Aim: To determine the pattern of ocular manifestations in people living with HIV/AIDS on highly active retroviral therapy (HAART).

Study Design: A descriptive hospital based cross sectional study.

Place and Duration of Study: Presidential Emergency Plan for AIDS Relief (PEPFAR) clinics of the University of Benin Teaching Hospital and Central Hospital, Benin City, Edo State, Nigeria. Between 1st July 2018 and 31st October 2019.

Methodology: Four hundred and fifty one (451) patients living with HIV/AIDS on HAART were the subjects of this study. An interviewer administered questionnaire was used. They all had a comprehensive eye examination done. General examination including their height, weight and blood pressure were done.

Results: There were 451 patients (104 males and 347 females with a male to female ratio of 0.3:1), the age range was 14 to 75 years with a mean age of 46.55 ± 10.77 years. Most of them, 305 (67.6%) were married. A Majority 210 (46.6%) of them had a CD4 count of 500 cells /microliter and more. Ocular morbidity was present in 385 (85.1%) respondents. The most common ocular morbidity was an uncorrected refractive error in 262 patients with presbyopia being the most common type. Other morbidities seen were cataract followed by allergic conjunctivitis and glaucoma. Ocular manifestations of HIV/AIDS occurred in 32 patients (7.1%). The most common was dry eyes in 15 (46.9%) of these patients followed by posterior uveitis secondary to presumed Toxoplasmosis in 9 (28.1%) patients. Other types of HIV associated ocular morbidities seen were conjunctival squamous cell carcinoma, retinal detachment, optic neuritis and Herpes Zoster ophthalmicus.

Conclusion: There is a reduction in the prevalence and a change in the type of ocular manifestations in people living with HIV/AIDS on HAART. They are more prone to developing other ocular morbidities due to their increased lifespan. Eye health care programs should be established for people living with HIV/AIDS.

Open Access Original Research Article

Post Kala-Azar Dermal Leishmaniasis Following Treatment with 10 mg/kg of Single Dose AmBisome for Visceral Leishmaniasis in Bihar, India

Roshan Kamal Topno, Manas Ranjan Dikhit, Maneesh Kumar, . Madhukar, Kanhaiya Agrawal, Vahab Ali, Ganesh Chandra Sahoo, Rajeev Kumar, Sanjay Sinha, Rishikesh Kumar, . Bhawana, Krishna Pandey, V. N. R. Das, Pradeep Das

International Journal of TROPICAL DISEASE & Health, Page 28-33
DOI: 10.9734/ijtdh/2020/v41i1930385

In view of the significant role of Post kala-azar dermal Leishmaniasis (PKDL) patients in the transmission/recurrence of visceral leishmaniasis (VL) outbreaks, control of PKDL is among the priorities. As the Single Dose AmBisome 10 mg/kg (SDA) became the obvious choice for the treatment of VL, therefore, in this study, 896 patients were included to explore the probability of developing PKDL. Among the treated patients, 30 (3.35%) of them found confirmed as PKDL with clinical symptoms. Out of the 30 patients, 53.33% male and 46.67% female patients had macular lesions respectively, with a median time (Interquartile range [IQR]) to development of 13.5 (9–23.5) and 23 (9-17) months following treatment. No, significant associations were established concerning any patient's demographics and clinical characteristics. However, with the patients presenting with confirmed PKDL, females were significantly younger than males. This study suggests the rate of PKDL appearance is directly associated with 10 mg/kg of SDA and therefore there is a need for more concerns regarding doses during treatment.

Open Access Original Research Article

Knowledge of Malaria and Utilization of Its Preventive Measures among Pregnant Women Attending Antenatal Care at a Tertiary Hospital in Port-Harcourt, Nigeria

P. A. Awoyesuku, C. Ohaka, B. Ngeri

International Journal of TROPICAL DISEASE & Health, Page 34-46
DOI: 10.9734/ijtdh/2020/v41i1930386

Background: Prevention of malaria is a major priority for the roll back malaria partnership which recommends three-pronged approach for reducing the burden of malaria among pregnant women. The WHO framework for malaria prevention during pregnancy in areas of stable malaria transmission recommends IPT, use of ITN, and case management of malaria illness.

Objective: This study sought to determine the knowledge of malaria and its preventive measures among pregnant women, assess their utilization of malaria preventive measures and attitude to treatment. To ascertain whether there exists any relationship between their knowledge and practice of prevention.

Methodology: An institutional based, cross-sectional study was carried out. 385 consenting participants, between 18-48 years, were interviewed using a structured questionnaire. Information on socio-demographic characteristics, knowledge of malaria and its preventive measures, use of IPT and ownership/use of ITN, and attitude to treatment were recorded. Data were entered into Excel spreadsheet and analyzed with SPSS version 20. Associations between different variables were determined using Fisher’s exact test or Chi-square test, as appropriate, and logistic regression used to test statistical significance at P<0.05.

Results: Of the 385 women, 307 (79.7%) had excellent (18.7%) and good (61%) knowledge, while 78 (20.3%) had average (16.6%) and poor (3.6%) knowledge. There was no difference in association of Knowledge with age, marital status, education, occupation, and parity. Of the 385 women, 61.3% were using IPT for chemoprophylaxis, 66.2% were using insecticide spray or repellants and 71.4% owned mosquito net; of these, 84% owned insecticide treated nets, but only 65.8% were using it in this current pregnancy. Reasons for not using nets ranged from unavailable 49.0%, discomfort due to heat 32.9%, fear of suffocation 6.9%, Spouse’s disapproval 3.9% and 1.0% ineffective. There was statistically significant difference between knowledge and use of IPT, ITN and insecticide sprays.

Conclusion: There was adequate knowledge of malaria in pregnancy and its preventive measures, but utilization of these measures needs improvement. Efforts should be made to address barriers to utilization.