Open Access Original Research Article

Bacterial Profile and Risk Factors Associated with Dental Caries in Enugu Metropolis, Southeast Nigeria

U. C. Maduakor, N. F. Onyemelukwe, S.N. Maduakor, I. P. Udoh, M. B. C. Chukwubuike

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/ijtdh/2021/v42i1530517

Dental caries is one of the most prevalent and costly diseases that are a challenge to health care providers. There is limited data on the bacterial profile and risks associated with dental caries in Nigeria. The study aimed to isolate and identify bacteria and risk factors associated with dental caries in Enugu. It was a case-controlled study. A total of 336 samples were randomly collected comprising of 125 healthy subjects and 211 patients with dental caries attending various hospitals and dental clinics in Enugu, Nigeria. Samples were subjected to standard microbiological and biochemical techniques. Standardized questionnaires were used to record demographic variables and risk factors. A total of 635 and 254 microorganisms were isolated from carious lesions and healthy subjects respectively. Of these 635 isolates, 218 (34.4%) Gram-positive bacilli, 210 (33.0%) Gram-positive cocci, 46 (7.2%) Gram-negative cocci, and 43 (6.8%) yeasts were recovered. Two hundred and seven samples were (98.1%) polymicrobial while 4 samples (1.9%) were monomicrobial. Among the organisms recovered, anaerobic Lactobacillus spp (141, 66.8%) was the most prevalent followed by Streptococcus mutans (104, 49.2%), and the least were Actinomyces israelii and Capnocytophaga spp (1, 0.05%) respectively. Of the 254 isolates from apparently healthy subjects, Streptococcus sanguis ranked highest and the least was Porphyromonas gingivalis. The factors that were found to be significantly associated with dental caries were level of education P=0.005, feeding habit P= 0.001, Favourite snack P=0.004, sweet consumption P< 0.0001, type of gum P < 0.0001, history of toothache P < 0.0001, visit dentist P< 0.0001, and the bleeding gum P < 0.0001. This research highlighted the polymicrobial nature of carious lesions and associated predictors of dental caries.  Hence public enlightenment and the implementation of oral health education in schools are crucial.

Open Access Original Research Article

Glucose and Lipid Profile Changes in Hepatitis C Patients After Direct Acting Antivirals Therapy

Ahmed Hashem Sultan, Mohamed Abd-Elrazik Sharaf-ELdin, Samah Mosaad Soliman, Reham Abd-Elkader Elkhouly

International Journal of TROPICAL DISEASE & Health, Page 12-24
DOI: 10.9734/ijtdh/2021/v42i1530518

Background: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease. Chronic HCV infection is associated with development of insulin resistance and therefore type 2 Diabetes mellitus (T2DM), it is also associated with hepatic steatosis and hypocholesterolemia. The treatment by Direct Acting Antivirals (DAAs) leads to sustained virological response (SVR) in almost all infected patients and decreases liver-related as well as all-cause mortality in these patients. The evidence for the effect of DAAs therapy on T2DM is quite conflicting. Some studies agreed with the glucometabolic amelioration induced by the Sustained Virological Response (SVR) but other studies disagreed with this hypothesis. The aim of the work was to evaluate glucose and Lipid Profile changes in hepatitis C patients at 12 weeks post treatment (SVR12) by Direct Acting Antivirals Therapy.

Methods: This prospective study was carried out on 80 chronic HCV infected patients who are treatment naïve and subjected to HCV DAAs treatment (Daclatasvir + Sofosbuvir for 12 weeks +/- Ribavirin or any DAA available) with 100% SVR rate at 12 weeks with no relapse. All patients are subjected to assessment of Fasting blood glucose, HbA1C and assessment of Lipid profile; Total cholesterol, Triglycerides, HDL, LDL at baseline (pretreatment) and at end of treatment then they are followed up at SVR12.

Results: Average HbA1C, fasting blood glucose has significantly decreased in group A diabetic patients from baseline to end of treatment and to SVR12, Average Total Cholesterol, LDL has significantly increased in group A and B from baseline to end of treatment and to SVR12 respectively. Average Triglycerides has significantly decreased from baseline to end of treatment in group A and B and to SVR12 in group A only. Average HDL has significantly increased only in group B non-diabetics from baseline to end of treatment and to SVR12.

Conclusions: Successful clearance of HCV viremia (SVR12) with DAAs treatment has been associated with significant Improvement or decrease of HbA1c and Fasting plasma glucose levels in diabetic chronic HCV infected patients, and has been associated with Rise in the Lipid profile; Total Cholesterol, LDL, HDL (non-diabetics only) while it decreases Triglycerides in both diabetic and non-diabetic chronic HCV infected patients.

Open Access Original Research Article

The Prevalence, Intensity and Risk Factors of Gastrointestinal Parasitic Infections in Outpatients in Bafoussam II, West Region, Cameroon

Yannick Duclair Tchinde, Lem Edith Abongwa, Fotsing David, Ntonifor Helen Ngum

International Journal of TROPICAL DISEASE & Health, Page 25-36
DOI: 10.9734/ijtdh/2021/v42i1530519

Background: Gastrointestinal parasitic infections remain a public health problem in tropical and subtropical countries. This study aimed at assessing the prevalence and density of gastrointestinal parasites and to identify the risk factors of their transmission.

Methodology: A hospital-based cross-sectional study was carried out from June to October 2020, on outpatients visiting the Djeleng Sub divisional medical centre in Bafoussam II. All consenting participants provided a stool sample and completed an open-ended questionnaire. Stool samples were examined simultaneously as fresh wet mounts, formal-ether concentration technique and modified Zieihl Neelsen staining technique. Data was analysed using SPSS version 20.0.

Results: Results obtained from this study revealed that the overall prevalence and mean intensity of parasite infection was 29.1% (94/323) and 1464±314 ppg respectively. Parasites recovered were: Entamoeba histolytica 54.26% (51/94), Trichomonas intestinalis 21.28% (20/94), Entamoeba coli 19.15% (18/94), Cryptosporidium spp 3.19% (3/94) and Trichuris trichiura 2.13% (2/94). Prevalence was slightly higher in males 31.76% (27/85) than females 28.15% (67/238) and the difference was not statistically significant (p=0.364). The prevalence was higher among individuals aged 21-30 years 35.22% (31/88). Most infected individuals resided in Djemoun 40.0%(4/10) and this prevalence was significant (p=0.025). Hair dressers harboured the highest rate of intestinal parasites 60.0% (6/10) and the difference was not statistically significant (p=0.235). Hand washing practices, washing of fruits, walking bare footed, toilet cleaning, screening of houses, pet possession, and frequency of nail trimming were not identified as risk factors associated with gastrointestinal parasitic transmission (p>0.05).

Conclusion: Provision of health education, improving personal and communal hygiene, and community based deworming with addition of antiprotozoal drugs should be of major focus to prevent and control these infections.

Open Access Original Research Article

Entrepreneurial Potentials of COVID-19 Vaccination

Ernest Jebolise Chukwuka, Amahi U. Fidelis

International Journal of TROPICAL DISEASE & Health, Page 37-52
DOI: 10.9734/ijtdh/2021/v42i1530520

The study investigated the entrepreneurial potentials of COVID-19 vaccination. The objective of the study is to identify entrepreneurial potentials in COVID-19 vaccination, to determine the business viability of COVID-19 vaccine production and to identify how an entrepreneur can contribute to covid-19 vaccination. A descriptive survey research design was adopted for the study. The sample of the study was achieved using random sampling technique. The sample for this study was 69 respondents. These respondents were selected sixty nine (69) employees of health Centres and hospitals dispensing COVID-19 vaccines in Nigeria.  The instrument used to collect data was the questionnaire. The data collected were analyzed using simple percentage, mean, standard and chi square. The overall finding of the study are that there is entrepreneurial potential in covid-19 vaccination, sales of vaccine, production of vaccine and distribution of vaccine are the entrepreneurial potentials in COVID-19 vaccination; the study also revealed that there is significant and positive relationship between Covid-19 vaccine production and profitability and It was also discovered that entrepreneurial innovation made Covid-19 vaccines possible and a viable business model. High demand of COVID-19 vaccine, global acceptance of the COVID-19 vaccine, effectiveness of the vaccine has made COVID-19 vaccine production a viable business. Base on the findings of the study, the following recommendations were made among others that government officials should support a more productive interaction and collaboration between them and pharmaceutical firms with a focus on capacity building for entrepreneurship development.

Open Access Original Research Article

A Prospective Study of COVID-19 Associated Mucormycosis at Tertiary Care Hospital

. Munesh, Naveen Kumar Singh, . Sweta, Rajeev Sen

International Journal of TROPICAL DISEASE & Health, Page 53-58
DOI: 10.9734/ijtdh/2021/v42i1530521

Introduction: Mucormycosis is an emerging aggressive angioinvasive fungal infection due to non-septate fungi which belongs to order Mucorales. It is associated with covid-19 patients mainly with risk factors like diabetes mellitus use of steroids etc.

Materials and Methods: The present study was carried out in 30 cases with a history of covid-19 infections and had acquired mucormycosis after recovery from SARS CoV-2 infection. These patients with history of mucormycosis were studied prospectively concerning the site involved, associated disease, evolution and diagnosis, therapy, and end result of the disease. Diagnosis was confirmed by histopatholgy with broad non-septate hyphae, ribbon-like with 90 degree-angled branching showing in specimen of tissue submitted.

Result: Out of 30, 22 patients with maxillary sinusitis, seven cases of rhino-orbital mucormycosis, and one case with the rhino-orbital-cerebral mucormycosis. Twenty-five (83.3%) were males and mean age was 51 years. 25(83.3%) cases had diabetes Mellitus. HbA1C ranges from 5.4-10.9 and mean were 8.3. Out of 25 patients of diabetes mallitus, 16(64%) had uncontrolled Diabetes Mellitus on admission. Four (4/25, 16%) patients had Diabetes Mellitus of new onset. Out of the sixteen cases of uncontrolled Diabetes Mellitus 9(30%) had diabetic ketoacidosis. Out of 30 cases, 6 patients had no risk factors except steroids given as a part of therapy for covid-19 infection.Amid of 30 cases with COVID-19 eighteen (18/30,60 %) patients had severe COVID-19 disease, required ICU mechanical ventilation. 9(30%) had CKD out of which8(26.6%) cases. Mucormycosis were identified in all 30(100%) patients on H&E, PAS, and GMS.

Conclusion: Mucormycosis is an aggressive angioinvasive disease with high morbidity and mortality. The disease has risen drastically in the recent times due to COVID 19 pandemic together with diabetes, inappropriate corticosteroid use and immunosuppression due to mechanical ventilation, prolonged hospitalization setting the perfect stormfor mucormycosis.