Dynamics of the Composition of Plasmodium Species Contained within Asymptomatic Malaria Infections in the Central Region of GhanaRead the full article
Journal of Tropical Medicine publishes articles on all aspects of tropical diseases. Topics include pathology, diagnosis and treatment, parasites and their hosts, epidemiology, and public health issues.
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Prevalence and Associated Factors of Intestinal Parasitic Infections among Food Handlers in Mettu Town, Southwest Ethiopia
Food handlers are important sources of intestinal parasitic infection to the public and mass catering service areas. Several reports worldwide particularly in developing countries showed a high prevalence of intestinal parasitic infections among these groups of individuals. In an attempt to determine the prevalence of intestinal parasites, a cross-sectional study was carried out among food handlers in food establishment areas of Mettu town, Southwest Ethiopia. To collect sociodemographic characteristics of the study participants, a structured questionnaire and physical observation were employed. Stool specimens collected from each food handlers participated in the study were then examined using light microscopy of the wet mount followed by formol-ether concentration methods to see infection status. A total of 139 food handlers were enrolled in the study. Majority of them were females 89 (64%), and 124 (89.2%) of them had not taken any training related to food handling and preparation. Sixty-two (44.6%) of the study participants were diagnosed with one or more intestinal parasites. The chi-square test showed that intestinal parasite infection was found associated with personal hygiene ( ≤ 0.0001), nail trimming status ( ≤ 0.0001), and hair cover status ( ≤ 0.040). The multivariable logistic regression indicated that the risk to be infected with intestinal parasites were related with older age ( ≤ 0.032), food handlers who had no hand wash practices ( ≤ 0.033), who had no food handling and preparation training ( ≤ 0.005), poor personal hygiene ( ≤ 0.0001), who had not taken regular medical checkup ( ≤ 0.008), and whose nail was not trimmed ( ≤ 0.0001). The most abundant intestinal parasite identified was G. lamblia (24, 26.7%) followed by E. histolytica/dispar (22, 24.4%), and A. lumbricoides (15, 16.7%). Twenty-eight (45.2%) study individuals were also found with mixed infections. The study thus revealed a high prevalence of intestinal parasitic infection among apparently healthy food handlers in food establishments of the study area. Mass drug administration for all food handlers working in food establishment areas of the town coupled with health education and training should be initiated urgently.
Situation of Rabies in Ethiopia: A Five-Year Retrospective Study of Human Rabies in Addis Ababa and the Surrounding Regions
Objective. The study objective was to estimate the burden of human rabies in Ethiopia from 2015–2019. Study Design. A descriptive study design was applied to measure the size of the problem. Method. Retrospective data were used from the Ethiopian Public Health Institute rabies case record book that was registered between 2015 to 2019. Result. Eighty-seven (87) cases of human rabies were diagnosed clinically in the Ethiopian Public Health Institute over the period of five years (2015–2019) with 100% case fatality. Of these, 83 (95.4%) cases were attributed to dog bites, whereas 1 (1.1%) to a cat and 3 (3.4%) to wild animals. The fatalities were from Oromia (n = 51 (58.6%), 13 (14.9%) were from Amhara, 15 (17.2%) were from Addis Ababa, and 8 (9.2%) from the Southern region. All referred cases had no record of immunization against rabies except eight. Ineffective postexposure treatment was the reason for 5 (5.7%) deaths. Out of 1,652 brain samples of different animals, mainly dogs, submitted for examination, 1,122 (68%) were found to be positive for rabies by the FAT. Dog bites were more common among males than females. The number of dog bite victims who had visited the EPHI counseling office and recommended to take postexposure prophylaxis against rabies both from Addis Ababa and the surrounding areas were 9,592 and 4,192, respectively. Out of these, 5,708 were males and 3,884 females for the capital Addis Ababa. Similarly, 2,439 males and 1,753 females account for areas surrounding Addis Ababa. Among those exposed from Addis Ababa, 1,079 (11.2%) were in the age group less than five, 1696 (17.7%) were in the age group 6–13, and 6,817 (71.1%) in the age group 14 and greater. Victims from outside of the capital Addis Ababa account for 644 (15.4%) for the age group less than 5 years, 964 (23%) for the age group 6–13 and, 2,584 (61.6%) for the age group 14 and greater. Conclusion. Mechanisms must be sought to reduce the cost of PEP and means of obtaining funds so as to initiate timely treatment for rabies exposed individuals of low socioeconomic status. Besides prevention, strategies should focus on public education and strict dog population control.
In Silico Analysis of Common Long Noncoding RNAs in Schistosoma mansoni and Schistosoma haematobium
Background. Schistosomiasis caused by Schistosoma parasites is one of the most common parasitic infections worldwide. Genetic regulation of the genus Schistosoma, which has different developmental stages throughout its life, is quite complex. In these parasites, thousands of long noncoding RNAs (lncRNAs) estimated to be functional were identified. Identifying the transcripts expressed in common and detecting their functions for better understanding of the role of these lncRNAs require a comparative study. Methods. Assembled RNA-seq datasets belonging to S. mansoni and S. haematobium were obtained from the National Center for Biotechnology. A basic local alignment search tool (BLASTN) analysis was conducted against previously constructed lncRNA library to identify the common lncRNAs between two species. LncRNAs target genes and their gene ontology annotation was performed. Results. In S. mansoni and S. haematobium, 5132 and 3589 lncRNA transcripts were detected, respectively. These two species had 694 lncRNAs in common. A significant number of lncRNAs was determined to be transcribed from sex chromosomes. The frequently expressed lncRNAs appear to be involved in metabolic and biological regulation processes. Conclusions. These two species share similar lncRNAs; thus, this finding is a clue that they might have similar functions. In sexual development, they especially might play important roles. Our results will provide important clues to further studies about interactions between human hosts and parasites and the infection mechanisms of Schistosoma parasites.
Socioenvironmental Factors Influencing Distribution and Intensity of Soil-Transmitted Helminthiasis in the Brazilian Amazon: Challenges for the 2030 Agenda
Soil-transmitted helminthiasis (STHs) are poverty-related diseases with high prevalence rates in developing countries. The present study aims to describe the epidemiological scenario of STHs in an urban population in the Brazilian Amazon. A cross-sectional survey (n = 349 children aged 1–15 years) was carried out to obtain faecal samples and sociodemographic and sanitation data. Among the children, 143 (41%) were positive for at least one STH. Prevalence rates of infections by A. lumbricoides, T. trichiura, and hookworms were 24.4%, 42.6%, and 9%, respectively. A logistic regression multivariate model showed that infection with A. lumbricoides is significantly more frequent in children aged 11–15 years (odds ratio [OR] = 2.38; 95% confidence interval [CI] = 1.15–4.94; ) and the presence of latrines inside houses is a protection factor against ascariasis (OR = 0.38; 95% CI = 0.17–0.85; ). Positivity for T. trichiura is higher in the 5–10 (OR = 3.31; 95% IC = 1.85–5.89; ) and 11–15 age groups (OR = 3.16; 95% IC = 1.66–6.00; ), in children living in poor families (OR = 1.78; 95% IC = 1.01–3.14; ) and practicing open evacuation (OR = 2.07; 95% IC = 1.07–3.99; ). Hookworm infection is more frequent in children aged 11–15 years (OR = 6.70; 95% IC = 1.91–23.43; ), males (OR = 6.35; 95% IC = 2.00–20.14; ), and those living in stilt houses (OR = 3.52; 95% IC = 1.22–10.12; ). The use of albendazole in the last six months was a protection factor against hookworm infection (OR = 0.31; 95% IC = 0.10–0.96; ). The proportion of mild, moderate, and severe infections was 55.2%, 37.8%, and 7%, respectively, for A. lumbricoides, 72.4%, 24.3%, and 3.3% for T. trichiura, and 93.8%, 3.1%, and 3.1% for hookworms. Significantly higher worm burdens in T. trichiura and hookworm infections were associated with practicing open defecation and living in stilt houses. The data points to the need to improve sanitation infrastructure in Amazonian cities with similar sociodemographic and environmental characteristics.
Health Facilities’ Readiness to Manage Hypertension and Diabetes Cases at Primary Health Facilities in Bidibidi Refugee Settlement, Yumbe District, Uganda
Background. NCDs are the greatest global contributors to morbidity and mortality and are a major health challenge in the 21st century. The global burden of NCDs remains unacceptably high. Access to care remains a challenge for the majority of persons living with NCDs in sub-Saharan Africa. In Uganda, 55% of refugee households, including those with chronic illnesses, lack access to health services. Of these, 56% are in the West-Nile region where the Bidibidi settlement is located, with 61% of its refugee households in need of health services especially for NCDs (UNHCR, 2019). Data on NCDs in Bidibidi are scarce. Unpublished health facilities’ (HFs) data indicate that cardiovascular diseases (CVDs) (54.3%) and metabolic disorders (20.6%) were the leading causes of consultation for major NCDs (IRC, 2019). No readiness assessment has ever been conducted to inform strategies for the efficient management of NCDs to avert more morbidity, mortality, and the economic burden associated with NCD management or complications among refugees. This study sought to determine the readiness of HFs in managing hypertension (HTN) and diabetes cases at primary health facilities in the Bidibidi refugee settlement, Yumbe district, Uganda. Methods. The study used facility-based, cross-sectional design and quantitative approach to assess readiness for the management of HTN and diabetes. All the 16 HFs at the Health Centre III (HCIII) level in Bidibidi were studied, and a sample size of 148 healthcare workers (HCWs) was determined using Yamane’s formula (1967). Proportionate sample sizes were determined at each HF and the simple random sampling technique was used. HF data were collected using the Service Availability and Readiness Assessment (SARA) checklist and a structured questionnaire used among HCWs. Data were analyzed using SPSS version 20. Univariate analysis involved descriptive statistics; bivariate analysis used chi-square, Fisher’s exact test, and multivariable regression analysis for readiness of HCWs. Results. 16 HCIIIs were studied in five zones and involved 148 HCWs with a mean age of 28 (std ±4) years. The majority 71.6% (106) were aged 20–29 years, 52.7% were females, and 37.8% (56/148) were nurses. Among the 16 HFs, readiness average score was 71.7%. The highest readiness score was 89.5% while the lowest was 52.6%. The 16 HFs had 100% diagnostic equipment, 96% had diagnostics, and 58.8% had essential drugs (low for nifedipine, 37.5%, and metformin, 31.2%). Availability of guidelines for the management of HTN and diabetes was 94%, but only low scores were observed for job aid (12.5%), trained staff (50%), and supervision visits (19%). Only 6.25% of the HFs had all the clinical readiness parameters. On the other hand, only 24% (36) of the HCWs were found to be ready to manage HTN and diabetes cases. Chi-square tests on sex (), education level (), and Fisher’s tests on profession () established that HCWs with bachelor’s degree (AOR = 3.15, 95% CI: 0.569–17.480) and diploma (AOR = 2.93, 95% CI: 1.22–7.032) were more likely to be ready compared to the reference group (certificate holders). Medical officers (AOR = 4.85, 95% CI: 0.108–217.142) and clinical officers (AOR = 3.79, 95 CI: 0.673–21.336) were more likely to be ready compared to the reference group, and midwives (AOR = 0.12, 95% CI: 0.013–1.097) were less likely to be ready compared to the reference group. In addition, female HCWs were significantly less likely to be ready compared to male HCWs (AOR = 0.19, 95% CI: 0.073–474). Conclusion. HFs readiness was high, but readiness among HCWs was low. HFs had high scores in equipment, diagnostics, and guidelines, but essential drugs, trained staff, and supervision visits as well HCWs had low scores in trainings and supervisions received. Being male, bachelor’s degree holders, diploma holders, medical officers, and clinical officers increased the readiness of the HCWs.
Formulation and In Vitro Evaluation of Oral Capsules from Liquid Herbal Antimalarials Marketed in Ghana
Malaria ranks amongst the major health challenges faced by many developing countries. In Sub-Saharan and tropical regions of Africa, malaria continues to claim the life of one out of every twenty children below the age of five years. In adults, mortality rates are lower, but frequent debilitating attacks reduce the quality of life for chronic sufferers. The patronage and usage of liquid herbal antimalarials in the management and treatment of malaria in Ghana have been on the ascendency over the past decade. This project seeks to transform five liquid herbal antimalarial preparations (Agbeve pevah, Time mixture, Givers mixture, Masada mixture, and Rooter mixture) produced locally and commonly used for the treatment of malaria fever into capsules. This will help eliminate the current limitations, such as lack of patient compliance due to the bitterness and bulky nature of packaged preparation. The amount of dry extract per dose of each herbal antimalarial preparation and the wavelength of maximum absorption (λmax) of aqueous solutions of Agbeve, Time, Givers, Masada, and Rooter extract were determined. The flow properties of formulated granules were determined and subsequently encapsulated. The formulated capsules were evaluated using basic pharmacopeial tests, such as uniformity of weight, disintegration, drug content, and dissolution. Difference, f1, and similarity, f2, factors were employed in analyzing the dissolution profiles of the formulated capsules. The formulated granules exhibited good flow properties and passed the weight uniformity, disintegration, and drug content tests. The capsules exhibited optimal release of extract at the 45th minute in 0.1 M HCL. All formulated capsules had ƒ2 values >50 and ƒ1 values <15, indicating the similarity of their drug release profiles with their respective liquid herbal antimalarials. Oral capsules of Agbeve, Time, Givers, Masada, and Rooter have been successfully formulated and can be used as a substitute for Agbeve pevah, Time mixture, Givers mixture, Masada mixture, and Rooter mixture, respectively, in the treatment of malaria.