Asian Pacific Journal of Tropical Disease

645-649

Authors: Panagoda Weththasinghage Prasad Chathurangana, Dellabada Batawalage Dulani Lakmali Samaranayake, Vinushiya Gunalini Quienters, Vithanage Pujitha Wickramasinghe

Objective: To evaluate the effects of vitamin E supplementation on the clinical course of dengue fever (DF) and dengue haemorrhagic fever (DHF) in 5–12 years old Sri Lankan children. Methods: A triple blinded controlled interventional trial was conducted at a tertiary care hospital in Sri Lanka. Five to twelve-year-old children with clinically suspected dengue infection within 84 h of onset of fever were randomly allocated to receive an age-adjusted dose of vitamin E or placebo. Standard ward management for DF/DHF was provided for both groups. Clinical, biochemical [aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum albumin, serum cholesterol, serum calcium] and haematological [white blood count (WBC), platelets, packed cell volume (PCV)] parameters were monitored regularly throughout the course of the illness. Results: Data of 127 subjects (n = 61 in treatment group) were analysed after they were confirmed of dengue infection. Treatment and placebo groups both were similar. The temporal distribution patterns of WBC, platelets, serum albumin and serum cholesterol were higher, while PCV, serum AST and ALT levels were lower in the treatment group compared to placebo group. PCV on Day 3.5, WBC on Day 6, ALT on Days 4 and 5, AST on Days 3–5 and albumin on day 5 were significantly improved in the treatment group. There was no difference in the duration of hospital stay or occurrence of leaking. However, the duration of leaking was significantly lower in the treatment group. Conclusions: Treatment with vitamin E shows a significant improvement in clinical, haematological and biochemical parameters in children with DF and DHF.

653-658

Authors: Premanshu Dandapat1*, Arijit Chakrabarty1, Sonjoy Dey2, Pramod Kumar Nanda1, Suresh Chandra Das1, Suman Dey3, Arun Kurien4, Apurba Chakraborty5, Samiran Bandyopadhyay1, Subhasish Bandyopadhyay1, Raj Kumar Singh

Objective: To investigate an anthrax outbreak affecting multi-species of animals including human in five remote tribal villages in West Midnapur district, India, with no previous history of anthrax cases for decades. Methods: A systematic epidemiological investigation, along with bacteriological examination, cultural isolation, biochemical and molecular characterization of the samples (blood, dried meat, pieces of bones) was carried out to confirm diagnosis, identify transmission routes and risk factors to recommend suitable control measures. Results: Samples from nine animals were confirmed for presence of Bacillus anthracis by characteristic morphology, biochemical profile, McFadyean reaction in blood smear, ‘medusa head’ appearance of colonies and PCR based detection of pXO1 plasmid. Epidemiological investigation revealed that the human patients contracted the infection during butchering or while handling contaminated animal products. In total, 14 animals died and 11 people got infected with cutaneous anthrax during the outbreak period. Conclusions: Anthrax continues to be a persisting problem in Indian subcontinent causing considerable morbidity and mortality in animals and human. Collaborative efforts of human and animal health officials through various controlled measures viz., ring vaccination, early treatment of human cases, quarantine of affected animals, safe disposal of carcass and public health campaign effectively controlled the zoonotic anthrax outbreak.

665-670

Authors: Godfred Ngu Tanih1*, Anthony Ifeanyin Okoh2,3, Roland Ndip Ndip4, Uchechukwu Uchechukwu Nwodo2,3, Ezekiel Green

Objective: To evaluate the prevalence of Enterococcus species in cattle faeces, their corresponding drug resistant patterns as well as the genes coding for resistance in the isolates. Methods: Two hundred and ninety rectal swabs were cultured for the isolation of Enterococcus. Presumptive isolates were confirmed by PCR, targeting the tuf gene, and confirmed isolates were identified to species level, using species-specific primers aimed at targeting six different species. Additionally, antibiogram was performed by disc diffusion and genes implicated in resistance were evaluated using molecular methods. Results: All presumptive isolates were confirmed as Enterococcus and speciated as: Enterococcus hirae (82%), Enterococcus faecium (5%), Enterococcus durans (5%), Enterococcus faecalis (2%) and 6% of unidentified species. Resistance to various antimicrobials ranged from 16.4% for penicillin to 69.6% for erythromycin. Among the tetracycline and erythromycin-resistant isolates, tet M (100%) and erm B (29%) were the only amplified genes known to mediate resistance respectively. Other detected genes included van B (25%), van C1 (21%) and bla Z (11%). Conclusions: A high prevalence of multidrug resistant Enterococcus species was observed in this study, accentuating the need to improve on animal farming practices to prevent the dissemination of this microorganism to the environment.

676-682

Authors: Azza Abdelmageed Matloub1*, Waled Morsy El-Senousy2, Abo El-Khair Badawy El-Sayed3, Hanan Farok Aly

Objective: To evaluate the glycoprotein isolated from Spirulina platensis (S. platensis) as antiHCV, cytotoxicity, antioxidant and hypolypidemic activities. Method: Cold and hot aqueous extraction methods (SCEM and SHEM) of S. platensis were performed and their physico-chemical characterizations were studied. Further, monosaccharides and amino acids composition of SCEM and SHEM were studied using GLC and amino acid analyzer, respectively. Both glycoproteins SCEM and SHEM were evaluated in vitro for anti-HCV replicon, cytotoxicity, antioxidant and hypolipidemic activities. SCEM was fractionated and their physico-chemical characterization and anti-HCV replicon were studied. Results: The yield of SCEM and SHEM was 4.45% and 3.37% of dried algal sample, respectively. The physico-chemical characterizations of SCEM and SHEM revealed the presence of ash (13.33% and 10.42% w/w), sulfur (1.22% and 0.71% w/w), nitrogen (7.14% and 5.59% w/w) and sugar (67.29% and 64.66% w/w) contents. The physico-chemical characterizations confirmed that SCEM and SHEM were polysaccharide bounded protein (glycoprotein). Twelve and eleven sugars could be identified in SCEM and SHEM polysaccharide of S. platensis using gas chromatography analysis, respectively. Glucose, galactose and mannose are predominant sugars in both extracts. Further, amino acid analysis of SCEM and SHEM revealed the presence 16 amino acids. Aspartic acid and alanine were detected as predominant non-essential amino acids in SCEM while glutamic and aspartic acids were existed as dominant amino acids in glycoprotein SHEM. Whereas leucine, phenylalanine and valine were presented as mean essential amino acids. Evaluation of both glycoproteins of SCEM and SHEM for anti-HCV, cytotoxic, antioxidant, and hypolipidemic activities revealed that SCEM reduced the HCV (genotype 4 replicon) to 50% at non-toxic dose (522 µg/mL). In addition, SCEM inhibitd enzyme activity, β-hydroxy-β- methyl glutaryl coA reductase, to 80% and had scavenging efficacy against nitric oxide 67.57%–62.16% at the concentration of 100–500 µg/mL. While, SHEM exhibited cytotoxic activity against Hep G2 human cell line with IC50 of 69.49 µg/mL. Conclusions: Polysaccharide bounded protein (glycoprotein) isolated from cold water extract of S. platensis might become increasingly important in drug development for treatment hepatic disease.

688-690

Authors: Khalid Hafiani1*, Halima Bazoui2*, Youssef El Madhi3, My Mustapha Hafid4, Youssef El Guamri1,5, Omar Amahmid5,6, Samira Marhabene2, Khadija El Kharrim1, Driss Belghyti

Objective: To highlight the epidemiological characteristics and plot the current mapping of the sickle cell syndromes in children under 15 years old. Methods: A descriptive study was conducted on children with sickle cell disease over a period of 4 years (from January 2011 to December 2015) at the Pediatric Department at El Idrissi Regional Hospital Center in Kenitra, Morocco. Results: The mean age of patients was (8.56 ± 3.97) years and the age group 6–15 years was the most affected. The male gender was the most dominant with 60.94% of cases versus 30.06% for females. The homozygous form SS was the most frequently identified (81.25% of cases) while the heterozygous form SC was rarely detected (2.08%). Conclusions: Sickle cell anemia remains a reality in Morocco and may not be perfectly understood yet by health professionals. A screening policy and a sustainable management program can prevent hemoglobinopathies in the studied region. An action plan must be implemented at national level to improve the quality of management of main sickle cell syndromes.

696-698

Authors: Teik June Ling, Raajini Devi Krishnan, Hazlita Mohd Isa, Norshamsiah Md Din

A 34-year-old lady presented with sudden onset of central blurring of vision of left eye on Day 7 of dengue fever confirmed by positive IgM serology. Visual acuity was 6/6 OD (right eye) and 6/18 OS (left eye). Relative afferent pupillary defect was absent. Anterior segment was unremarkable bilaterally. Fundus examination revealed an area of preretinal haemorrhage with surrounding cotton wool spot and exudation at the macula OS and a single dot hemorrhage at the superotemporal arcade OD. Optical coherence tomography showed bilateral macular oedema with extensive central foveal involvement of intraretinal and subretinal fluid OS. The central macular thickness was 408 µm. Fluorescein angiography showed late leakage at the macula with no capillary fall out OS. No obvious leak was seen OD. She was immediately treated with oral prednisolone 1 mg/kg/day with weekly tapering dose. Subsequently, her left eye showed remarkable improvement in visual acuity to 6/9 and reduction in central macular thickness to 207 µm. In conclusion, dengue foveolitis, although rare, can lead to visionthreatening complication if left untreated. Prompt diagnosis and treatment may result in promising visual outcome, as this case