Asian Pacific Journal of Tropical Disease

88-96

Authors: Umar Saeed, Yasir Waheed, Muhammad Ashraf

Hepatitis B and hepatitis C viruses (HCV) are frequently propagating blood borne pathogens in global community. Viral hepatitis is primarily associated with severe health complications, such as liver cirrhosis, hepatocellular carcinoma, hepatic fibrosis and steatosis. A literature review was conducted on hepatitis B virus (HBV), HBV genome, genotypic distribution and global epidemiology of HBV, HCV, HCV genome, HCV and host immune responses, HCV genotypic distribution and global epidemiology. The valued information was subjected for review. HBV has strict tissue tropism to liver. The virus infecting hepatocytes produces large amount of hepatitis B surface antigen particles which lack the DNA. It has capability to integrate into host genome. It has been found that genotype C is most emerging genotype associated with more severe liver diseases (cirrhosis). The approximate prevalence rate of genotype C is 27.7% which represents a major threat to future generations. Approximately 8% of population is chronic carrier of HBV in developing countries. The chronic carrier rate of HBV is 2%-7% in Middle East, Eastern and Southern Europe, South America and Japan. Among HCV infected individuals, 15% usually have natural tendency to overcome acute viral infection, where as 85% of individuals were unable to control HCV infection. The internal ribosomal entry site contains highly conserved structures important for binding and appropriate positioning of viral genome inside the host cell. HCV infects only in 1%-10% of hepatocytes, but production of tumor necrosis factor alpha (from CD8+ cells) and interferon-gamma cause destruction of both infected cells and non-infected surrounding cells. Almost 11 genotypes and above 100 subtypes of HCV exists worldwide with different geographical distribution. Many efforts are still needed to minimize global burden of these infections. For the complete eradication of HBV (just like small pox and polio) via vaccination strategies, sincere efforts would be required from government and nongovernmental organizations.

104-109

Authors: Nesrine Ouda Amari, Mohamed Bouzouina, Abdellah Berkani, Brahim Lotmani

Objective: To assess antioxidant activities of different aerial parts of Thymelaea hirsuta (T. hirsuta) from west Algeria, and to search for new sources of safe and inexpensive antioxidants. Methods: Samples of leaves, stems and flowers from T. hirsuta were tested for total phenolic content, flavonoids content, and evaluation its total antioxidant activity, were done using the spectrophotometric analyses. Results: Results of preliminary phytochemical screening of leaf, flower and stem of T. hirsuta revealed the presence of tannins, alkaloids, steroids, saponins, coumarins, reducteurs compound and anthraquinones. The total phenolics and flavonoids were estimated. The aqueous extracts of the aerial parts of T. hirsuta showed potent in vitro antioxydant activities using various models viz, DPPH scavenging assay, ferric reducing antioxidant power (FRAP) and ABTS radical scavenging activity. Conclusions: On the basis of the results obtained, T. hirsuta extracts are rich sources of natural antioxidants appears to be an alternative to synthetic antioxidants and this justifies its therapeutic usage.

115-119

Authors: Tajeldin Mohammedien Abdallah, Hashim Balla Mohammed, Mamoon Hassan Mohammed, Abdel Aziem Abdalla Ali

Objective: To investigate the prevalence of Helicobacter pylori (H. pylori) among patients with dyspepsia and to evaluate the correlation between H. pylori infection and socio-demographic factors. Methods: This cross-sectional hospital-based study, which ran from June to August 2012, determined seroprevalence of H. pylori among adult patients in Eastern Sudan. The presence of H. pylori was determined using ELISA. Results: A total of 225 adult Sudanese patients were enrolled in the study. Of these, 148 (65.8%) tested positive for H. pylori. In logistic regression analysis, rural residency (OR=3.933, CI=1.337- 11.26, P=0.01) was the only socio-demographic factor that was associated with H. pylori infection. The most common symptoms among seropositive patients were heartburn (OR=30.442, CI=9.478- 97.776, P≤0.001) and/or epigastria pain (OR=28.225, CI=4.365-182.508, P≤0.001). Conclusions: Clinical suspicion can facilitate the detection of H. pylori among patients with dyspeptic symptoms in a geographic area with high prevalence of H. pylori infection.

125-130

Authors: Ahmad Oryan, Mohammad Hashemnia, Ahmad-Reza Hamidi, Adel Mohammadalipour

Objective: To evaluated the differential effects of ethanol extraction of Citrullus colocynthis (C. colocynthis) on the blood glucose concentration and pathology of pancreas, liver, lungs, kidney and gastrointestinal tract in the alloxan induced diabetes in rats. Methods: Diabetes mellitus was induced in 20 adult female Albino rats, using intraperitoneal injection of 120 mg/kg alloxan. The diabetic rats were randomly assigned into two equal groups. The first group was treated with the extract of C. colocynthis seed (300 mg/kg) and the rats of the second group, as an untreated diabetic group, received ordinary diet. Ten non diabetic rats remained as a normal control group. Results: The results of this study indicate that C. colocynthis was able to reduce blood glucose significantly compared with the control diabetic group (P<0.05). Histopathologically, alloxan resulted in severe necrotic changes in the pancreatic islets, especially in the central area of the islets. Tissue sections of the pancreas in the treated rats demonstrated enhanced regeneration of B cells and increased size of pancreatic islets. Liver of the treated diabetic rats revealed significant improvement of the hepatic tissue compared to those of the untreated diabetic rats. Conclusions: The present study indicated a significant anti-hyperglycemic effect of C. colocynthis seed and supported its traditional usage in treatment of diabetes mellitus.

135-139

Authors: Irene Ocran, Daniel Nii Aryee Tagoe

Objective: To assess knowledge and attitude of healthcare workers (HCWs) and patients on healthcare associated infections (HAIs) in the central regional hospital in Ghana. Methods: The purposive random sampling method was used to administer questionnaires over a period of 6 months to HCWs and patients visiting the hospital. Results: A total of 210 patients and 71 HCWs were sampled. One hundred and three (53.8%) patients had some knowledge of HAIs with 52 (28.4%) being informed by a HCW compared with 63 (88.7%) of HCWs who were well informed about HAIs. Ninety-seven (46.2%) responding patient always washed their hands while 65 (31%) and 48 (22.9%) respectively sometimes or never washed their hands within or after leaving the hospital. Out of those who washed their hands, 64 (39.5%) always washed with soap while 46 (28.4%) did sometimes. This positively and significantly correlated (r=0.440, P<0.001) with knowledge on HAIs which was however insignificant in HCWs (r=0.025, P=0.835). As many as 48 (67.6%) of HCWs believed that authorities in the hospital had done little to prevent HAIs with the main reason being that the hospital was unclean. Whereas, 112 (53.3%) of patients considered the hospital clean. Twenty-seven (38%) of HCWs had had confirmed HAIs of which cholera made up 12 (16.9%) while 94 (44.8%) of patients believed they had had unconfirmed HAIs. Conclusions: Although knowledge on HAIs is adequate, low compliance on preventive techniques resulting in high HAIs indicates attitudinal change is the best means of prevention

150-153

Authors: Tyagita Hartady, Mohd Zamri Saad, Siti Khairani Bejo, Mohd Shahrom Salisi

Clinical human brucellosis is quite rare in Malaysia although seroconverters are relatively more. This report describes a case of clinical human brucellosis in Malaysia. This case involved a 29-year-old research assistant in a veterinary microbiology laboratory. She complained of intermittent fever, anorexia, profuse sweating, malaise, headache, normotensive (110/60 mm Hg), muscle pain, and arthralgia for 3 d. Blood tests against dengue and malaria were negative thus she was prescribed vitamin C, paracetamol and cough syrup for common flu. The complaints, however, persisted on and off for the next 1 month. She eventually developed anemia and hypotension (90/50 mm Hg) and started to show reduced body weight. Abdominal palpations revealed hepatomegaly and splenomegaly with pain. Thus, brucellosis was suspected before the Rose-Bengal plate test was performed, which revealed the presence of high level of antibody against Brucella. The same test was repeated after 14 d and the results confirmed the presence of high antibody level against Brucella. Following serum agglutination test, a diagnosis of brucellosis was made and she was eventually prescribed rifampicine p.o. once a day combined with doxycycline p.o. twice a day for 6 consecutive weeks before she made a full recovery.

159-165

Authors: Ijeoma Emeka-Nwabunnia, Bartholomew Okey Ibeh, Tochukwu Ekwutosi Ogbulie

Objective: To investigate the prevalence and sexual behavioural dynamics of HIV infection in students of institutions of higher education (IHEs) as a guide to the design of a tailor-made HIV intervention programmes. Methods: A total of 9 709 sexually matured students from five IHEs in Southeast Nigeria aged 19-24 years were recruited to obtain representative data from the institutionalised student population. HIV status was confirmed using enzyme based immuno-assay technique. Demographic and behavioural information were obtained through a structured questionnaire. Association of HIV infection with behavioural risk factors was done using multiple logistics regression model. Results: IHEs in Southeast Nigeria have a higher HIV prevalence of 3.69% against the national projected rate of 2012. The age-specific prevalence among male students (2.91%) is nonsignificantly (P>0.1) lower than that of females (4.31%). Female students had higher rate of infection, multiple sexual partner, transactional and forced sex, unusual genital discharge and low condom use when compared with their male counterparts. These risk factors were associated with increased HIV seropositivity. HIV prevalence and sexual risky behaviour were high among students of IHEs when compared with previous estimates of their non-institutionalised age brackets. Unprotected sexual activity have a 4.2 times higher chances of infecting the partner with HIV. Conclusions: The data showed a higher prevalence of HIV infection in students of IHEs in comparison with non-institutionalised persons of the same age bracket. Specifically, it could be inferred that appropriate HIV intervention measures was absent with higher incidence of the infection and risky behaviour found in female students. Therefore, a prioritised tailor-made policy for HIV control for students of IHEs should be considered.