Open Access Original Research Article

Hepatitis C Virus Core Antigen for On-treatment Prediction of Sustained Virological Response to Direct Acting Antivirals in Chronic Hepatitis C

Sara Askar, Mahmoud Anees, Amal Elbendary, Abdelrahman Kobtan

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/ijtdh/2021/v42i630461

Background and Aim: Cirrhotic patients have lower response rates to DAAs with increased frequency of adverse events. This study aims to evaluate the value of HCVcAg as an early predictor of SVR to DAAs in cirrhotic patients to justify the treatment and avoid side effects.

Patients and Methods: This prospective cohort study was conducted on 85 treatment-naive HCV cirrhotic patients who had fulfilled the inclusion and exclusion criteria of the National Treatment Protocol of chronic HCV infection. HCVcAg detection was done on 10th day of treatment. Predictivity of HCVcAg for SVR was assessed in terms of specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy rates. ROC curve was conducted to assess predictivity of HCVcAg as well.

Results: SVR12 was (91.76%). HCVcAg was negative in 79 patients; 78 of them achieved SVR, while it was positive in 6 patients; all of whom did not achieve SVR. HCVcAg had sensitivity, specificity, PPV, NPV and accuracy rates of 100%, 98.73%, 85.71%, 100% and 98.82% respectively in prediction of SVR. With AUC of 0.929. There was a positive strong significant correlation between HCVcAg and SVR12 (r = 0.898, P = 0.015).

Conclusion: HCVcAg is a sensitive, specific, accurate, easily available, and affordable on- treatment predictor of SVR in cirrhotic patients with chronic HCV with possible future treatment regimen modification to improve efficacy and tolerability in difficult to treat cirrhotic patients.

Open Access Original Research Article

Malaria and Intestinal Parasites among Children in Muslim Schools, Port Harcourt, Rivers State, Nigeria

Eze, Chinwe Nwadiuto, Owhoeli Ovutor, Olasunkanmi, Rukayat Motunrayo

International Journal of TROPICAL DISEASE & Health, Page 8-16
DOI: 10.9734/ijtdh/2021/v42i630462

Introduction: Malaria and intestinal helminthes infections are major public health problem in low and middle-income countries affecting over 2 million people across the globe.

Objectives: This survey was carried out to determine the prevalence of malaria and intestinal parasites among Muslim school children in Port Harcourt, Rivers State.

Methodology: Four Muslim schools: kab model school Rumuagolu, Manbaul hikma Eliozu, An-nur school Rumuodomaya and Al-ameen school Eneka. One hundred and fifty (150) blood and stool samples were collected randomly from the pupils (70 males and 80 female; age range 5-12 years) and examined between the Months of May to July 2018.

Results: The overall prevalence of 50.7%, and 43.3% was recorded for malaria and intestinal helminthes respectively. The prevalence for malaria was 32.5%, 63.0%, 58.0% and 50.0%. Intestinal helminthes was 30%, 53.3%, 42.0% and 53.0% for kab, Manbaul hikma, An-nur and Al-ameen Schools respectively. The frequency of parasites encountered was as follows, Strongyloides stercoralis 8.7%, Ascaris lumbricoides 14.0%, Enterobious vermicularis 1.3%, Necator americanus 5.3%, Ancylostoma duodenale 4.7%, and Trichuris trichuria 9.3%. Malaria and intestinal helminthes infection was highest in females with 51.2% and 45.0% respectively. Pupils between ages 9-10 had the highest infection rate of (54.0%) for malaria while ages 7-8 had the highest prevalence of 47.7% for intestinal helminthes. Co-infection was 22.0%, 23.0%, 22.0% and 32.0% for kab, Manbaul hikma, An-nur and Al-ameen Schools Respectively.

Conclusions: The overall infection for malaria and intestinal helminthes was high. Therefore, regular de-worming of the pupils by parents, and health education are necessary to keep the prevalence in check. This study may also be used to predict risk for communities under consideration.

Open Access Original Research Article

The Potential Risk of the Used Thaumatococcus danielli (Benn) Leaves in Food Packaging Process in Transmission of Antibiotic Resistant Pathogens in Ghana

Victoria Klutse, Samuel Addo Akwetey, Priscilla Abena Ankamaa Opare, Godwin Kwakye-Nuako

International Journal of TROPICAL DISEASE & Health, Page 17-26
DOI: 10.9734/ijtdh/2021/v42i630463

Thaumatococcus danielli leaf is a known forest plant species that is widely used by food vendors for food packaging. In this study, the possible risk of T. danielli leaf used in food packaging, with its antibiotic-resistant pathogen transmission potential was evaluated. Five hundred leaves were swabbed from vendors at different food joints and were subjected to the routine bacteriological examination. Pure cultures from swabs were biochemically analysed, after microscopic examination. Most bacteria isolates were members of the Enterobacteriaceae. Other species included Staphylococcus aureus, CoNS (Coagulase-Negative Staphylococci) and Pseudomonas sp. The bacterial isolates were tested for their antimicrobial susceptibility towards 11 antimicrobials. As well as some factors such as community hygiene levels and people behaviour and their influences on the transmission of these microorganisms were statistically analysed using frequency tables. Most of the food vendors (43%) were between the ages of 31-40. Those with tertiary education were mostly aware (58%) of the possible transmission of pathogens by the leaves. Moreover, the leaves are preferred by food buyers irrespective of their income. Bacteria belonging to sixteen (16) different genera were identified, all of which were resistant to at least three antibiotics. The study showed that T. danielli leaves used by food vendors in two popular markets in Cape Coast Metropolis were contaminated and may serve as a possible vehicle for antibiotic-resistant bacteria transmission.

Open Access Original Research Article

Assessing the Current States of Logistics Management and Training on Family Planning Services in Nigerian Healthcare Facilities

Ali Johnson Onoja, Felix Olaniyi Sanni, Simon Peterside Akogu, Paul Olaiya Abiodun, Sheila Iye Onoja, Samuel Ayorinde Lemah

International Journal of TROPICAL DISEASE & Health, Page 27-36
DOI: 10.9734/ijtdh/2021/v42i630464

Background: Management of Family planning (FP) commodities is a significant problem that is not limited to compromising the quality of FP services but also results in economic burden especially in developing countries.  Some facilities may have ample FP commodities while others have a shortage if FP logistics are managed poorly. Hence, assessing the FP commodities logistic management is relevant to inform decision-makers.

Methods: This survey was a cross-section study of 763 public primary and secondary healthcare facilities in Nigeria. The study involved facility assessment and quantitative interview of key personnel in each facility, using a structured questionnaire. The study was conducted from May to July 2019. The data collected were analysed with IBM-SPSS version 25.0. Descriptive statistics were performed, Chi-Square and linear logistics regression were used to establish significant associations; p<0.05 was considered significant.

Results: About half (51.4%) of primary and 33.5% of secondary healthcare facilities were not using forms for reporting FP supplies. Also, 23.8% of primary and 18.8% of secondary facilities waited for more than two months before receiving orders. The facilities have an average of 2-3 trained personnel on FP services. FP staff who were trained had their last training over a year ago (primary-31.9%); secondary-37.4%). Secondary facilities were 2.102(95% CI:1.567–2.820) times more likely to use log forms, 1.845(95% CI: 1.076–3.165) times more likely to have cold chains, and 4.785(95% CI: 3.207–7.139) more likely to have trained staff on insertion and removal of implants than primary facilities (p<0.05).

Conclusion: We advocate that the government and donor agencies carry out urgent interventions such as regular supply of contraceptives, regular training of FP service providers, provide sufficient manpower, carry out regular monitoring and evaluation of FP services and create awareness on the need to use FP services among grassroots citizens.

Open Access Original Research Article

Prevalence of Typhoid Fever in Franceville (Gabon): Case of the Sino-Gabonese Friendship Hospital; Retrospective Analysis of Clinical Data Over Three Years

Thiery Ndong Mba, Cédric Sima Obiang, Otogo N'Nang Elvis, Landry Eric Mombo, Mireille Andeme Ompana, Ulrich Kevin Ivala Zogo, Judicaël Obame Nkogué, Louis-Clément Obame Engonga, Joseph Privat Ondo, Cyrille Bisseye, Patrick Mickala

International Journal of TROPICAL DISEASE & Health, Page 37-45
DOI: 10.9734/ijtdh/2021/v42i630465

Typhoid fever is an infectious disease that is fatal if left untreated. The most recent global data show more than 20 million cases annually, with more than 200,000 deaths. In Gabon, a study has shown that young adults are increasingly affected. Nevertheless, national data on this scourge are rare. The aim is to determine the prevalence of typhoid fever at the Sino-Gabonese Friendship Hospital in Franceville. The data are confirmed cases of typhoid fever at the Sino-Gabonese Friendship Hospital in Franceville, entered into a database of the health information management system of the South-East Franceville Gabon Regional Health Directorate between January 2018 and December 2020. A trend analysis was conducted over time to establish correlations between the prevalence of typhoid fever and factors such as age, gender and time of year. To statistically analyze these data, measure incidence rates, and establish relationships between these values and their significance, we used R version 3.6.1 software. 2175 people suffered from typhoid fever during the three years of the study. Of these, 960 (44.07%) were men and 1215 (55.93%) were women. A 95% confidence interval was estimated and a value p≤0.05 was considered statistically significant. The age group 15-49 years was the most affected. Although cases occurred throughout the year, there were increasing cases of typhoid from 2018 to 2020 and a high prevalence during quarters 1 and 4. The prevalence over the years was 454 cases or 20.87% in 2018, 750 cases or 34.48% in 2019, and 971 cases or 44.65% in 2020. In Gabon, particularly in Franceville, typhoid fever is a real public health problem. To protect themselves against this disease and avoid possible epidemics, the health authorities and decision-makers must educate the population about the disease.

Open Access Original Research Article

Clinical Outcomes of Trans-caesarean and Vaginal Post-placental CuT380A IUCD Insertions: A Comparative Study

N. P. Okoye, D. N. Onwusulu, C. P. Nnamani

International Journal of TROPICAL DISEASE & Health, Page 46-57
DOI: 10.9734/ijtdh/2021/v42i630471

Background: Immediate postpartum CuT380A intrauterine contraceptive device (PPIUCD) insertion provides a novel approach in reducing the unmet contraceptive needs of family planning. The insertion can be trans-caesarean or vaginal following delivery of the placenta. The clinical outcomes of the different routes of insertion have not been adequately studied.

Aim: The study aimed at comparing the clinical outcomes following trans-caesarean and vaginal post-placental insertions of CuT380A IUCD.

Methodology: The study was a prospective cohort study of 81 pregnant mothers managed at a tertiary health institution in southern Nigeria. They were recruited into two groups using a convenient sampling technique; 27 and 54 mothers in the caesarean and vaginal delivery groups respectively. The pregnant mothers were followed up till delivery and at the six weeks postnatal visit. Information on their socio-demographic characteristics, Obstetrics and Gynecology history were obtained with the aid of a proforma. The proforma was updated with the clinical outcomes of immediate PPIUCD insertions in the two groups, at the six weeks visit. Data obtained were analyzed using statistical package of social sciences version 21. Continuous variables were expressed as means and standard deviations. The Chi square test was used for dichotomous or categorical variables. A p-value of less than 0.05 was considered statistically significant.

Results: The study showed that PPIUCD is a safe practice in both vaginal and caesarean deliveries with no significant differences in clinical outcomes. However, incidence of missing string was higher in the caesarean group compared to vaginal group (81.5% vs 51.9%; p value-0.01); and expulsion rate was also high in the vaginal group but not significant. (13.0% vs 7.4%; p value 0.45).

Conclusion: Immediate postpartum CuT380A contraception, irrespective of route of insertion, is convenient, effective, and safe. Although there is a relatively higher incidence of missing strings, including expulsions after vaginal PPIUCD insertions, immediate post-partum contraception should be encouraged. This will help to reduce high unmet contraceptive needs in our environment and loss to follow up irrespective of route of delivery.

Recommendation: Immediate PPIUCD, irrespective of the route, should be encouraged and integrated into the existing Maternal and Child Health Programme. Awareness should be created to promote acceptance in our environment.