Asian Pacific Journal of Tropical Disease

759-764

Authors: Method Kazaura, Kristina Lugangira, Festus Kalokola

Objective: To determine prescription practices for non-malarial fever cases among febrile under-fives in the Lake Zone of Tanzania. Methods: A health facility-based study was conducted in health facilities of the Lake Zone regions targeting 1 080 medical records. From patients’ medical records, we collected information on how non-malarial fever was managed. Statistical analyses involved descriptive statistics and comparisons of proportions of prescribing medications between clinicians working in health facilities supported by Tibu Homa Project against others. Logistic regression analysis was used to assess independent variables associated with irregular prescription of antimalarials to non-malarial fever cases. Results: The main clinical diagnoses among febrile under-fives tested negative for malaria were respiratory tract infections (17%), pneumonia (15%) and urinary tract infections (10%). Over-prescription of antimalarial was to 12% (95%, confidence interval: 10%–14%) and only 14% (95%, confidence interval: 12%–16%) under-fives were correctly prescribed antibiotics based on correct final diagnosis. Health care providers from non-Tibu Homa Project supported health facilities, those working in hospitals and inpatient febrile under-fives were independent predictors of prescribing anti-malarial drugs to febrile under-fives with no malaria. Conclusions: The proportion of clinicians prescribing antimalarial medications and overprescribing antibiotics to malaria negative-tested under-fives in the Lake Zone is high, 11%, and as low as 14% of clinicians prescribed antibiotics correctly based on correct final diagnoses. Training of health care workers, health managers and regular supportive supervision may significantly improve prescription practices among clinicians attending under-fives.

770-775

Authors: Godwin Kwakye-Nuako, Johnson Nyarko Boampong, Mark Kweku Dong, Dorcas Obiri-Yeboah, Yeboah Kwaku Opoku, Daniel Amoako- Sakyi, Kwame Kumi Asare

Objective: To investigate the role CD4+ levels play in controlling diarrhea conditions caused by intestinal coccidian infections among HIV/AIDS infected individuals visiting Tarkwa Municipal Hospital. Methods: Fifty HIV/AIDS infected subjects with diarrhea conditions were enrolled into the study. Stool and blood samples were collected from each in two or three consecutive times to examine intestinal coccidian and microsporidian infections using microscopy and also estimate CD4+ cells using BD FACSCount TM. Results: Fourteen of the participants had intestinal coccidian or microsporidian representing 28% while 72% of the participants had diarrhea of unknown origin. Cryptosporidium recorded the highest prevalence of 42.86% whilst Cyclospora and Microsporidia equally recorded a prevalence of 28.57%. A significant protection against cryptosporidiosis was observed for CD4+ count above 200 cells/μL (χ2 = 6.522, P = 0.038), but not cyclosporiasis (P = 0.233) or microsporidiosis (P = 0.060). Conclusions: This study has shown that CD4+ cells above 200 cell/μL of blood protect HIVinfected patients from cryptosporidiosis. Standardization of the association between CD4+ cells and diarrhea condition caused by Cryptosporidium species is therefore suggested to serve as an indicator for prompt diagnosis and treatment of HIV-infected individuals with cryptosporidiosis.

778-782

Authors: Watcharapong Ruankham, Phatcharin Winyangkul, Nophawan Bunchu

Objective: To survey the prevalence of head lice infestation among primary school students in Chiang Rai Province, Northern Thailand from November 2015 to February 2016 and to investigate factors involving these infestations. Methods: A total of 703 students were checked for head lice infestations. The data were analyzed by using descriptive statistics i.e. frequencies, percentages and correlations [odds ratio (OR) and 95% confidence interval (CI)]. Results: The overall percentage of head lice infestations was 15.1%. No infestation was found in boy students. The prevalence of head lice infestation was significantly associated with itching on a scalp (OR = 5.206, 95% CI = 3.116–8.696), having dirty fingernails (OR = 2.019, 95% CI = 1.217–3.352), wearing dirty clothes (OR = 4.532, 95% CI = 1.651–12.438), having history of head lice infestations (OR = 3.998, 95% CI = 2.174–7.356) and family member having history of head lice infestations (OR = 1.997, 95% CI = 1.092–3.651). Conclusions: Pediculosis capitis is still public health problem in this region. Effective treatment is required to control this infestation in urgent.

787-792

Authors: Leila Tajedin, Hasan Bakhshi, Faezeh Faghihi, Zakkyeh Telmadarraiy

Objective: To ascertain the prevalence of the Anaplasma/Ehrlichia infections in tick population within four provinces of Iran. Methods: A total of 384 tick specimens were collected from domestic animals inhabiting in four provinces (East Azerbaijan, Gilan, South Khorasan and Yazd). Specimens were identified based on morphological analysis. The detection of Anaplasma spp./Ehrlichia spp. within tick samples was carried out by nested PCR amplification of the 16S ribosomal RNA gene accompanied by DNA sequencing and analysis for verification. Results: A total of 10 tick species were identified as follows: Ornithodoros lahorensis (O. lahorensis) (44.8%), Hyalomma dromedarii (15.6%), Dermacentor marginatus (13.5%), Hyalomma anatolicum (11.2%), Hyalomma asiaticum (5.7%), Hyalomma marginatum (4.9%), Rhipicephalus sanguineus (2.3%), Hyalomma detritum (1.0%), Dermacentor niveus (0.5%) and Argas persicus (0.3%). The percentage distribution of Anaplasma/Ehrlichia was 55.5% (213) across 384 studied ticks. Conclusions: To the best of our knowledge, this is the first report of Anaplasma ovis infection in O. lahorensis in Iran. We also conjecture the prevalence of Ehrlichia spp. in Yazd Province based on sequencing results; also, it is suggested that O. lahorensis is a potential vector in the studied area. This survey highlights the importance of Argasidae family to verify and correlate their threat in causing anaplasmosis and other diseases in animals.

797-801

Authors: Nagwa Mostafa El-Sayed, Shereen Magdy Kishik, Rasha Mohamed Fawzy

Objective: To ascertain a relationship between Toxoplasma gondii (T. gondii) infection and rheumatoid arthritis (RA) disease among Egyptian patients. Methods: One hundred RA patients and 50 healthy subjects participated in this study. The patients were classified into three groups, namely GI, G2 and G3. Patients in G1 were recently diagnosed with RA with the disease duration of less than one year (prior treatment); G2 included RA patients receiving anti-tumor necrosis factor agents and RA patients in G3 received disease modifying anti-rheumatic drugs (methotrexate, antimalarial, corticosteroids). Serum samples of all participants were examined for the presence of anti-Toxoplasma immunoglobulin G (IgG) antibodies and positive samples were further analyzed for anti- Toxoplasma IgM antibodies to detect the possibility of reactivation of latent toxoplasmosis. Also, the association between Toxoplasma seropositivity and clinical, laboratory and radiological features of these patients were determined. Results: There was a significantly higher percentage of T. gondii IgG positivity in RA patients (54%) than in the controls (32%). At the same time, 20.40% of T. gondii IgG positive patients had anti-T. gondii IgM antibodies with a statistically significant difference as comparing to T. gondii IgG positive controls. Out of T. gondii seropositive patients, 20.37% had a lower IgG level with a mean titer of (65.3 ± 17.7) IU/mL, 46.29% had moderate level with a mean titer of (184.2 ± 60.0) IU/mL and 33.33% had higher level with a mean titer of (404.3 ± 50.0) IU/ mL. A positive correlation was found between disease activity and Toxoplasma seropositivity. T. gondii seropositive RA patients had longer disease duration, longer time morning stiffness, higher numbers of tender and swollen joints and also increase in disease severity markers (erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, anti-cyclic citrullinated peptide anti-bodies, rheumatoid factor) than T. gondii seronegative patients. As regards radiological findings, Larsen score was found significantly higher in T. gondii seropositive RA patients. Conclusions: The positive correlation between T. gondii infection and RA disease among Egyptian patients indicated the need to improve awareness of this parasitic infection and its management in this risk group.

807-810

Authors: Debasish Kar, Samiran Bandyopadhyay, Umesh Dimri, Deba Brata Mondal, Pramod Kumar Nanda, Arun Kumar Das, Subhasish Batabyal, Premanshu Dandapat, Subhasish Bandyopadhyay

Objective: To evaluate the antibacterial property of silver nanoparticles (AgNPs) and capsaicin against multidrug resistant (MDR) and extended spectrum beta-lactamase (ESBL) producing Escherichia coli of bovine and poultry origin. Methods: Antibacterial efficacy of AgNPs and capsaicin was measured using broth dilution method. Five MDR-ESBL producing E. coli isolates of poultry (PEC4, PEC6, PEC15 and PEC16) and cattle mastitis origin (MEC2) were taken to evaluate the antibacterial effect of AgNPs and capsaicin. Results: At 50 mmol/L AgNPs, the viability of MDR of bacterial pathogens was reduced to almost 80%–90% and at 1000 mmol/L, the viability went down to 0%–3%. The minimum inhibitory concentration (MIC50) of AgNPs against these MDR-ESBL producing isolates was found to vary between 172–218 mmol/L whereas the MIC80 varied between 450–640 mmol/L. Capsaicin showed more prominent bactericidal effect and only at 2.5 mmol/L concentration, the viability was shown to be reduced by 20%–35% whereas at 7.5 mmol/L concentration, there was approximately 60% reduction in viability. Further at 25 mmol/L concentration, the viability was reduced to 0%–8%. The MIC50 and MIC80 of capsaicin against these MDRESBL producing isolates were found to vary between 4.6–7.5 mmol/L and 10.9–16.9 mmol/L, respectively. Conclusions: The results point out that capsaicin and AgNPs could be of use in treating ESBL infection.

816-818

Authors: Mohammed Abubaker Altayeb, Shamsaldin Ibrahim Mokhtar, Mona Eltahir Adam, Salahaldeen Isamail Mohammed, Hassan Hussein Musa

Objective: To diagnose primary cytomegalovirus (CMV) infection in pregnant women by determining CMV immunoglobulin G (IgG) avidity index. Methods: Ninety pregnant women with an average age of 23 years were studied. Their demographic data were obtained along with blood samples. The anti-CMV immunoglobulin M (IgM) antibodies were determined on fully automated immuoanalyzer, while the CMV IgG avidity testing was carried out using avidity ELISA assay. Results: Among the pregnant women, 15.6% were in the first trimester, 30.0% in the second, and 54.4% in the third trimesters. Besides, 40.0% had chronic disease, while the other 60.0% did not. Anti-CMV IgM antibodies and CMV IgG avidity test showed that 1.1% of the pregnant women were CMV IgM positive and 98.9% were CMV IgG positive, respectively. The avidity test revealed the presence of low avidity of CMV IgG antibodies in 1.1% cases while 98.9% cases exhibited high avidity of CMV IgG antibodies. Conclusions: CMV IgG avidity test was important to distinguish between CMV recent and past infection rather than relying on IgG and IgM only, and IgM is not always indicative for recent or primary CMV infection.

822-826

Authors: Bouabedelli Fatma, Missoun Fatiha, Benhamimed El attafia, Djebli Noureddine

Objective: To investigate the antibacterial effect of Peganum harmala (P. harmala) extracts against urinary tract infection pathogens isolated from infected patients. Methods: Agar diffusion technique was used for detecting the antibacterial activity. The minimum inhibitory concentration was tested by serial dilution methods. Alkaloids extract of seeds was fractioned using thin layer chromatography. Results: Phytochemical screening in the leaves of P. harmala showed the presence of flavonoids, alkaloids, saponins, tannins, glycosides, terpenoids and steroids and the absence of anthraquinons, whereas the results in the seeds showed the absence of flavonoids and the presence of alkaloids, saponins, tannins, glycosides, anthraquinons, terpenoids and steroids. The results of thin layer chromatography revealed that the alkaloids profiles of the seeds extracts of P. harmala are different. The major alkaloids detected and quantified from the intensity of their fluorescence were harmine, harmaline, harmalol and harmol. The methanolic extract of the plant was effective against the four microorganism tested. It was observed that the minimum inhibitory concentration and minimum bactericidal concentration of flavonoids extracted from the leaves and seeds of P. harmala were bactericidal to Staphylococcus aureus. Conclusions: Results of this study suggest that the flavonoids extract of P. harmala may be useful to treat uropathogenic bacteria.

832-836

Authors: Mai Mohammed Farid, Sameh Reda Hussein, Mahmoud Mohammed Saker

Scientists continue to search for and conserve plants whose medicinal properties have become crucial in the fight against diseases. Moreover, lessons from folk medicine, indigenous knowledge and Chinese medicine on crude extracts points to possible findings of novel promising and strong pharmaceutically bioactive constituents. Arum palaestinum, commonly known as black calla lily, is one of the most important medicinal plants belonging to the family Araceae, which has not been well studied. Little is known about its pharmaceutically bioactive constituents and the effective conservation through the use of biotechnology. Thus, Arum Palaestinum is selected and reviewed for its phytochemical analysis and biological activities. Besides, the tissue culture and genetic characterization developed for effective conservation of the plant were also summarized.