Open Access Case Study

Late Onset Neonatal Sepsis Due to Hafnia alvei in Three Neonates at the University of Nigeria Teaching Hospital, Enugu, Nigeria

Uchenna C. Nnajekwu, Kenechukwu K. Iloh, Ijeoma N. Obumneme-Anyim, Chukwubike O. Nnajekwu, Ifeyinwa N. Nwafia, Hebert A. Obu, Gilbert N. Adimora

International Journal of TROPICAL DISEASE & Health, Page 27-32
DOI: 10.9734/ijtdh/2021/v42i930482

Background: Hafnia alvei is a Gram-negative motile bacillus, belonging to the Enterobacteriaceae family. It is commonly found in stool of humans and animals and soil. It is very rare in neonates. This organism is resistant to most commonly used antibiotics, and causes nosocomial outbreaks with significant mortality. Therefore, awareness regarding this organism is important to improve outcome.

Presentation of Cases: We report three cases of late onset neonatal sepsis caused by Hafnia alvei. Of these, two were preterm while one was term. The term neonate was referred on account of perinatal asphyxia and developed fever, reduced activity, tachycardia, and tachypnoea 5 days into admission. The two preterm neonates were delivered at the index hospital and developed hypothermia, and other symptoms on the 4th day of life.  Two sets of blood cultures were done for each case after collecting blood from two different sites. Blood culture was done using BACT/ALERT 3D (BioMerieux, Marcy I’Etoile, France) which uses a colorimetric sensor and reflects light to monitor the presence of carbon dioxide produced by micro-organisms. This yielded Hafnia alvei in all three samples after 72 hours of incubation. Gram stain done showed presence of Gram negative bacilli and subculture was done on MacConkey and 5% sheep agar incubated at 37 0 C for 18-24 hours. Identification of isolates was done with standard biochemical test and confirmed with API 20 E identification system (BioMerieux, Marcy I’Etoile, France). Antibiotic sensitivity was done using the modified Kirby Bauer disc diffusion method (Oxoid, Cambridge, UK). At most five antibiotic discs were used for each isolate and these were incubated at 370C for 24 hours. Isolates were sensitive to fluoroquinolones, cefepime and meropenem. Patients received intravenous antibiotics for two weeks, phototherapy and exchange blood transfusion. They were subsequently discharged and are currently on follow up.

Discussion and Conclusion: Though rare, three infections with H. alvei were reported in this study. The isolates were sensitive to fluoroquinolones, cefepime and meropenem and resistant to amoxicillin/clavulanic acid, piperacillin/tazobactam. The outcomes were improved by a high index of suspicion, early diagnosis, prompt institution of appropriate antibiotics and supportive care.

Open Access Original Research Article

The Causal Relationship between Type 2 Diabetes Mellitus and Ovarian Cancer: Two-Sample Mendelian Randomization

Langat Kipkirui Victor, Reuben Cheruiyot Lang’at, Ayubu Anapapa Okango

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/ijtdh/2021/v42i930480

Aims: This research aimed at determining the causal relationship between type 2 diabetes mellitus (T2DM) and ovarian cancer using two-sample Mendelian randomization technique. This is because there is an assumption that type 2 diabetes mellitus (T2DM) has a causal relationship with ovarian cancer due to the alarming rising incidence statistics.

Study design: This study used a two-sample Mendelian Randomization (MR) design to undertake the causal relationship investigation. Mendelian randomization technique uses genetic variants as instrumental variables, which undergo random allocation at conception and are non-modifiable. This makes it not to be affected by confounding factors and reverse causation. The MR techniques employed are MR-Egger and Inverse Variance Weighted (IVW.)

Data sources: The outcome (ovarian cancer) summary statistics was retrieved from Ovarian Cancer Association Consortium (OCAC), which has 66,450 samples (number of cases=25,509, number of controls=40,941) of European population. The exposure (T2DM) summary genetic data came from DIAGRAM plus Metabochip consortium which involved approximately 149,821 samples (number of cases=34,840, number of controls=114,981) of mixed population.

Results: The study indicated that there was no evidence of causal relationship between T2DM and ovarian cancer (MR-Egger: b= -0.0476, se = 0.0619, p-value = 0.4479, IVW: b = -0.0165, se = 0.0257, p-value = 0.5217). The odds ratios indicated that the two-sample Mendelian randomization had the power to detect 0.0464 and 0.0164 decrease in variability per 1 SD for MR-Egger and IVW respectively (MR-Egger: OR = 0.9536, CI: 0.8447, 1.0765, IVW: OR = 0.9836, CI: 0.9352, 1.0345).

Conclusion: This approach alleviated the usual problem of reverse causation and confounding factors hence depicting clearly that there is no causal relationship between T2DM and Ovarian cancer.

Open Access Original Research Article

Knowledge and Practice of Food Hygiene among Food Vendors in Selected Primary Schools within Sokoto Metropolis

Balarabe A. Isah, Yahaya Musa, Malami M. Bello, Abdauaziz M. Danmadami, Edzu. U Yunusa

International Journal of TROPICAL DISEASE & Health, Page 13-26
DOI: 10.9734/ijtdh/2021/v42i930481

Aims: This study aims to assess the knowledge and practice of food hygiene among food vendors in primary schools within Sokoto metropolis.

Study Design:  A cross-sectional descriptive study.

Place and Duration of Study: The study was conducted in Sokoto metropolis, Northwest Nigeria between June and December 2020.

Methodology: Eighty-seven food handlers were selected from 11 randomly selected primary schools that met the inclusion criteria. Data were collected via the use of interviewer administered questionnaire and observation checklist.  and was analyzed using statistical package for social scientists (SPSS) version 23. Descriptive statistics, chi-square tests, and frequencies of the various variables were tabulated.

Results: Eighty-seven (87) food handlers with mean age of 31.95 ± 15.12 years were enrolled, out of this, 93.1% were females and only 6.9% were males. Ninety-two percent of the respondents had good knowledge of food hygiene while 78.2% had good practice and 79.3% had good level of neatness. There was no statistically significant association between the knowledge of food hygiene and any of the socio-demographic characteristics of respondents. However, there was statistically significant association between the practice of food hygiene and age category (p-value=0.001) as well as marital status of the respondents (p-value=0.001). There was also statistical significance between the level of neatness of the food handlers and age category (p-value= 0.001), marital status (p-value 0.001) and educational status (p-value 0.001).

Conclusion: Food handlers in primary schools within Sokoto metropolis generally have good knowledge of food hygiene but this was not reflected in their hygiene practices. It is recommended that a massive health education directed at both the general public and food handlers should be provided in such a way that it enables people take necessary steps towards preventing foodborne illnesses.

Open Access Original Research Article

Cord Blood Haematological Profiling Study: Predictive Markers of Neonatal Health Status at Birth in Anyigba, North Central Nigeria

Shedrack Egbunu Akor, Dickson Achimugu Musa, S. P. O. Akogu, Akpa Matthew, Adeyemi Alapo Funmilola, Patience Onoja, Boaz Adegboro, Samuel Eneọjọ Abah

International Journal of TROPICAL DISEASE & Health, Page 33-39
DOI: 10.9734/ijtdh/2021/v42i930483

Background: Neonatal mortality refers to the death of a live-born babies within the first 28 days of life remains a global public health challenge. Cord blood being the medium of communication, transmission of nutrients and wastes between mothers and fetus can reflect the health status of baby at birth if properly utilized. Owing to multiple factors involved in neonatal mortality, this study used umbilical cord blood haematological parameters to ascertain the health status of neonates at birth, the aim of this study is to use umbilical cord blood haematological parameters for management of neonates at birth.

Methodology: This research is a cross-sectional study carried out at the Departments of Obstetrics and Gynaecology and Medical Laboratory Department, Kogi State University Teaching Hospital, Anyigba, North Central Nigeria between January, and December, 2020.  Cord blood from 164 babies delivered in Kogi State University Teaching Hospital, Grimard Catholic Hospital, and Amazing Grace Hospital between January and December, 2020 were analyzed for haematological parameters using Sysmex XP-300 automated haematology analyzer. The data obtained were expressed as mean ±standard deviation using SPSS statistical software, version 23.0. The indicator level of statistical significance was set at p<0.05.

Results: The results showed significant increase (p<0.05) of WBC, RBC, MCV, MCH and MCHC in unstable babies compared to the stable babies, significant decrease (p<0.05) in the platelets, neutrophil and mixed among unstable babies compared to the stable babies, but no significant difference in PCV,  haemoglobin and lymphocyte counts of both stable and unstable babies. The results also demonstrated 25 deaths per 1000 live newborn neonates within 48hour during the period of study.

Conclusion: This study shows that cord blood haematological parameters at birth can be used to ascertain the health status of neonates.

Open Access Original Research Article

Seroprevalence of Hepatitis B Virus Infection amongst Pregnant Women in a Community North Central Nigeria

Ndako, James A, Mawak, John D, Fajobi, Victor O, Ilochi Ifeanyi, Oludolapo Olatinsu, Odiase Marily C

International Journal of TROPICAL DISEASE & Health, Page 40-46
DOI: 10.9734/ijtdh/2021/v42i930484

Background: Hepatitis B virus (HBV) is a global challenge mostly in developing countries. Hepatitis B virus has infected almost one third of the world population. Pregnant women infected with hepatitis B virus (HBV) can transmit the infection to their fetuses and newborns. As a result of the developing status of most of our communities screening of antenatal attendees is rarely done as a routine in most health facilities that offers antenatal services, hence the need for this studies at our location of study.

Methods: One hundred and ninety (190) serum samples were screened among pregnant women on ante-natal care, using standard ELISA method. A well-structured questionnaire was administered to individuals to determine incidence rates and identify relative risk factors that predispose subjects to the Hepatitis B Virus (HBV) infection.

Results: From the total samples screened, Sixty-three, 63 (33.2%) were found to be positive for Hepatitis B virus. The highest prevalence was found among those aged 21-30 with overall number of 37(19.5%) Positivity, X2 =1.508; P=0.471. Considering educational status of subjects screened, high prevalence was recorded among those without formal education with 25(13.2%) Prevalence, x2= 5.381; P = 0.146 considering the various risk factors, subjects with history of tattooing/tribal markings recorded 41(21.6%), while women in their second trimester of pregnancy had a higher prevalence of 42(22.2%).

Conclusions: This study recorded a high prevalence of Hepatitis B virus infection amongst pregnant women at our study location, which also reflects high probable risks of HBV perinatal transmission. It is therefore strongly recommended that pregnant women be routinely screened for Hepatitis B virus infection as part of antenatal care services.

Open Access Original Research Article

Health, Nutrition and Treatment Compliance of People Living with HIV/AIDS (PLWHA) at the Liberian Government Hospital in Buchanan, Grand Bassa County, Liberia

Arthureen Tina Nessian, Leila S. Africa, Jaidee P. Agne, Kristine V. Montecillo

International Journal of TROPICAL DISEASE & Health, Page 47-59
DOI: 10.9734/ijtdh/2021/v42i930485

Aims: To assess the nutritional and health status, and compliance with treatment and health services of adult people living with HIV/AIDS (PLWHA) attending Liberian Government Hospital (LGH).

Study Design:  Cross-sectional study

Place and Duration of Study: LGH, Buchanan, Grand Bassa County, 2018

Methodology: The survey was conducted among 90 adults PLWHA.

Results: The majority had acute HIV infection, and tuberculosis and herpes zoster were the most contracted opportunistic infections. Although the majority had normal nutritional status, malnutrition was still observed especially among the women. Most had poor diet diversity and claimed to have faced challenges, mainly monetary concerns, while some experienced other traumatic events. A few also showed indications of self-harm. Moreover, they generally have a good health condition and medication adherence and demonstrated substantial knowledge about the disease and its treatment. Compliance was found to be associated with the health status of the participants, but not with their nutrition status, socio-economic and other characteristics.

Conclusion: The results provide an insight into the nutritional status and compliance of the adult PLWHA in Liberia. It is hoped that this study would be useful in crafting and enhancing existing intervention programs and policies promoting the better quality of life of adult PLWHA in the country.