Asian Pacific Journal of Tropical Disease

1-3

Authors: Zinaye Tekeste, Meseret Workineh, Beyene Petros

Objective: To assess the accuracy of Paracheck Pf® in reference to the conventional light microscopy. Methods: A total of 400 patients visiting Awash, Methara and Ziway malaria centers were simultaneously screened with both light microscopy and Paracheck Pf® for the presence of Plasmodium falciparum (P. falciparum) malaria. Results: Of the 190 samples that were negative by light microscope, the Paracheck Pf® showed 11 false positive and 179 true negative results, and from a total of 210 samples positive by light microscope, Paracheck Pf® accurately diagnosed 200 true malaria cases. Taking the light microscopy as a standard test for malaria, the sensitivity, specificity, positive predictive value and negative predictive value of Paracheck Pf ® is 95.2% [cofidence interval (CI)=92.4-97.1], 94.2% (CI=91.1-96.3), 94.8% (CI=92.0-96.7) and 94.7% (CI=91.6-96.8), respectively. Conclusions: Paracheck Pf® showed good sensitivity and specificity for the diagnosis of P. falciparum malaria, and fulfill the world health organization (WHO) recommendation that requires the sensitivity of rapid diagnostic tests (RDTs) to be greater than 95%. Therefore, Paracheck Pf® can be used as an alternative to the Giemsa stain light microscopy in resource poor set ups.

7-11

Authors: Jombo GTA, Emanghe UE, Amefule EN, Damen JG

Objective: To ascertain antimicrobial susceptibility profile of Proteus mirabilis (P. mirabilis) from cplaitntiecranls u.Mrineet hsopdecsi:m Tehnes sattu ad yu nwivaes rrseittyr ohsopsepcittiavle i nin t hnea stupraete. Dofa ittas greecnoerrdaetedd i nfrcormea suirnign ere csuislttaunrcees ocfo mpaptiileendt.s Raet lUevnainvet risniftoyr omf aCtiaolna boabrt aTienaecdh iwnegr eH oasgpei taanl df ogre an dpeerr ioofd p oaft ifeivnets ,y eoargrsa n(2i0s0m4s- 2r0e0c9o)v wereerde apnrodc ethdeuirre asn. tRibeisoutilct ss:u Psc. emptiirbaibliitlyis psahtotewrends . tPhe. mhiigrahbeislti sr ewsaisst aidnecnet iafgieadin usts ianmg psitcainldlianr,d c llaobxaocrailtloirny, wamhiolex iccoillliisnti,n t,e otrflaocxyaccliinn,e c, icporo-ftlroixmaocxina,z ocleef,t reiarxyothnreo, mnaylciidni xaicn da ccihdl oarnadm npihtreonfuicraonl t(o1i0n0 %re-c3o7r.d2e%d) nthoes ohciogmheiastl aiscotilvaitteys (o5f9 .t1h%e- o96rg.9a%n)i swmit hw enroe dsriugng ifrieccaonrtdliyn gh i1g0h0e%r tahcatinv itthye. Tchoem mreusinsittayn caec qoufi rtehde sishooluatleds baeg aeixnesrtc tihseadt oinf tahnet icboimotmico and amnitnibisiotrtaictiso nin i nu sheo (sPp

Authors: Nweze EI1*, Ezute S, Emeka Nweze CC, Ogbonna CC, Eze C

Objective: To study the bacteria etiological agents of respiratory tract infection among 280 tsoc hao opla ncehli lodfr etnen i na nStoibuitoht iEcsa.s tM Neigtheroida,s :a nTdh rtooa td sewtearbmsi n(2e8 0t)h ewier raen ctiomlleiccrtoebdi afrl ormes issttuadnecnet sp aintt efornusr bwoearred uinsge ds ctoh osoclrse leonc athteeds ei ns wEanbusg uto adnedt eOrmniitnshe at hmee ptrroepvoalliesn. cSet aonfd raersdp imraitcorroyb ipoalothgoicgaeln sp rwocheildeu trhees disioslca tdeisf.f uRsieosnu lttess:t Owfa tsh eu s2e8d0 tsoa mdeptleersm sicnree etnheed a, n5t7i.m1icrobial resistance patterns of the recovered the most prevalent % were positive. Haemophilus influenzae was (16.1%), followed by Streptococcus pyogenes (13.9%), Klebsiella pneumoniae (12.5%), Streptococcus pneumoniae (6.8%), Staphylococcus aureus (5.4%) and Corynebacterium diphtheriae (2.5%). More isolates were recovered in the two male schools investigated. However, tlhoceareti owna so fn oth sei gsnuibfijceacntst .d Gifrfeeraetenrc en uinm tbheer oovfe risaolll aptreesv a(5l6ence of isolates according to sex or school years. This was statistically significant %) was recovered from those aged 11-14 years and (P<0.05), compared to the other two age groups (15-18 were multi1-9r-e2s3is ytaenatr si)s.o Tlahtee sp. attern of resistance varied according to the bacteria species. There infection particularly from resSeinrvcoei rtsh easme osntugd tehnetms s, ttahnedr et hies rniesked o ft oc oinnctrraecatsineg s urersvpeiirlalatonrcye traancdt adnedve olothpe br estitmeri lsatrr areteggioienss toof cAufrrbic tah. eC ionncrceluassiinogn sp:r eTvhael esnpceec torfu mre sopfi rbaatcotreyr itar accat uisnifnegc trieosnp iinra ttohriys trreascits tiannfeccet iaopnp iasr esntitllly w diduee itno Nanigteibriiao.t iMc aanbyu siseo. laDteevs eslhoopwmeedn ta popf rneecwia bslter a tleegvieelss toof acnutribb itohtiic

27-30

Authors: Yonggen Zhang, Shiwen Wang, Yonglin Shi, Huilan Yu, Minghua Cao, Ling Mei, Gaorong Hua, Lingfu Yao, Lina Tian, Qiang Yu, Lijuan Zhang

Objective: To investigate the epidemiological status of anaplasmosis among farmers and dtroamnsemstisicsi oann iomf ahlusm iann Gguraannugldoec yCtiocu anntayp wlahsmeroes itsh eoc ucunrurseuda iln nAonshocuoi mprioavl inhcuem aannd ttoh eh uinmdaenx patient in this event lived, as well as Huaiyuan County and Mingguang City in Anhui province. Methods: From April to May in 2009, 596 farmers, 132 goats, 12 dogs and 6 cows was collected from Ginu faanrgmdeer,s M, ginoagtgsu, adnogg sa nadn dH cuaatityleu awna cs oduentteirems iannedd tuhsei nIgg Ga na nimtibmoudnieosf luagoareinscste nAc. ep hasasgaoyc ytophilum (IFA). The A. phagocytophilum 16S rRNA gene was amplified from blood samples from domestic animals puesirncge nntaegstee do f PfCarRm, earnsd w tihthe IggeGn eatnict ibdoivdeiressi tayg oafi ntshte A 1.6 pSh raRgNoAcy tgoepnhei luwmas iann tahley s3e ds.u rRveesyu cltosu:n Ttihees was 33.7%, and the individual percentages for Guangde, Mingguang and Huaiyuan counties were 76.5%, 59.2% and 10.4%, respectively. The total seroprevalence in dogs, goats and cattle was 33.3%, 0g.e8n%e aonfd A 0.% p,h raegspoceycttoivpehliyl.u Tmh ein p egrocaetns,t adgoeg osf asnadm pclaetstl ep owsiatsiv e for amplification of the 16S rRNA 33.3%, 25.0% and 0%, respectively. Analysis of the genetic diversity of the 16S rRNA gene showed that there were two genotypes of A. phagocytophilum. Group A was endemic in Guangde County, which is located in the southeast oofc cAunrhreudi .p Grorvoiunpc eB, wwhaesr el otchaet endo snoocrotmh ioafl hHuumaiaynu agnra nCuoluonctyyt.i cC oountbcrleuaskio onf sa:n Wapel acsomnocsliusd iend 2t0h0e6 dperemvoanlesntrcaet eodf, Aa.n dp hdaigagoncyotsoips hainludm d iaffmeroenngt ifaalr dmieargsn oasnids odfo zmoeosntoicti ca n“irmicaklest tisni aAl”n hinufie cptrioovnisn cseh owualds tbhee epmupbhliacs hizeeadl thin t hcrlienaitc taol hpuramcatincse .a nAd s aynstiemmailcs. ecological survey should be conducted to reduce

36-42

Authors: Enomfon J Akpan, Jude E Okokon, Idongesit C Etuk

Objective: To evaluate the antimalarial activities of ethanolic root extract/fractions of Anthocleista djalonensis (A. djalonensis) in Plasmodium berghei (P. berghei) infected mice. Methods: A. djalonensis root extract (175-1 000 mg/kg) and fractions (chloroform, and methanol; 250 and 500 mg/kg) were investigated for antiplasmodial act ievtihtyyl aagcaeitnatset cdhinloitrrooqpuhienneo-ls, eanmsipthiveet aPmlainsem aonddiu yme absetr-gihnediu icnefdec ptiyornesx iian. mThicee a nantidp lfaosrm aondtiipaly raecttiicv iatcyt divuitryin agg eaainrlsyt panyrdi mesettahbalmisihneed ( 1i.n2 fmecgt/ikogn)s w aesr ew ueslle da sa sp rpoopshityivlaec ctiocn twroelrse. iAnnvteipstyirgeattiecd a. cAtirvtietsyu onfa tthee (5c rmudge/k egx) traancdt was also evaluated against dinitrophenol, amphetamine and yeast-induced pyrexia. Results: Tsehnes ietxivtrea cPt laansmd oidtsi ufmra cbtieorngsh edio isnef-edcteipoenn idne nptrloyp rheydluaccetidc ,p saurapspirtaeessmiviae iannddu cceudr abtiyv ec hmloordoeqlusi nine msuircvei.v aTlh teismee rferdoumc t1i3o ntso w28e rdea ystsa rtiesltaitciavlel yt os icgonnitfricola n(Pt <(P0.<000.10).0 1T).h eT haecyti vailtsioe si mofp eroxvtreadc tt/hfrea cmtieoanns iwnedruec ceodm bpya rdaibnlietr toop thheanto ol,f tahmep shtaentadmarind ed raungds yuesaesdt ,( cthhelo reoxqtruaicnte iannhdib pityerdim seigthnaifmiciannet).l yO (nP

48-50

Authors: Nnadi Nnaemeka Emmanuel, Orazio Romeo, Ayanbimpe Grace Mebi, Ojogba Okolo Mark, Fabio Scordino, Enweani Ifeoma Bessy, Giuseppe Criseo

Objective: To investigate the fluconazole susceptibility of the genotypes of Candida albicans (C. albicans) strains isolated from patients with vulvovaginal candidiasis (VVC) in Jos, Plateau State, Nigeria. Methods: A total of one hundred and seventy seven (177) Candida isolates were examined. The strains were obtained from 320 female patients with VVC and were identified using both phenotypic and molecular methods. Their genotypes were determined, based on the presence or absence of a transposable intron in the 25S rDNA. Results: Eighty four (84) strains were recognized as being C. albicans and all the 84 C. albicans strains resulted to be genotype A. Antifungal susceptibility testing showed that 13 of those isolates (15.48%) were resistant to fluconazole. Conclusions: Based on these data, we concluded that C. albicans genotype A was common among VVC patients in Jos, and resistance to fluconazole is quite high. To our knowledge, this is the first study that reports C. albicans genotypes in Jos and its resistance to fluconazole.

55-59

Authors: Sreenivasan Sasidharan, Batumanathan Ghayethry, Manickam Ravichandran, Lachimanan Yoga Latha, Subaramanion Jothy Lachumy, Khoo Miew Leng, Surya Gegu Surasa Rao

Objective: To study the prevalence of Helicobacter pylori (H. pylori) infection, according to ethnicity and gender among the people of Sungai Petani, Kedah, Malaysia who undergo endoscopy. Methods: To study the epidemiology of H. pylori infection in Kedah, Malaysia population, we assessed the database of hospital admissions of the patients referred to the Endoscopy Unit at Sungai Petani Hospital for oesophagogastro-duodenoscopy (OGD) between January 2000 and December 2007. For statistical analysis, the Fisher’s exact test (2- tailed test) was used. H. pylori infection rate was determined in 1 965 consecutive patients. Results: Out of 1 965 patients, 597 (30.4%) were positive and 1368 (69.6%) were negative for H. pylori infections. Generally, the prevalence rate among males (51.9%; 398/767) was significantly higher (P<0.05) than for females (33.1%; 199/601). In terms of ethnics, the overall prevalence showed H. pylori infection was commonly found among Indians and Chinese with prevalence rate of 35.6% (194/545) and 28.6% (100/350) respectively. These figures are significantly higher (P< 0.05) than the 28.5% (300/1051) for Malays. The prevalence rates for Malay males was lower (P<0.05) than those of Chinese and Indians. Conclusions: In conclusion, there is a significant difference in H. pylori infection prevalence rates among ethnic groups (highest in Indians, then Chinese and unusually low in Malays) and gender groups (highest in males) in Kedah, Malaysia.

62-65

Authors: Sudeshna Behera, Manaswini Mangaraj, Prakash Chandra Mohapatra

Objective: To evaluate the diagnostic efficacy of ischemia modified albumin (IMA) and its correlation with lipid profile, oxidative stress in acute myocardial infarct (AMI) patients attending Cardiology Emergency Department (ED). Methods: At presentation serum IMA in conjunction with electrocardiogram (ECG) and cardiac troponin T (CTnT) was evaluated in 35 AMI patients attending the ED within 6 hours of chest pain. These patients were subjected to standardized diagnostic procedures and treatment. Thirty five healthy volunteers were enrolled as control. Results: IMA showed a higher level in ischemic patients than in control with the highest sensitivity (77%) in comparison to CTnT and ECG. With CTnT or ECG, IMA documented a sensitivity of 83% and 88%, respectively. Whereas with both CTnT and ECG, IMA identified 94% of AMI patients with the highest negative predictive value (90%). Conclusions: IMA has evolved as a cost effective, highly sensitive, early diagnostic marker of cardiac ischemia and an earlier rule out test in AMI patients.

70-72

Authors: N Yusuf, M Ahmed Ali, MF Islam, JA Khanam

Objective: To find out different grades of cervical intraepithelial lesions of cervix with visual inspection of cervix with acetic acid (VIA). Methods: VIA was carried out in 540 eligible women attending Gynaecology Outpatient Department for gynecological problems. The women underwent a complete clinical evaluation. All screened women (540) were evaluated by colposcopy and biopsies which were taken from different quadrants of the cervix. The final diagnosis was based on histology, which allowed direct estimation of sensitivity, specificity, and predictive values of VIA and colposcopy. Those with abnormal lesions diagnosed by histology were considered as true positive. Results: Out of 540 patients screened, 212 (39.27%) were VIA positive. More patients with cervical lesions were detected by VIA than colposcopy. There were 63 (11.67%) women with histologic cervical intraepithelial neoplasia (CIN I), which was found in 150 (27.78%) by VIA and 138 (25.56%) by colposcopy. VIA and colposcopy yielded high grade CIN II in the same number of patients. Biopsy proven cancer was found in 24 (4.45%) which was detected in 18 (3.33%) by VIA and colposcopy. Sensitivity and specificity of VIA were 68.50% and 70.45% respectively. Positive predictive value was 41.04% and negative predictive value was 90.85%. Conclusions: VIA can differentiate a normal cervix from a precancerous cervix with reasonable accuracy. The sensitivity and specificity of VIA are comparable to the other studies. So VIA may reduce the cervical intraepithelial lesions both in urban and rural areas.

78-79

Authors: Sant Parkash Kataria, Sneh Singh, Parul Tanwar, Sanjay Kumar, Gajender Singh

Tuberculosis is a chronic granulomatous disease which can affect any part of the body. Lung is the most common site of primary disease, however it can occur in other organs as well specially in immunocompromised state. Secondary spread occurs from a healed primary focus or due to endogenous spread of the infection. Oral manifestations of tuberculosis are usually secondary to infection of other parts of the body. Primary tuberculosis of the oral cavity including that of the tongue is rare. Here we present the case of a fifty year old patient presenting with growth on tongue which on histology and Ziehl-Neelsen staining was proved to be tuberculosis.

82-84

Authors: Krishnalatha Buandasan, Adil Hussein

Follicular thyroid carcinoma (FTC) is a well-differentiated tumor which resembles the normal microscopic pattern of the thyroid. Although intracranial metastasis to the brain is frequent in adults, metastasis from FTC is very rare. Dural metastases mimicking meningioma have been documented in the literature now and then. However, cases arising from a FTC are again very rare. We report the case of a middle-aged lady who presented with progressive, painless left eye proptosis. She was noted to have a non-axial proptosis with dystopia, compressive optic neuropathy and exposure keratitis. She also had a painless swelling over the occipital region. She was initially misdiagnosed to have multiple foci of meningioma based on magnetic resonance imaging findings. Subsequent histopathological examination revealed presence of FTC. She was euthyroid but was found to have multiple small thyroid nodules by ultrasonography. Hence, the definite diagnosis of all dural masses must be histological wherever possible and thyroid carcinoma should be considered as a potential primary tumour in such presentations.