Open Access Original Research Article

Self-Care Practices among Diabetic Patients in Selected Sub-Metropolitan Cities of Nepal

Supendra Karki, Srijana Pandey, Purusotam Raj Shedain

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/ijtdh/2021/v42i230434

Aims: Diabetes self-care requires a multipronged approach, wherein the diabetic patient has a significant role to play. This study was undertaken to explore self-care practices of diabetic patients residing in two sub-metropolitan cities of Nepal.

Study Design: A cross-sectional comparative study.

Place and Duration of Study: The study was carried out from March 2019 to June 2020.

Methodology: An analytical cross-sectional study was done among 415 diabetic patients aged above 25 years. A simple random sampling technique was used to select the study participants. A structured questionnaire was adopted and making necessary contextual to collect the data. Descriptive statistics along with association between means, t-tests and ANOVA were calculated and a p < 0.05 was considered significant for data analysis.

Results: Regarding the diabetes self-care activities in different domains with respect to sociodemographic independent variables, blood sugar testing and foot care was a statistically significant associated with education i.e.  (p= 0.018) and (p=0.003) simultaneously. The study also reveals that specific diet, physical activity/exercise and blood sugar testing are significantly associated with HbA1c of diabetic patients. i.e. (p=0.003), (p=0.004) and (p=0.037) respectively.

Conclusion: The general awareness regarding both general and specific diet, physical activity/exercise, blood sugar testing, foot care and medications were poor in our study. More strategies need to be explored to make sure patients adhere to self-care activities.

Open Access Original Research Article

Parasitic Infections among Independent Refuse Disposal Workers in Port Harcourt, Rivers State, Nigeria

Eze Chinwe Nwadiuto, Mbah Kelechi Sam

International Journal of TROPICAL DISEASE & Health, Page 10-18
DOI: 10.9734/ijtdh/2021/v42i230435

Background: A study was carried out to ascertain the prevalence of parasitic infections among independent refuse disposal workers in Port Harcourt, Rivers State, Nigeria, and to ascertain the risk factors that enhance their vulnerability to parasitic infections.

Aims: The study was undertaken to determine parasitic infections among independent refuse

disposal workers in Port Harcourt, Nigeria.

Methods: Urine, stool and blood specimens were collected from 210 male refuse disposal workers. Standard parasitological procedures were employed in sample collection and examinations for the presence of various parasitic organisms.

Results:  Results showed 86.2% of the subjects were infected with Plasmodium sp, 94.3% were infected with one or more of 9 parasitic species, of which hookworm had the highest prevalence (91.4%). Others included are Ascaris lumbricoides, Trichuris trichiura, Taenia sp, Strongyloides stercoralis, Enterobius vermicularis, Schistosoma mansoni, Entamoeba hystolytica, Girdia lamblia. Schistosoma haematobium was not recovered from the urine specimens. Age group 26-29 years had the highest malaria prevalence of 89.1%, followed by age group 18-21 years (88.4%) while parasitic infection rate was highest among the age group 18-21(97.6%). Refuse disposal workers who reside in Rumuokoro camp had the highest malaria and intestinal parasites followed by Eneka. Poly-parasitism with A. lumbricoides and hookworm recorded the highest prevalence of 58 (27.8%) and fifteen subjects had triple poly-parasitism, with A. lumbricoides, hookworm and T. trichiura. Only 49 of the 210 respondents used one or more of the various personal protective equipment, while 161 used none at all.

Conclusion: Intestinal parasitic infection is highly prevalent among the independent refuse disposal workers in Port Harcourt. Inadequate use of personal protective equipment, poor personal hygiene and deplorable living conditions were identified as the major risk factors that enhanced transmission. It is therefore, imperative that the government enforces the use of personal protective equipment, implementation of preventive chemotherapy with health education to reduce morbidity and control transmission among the workers.

Open Access Original Research Article

Knowledge, Attitude and Practices towards Malaria and the Use of Insecticide-Treated Net among Rural Dwellers in Mubi North Local Government Area, Adamawa State, Nigeria

Ephraim Ibeabuchi Ezaka, Mercy Nwakaego Ezeunala, Obi Chidera Gabriel, Nwankwo Precious Chinasa, Babangida Buba, Dashar Tangkat Moses, Odoh Victor Chibueze

International Journal of TROPICAL DISEASE & Health, Page 19-29
DOI: 10.9734/ijtdh/2021/v42i230436

Malaria continues to be a critical health issue globally with more cases from the WHO African region and has remained endemic in Nigeria despite the possession of insecticide-treated nets. This present study aimed to explore the knowledge, attitude and practice regarding malaria and the use of ITNs as a malaria prevention strategy among rural dwellers in Mubi North Local Government Area, Adamawa State, Nigeria. A systematic questionnaire was used to get responses from a total of 304 households from January to March 2020 with only one adult interviewed per household. The respondents were the heads of the household. In their absence, a responsible adult above eighteen years, chosen by the family was interviewed. 99.3% (302) of the respondents agreed that malaria is caused as a result of a mosquito bite. The majority (90.8%) of them also agreed that ITN prevents mosquito bites, while 86.8% of them had ITNs. The study participants identified Fever (82.2%) and Headache (33.9%) as the most common evidence of malaria. Our study participants applied various preventive measures against mosquito bites such as the use of ITNs (86.5%), clearing breeding sites around their homes (28.3%), use of insecticidal sprays (18.8%), and wearing protective clothing’s (6.9%). This study has shown that respondents had good knowledge and attitude towards malaria and ITN, and also employed various measures to reduce the prevalence of malaria in the area.

Open Access Original Research Article

Pattern of Prescription of Anti-malarial Drugs in the Primary Health Care Facilities in Sokoto State Nigeria

U. M. Ango, M. O. Oche, A. U. Kaoje, M. M. Bello, M. T. Umar, A. Adamu, Y. F. Kalgo, S. A. Basakkwace, A. Musa

International Journal of TROPICAL DISEASE & Health, Page 30-38
DOI: 10.9734/ijtdh/2021/v42i230437

Introduction: Prescription practices for malaria have been shown to influence the emergence of resistance to antimalarial drugs.  Appropriate antimalarial drug use contributes to reductions in morbidity and mortality due to malaria with a consequent socioeconomic benefit, thus the success of a new malaria treatment policy would depend on the adherence of health care providers and patients to treatment recommendations. This study aimed to determine the prescribing pattern of anti-malaria in primary health care facilities in Sokoto State.

Methods: A cross sectional study was carried-out in the Primary Health Care facilities in Sokoto State. Screening of prescription forms from the patients who presented at the outpatient clinic during the period of the study in the selected health facilities was done at the point of exit, and only those with antimalarial prescription were consecutively selected. An interviewer administered questionnaire was used to obtained brief history of the illness among 276 respondents who were enrolled in to the study. Record of Rapid Diagnostic Test (mRDT) for the diagnosis of the malaria was obtained from the patients and or their caregivers. Data were analyzed using IBM® SPSS version 20 statistical packages.

Results: Majority 85 (30.8%) of the respondents were aged ≤ 1-10 years followed by 21-30 years 81 (29.3) Of the 276 antimalarial prescription forms obtained from the respondents, artemisinin- based combination therapy (ACT) was 166 (60.1%) and monotherapy was 110 (39.9%). The commonest artemisinin-based combination therapy prescribed for the respondents was Artemether-Lumefantrine 141 (84.9%) followed by Artesunate- Amodiaquine 16 (9.6%). The commonest oral mono-therapy prescribed was Sulphadoxine-pyrimethamine 28 (75.7%) while the most prescribed injectable monotherapy was artemether 59 (80.8%). Rapid Diagnostic Test for malaria (mRDT) was done for 274 (99.3%) respondents; those with mRDT positive were 238 (86.9%). The commonest presenting symptoms was fever 274 (99.3%) flowed by headache 225 (80.7%) and loss of appetite 215 (77.9%).  

Conclusion: The pattern of antimalarial prescription observed in this study was mainly artemisinin-based combination therapy. However, antimalarial monotherapy is still being prescribed. There is need for regular training of the health care workers on the appropriate treatment of malaria using the national guideline for treatment of malaria. Regular supply and availability of ACTs in all health facilities across the state will ensure full compliance with national guideline for malaria treatment using ACTs.

Open Access Original Research Article

Prevalence and Types of Skin Diseases Seen among Children Attending the Children’s Outpatient Clinic in a Tertiary Care Hospital in Southern Nigeria- A Descriptive Study

Uju S. Azubogu, Inumanye Ojule

International Journal of TROPICAL DISEASE & Health, Page 39-46
DOI: 10.9734/ijtdh/2021/v42i230438

Aims: To determine the prevalence and types of skin diseases seen among children attending the Children’s Outpatient Clinic of the University of Port Harcourt Teaching Hospital (UPTH).

Study Design:  A descriptive Cross sectional study design was used.

Place and Duration of Study: The study was conducted in the Children’s Outpatient Clinic of the University of Port Harcourt Teaching Hospital from June to August 2020 (3 months).

Method: It involved 370 children aged less than 18 years.  A semi structured interviewer-administered questionnaire was used to obtain all relevant data. This was followed by dermatological examination of the children to make diagnosis of skin diseases. Laboratory confirmation was carried out where necessary.

Results: The study participants consisted of 370 children aged 1 month to 17 years with a mean age of 8.4±5.9 years. The male to female ratio was 0.9:1 and the overall prevalence of skin diseases among the children studied was 23.7%. The three most common aetiologic categories of skin diseases seen were:  Infective (13.5%), Inflammatory (5.7%) and infestations (3.5%). The five most common skin diseases identified included: Impetigo (4.1%), Scabies (3.5%), Atopic dermatitis (3.0%), Tinea capitis (2.7%) and Pityriasis versicolor (2.4%).

Conclusion: Skin diseases are common among children attending the children’s outpatient clinic in our hospital with Infective skin diseases predominating. Greater efforts need to be put into the treatment, prevention and control of these skin diseases in order to limit morbidity and mortality.

Open Access Original Research Article

Appropriate Use Criteria for Paediatric Echocardiography – Applicability in a Resource Poor Setting in the Niger Delta Region of Nigeria

P. N. Tabansi, U. C. Onubogu

International Journal of TROPICAL DISEASE & Health, Page 47-57
DOI: 10.9734/ijtdh/2021/v42i230439

Aims: To make comparative analysis of the indications and outcome of paediatric echocardiography in tertiary centers in Rivers State, Nigeria using the Appropriate Use Criteria (AUC) guidelines [11].   

Methodology: A retrospective analysis of 645 echocardiography requests done between July 2019 to June 2020. Patients’ biodata and indications for echocardiography and echocardiography diagnosis were retrieved. Using the AUC guidelines, each indication was scored from 1 to 9, after which they were categorized into Appropriate, May be appropriate and Rarely appropriate to determine the respective percentages accordingly. Cochran-Armitage test for trend was done to assess degree of yield of cardiac anomaly for each level of AUC classification while bivariate associations were assessed using persons chi squared tests.

Results: There were 645 echocardiography requests within the study period. The median age was 5months, with interquartile range of 2months to 24months. There were 355(55%) males and 290(45%) females. The clinical indication for echocardiography was appropriate in 490(76.0%), May be appropriate in 32(5.0%) and Rarely appropriate in 104(16.1%). Nineteen (2.9%) clinical indications were “Unclassified” under the AUC. Echocardiography showed abnormality in 544(84.3%) reports, among which children with “Appropriate indications” had the highest yield 457(93.3%), while “unclassified indications” had the lowest yield 8(42.1%). The yield for cardiac anomalies significantly decreased with decreasing appropriateness (p=0.00001).

Conclusion: Most indications for paediatric echocardiography in our centers were appropriate according to the AUC guidelines. The AUC guidelines are applicable in resource poor settings.