Asian Pacific Journal of Tropical Disease

65-67

Authors: Yasir Waheed, Mehreen Tahir, Hasnain Waheed, Sher Zaman Safi

The 2014–2015 Ebola epidemic in West Africa was the largest of its kind, with more than 11000 deaths and 28637 cases. The epidemic mobilized a coalition of countries from US to China, European Union, and African countries. The international community was not prepared to face this unprecedented epidemic. Numbers of research groups are working to find a potent vaccine against Ebola. Ebola virus has the ability to dodge the immune system either by blocking interferon production or by glycoprotein-based immune diversion. Individuals who survived from the Ebola virus are facing different health issues after the infection. The rate of miscarriage is also high in Ebola survivors while there are variable reports of the presence of Ebola virus in semen of Ebola survivors. There are many asymptomatic Ebola patients under consideration. West African countries lack the basic healthcare system, for which the actual number of deaths by the Ebola outbreak are much more than the deaths caused by the direct viral infection. The hospitals were empty due to fear and death of nurses and doctors. Millions of children missed the vaccine against measles. Hundreds of thousands of people could not get food. The Ebola epidemic also affected the mental health of people living in endemic countries. The families affected by Ebola are facing discrimination in the society. There is a dire need to adopt United Nations Sustainable Development Goal 3, which stresses to prepare ourselves to face any national or global health risk.

71-74

Authors: Andrea Leticia Cáceres, María Eugenia Flores-Giubi, María Cristina Romero-Rodríguez, Nelson Luis Alvarenga

Objective: To evaluate the chemical composition and the anthelmintic activity of the methanol extracts and the acid and basic fractions of Croton paraguayensis (C. paraguayensis) and Vernonia brasiliana (V. brasiliana) against Eisenia fetida. Methods: A preliminary phytochemical analysis was performed to assess the presence of groups of secondary metabolites. The plants were extracted with methanol to obtain the crude extracts. A differential pH extraction was performed to isolate basic compounds like alkaloids. The methanolic extracts and the fractions obtained were tested for anthelmintic activity against Eisenia fetida, using albendazole as positive control. Results: The phytochemical test demonstrated the presence of alkaloids in the crude extracts and alkaline fractions, along with flavonoids, coumarins, steroids/triterpenes and tannins. The anthelmintic activity of the extracts and fractions of C. paraguayensis and V. brasiliana showed a statistically significant decrease of the times for paralysis and death compared to albendazole. Conclusions: The methanolic extracts and fractions of C. paraguayensis and V. brasiliana contain compounds that possess anthelmintic activity. The isolation of the substances responsible for the biological effect described could result in the development of new drugs to treat helminth diseases.

80-83

Authors: Ezeudu Terry Adaeze, Idika Idika Kalu, Eze Ukamaka Uchenna, Anyogu Davinson Chuka, Aneke Inyang Chioma, Nzeakor Nnamdi Chizoba, Chah Kenedy F

Objective: To ascertain the helminth profile of Lemniscomys striatus (L. striatus) and Cricetomys gambianus (C. gambianus) in Nsukka, Southeastern Nigeria, and their zoonotic potentials and public health risk. Methods: A total of 63 rodents were captured during the study period, of which 54 (85.7%) were L. striatus and 9 (14.3%) were C. gambianus. Following evisceration, various organs from the rodents (the lungs, liver, stomach, small intestines and large intestines) were split open and thoroughly examined under a stereomicroscope. The liver samples were subjected to histopathological processing and examination. Results: No helminth parasite was found in C. gambianus while 44 (81.5%) of L. striatus were infected with one or more species of helminth parasites. And 10 (18.5%) and 34 (63%) of L. striatus had mixed and single infections, respectively. Three helminth species were recovered during the study. Two nematodes [Capillaria hepatica (C. hepatica) and Protospirura spp.] and one cestode parasite (Hymenolepis spp.) were found at prevalence rates of 3.7%, 14.8% and 81.5%, respectively. Histopathology revealed the typical characteristic bipolar plugs of C. hepatica ova. There were also massive areas of degenerative necrosis of hepatocytes, fibrous encapsulation of C. hepatica ova and infiltration of inflammatory cells. Conclusions: Two out of the three helminths (C. hepatica and Hymenolepis spp.) recovered in this study are of serious zoonotic importance and thus pose great public health risk to the community.

88-96

Authors: Hedia Bellali, Khouloud Talmoudi, Nissaf Ben Alaya, Madiha Mahfoudhi, Samir Ennigrou, Mohamed Kouni Chahed

Objective: To study the effect of climate variability and rodent density on the incidence of zoonotic cutaneous leishmaniasis (ZCL) in humans. Methods: We collected monthly ZCL human cases in primary health care facilities, in schools and in the community. We collected monthly climate parameters such as temperature, humidity, rainfall, wind direction and wind speed, and rodent density. We investigated the relationship between ZCL incidence and climate and environmental variables by univariate and different multivariable analysis (multiple linear regression, negative binomial regression and autoregressive integrated moving average). Results: The ZCL number peaked in October and November. In univariate analysis, positive associations were found for the maximum, mean and minimum temperatures lagged for three and six months, with higher correlation coefficient for the mean temperature lagged for six months (r = 0.837, P < 0.01). All multivariate analyses showed positive association between monthly ZCL incidence and the six months moving average temperature with higher correlation coefficients and very small significant level, whereas negative association was observed for the cumulative rainfall of the last year. Conclusions: This work showed a significant association between ZCL incidence and climate variables suggesting that ecological early warning system could be applied for ZCL.

99-105

Authors: Mekonnen Assefa Ahunie, Endris Assen Ebrahim

Objective: To investigate the mortality predictors of HIV-infected individuals who were receiving antiretroviral treatment. Methods: Data were extracted from medical records of 698 antiretroviral therapy (ART) users enrolled at Debre Tabor General Hospital and Woreta Health Center from January 2005 to June 2014 and sociodemographic, clinical and ART-related data were collected. Mortality was compared by using time-to-event Kaplan-Meier method and log rank test and Cox regression analysis were used to identify the predictors of mortality. Results: The overall mortality rate was 1.5 per 100 persons per year. Ambulatory and bedridden patients had four- and seven-fold higher risk of death [adjusted hazard ratio (HR) = 4.2, 95% confidence interval (CI): 1.7–10.7 and adjusted HR = 6.5, 95% CI: 2.0–20.7, respectively] as compared to those patients who had worked functional status. Patients who had poor antiretroviral drug adherence had five times higher risk of death (adjusted HR = 5.1, 95% CI: 1.6–16.3) than patients who had good antiretroviral adherence. Conclusions: Mortality rate was highly observed in the early phase of antiretroviral treatment. Poor ART adherence, being ambulatory and bedridden functional status was independent predictors of mortality.

112-120

Authors: Davood Keshavarzi1, Zahra Soltani2*, Mostafa Ebrahimi2, Aboozar Soltani3, Gidiglo Godwin Nutifafa1, Firoozeh Soltani2, Hosssein Faramarzi4, Kamyar Amraee5, Amir Hassanzadeh6

Objective: To get new data about the ecology of mosquitoes, which would be valuable to develop programs for future provision of mosquito controls in the study area. Methods: During April to September 2012, larvae of mosquitoes were collected from six counties in south of Fars Province using dipping method. Characteristics of larval breeding places were considered based on water conditions. Species diversity was examined in terms of alpha and beta measures, with the intent of comparing mosquito diversity according to the typology of regions. Results: During this investigation, totally, 5057 larvae of mosquitoes belonging to 5 genera and 17 different mosquito species were recognized, namely, Anopheles dthali, Anopheles fluviatilis, Anopheles stephensi, Anopheles superpictus, Culex quinquefasciatus (Cx. quinquefasciatus), Culex mimeticus, Culex perexiguus, Culex pipiens (Cx. pipiens), Culex tritaeniorhynchus, Culex theileri (Cx. theileri), Culex tritaeniorhynchus, Culex sinaiticus, Culex torrentium, Culex modestus, Ochlerotatus caspius, Culiseta longiareolata and Aedes vexans (Ae. vexans). This is the first record of Ae. vexans, Culex perexiguus and Culex modestus in the Province. Cx. pipiens (27.3%), Cx. theileri (15.9%) and Cx. quinquefasciatus (9.4%) were the most abundant species found respectively. Cx. pipiens reached the highest density in August and July, while Cx. theileri, Cx. quinquefasciatus and Ae. vexans were found in high numbers in June. Diversity analysis indicated the highest species diversity in the Mohr County (Margalef index of 1.41 and Shannon index of 1.7) and the lowest species diversity in the Lamerd County (Margalef index of 0.33 and Shannon index of 0.38). Conclusions: Regarding to this research, there are some potential vectors of medical and veterinary importance in Fars Province. Results of the present study may serve as a basis for risk assessment of emerging mosquito-borne diseases.

127-128

Authors: Sanjay Kumar, Pratap Singh, Vijay Kumar, Mukesh Verma, Satender Pal Singh

We present a case of a 40-year old male who presented with complaints of generalized weakness, lethargy, breathlessness on exertion, easy fatigability for a 2-month duration. He also had the history of mild bleeding from gums and nose since 2 days ago and had pallor on general physical examination. The peripheral smear revealed pancytopenia with several microfilariae in the buffy coat. Bone marrow aspiration showed hypocellular marrow with microfilariasis and increase in mature plasma cells. The patient was starting on diethylcarbamazine. However, his bone marrow aspirate done 2 weeks later showed hypocellular marrow with no parasites and biopsy showed picture that was suggestive of aplastic anemia. He was later referred to higher center for further investigation and management. Pancytopenia as a presenting feature of filariasis is rare, but a few case reports have been published. Yet a causal relationship of filariasis and pancytopenia, hypoplasia or aplasia of bone marrow has not been determined. It has also not been proved that a treatment of filariasis has led to a reversal of bone marrow hypoplasia or aplasia.