Open Access Opinion Article

Blood Neutrophil / Lymphocyte Ratio and C –Reactive Protein / Albumin Ratio as Markers of Response for Treatment of Spontaneous Bacterial Peritonitis

Marwa Awad Mustafa, Maaly Mohamad Mabrouk, Sabry Abd Ellatif Abou Saif, Nadia Muhammad Elwan

International Journal of TROPICAL DISEASE & Health, Page 52-62
DOI: 10.9734/ijtdh/2021/v42i730473

Background: Spontaneous bacterial peritonitis (SBP) is an acute infection of ascites with the absence of surgically treatable cause and the gold standard method in its diagnosis is the presence of 250 polymorphonuclear neutrophils (PMN) /mm3 or more by diagnostic paracentesis. Blood neutrophil/lymphocytic ratio (NLR) is an applicable, inexpensive, and simple test for inflammation. C-reactive protein/albumin ratio (CAR) is an inflammatory marker used for the diagnosis and follow-up of many diseases and morbidities. We aimed to evaluate the clinical utility of both blood NLR and CAR as applicable, simple and non-invasive tests for SBP follow-up.

Patients and Methods: This study was done on 80 cirrhotic ascitic patients attending the Tropical Medicine Department of Tanta University Hospital. They were subjected to full history taking, clinical examination, laboratory investigations, and ascitic fluid analysis. The patients were divided into two groups according to the results of diagnostic paracentesis into group I: 40 cirrhotic ascitic patients without spontaneous bacterial peritonitis and group II: 40 cirrhotic ascitic patients with spontaneous bacterial peritonitis, and then SBP group were tested after treatment by third-generation cephalosporin for five days for ascitic sample, NLR and CAR.

Results: Both blood NLR and CAR were significantly higher in SBP patients. Also, a significant decrease in both ratios was observed post-treatment with significant positive correlations between both NLR and CAR with ascitic neutrophil count after SBP treatment.

Conclusion: NLR and CAR can be used as quick, cheap, and applicable markers of the response of treatment in SBP patients.

Open Access Original Research Article

Transmission Dynamics of Intestinal Parasites Infection in Children under Anthelminthic Treatment Residing in a High-Risk Area in Cameroon

Arnol Bowo-Ngandji, Djabidatou Ousmanou, Atembeh-Noura Efietngab, Nkengazong Lucia, Halmata Mohamadou, Ngonde Marie Chantal

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/ijtdh/2021/v42i730467

Introduction: Intestinal parasites continue to pose an important public health problem in low-income countries with children being the most affected, thus justifying their therapeutic follow up.

Objective: This work aimed to update the epidemiological base data and evaluate transmission dynamics of intestinal parasites at one and three months post treatment following the administration of multiple doses of mebendazole 100mg in children of the Lolodorf health district, South Region.

Methods: 381 stool samples were collected from participants and analysed using the kato-katz and formol ether technicsand each participant treated with multiple dosesof mebendazole within three days. Samples were collected at one and three months post treatment from same individuals. Two indicators were used to evaluate transmission dynamics: reinfection rate and number of newly infected individuals.

Results: A global infection rate of 65.3% involving Ascaris lumbricoides (23.1 %), Trichuris trichiura (35.2 %), hookworms (7.9 %), Hymenolepis diminuta (0.3 %), Entamoeba histolytica/E. dispar (5.8 %), Entamoeba coli (19.2 %), Entamoeba hartmanni (0.3 %) and Candida sp (26.0 %) was registered. Single infection (53.6%) was significantly higher than multiple infections (46.4%) (P=0.04). Significance was in favour of male sex for hookworm infections (P=0.04). Transmission dynamics of the different groups of parasites showed a reduction of helminths and protozoan parasites infections with complete absence of Candida sp. after treatment. The global reinfection rate obtained at three months post treatment was 7.3% with high values observed for T. trichiura (6.1%). The proportion of newly infected individuals varied from 6.2% to 8.9% at one and three months post treatment.

Conclusion: These results showed persistence in active transmission of various intestinal parasites in the study area. Hence, stakeholders in charge of controlling theseinfections shouldreinforce specific intervention measures against these diseases such as the implication of control measures at all levels of the transmission chain (individual and environmental level).

Open Access Original Research Article

Pattern of Cancer in Irrua Specialist Teaching Hospital

Clifford Ikhuoria Owobu, Akhator Terence Azeke, Victor Valentine Ideiyenmin, Orume Enegbuya, Adaugo Chizoma Owobu, Ehioze Matthew Isoa, Esteem Tagar, Ehiremhen Ozah, Alex Payim Igbe, Reuben Eifediyi, Maxy Odike

International Journal of TROPICAL DISEASE & Health, Page 14-21
DOI: 10.9734/ijtdh/2021/v42i730468

Aims: To reveal the pattern and trend of cancer in a predominantly rural population in Nigeria and compare the findings with those of earlier researches across the world.

Study Design: A descriptive retrospective analysis of all cancer cases seen among surgical specimens in Irrua Specialist Teaching Hospital. The cancer cases are classified according to the organ/tissue involved and the data obtained were analysed using SPSS (version 25).

Place and Duration of Study: The Department of Anatomic Pathology, Irrua Specialist Teaching Hospital, Nigeria; between January 2011 and December 2020.

Results: A total of 9,058 histologic samples were reviewed out of which 1,474 (16.27%) were cancer cases. The yearly number of cancer cases increased from 85 in 2011, to 258 over the next 10-year study period. At variance with WHO 2020 GLOBOCAN worldwide estimates, the common cancer types seen in this study (both sexes combined) were prostate cancer, breast cancer, cervical cancer, colorectal cancer and non-melanoma skin cancer, in decreasing frequencies. The peak age of occurrence was the 7th decade while the mean age was 54.21 years, and the gender-specific mean ages for males and females were 59.92 years and 49.44 years respectively. The male to female ratio was 1:1.2 and males are more likely to be diagnosed of cancer approximately 10 years later than their female counterparts.

Conclusion: Many of the findings in this study are similar to those of previous researches across the country. It is our hope that the findings in this study would contribute to national data and be found useful in efforts to build a more inclusive and robust national system of cancer registration.

Open Access Original Research Article

Awareness, Ownership and Utilization of Insecticide Treated Nets against Malaria Vectors among Pregnant Women Attending Antenatal Clinics in Awka Metropolis, Anambra State, Nigeria

Anthony Chibuike Onyebueke, Ancilla Kate Umeobieri, Kindness Chidi Irikannu

International Journal of TROPICAL DISEASE & Health, Page 22-31
DOI: 10.9734/ijtdh/2021/v42i730469

Aim: To determine the level, sources of awareness, ownership and utilization of Insecticide Treated Nets (ITNs) by pregnant women, according to age, parity, trimester, occupation and hospital attended.

Study Design: The study was a cross sectional survey of 577 randomly selected pregnant women who were attending antenatal clinic in different hospitals in Awka Metropolis, Anambra State, Nigeria.

Duration of Study: The study was conducted in February 2016.

Materials and Methods: A semi-structured questionnaire was used to obtain information from the study participants.

Results: Of a total of 577 respondents, 566(98.1%) had previous knowledge of ITNs while only 11(1.9%) had no prior knowledge. Also, 218(38.5%) had heard about ITNs from Radio, 184(32.5%) from Television, while 374(66.1%) from Antenatal clinics. A total of 217(46.2%) obtained at least one net at antenatal clinic, 39(8.3%) purchased at least one of the ITNs owned, 49(10.4%) received the net at their Local Government Headquarters while 263(66.9%) received at least one by free distribution at other locations. Respondents from government owned Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) had the highest ownership rate of 92.7%, while least 65.0% was observed at the privately owned Divine Hospital and Maternity. The ownership of ITNs was dependent on the hospital as there was a significant difference (X2=56.374, df=2, p < .05). Age group 25–34 years had the highest ownership rate of 87.1% while the least 72.8% was in age group 15–24 years. Women in age group 35–44 years had the highest utilization rate of 52.3% while least usage rate was in age group 15-24 years and there was a significant difference (X2=7.042, df=2, p < .05).

Conclusion: Public health educators, Doctors and Antenatal heads need to do more in sensitization on the importance of utilization of ITNs during pregnancy for protection against malaria vectors.

Open Access Original Research Article

WHO Five Keys to Safer Food Handling: Knowledge and Practice among Food Handlers in Sokoto Metropolis, Sokoto, Nigeria

Ismail Abdullateef Raji, Oche Mansur Oche, Aminu Umar Kaoje, Yahaya Mohammed, Balarabe Adamu Isah, Mansur Olayinka Raji, Kehinde Joseph Awosan, Auwal Usman Abubakar, Amina Mohmmed

International Journal of TROPICAL DISEASE & Health, Page 32-42
DOI: 10.9734/ijtdh/2021/v42i730470

Background: The (WHO) developed the five keys to safer food which was designed to be practical and straightforward for food handlers. In recognition of the role they play in preventing Foodborne Disease (FBD) outbreak. In this study, we aimed to determine the knowledge and practice of the five keys to safer food among food handlers in food establishments in Sokoto Metropolis, Nigeria.

Methods: We conducted a cross-sectional study between August and November 2019. We recruited 366 food handlers working in restaurants using a multistage sampling technique. We assessed knowledge and practice of five keys to safer food, and we examined the predictors of knowledge among the participants using chi-square and binary logistic regression at a 5% level of significance.

Results: More than two-thirds, 288 (78.7%) less than 40 years and less than half, 163 (44.5%), were involved in cooking the food. One hundred and twenty-seven (34.7%) have greater than five years’ experience. Overall, less than one-quarter, 87 (23.8%) had good knowledge of the five keys to safer food handling. One hundred and thirty-two (36.1%) wash hands before and during preparation most times. Two hundred and fifty-three (69.1%) never wash their hands after using the toilet, and 144 (39.3%).Age (adjusted Odds Ratio [aOR]: 10.05; 95% CI = 4.0 - 21.04), gender (aOR: 2.70 95CI = 1.44 - 5.09) and Education (aOR: 3.67; 95% CI = 1.92 - 7.01) were significant predictors of knowledge.

Conclusion: There is poor knowledge, and most of the practices of the five keys to safer food were below the required for food safety. Therefore, we recommend that the Sokoto state ministry of health coordinate training interventions on five keys to safer food with particular attention to those older than 40 years and those without formal education.

Open Access Original Research Article

Characteristics of Cerebrospinal Meningitis Cases in 2017 Outbreak, Sokoto State, Nigeria: A Secondary Data Analysis

Auwal Usman Abubakar, Ismail Abdullateef Raji, Aminu Umar Kaoje, Umar Mohammed Ango, Mohammed Abdullahi Abdulkarim, Mohammad Danmadami Abdulaziz, Abubakar A. Danmafara, Yahaya Mohammed

International Journal of TROPICAL DISEASE & Health, Page 43-51
DOI: 10.9734/ijtdh/2021/v42i730472

Introduction: Cerebro-Spinal Meningitis (CSM) is an acute illness affecting surrounding layers of the brain and spinal cord, mostly caused by bacterial infection. The disease is responsible for the occurrence of epidemic meningitis in the African Meningitic belt. For many years, this region has experienced a large serogroup A epidemic every 7-10 years. A sharp decrease in the number of reported cases was demonstrated in countries where Men Afrivac has been introduced. However, serogroup replacement with serotype C was noted in the region, which has posed a serious threat to eliminating CSM epidemics. We describe the characteristics of cerebrospinal meningitis cases in the 2017 outbreak in Sokoto state, Nigeria.

Methodology: We obtained CSM data from the state epidemiology unit from 7th February to 24th May 2017. We extracted data on demographic characteristics, clinical features, case management and outcome of cases. We used Microsoft Excel and SPSS to analyze the data for proportions, cross-tabulations and chi-square test to find associations between variables.

Results: A total of 4969 CSM cases were recorded, with 283 deaths (case fatality rate: 5.7%). The cumulative attack rate was 96.4/ 100,000 populations. The highest proportion of cases was among ≥ the 15-year age group 2063(41.5%), and males were more affected, 2843(57.2%). Of the total 4969 suspected CSM cases, specimens were collected for only 225 (4.4%) cases, of which 58 (25.8%) were positive. Most 48 (82.8%) of the positive specimen were of NmC serotype. Only age was found to predict outcome (aOR: 1.52; 95% CI= 1.18 – 1.97).

Conclusion: Sokoto State outbreak of Cerebro-spinal meningitis in 2017 was huge and largely caused by NmC. Those aged less than 15 years might be at higher risk of dying from CSM and we therefore recommend that specific preventive interventions such as vaccination and awareness creation should target this age group.