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   2016| July-August  | Volume 9 | Issue 4  
    Online since June 28, 2016

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Recurrent high fistula-in-ano: Think of tuberculosis!
Reetika Dawar, Sushil Kumar Jain, Hena Rani, Leena Mendiratta, Raman Sardana
July-August 2016, 9(4):273-275
A 41-year-old male presented with purulent discharge and pain in the perianal region. There was no history of fever or weight loss. The patient gave a history of being operated 14 times earlier for the same complaints. Perioperative discharge showed acid-fast bacilli on Ziehl-Neelsen (ZN) stain. No pulmonary focus of tuberculosis (TB) was found. The patient was started on antitubercular treatment and has not reported any pain or discharge from the perianal region for the last 1 year. A high index of suspicion of TB should be kept in mind in perianal lesions, especially recurrent lesions, even when no primary focus is found. Surgery and medical treatment combined may be needed in such cases.
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Intramuscular calcifications after quinine injections
Anna M.C Koop, Jos P.A.M Vroemen, Jennifer M.J Schreinemakers
July-August 2016, 9(4):263-265
A 45-year-old woman presented with a painful swelling of the right leg. Twenty years previously, she suffered from malaria and was treated with intramuscular injections of pure quinine. Over the years, she noticed two solid tumors at the site of the quinine injections. Because of the pain and discomfort, we decided to excise the tumor. No evidence exists indicating how to treat dystrophic calcifications after intramuscular injections. Our advice is to consider resection if the calcifications are present for many years and cause complaints.
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Pharmacoepidemiology: Pattern of some commonly reported diseases and drugs utilized in a tertiary health institution
Sylvester Erhunmwonsere Aghahowa, Chukwunonso Ezekwueche, Esiekpaobo Omonokhua, Philip Obarisiagbon
July-August 2016, 9(4):219-225
Purpose: Due to a wide variation of diseases reported and drugs utilized in different regions, It became necessary to assess the pattern of diseases commonly reported and drugs utilized prior to and after visiting the University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. Materials and Methods: Patients who reported with various diseases at the first point of visit were randomly selected after obtaining ethical consent from the health institution. Results: Out of 4253 patients who were assessed, the male to female ratio was 0.92:1. The age range was 56 ± 26.02 [mean ± standard deviation (SD)] years. The diseases reported were classified; the most common was trauma (open wounds: 62.69%) followed by infection (malaria: 62.51%), gastrointestinal disease (upset stomach: 65.06%), respiratory disease (cough: 69.79%), cardiovascular disease (hypertension: 68.51%), central nervous system disease (headache: 63.97%), endocrine disease (diabetes: 81.66%), musculoskeletal disorder (pain: 91.40%), and dermal disease (rash: 63.15%). The commonly utilized classes of drugs prior/post visits were analgesics (acetaminophen 44.87%/diclofenac 24.24%), antiallergic (chlorpheniramine 1.01%/loratadine 0.16%), anti-infective (ampicillin-cloxacilline 12.16%/ciprofloxacine 18.75%), antidiarrhea (oral rehydration salt 0.6%/zinc sulfate 0.25%), antifungal (clotrimazole 1.42%/fluconazole 3.12%), antihypertensive (Moduretic 10.02%/amlodipine 7.02%) antimalarial (artemether-lumefantrine 24.42%/artemether-lumefantrine 41.51%), antiulcer (mist magnesium trisilicate 1.08%/omeprazole 2.40%), anxiolytic (diazepam 0.42%/bromazepam 0.55%), and minerals/vitamins (ascorbic acid 4.00%/ferrous sulfate 1.48%). There was a significant difference in the pattern of disease among the ages (P < 0.05) but the difference was insignificant between the sexes (P > 0.05). Conclusion: Essential drugs were being prescribed and utilized prior to and after hospital visits. It is therefore, recommended that an enhanced adequate stocking and prescribing be encouraged in accordance with the reported diseases.
  4,071 26 -
Head lice treatment with two interventions: Pediculosis capitis profile in female schoolchildren of a rural setting in the south of Iran
Mohammad Djaefar Moemenbellah-Fard, Zahra Nasiri, Kourosh Azizi, Mohammad Reza Fakoorziba
July-August 2016, 9(4):245-250
Background: Previous research suggests that certain communities, including rural residents, exhibit endemic infestations which can be prevented by banned interventions such as the use of certain chlorinated lice-killing chemicals. The aim of this study was to evaluate two different treatments on head lice among primary school girls of Lar, Fars Province, south of Iran. Patients and Methods: Lindane (1%) or permethrin (1%) shampoos were used on two groups who were treated for live head lice after screening with plastic lice detection combs at schools. A questionnaire form on the epidemiologic factors was included. The outcomes were followed up for 2 weeks from the initial treatment on days 2, 6, 9, and 14. Data analyses were performed using analysis of variance (ANOVA) and Kruskal–Wallis tests. A P value <0.05 was considered to be statistically significant. Results: From 2,084 students examined, 82 girls (3.93%) were infested with pediculosis. No significant correlation was found between head lice infestation level and hair length, hair style, itching, family size, education grade, and age. The data on days 2, 6, 9, and 14 from permethrin and lindane treatments were 71.8%, 64.1%, 89.7%, and 89.7% versus 92.5%, 92.5%, 97.5%, and 95%, respectively. On days 2 (P = 0.017) and 6 (P = 0.002) after treatment, significant differences were noted on reexamination of the cases. Only one reinfestation case was identified during the treatment period. The level of insensitivity to permethrin was twice that of lindane at the end of this period. Conclusion: The level of cure in treated students was similar for both shampoos. Lindane swiftly acted to reduce the level of infested cases by the second day.
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Correlates of individual-level stigma and unsafe abortions among women seeking abortion care in Trans Nzoia and Machakos Counties, Kenya
Erick Kiprotich Yegon, Peter Kabanya Mwaniki, Elizabeth Echoka, Joachim Osur
July-August 2016, 9(4):226-234
Objectives: To compare the levels of abortion stigma in regions with high and low incidence of unsafe abortion in Kenya to explore whether abortion-related stigma is associated with incidence of unsafe abortion. Study Design: A cross-sectional survey of 759 women receiving abortion services in private and public health facilities in two counties located in regions with high and low incidence of unsafe abortion regions of Kenya. Results: Of the total respondents, 424 sought postabortion care (PAC), whereas 335 sought induced abortion. Factor analysis revealed a four-factor model for examining individual-level stigma related to seeking an abortion. The mean of stigma scores for women in a Trans Nzoia was higher than in Machakos. (49.82 compared to 47.58, P< 0.001). In the combined sample, respondents seeking PAC reported higher stigma scores compared to those seeking induced abortion. For the overall scale and subscales, stigma reduced with increases in the age of respondents (b = −7.7, P< 0.001 for 25–34 years and b = −4.6, P< 0.001 for 35–49 years). Regression analysis showed that stigma decreased in the county with low incidence of unsafe abortion on interaction between with type of abortion service. Conclusions: Respondents from a county with higher incidence of unsafe abortion reported higher stigma scores compared to those from a county with lower incidence of unsafe abortion. Age, marital status, type of abortion service, and socioeconomic status of respondents were all significantly associated with stigmatizing attitudes across the stigma scale's subscales. Young unmarried women, women who received PAC low socioeconomic background, and married women reported higher stigma scores.
  3,883 28 -
Rapid multiplex polymerase chain reaction for simultaneous detection of Vibrio harveyi, V. parahaemolyticus, and V. vulnificus in pacific white shrimp (Litopenaeus vannamei)
Kanittada Thongkao, Yuttana Sudjaroen, Parin Chaivisuthangkura
July-August 2016, 9(4):255-262
Context: A comparatively small number of species, e.g., Vibrio parahaemolyticus and V. vulnificus, cause disease in both aquatic animals and humans. V. harveyi is marine animal pathogen and rarely causes infections in humans; however, it might become a reservoir of antibiotic-resistant bacteria forms and virulence genes. Aims: 1) to develop rapid multiplex polymerase chain reaction (PCR) assay for the simultaneous detection of V. harveyi, V. parahaemolyticus, and V. vulnificus by using vhhP2, tl, and rpoS genes as the respective target genes and 2) to evaluate specificity and determined detection of multiplex PCR technique. Materials and Methods: The multiplex PCR assay was developed and evaluated for specificity on 36 isolates of V. harveyi, 30 isolates of V. parahaemolyticus, and 14 isolates of V. vulnificus, along with other species of Vibrio and non-Vibrio bacterial isolates. Sensitivity of test was described as detection limit of pathogens in lowest amount of sample (CFU/mL or CFU/g) was determined by diluted DNA extracts of the pure cultures and spiked pacific white shrimp (Litopenaeus vannamei) samples Results: This developed multiplex PCR was proved as an accurate method, which was specific for three Vibrio species. The detection limits of V. harveyi, V. parahaemolyticus, and V. vulnificus in pure cultures and spiked shrimp samples ranged 1.05-4.8 × 103 CFU/mL and 1.9-7 × 104 CFU/g, respectively. Conclusions: This rapid multiplex PCR assay can decrease amount and process of sample preparation, which was time-consuming, and had preferable accuracy. This developed technique will be suitable and useful for food-borne pathogen detection in shrimp and horizontal gene transfer study among different Vibrio species in aquatic animals.
  3,865 26 -
Predictors and factors related to the uptake of cervical cancer screening test among female secondary school teachers in Sagamu, Ogun State, Nigeria
Tade Adesoji Emmanuel, Sholeye Oluwafolahan, Buari Moyosore Adebukola Sinat
July-August 2016, 9(4):235-240
Background: Cervical cancer is a cause of significant morbidity and mortality among Nigerian women. Early detection by screening has proved to be an effective preventive measure. Knowing the factors that determine and predict uptake helps to determine where more efforts need to be put to achieve better uptake of the screening test. Aim and Objective: To determine the predictors and factors related to the uptake of cervical cancer screening test among female secondary school teachers in Sagamu. Methods: A cross-sectional descriptive study was carried out among 256 secondary school teachers in Sagamu Local Government Area of Ogun State. Data were collected using semi-structured, self-administered questionnaires and analyzed using SPSS version 21. Chi-square test was used to determine factors related to the uptake of the screening test while logistic regression was done to predict which group was less likely to be screened. Results: Uptake of screening test was 17.6%. One hundred and sixty-nine (66%) respondents were willing to be screened. The most common reason for not willing to be screened was the belief of not been at risk of the disease. About 84% of the respondents had a positive attitude toward cervical cancer screening, with a mean score of 7.8 ± 1.5 while only 23.4% had good knowledge with a mean score of 7.6 ± 3.6. Teachers with lower knowledge and attitude scores who had one sexual partner were less likely to be screened. Conclusion: Adequate knowledge needs to be passed across to teachers to improve uptake of cervical cancer screening.
  3,507 26 -
Carbimazole induced atypia in the thyroid gland
Sunil Y Swami, Shrinivas Panchal, Grace D'Costa
July-August 2016, 9(4):271-272
Thyroid nuclear atypia associated with carbimazole is well-known. However, there are rare cases described in literature. We report here a case of thyroid fine needle aspiration cytology (FNAC) of a follicular lesion of undetermined significance or nuclear atypia of undetermined significance (FLUS/AUS) observed in a 56-year-old female presenting with Hashimoto's thyroiditis on treatment by carbimazole. In conclusion, thyroid nuclear atypia in the form of anisonucleosis, prominent nucleoli, and hyperchromasia associated with carbimazole treatment should be interpreted with caution in differentiating from malignancy.
  3,202 27 -
Affluence and adolescent obesity in a city in south-east Nigerian: A cross-sectional survey
Agozie C Ubesie, Chinyere V Okoli, Samuel N Uwaezuoke, Anthony N Ikefuna
July-August 2016, 9(4):251-254
Background: Pediatric obesity is becoming a public health challenge in both developed and developing countries. While poverty is a known risk factor for pediatric obesity in developed countries, the role of socioeconomic class in developing countries remains unclear. This study aims to determine the prevalence of adolescent obesity in Enugu, south-east Nigeria, and relate same to socioeconomic class. Materials and Methods: A cross-sectional study of adolescents aged 10-19 years in Enugu metropolis. The participants were enrolled by multistage sampling method. Their weights and heights were measured and body mass index (BMI) was calculated. The participants were classified as obese, overweight, and normal using age- and sex-specific BMI percentiles. Socioeconomic class was determined using parental income and educational level. Data were analyzed with the Statistical Package for Social Sciences (SPSS) version 20.0. Results: A total of 2,419 participants were included in the study (1,242 males and 1,177 females). Their mean age was 14.80 ± 2.07 years. The prevalence rates of obesity and overweight were 5.7% and 7.2%, respectively. Females were more likely to be overweight and obese [odds ratio (OR) = 2.55, P < 0.001, OR = 2.66, P < 0.001, respectively]. Adolescents from the upper socioeconomic class were more likely to be obese [OR = 2.57, P < 0.001, 95% confidence interval (CI): 1.80–3.67]. Conclusion: Adolescent obesity in Enugu, south-east Nigeria, is more common among children from the upper socioeconomic class.
  2,791 25 -
An uncommon presentation of progressive disseminated histoplasmosis
Vijay Kumar Agarwal, B Saroj Kumar Prusty, Karishma Rosann Pereira
July-August 2016, 9(4):279-282
Progressive disseminated histoplasmosis (PDH) caused by Histoplasma capsulatum generally develops in immunocompromised patients or those on long-term systemic corticosteroid therapy. Here, we report a case of PDH in an immunocompetent patient, which is a rare occurrence. A 56- year-old male patient, whose work often led him to caves, now reported with a low-grade fever and altered sensorium. Investigations revealed hyponatremia, bilateral adrenal enlargement, and mediastinal lymphadenopathy. A rare complication of the manifestations of histoplasmosis in an immunocompetent patient, in the form of ring lesions in the brain, came to light during the clinical investigations. The patient developed generalized tonic–clonic convulsions and needed care for the critical condition 2 weeks into treatment. This case report traces the clinical course, histological and serological findings, and response to amphotericin B therapy in the patient.
  2,520 29 -
Perception of injections in semi-urban communities in Sokoto, northwest Nigeria
Muhammad Tukur Umar, Shaibu Oricha Bello, Abdulgafar Olayiwola Jimoh, Anas Ahmad Sabeer, Umar M Ango
July-August 2016, 9(4):241-244
Objective: The hazards associated with injections constitute a serious public health challenge worldwide, especially in the developing countries such as Nigeria. To adequately address this menace, there is a need for a survey to assess the perception of health-care seekers and providers on injections generally to provide a platform upon which targeted intervention can be made. This study aimed at evaluating the semi-urban community perception on injections and awareness of dangers associated with it. Materials and Methods: This was a cross-sectional using validated interviewer administered questionnaires. A total of 102 respondents were recruited using a multi-stage sampling technique from semi-urban area. The questionnaire sought their demographic profiles, awareness of hazards associated with injections use, and perceptions. Results: Out all the respondents, 96.1% had injections in the last 3 months. Only 47.1% seek medical help in government health facilities. Majority considered injections to be more effective than oral drugs [80.4%, odds 4.10 and 95% confidence interval (CI) 2.53-6.65]. Most of the respondents preferred injections (74.5%, odds 2.92 and 95% CI 1.88-4.55). Chloroquine injection was the most cited by injections the respondents (70.6%). And only, 29.4% (odds 0.42 and 95% CI 0.27-0.64) had adverse events following injections. Awareness of hazards associated with injections was not too good as (27.5%, odds 0.38 and 95% CI 0.25-0.58) admitted that injection carries no risks. Conclusion: Awareness on dangers associated with injections was poor with erroneous perception that injections generally were more effective than oral drugs. Chloroquine is still widely used as an anti-malaria drug in private settings despite its ban. Incidence of injection is high in semi-urban communities.
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Working together to accomplish gender equality in health: World Health Organization
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):286-287
  2,204 26 -
Recurrent acute pancreatitis in a Saudi child with isovaleric acidemia
Satti Abdelrahim Satti
July-August 2016, 9(4):276-278
Isovaleric acidemia (IVA), also known as the sweaty foot syndrome, is an autosomal recessive organic acid disorder due to a defect in the mitochondrial Flavin Adenine Dinucleotide (FAD)-dependent enzyme isovaleryl CoA dehydrogenase. Acute pancreatitis as a complication has been reported. We are presenting a rare case of recurrent acute pancreatitis complicating a 9-year-old girl with IVA. She presented with repeated attacks of vomiting, severe abdominal pain, and fever since the age of 18 months. These were diagnosed as attacks of pancreatitis with high serum amylase presenting clinically as diabetic ketoacidosis. Later, she developed chronic pancreatitis which is proved by lapratomy. In the last attack, she was comatosed with fulminant sepsis and sooner the patient died. Blood sample taken during this last attack confirmed the diagnosis of IVA. An inborn error of organic acid metabolism should be considered in children with pancreatitis of unknown origin.
  2,180 25 -
Q-fever in a refugee after exposure to a central New York State livestock farm
Mustafa Qazi, Anita C Weimer, Brenden A Bedard, Byron S Kennedy
July-August 2016, 9(4):266-270
Q-fever is a zoonotic disease caused by Coxiella burnetii that can create an acute or chronic form of the illness. In March 2014, Q-fever was identified by serology and Real-time Polymerase Chain Reaction (RT-PCR), in a 62 year-old male that was a Nepalese refugee. The male visited a livestock farm with a slaughterhouse in rural Central New York State, twenty-two days prior to onset of symptoms. He had direct handling of goats on this farm prior to slaughter. We describe the case presentation of his illness and the public health epidemiological investigation.
  2,149 26 -
Standardized management of Zika virus infection during pregnancy
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):217-218
  2,049 25 -
Active screening for tuberculosis among slum dwellers in selected urban slums of Puducherry, South India
Palanivel Chinnakali, Pruthu Thekkur, Gomathi Ramaswamy, Kalaiselvi Selvaraj
July-August 2016, 9(4):295-296
  2,004 26 -
Coinfection between dengue virus and Zika virus: A complex situation
Somsri Wiwanitkit, Viroj Wiwanitkit
July-August 2016, 9(4):302-303
  1,986 25 -
Dengue in a patient with underlying polycythemia: The first global case report
Beuy Joob, Viroj Wiwanitkit
July-August 2016, 9(4):301-302
  1,860 25 -
Standardizing the assessment and management protocol of critically ill under-five children: World Health Organization
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):215-216
  1,828 25 -
Safe childbirth checklist: A simple tool to encourage best practices by skilled attendants
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):290-291
  1,770 37 -
Ayurveda practice in Hindu mandirs in Bangkok, Thailand
Viroj Wiwanitkit, Wasana Kaewla, Salingkarn Kulubrahm Kalasribharadwaj
July-August 2016, 9(4):300-301
  1,684 36 -
Implementing universal minimal standards to counter the challenge of gender-based violence in emergencies
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):289-290
  1,557 25 -
Salmonella osteomyelitis
Somsri Wiwanitkit, Viroj Wiwanitkit
July-August 2016, 9(4):283-283
  1,495 26 -
Emphasizing the need to achieve universal health coverage worldwide
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):292-293
  1,491 25 -
Laboratory findings from stool examination in blastocystosis diarrhea: A review of 26 cases
Sora Yasri, Viroj Wiwanitkit
July-August 2016, 9(4):284-285
  1,473 35 -
Postdoctoral degree in humanistic medical science: The first development from a public health curriculum unit
Viroj Wiwanitkit, Wasana Kaewla
July-August 2016, 9(4):285-286
  1,465 25 -
Contamination of drinking water collected from water machines in a university in Thailand
Sophorn Vong, Nipasak Kong-ngarm, Viroj Wiwanitkit
July-August 2016, 9(4):297-298
  1,460 27 -
Childhood tuberculosis: Administering child-friendly tuberculosis medicines in the right dosage universally
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):293-294
  1,420 25 -
Breastfeeding and strengthening of the economy: Offering merits beyond nutrition
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):298-299
  1,401 26 -
Skin disease after swimming in a dirty sea
Beuy Joob, Viroj Wiwanitkit
July-August 2016, 9(4):300-300
  1,371 35 -
Responding to the World Health Organization call for ensuring accessibility to antiretroviral therapy for all
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
July-August 2016, 9(4):288-289
  1,314 25 -
Varicella seropositivity among nursing students before clinical year practice: A short report
Beuy Joob, Viroj Wiwanitkit
July-August 2016, 9(4):283-284
  1,290 25 -
Attending to health checkup programs by medical personnel: Observation in a medical center
Won Sriwijitralai, Viroj Wiwanitkit
July-August 2016, 9(4):296-297
  1,272 26 -
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