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Record No. 13813 Record ID 013813 Publication type Journal Article Title Knowledge and Attitudes Regarding HIV/AIDS and Antiretroviral Therapy among Patients at a Nigerian Treatment Clinic Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Olowookere, Samuel Anu; Fatiregun, Akinola Ayoola; Adewole, Isaac F. Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2012 Volume and n° 6(11) Pages 809-816 Language English Descriptor HIV Infections; Acquired Immunodeficiency Syndrome; Attitude to Health; Medication Adherence Descriptor-Local People Living with HIV/AIDS Descriptor-Geographic Nigeria Abstract Introduction: We assessed the knowledge of and attitudes toward HIV/AIDS and antiretroviral therapy (ART) in people living with HIV/AIDS (PLWHA). Methodology: A descriptive, cross-sectional study design was employed. A structured interviewer-administered questionnaire was administered to consecutive, consenting PLWHA who had been receiving treatment for a minimum of three months. The level of ART adherence was calculated manually for each respondent.Results: In total 318 PLWHA completed the questionnaire. The mean and median time on ART was 17.8 months and 19 months respectively. The mean age of the respondents was 39.1±9.6 years. The majority of these respondents (76.9) had completed secondary education. Over 80 of the respondents reported knowing that HIV can be transmitted through blood transfusions and unprotected sexual intercourse. Seventy-six per cent of the respondents reported knowing that ART suppresses HIV activity. However, 33 of the respondents denied being HIV positive, while 22.6 reported that they felt that taking ART was shameful. Over 32 of the respondents reported that good adherence to ART would raise suspicions about their HIV status, and 66.7 had not yet disclosed their HIV status to anyone. Most (77.7) respondents had good knowledge of HIV/AIDS while 75.2 had good knowledge of ART. Also 78.9 had positive attitude to HIV/AIDS while 73.9) had positive attitude to ART. Respondents with good knowledge about HIV/AIDS and a positive attitude about the disease tended to be more adherent to ART (p 0.01). Conclusions: The majority of respondents had good knowledge of and a positive attitude toward HIV/AIDS and ART adherence. Electronic Access :  Full Text-1

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Record No. 13812 Record ID 013812 Publication type Journal Article Title Increase in the Detection Rate of Viral and Parasitic Enteric Pathogens among Egyptian Children with Acute Diarrhea Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) El-Mohammady, Hanan; Mansour, Adel; Shaheen, Hind I.; Henien, Nagwa H.; Motawea, Mohamed S.; Raafat, Ismail; Moustafa, Manal; Adib-Messih, Ibrahim A.; Sebeny, Peter J.; Young, Sylvia Y. N.; Klena, John D. Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2012 Volume and n° 6(11) Pages 774-781 Language English Descriptor Diarrhea, Infantile-epidemiology; Diarrhea, Infantile-parasitology; Diarrhea, Infantile-diagnosis; Attitude to Health Descriptor-Geographic Egypt Abstract Introduction: Acute diarrhea continues to be a major cause of morbidity and mortality in children from developing countries. Determination of the frequency of diarrhea in an area, along with the proportion of disease caused by specific enteric agents of different origins, is considered the first step in controlling diarrheal diseases. Methodology: From 2005 to 2007, a hospital-based surveillance was conducted in two locations in Egypt to determine the causes of acute diarrhea in children younger than 5-years seeking treatment. Five additional enteric viral and parasitic pathogens were tested using commercially-available enzyme immunoassays (EIA) to re-evaluate the prevalence of diarrheal pathogens in undiagnosed cases.Results: Adenovirus, astrovirus, norovirus and G. lamblia were detected as the sole pathogen in 2 (n=34), 3 (n=56), 9 (n=191) and 7 (n=146) of the cases, respectively. E. histolytica was never detected as the sole pathogen. The percentage of diarrheal cases with a known cause increased significantly, from 48 (n=1,006) to 74 (n=1,568) (P0.0001). Conclusion: In our study, the incorporation of immunoassays yielded useful data in identifying pathogens in previously pathogen-negative diarrhea cases. Electronic Access :  Full Text-1

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Record No. 13811 Record ID 013811 Publication type Journal Article Title Burden of Aeromonas Hydrophila Associated Diarrhea among Children Younger than 2 Years in Rural Egyptian Community Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Mansour, Adel M.; Elkhalek, Rania Abd; Shaheen, Hind I.; Mohammady, Hanan El; Refaey, Samir; Hassan, Khaled; Riddle, Mark; Sanders, John W.; Sebeny, Peter J.; Young, Sylvia Y. N.; Frenck, Robert Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2012 Volume and n° 6(12) Pages 842-846 Language English Descriptor Aeromonas hydrophila Diarrhea-epidemiology; Infant Rural Population Descriptor-Geographic Egypt Abstract Introduction: Between 2004 and 2007, a birth cohort of Egyptian children was analysed to evaluate the epidemiology of enteric diseases. Methodology: A stool sample was collected from the study children every two weeks as well as whenever they experienced diarrhea. Samples were tested for routine bacterial pathogens as well as enteropathogenic viruses and parasites. A secondary goal of the study was to evaluate the burden of less commonly reported pathogens including Aeromonas hydrophila. Results: Of the 348 study subjects, 79 had A. hydrophila isolated from their stool at some point during the study. Thirty-six children had exclusively symptomatic (S) infections while 33 had exclusively asymptomatic (AS) infections. However, 10 children had both S and AS infections. Among symptomatic cases, A. hydrophila was the sole pathogen isolated 36of the time. An important aspect of A. hydrophila associated diarrhea was the high level of resistance to cephalosporins. Conclusion: Although relatively uncommon, A. hydrophila was found to be associated with diarrhea among children living in Egypt and was frequently multi-drug resistant. Electronic Access :  Full Text-1

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Record No. 13810 Record ID 013810 Publication type Journal Article Title Sero-Epidemiology of Human Immunodeficiency Virus (HIV) in Plateau State, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Gomwalk, Nenfort Edward; Nimzing, Lohya; Mawak, John Danjuma; Nimzing G. Ladep,; Dapiap, Stephen B.; Damshak, Demas; Kim, Esther; Barau, Christiana; Jinung, John K.; Rumtong, Bala M.; Agabi, Yusuf A. Journal Title Journal of Infection in Developing Countries Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2012 Volume and n° 6(12) Pages 860-869, fig. Language English Descriptor HIV Infections; Population Groups; Seroepidemiologic Studies; Risk-Taking Descriptor-Geographic Nigeria-Plateau State; Abstract Introduction: Previous sentinel surveys of HIV in Nigeria studied pregnant women attending antenatal care, thereby omitting other important high-risk groups. We therefore investigated the prevalence of HIV/AIDS in low- and high-risk populations in the state of Plateau, Nigeria. Methodology: Blood samples were collected by venepuncture from 5,021 adults aged ?15 years between August and October 2008. At least one major town and one rural community were selected in each Local Government Area (LGA). Samples were initially screened with a rapid HIV testing kit; reactive samples were further tested using Stat Pak. Discordant samples were confirmed using Genie-II. Results: Of 5,021 subjects screened, 245 (4.88) were seropositive. Local Government prevalence ranged from 0.68 in Bassa to 16.07 in Jos North. On average, LGAs in the Southern Senatorial Zone had higher rates. Most (over 80) positive cases were younger than 40 years. Females had a significantly higher (6.85) prevalence than males (2.72). Age-specific prevalence was higher among females aged 25 to 29 years (2.09). Risk factors identified for acquisition of HIV infection were previous history of STDs (6, 16.28); men having sex with men (2, 11.76); having multiple sexual partners (97; 10.49); intravenous drug use (10, 7.58); sharing of sharp objects (20, 4.82); and history of blood transfusion (21, 3.65). Conclusion: The seemingly higher prevalence recorded in this survey could be attributed to the inclusion of high- and low-risk groups in the general population, unlike previous reports which studied only antenatal care attendees. This survey provides useful baseline information for further studies. Electronic Access :  Full Text-1

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Record No. 13809 Record ID 013809 Publication type Journal Article Title Baseline Findings of an HIV Incidence Cohort Study to Prepare for Future HIV Prevention Clinical Trials in Kisumu, Kenya Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Chege, Wairimu; Pals, Sherri L.; McLellan-Lemal, Eleanor; Shinde, Sanjyot; Nyambura, Monicah; Otieno, Frederick O.; Gust, Deborah A.; Chen, Robert T.; Thomas, Timothy Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2012 Volume and n° 6(12) Pages 870-880 Language English Descriptor HIV Infection-prevention&control; Prevalence Risk-Taking Cohort Studies Population Characteristics Descriptor-Geographic Kenya-Kisumu; Abstract Introduction: In an analysis of baseline findings of an HIV incidence cohort study, an assessment was made of HIV prevalence among persons presenting for enrollment and any differences in demographic characteristics between persons not enrolled compared to those enrolled. We also described and compared HIV risk behaviors in males and females enrolled in the study. Methodology: A computer-assisted survey was administered to collect baseline demographic and HIV risk data from 1,277 men and women aged 18-34 years. Testing for HIV and other sexually transmitted infections (STI) was conducted. Out of 1,277 persons prescreened for eligibility, 625 were enrolled. Results: HIV prevalence of all persons who completed screening was 14.8 (females: 21.1; males: 8.1). The odds of being enrolled in the study were higher for persons 18-24 years compared to those 30-34 years of age [adjusted odds ratio (AOR)=2.18, CI=1.13, 4.21] and males compared to females [AOR=2.07, CI=1.43, 2.99]. Among those enrolled in the study, the most prevalent HIV risk behaviors were unprotected sex (49), alcohol use (45), and transactional sex (30) in the last three months. Compared to females, a significantly greater proportion of males reported using any alcohol or recreational drug in the last three months, a history of oral sex, sex with partner other than a spouse or main partner, ever having a blood transfusion, ever being treated for an STI, and having knowledge of their last HIV test result. Conclusion: The Kisumu Field Station successfully recruited individuals with HIV risk characteristics for the HIV incidence cohort study. Electronic Access :  Full Text-1

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Record No. 13808 Record ID 013808 Publication type Journal Article Title Trends in Neonatal and Post-Neonatal Tetanus Admissions at a Nigerian Teaching Hospital Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Oyedeji, Olusola Adetunji; Fadero, Francis; Medewase, Victor Joel; Elemile, Peter; Oyedeji, Gabriel Ademola Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2012 Volume and n° 6(12) Pages 847-853 Language English Descriptor Tetanus; Tetanus Toxoid; Patient Admission; Pediatrics; Infant, Newborn; Pregnant Women; Hospitals, Teaching Descriptor-Geographic Nigeria Abstract Introduction: Tetanus accounts for high morbidity and case fatality rates in developing countries. This study therefore aimed to identify reasons for the persistence of this disease. Methodology: Paediatric admissions at Ladoke Akintola University Teaching Hospital between 1 January 2006 and 31 December 2008 diagnosed with tetanus were studied. Data was analyzed with SPSS 18 and statistical significance was set at p 0.05. Results: Of the total 1,681 paediatric admissions, 30 (1.8) had tetanus. Of the 878 neonatal admissions, 8 (0.9) had tetanus, while 22 (2.7) of the total 803 post-neonatal admissions had tetanus. Neonatal tetanus admissions were significantly higher in 2006 compared to 2007 and 2008 (7 [2.3] versus 1 [0.2] [?2 Electronic Access :  Full Text-1

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Record No. 13807 Record ID 013807 Publication type Journal Article Title Distribution of Candida Species among HIV-Positive Patients with Oropharyngeal Candidiasis in Accra, Ghana Source of Record WHO Regional Office for Africa, WR/Guinea Author(s) Kwamin, Francis; Nartey, Nii Otu; Codjoe, Francis S.; Newman, Mercy J. Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2013 Volume and n° 7(1) Pages 41-45 Language English Descriptor HIV Seropositivity; Candida; Candidiasis, Oral; Species Specificity; Pharyngeal Diseases; Disease Progression Descriptor-Geographic Ghana-Accra; Abstract Introduction: Oropharyngeal candidiasis is a common occurrence in the course of human immunodeficiency virus (HIV) disease progression. Changes in the clinical severity of oropharyngeal candidiasis and type of Candida species profile may be a reflection of immunological changes in patients. The aim of this study was to undertake a baseline Candida species identification for future reference. Methodology: Oral swabs of 267 HIV-infected patients with oropharyngeal candidiasis were cultured and Candida species were identified by API 32 C. Results: A total of 201 (75.3) Candida species and 10 (3.7) non candida fungi were identified. Twenty different Candida species were isolated. Candida albicans was the most prevalent species (68.5) followed by C. tropicalis (7.4), C. krusei (6.4), C. parapsilosis (3.0) and C. sake (2.5). Other species ranged from 0.5 to 1.5.Positive culture was independent of whether patients were on anti-retroviral therapy or not. Conclusion: of all Candida isolates, 68.5 were identified as C. albicans. Since other uncommon species were also isolated, it may be necessary in this group of patients to identify Candida species causing severe infections. Electronic Access :  Full Text-1

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Record No. 13806 Record ID 013806 Publication type Journal Article Title Statistical Modelling of Social Risk Factors for Sexually Transmitted Diseases among Female Youths in Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Adebowale, Ayo Stephen; Titiloye, Musibau; Fagbamigbe, Adeniyi Francis; Akinyemi, Odunayo Joshua Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2013 Volume and n° 7(1) Pages 17-27 Language English Descriptor Sexually Transmitted Diseases; Risk Factors; Models, Statistical; Female Descriptor-Geographic Nigeria Abstract Introduction: Sexually Transmitted Diseases (STDs) are avertable, but the social risks factors connected to these infections are often unnoticed by many, particularly female youths. Previous studies on STDs among youths in Nigeria only focused on its risk factors but failed to model these risk factors as evidenced in this study. Methodology: The study is retrospective cross-sectional in design which utilized Nigeria Demographic and Health Survey, 2008. It focused on female youths aged 15-24 (n=8093) who ever had sexual intercourse (vaginal, oral and anal). Data analysis was done using Chi-square and logistic regression models. The logistic regression on the data was performed at two stages. These stages generated three and eight different models respectively.Results: Data analyses revealed that the mean age of the respondents was 20.2±2.5. Female youths who were aged between 20-24 years contacted STDs in the last 12 months (2.5) than those between the ages of 15-19 months (1.4). A year prevalence of STDs among female youths in Nigeria was 2.1. Socio-demographic factors such as age, educational status, wealth index, marital status, toilet shared, place of residence, contraceptive use and total life-time number of sexual partners were found to be associated significant risk factors for contacting STDs (P0.05). Conclusions: The data confirmed the considerable impact of wealth index and contraceptive use as important predictors of STDs acquisition. Constant use of condoms, abstinence and having one uninfected sexual partner can help reduce the risk of STDs transmission. Electronic Access :  Full Text-1

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Record No. 13805 Record ID 013805 Publication type Journal Article Title Intestinal Parasitic and Candida Infection Associated with HIV Infection in Cameroon Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Lehman, Leopold Gustave; Kangam, Lafortune; Mbenoun, Marthe-Lilianne; Nguepi, Eveline Zemo; Essomba, Noël; Tonga, Calvin; Bilong Bilong, Charles Felix Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Publisher Pan-African Thoracic Society Date of publication 2013 Volume and n° 7(2) Pages 137-143 Language English Descriptor Intestinal Diseases, Parasitic; Candida; HIV Infections; CD4 Lymphocyte Count Descriptor-Geographic Cameroon Abstract Introduction: HIV causes progressive impairment of the cellular immune system leading to increased susceptibility to infectious agents. Parasitic infestations are common in HIV-infected patients and usually lead to diarrhoea. Few studies have addressed the issue of intestinal parasites among HIV-infected persons in Cameroon. This investigation was conducted in Douala, Cameroon, to assess the prevalence of gastrointestinal parasites in HIV-infected patients, taking into account their immune status and treatment course. Methodology: Stool and blood samples were collected from 201 HIV-positive patients for the investigation of intestinal pathogens and CD4+ counts. Results: Fifty-six (27.9) patients harbored pathogens. The most frequent pathogens were Candida spp. (14.9), Cryptosporidium spp. (7.5), Entamoeba histolytica, and Entamoeba dispar (3). The presence of pathogens was significantly associated with diarrhoea, as they were found in 48.6 of diarrhoeic stools and 23.2 of non-diarrhoeic stools (OR = 3.14, p= 0.0018). Prevalence of pathogens and diarrhoea were significantly higher in patients with CD4+ counts ? 200 cells/µL (OR = 2.17, p = 0.0349 and OR = 8.46, p = 0.000019 respectively). Conclusions: This study highlights the need for investigating intestinal pathogens in HIV-infected patients presenting with diarrhoea, especially when their CD4+ counts are low. Electronic Access :  Full Text-1

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Record No. 13804 Record ID 013804 Publication type Journal Article Title Seroprevalence of Antibodies (IgG) to Taenia Solium among Pig Rearers and Associated Risk Factors in Jos metropolis, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Weka, Rebecca Paul; Ikeh, Eugene I.; Kamani, Joshua Journal Title Journal of Infection in Developing Countries ISBN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2013 Volume and n° 7(2) Pages 67-72 Language English Descriptor Taenia solium; Antibodies; Seroepidemiologic Studies; Risk Factors Descriptor-Geographic Nigeria-Jos Metropolis; Abstract Introduction: In Nigeria, Taenia solium cysticercosis is a problem in rural areas where most pigs are kept and in urban areas where infected pork can be consumed. Methodology: We performed enzyme linked immunosorbent assays on serum samples collected from pig rearers in Jos, Nigeria, to determine the prevalence of IgG antibodies. Results: Of 125 subjects tested, 12 (9.6) were positive for T. solium. Seroprevalence did not differ significantly (P0.05) according to education, age, occupation, study location, gender or whether the subjects consumed pork. However, a statistical difference (P0.05) in seroprevalence was observed according to type and availability of toilet used, personal hygiene after using the toilet, and type of pig management practiced. Females were about two times more likely to be seroprevalent than males (OR Electronic Access :  Full Text-1

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Record No. 13803 Record ID 013803 Publication type Journal Article Title Epidemiology of Soil-Transmitted Helminths, Schistosoma mansoni, and Haematocrit Values among School Children in Ethiopia Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Abera, Bayeh; Alem, Genetu; Yimer, Mulat; Herrador, Zaida Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2013 Volume and n° 7(3) Pages 253-260 Language English Descriptor Helminths-transmission; Schistosoma mansoni Hematocrit Hematocrit Schools Descriptor-Geographic Ethiopia Abstract Introduction: This study aimed to determine the prevalence of intestinal helminths, risk factors and haematocrit values among primary schoolchildren. Methodology: Across-sectional study was conducted in 12 primary schools in March 2011. Stool samples were randomly selected from 778 children and were microscopically examined using Kato-Katz and formal-ether concentration methods. Haematocrit values were measured using heparinized capillary tubes. Results: The overall prevalence of intestinal helminths was 51.5 (rural = 68.3, urban = 36.2). Hookworm spp., Schistosoma mansoni and Schistosoma stercoralis were more prevalent in rural schools, whereas Hymenolepis nana was higher in urban schools (p = 0.0001). With regard to haematocrit, 34 of rural and 21.7 of urban schoolchildren had haematocrit values below the median (40.5) (p=0.001). Hookworm spp. and S. mansoni infected children had lower haematocrit values than non-infected children (p = 0.001). Lack of footwear was positively associated with intestinal helminths infection in rural schools [OR = 2.5 (95 CI: 1.5-4.1)], and having dirty fingernails and untrimmed fingernails were positively associated with the prevalence of intestinal helminths in urban samples [OR = 1.58 (95 CI: 1.03-2.5)]. Conclusion: The prevalence of soil-transmitted helminths and S. mansoni differs by geographical area of the schools and social determinants. Primary school de-worming and health education on proper hygiene are recommended.

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Record No. 13802 Record ID 013802 Publication type Journal Article Title Tuberculosis with Malaria or HIV Co-Infection in a Large Hospital in Luanda, Angola Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Valadas, Emília; Gomes, Augusto; Sutre, Ana; Brilha, Sara; Wete, Afonso; Hänscheid, Thomas; Antunes, Francisco Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2013 Volume and n° 7(3) Pages 269-272 Language English Descriptor Tuberculosis; HIV Infections; Acquired Immunodeficiency Syndrome; Malaria; Coinfections Descriptor-Geographic Angola-Luanda; Abstract Introduction: Three major public health problems, tuberculosis, malaria and HIV/AIDS, are widespread in Angola, often as co-infections in the same individual. In 2009, it was assumed that 44,151 new cases of TB occurred in Angola. Interestingly, interventions such as treatment/prevention of malaria appear to reduce mortality in HIV-infected and possibly TB co-infected patients. However, despite the seriousness of the situation, current data on TB and co-infection rates are scarce. This study aimed to characterize all TB cases seen at the Hospital Sanatorio de Luanda, and to determine the co-infection rate with HIV and/or malaria. Methodology: This retrospective study collected demographic, diagnostic and clinical data from all patients admitted during 2007. Results: A total of 4,666 patients were admitted, of whom 1,906 (40.8) were diagnosed with TB. Overall, 1,111 patients (58.3) were male and most patients (n=1302, 68.3) were adults ("d14 years). The rate of HIV co-infection was 37.4 (n=712). Malaria was diagnosed during admission and hospital stay in 714 patients (37.5), with Plasmodium falciparum the predominant species. Overall mortality was 15.2(n=290). Conclusions: Because Luanda does not have the infrastructure to perform culture-based diagnosis of TB, confirmation of TB is problematic. The HIV-co-infection rate is high, with 37.4 of patients requiring integrated approaches to address this problem. With more than 1/3 of the TB patients co-infected with malaria, even during the hospital stay, the prevention of malaria in TB patients appears to be an effective way to reduce overall mortality. Electronic Access :  Full Text-1

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Record No. 13437 Record ID 013437 Publication type Journal Article Title Epidemic Cholera in Kakuma Refugee Camp, Kenya, 2009: the Importance of Sanitation and Soap Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Mahamud, Abdirahman Sheikh; Ahmed, Jamal A.; Nyoka, Raymond; Auko, Erick; Kahi, Vincet; Ndirangu, James; Nguhi, Margaret; Burton, John Wagacha; Muhindo, Bosco Z.; Robert, F.; Breiman, Rachel; Eidex, B. Journal Title Journal of Infection in Developing Countries Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2012 Volume and n° 6(3) Pages 234-241, fig., tab. Language English Descriptor Cholera; Sanitation; Hygiene; Soaps; Public Health; Refugees Descriptor-Geographic Kenya Abstract Introduction: Cholera remains a major public health problem that causes substantial morbidity and mortality in displaced populations due to inadequate or unprotected water supplies, poor sanitation and hygiene, overcrowding, and limited resources. A cholera outbreak with 224 cases and four deaths occurred in Kakuma Refugee Camp in Kenya from September to December 2009. Methodology: We conducted a case-control study to characterize the epidemiology of the outbreak. Cases were identified by reviewing the hospital registry for patients meeting the World Health Organization (WHO) case definition for cholera. For each case a matched control was selected. A questionnaire focusing on potential risk factors was administered to cases and controls.Results: From 18 September to 15 December 2009, a total of 224 cases were identified and were hospitalised at Kakuma IRC hospital. Three refugees and one Kenyan national died of cholera. V. cholerae O1, serotype Inaba was isolated in 44 (42) out of 104 stool specimens collected. A total of 93 cases and 93 matched controls were enrolled in the study. In a multivariate model, washing hands with soap was protective against cholera (adjusted odds ratio [AOR] =0.25[0.09-0.71]; p 0.01), while presence of dirty water storage containers was a risk factor (AORConclusion: Provision of soap, along with education on hand hygiene and cleaning water storage containers, may be an affordable intervention to prevent cholera. Electronic Access :  Full Text-1 Full Text-2

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Record No. 11700 Record ID 011700 Publication type Journal Article Title Aetiology of Sexually Transmitted Infections in Maputo, Mozambique Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Zimba, Tomas F.; Apalata, Teke; Sturm, Willem A.; Moodley, Prashini Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2011 Volume and n° 5(1) Pages 41-47 Language English Descriptor Sexually Transmitted Diseases-etiology; Syndrome HIV Infections Descriptor-Geographic Mozambique-Maputo; Abstract Introduction: The study sought to ascertain the prevalence of the aetiological agents of genital discharge and genital ulcer diseases in Maputo, Mozambique. Methodology: Consecutive consenting patients presenting to the Centro de Saúde do Porto in Maputo between March and April 2005 with genital discharge syndrome and/or genital ulcer diseases were recruited. Specimens were collected for the identification of STI pathogens. Results: Of 346 recruited patients, 164 were male and 182 female. The prevalence of confirmed single aetiological agents for male urethritis was as follows: N. gonorrhoeae, 35; C. trachomatis, 10; and M. genitalium 4. For vaginal discharge, N. gonorrhoeae was found in11of the women tested, followed by C. trachomatis (6.5), bacterial vaginosis (34), and T. vaginalis (2). The prevalence of genital ulcers was as follows: Herpes simplex virus type 2, 62; H. ducreyi 4; and C. trachomatis biovar LGV, 4. Five percent of patients with genital ulcers had a positive syphilis serology (RPR = 1:8 and confirmed by TPHA) and 35of all tested patients were HIV-1/2 infected. Cases of mixed infections were present in 5, 11and 3of patients with male urethritis, vaginal discharge, and genital ulcers respectively. Conclusion: The classic sexually transmitted infection aetiologies are still prevalent in Maputo. The study highlights the need for a periodic surveillance to inform syndromic management protocols

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Record No. 11699 Record ID 011699 Publication type Journal Article Title Multidrug Resistant Salmonella Concord is a Major Cause of Salmonellosis in Children in Ethiopia Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Beyene, Getenet; Nair, Satheesh; Asrat, Daniel; Mengistu, Yohannes; Engers, Howard; Wain, John Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2011 Volume and n° 5(1) Pages 23-33, fig., tab. Language English Descriptor Diarrhea, Infantile; Salmonella Infections; Drug Resistance, Multiple; Child Descriptor-Geographic Ethiopia Abstract Introduction: S. Concord in Ethiopia. The objective of this study was to determine the aetiology of febrile and diarrhoeic illness in Ethiopian children focussing on Salmonella.Methodology: Paediatric patients (n = 1,225) presenting with diarrhoea or fever from the paediatric outpatient department of Tikur Anbessa University Hospital, Addis Ababa (n = 825), and Jimma University Hospital, South West Ethiopia (n = 400), were investigated for pathogens from January to August 2006. Results: Parasites were detected in 337 cases, Salmonella in 65, and Shigella in 61. Serotyping of Salmonella (including 48 stored isolates) demonstrated the dominance of S. Concord: S. Concord (85), S. Typhimurium (7), S. Paratyphi B (2), S. Haifa (1), S. Typhi (2), S. Enteritidis (4), S. Butantan (2), S. Infantis (1), S. Pomona (1), Salmonella group M (28:y:-) (1), and S. Oskarshamn (1). Six isolates in serogroups B and D were untypeable. Of 81 S. Concord isolates, 30were invasive, most (86.5) were positive for ESBL production by E-test and 70were multiply resistant to trimethoprim-sulphamethaxole, ceftriaxone, chloramphenicol and gentamicin, of which over one quarter (27) also showed reduced susceptibility to ciprofloxacin.Conclusion: Multi-drug resistant S. Concord was the major cause of salmonellosis in two regions of Ethiopia. The strain isolated was highly invasive, highly antibiotic-resistant, and represents a threat to heath care globally.

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Record No. 11698 Record ID 011698 Publication type Journal Article Title A Perspective of the Epidemiology of Malaria and Anaemia and their Impact on Maternal and Perinatal Outcomes in Sudan Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Adam, Ishag; Elhassan, Elhassan M.; Haggaz, Abd Elrahium D.; Ali, Abdel Aziem A.; Adam, Gamal K. Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2011 Volume and n° 5(2) Pages 83-87, fig., tab. Language English Descriptor Malaria-epidemiology; Anemia Pregnant Women Pregnancy Outcome Descriptor-Geographic Sudan Abstract Introduction: Both malaria and anaemia have adverse effects on maternal and perinatal outcomes. Thus there is an urgent need to investigate the co-epidemiology of malaria and anaemia and their combined impact on maternal and perinatal outcomes in the different regions of Sudan.Methodology: Various cross-sectional and case control studies conducted during the years 2003-2010 to investigate the epidemiology of malaria and anaemia and their impact on maternal and perinatal outcomes in different regions of Sudan were compared. Results: While 13.7of antenatal attendants in New Halfa had peripheral microscopically detected Plasmodium falciparum malaria, placental malaria (using histological examinations) was prevalent in 32.0-40and 19.5of parturient women in New Halfa and Gadarif Hospitals, respectively. Malaria was a risk factor for anaemia in New Halfa and for stillbirths in Omdurman Maternity Hospital. Anaemia was present in 52.5, 62.6and 80.2of pregnant women in Medani, New Halfa, and Gadarif Hospitals, respectively. In Gadarif, 57.3of pregnant women had a folate deficiency, while 1had a vitamin B12, deficiency. In Medani, zinc and copper deficiencies were detected in 45.0and 4of pregnant women, respectively. Anaemia was a risk factor for low birth weight in Al-Fashir, for fetal anaemia in New Halfa, and for stillbirth in Kassala Hospital. Conclusion: More care should be taken to ensure proper nutrition and malaria prevention such as bed nets and intermittent preventive treatments to avoid these diseases and their effects on maternal and perinatal outcomes

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Record No. 11697 Record ID 011697 Publication type Journal Article Title Low Sensitivity of ParaHIT-f Rapid Malaria Test among Patients with Fever in Rural Health Centers, Northern Tanzania Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Kweka, John Eliningaya; Lowassa, Asanterabi; Msangi, Shandala; Epiphania E Kimaro,; Lyatuu, Ester E.; Mwang'onde, Beda J.; Mahande, Aneth M.; Mazigo, Humphrey D. Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2011 Volume and n° 5(3) Pages 204-208, tab. Language English Descriptor Malaria; Plasmodium falciparum; Rural Health; Sensitivity and Specificity; Diagnostic Tests, Routine Descriptor-Geographic Tanzania Abstract Introduction: Several rapid diagnostic tools for malaria are currently available in local markets. However, diagnostic accuracy varies widely. The present study was conducted to evaluate a cheaply and easily available rapid diagnostic malaria test (ParaHIT-f) in rural Tanzania. Methodology: Participants presenting with fever at health centers in the Kilimanjaro and Manyara regions were eligible. Parasitological thin and thick smears were examined from finger-prick blood samples and compared to ParaHIT-f test results. Sensitivity, specificity and predictive values were calculated using microscopic parasitological examination as the gold standard. Results: In total, 236/743 (31.8) individuals had a positive malaria microscopy, and 25/715 (3.4) were positive in the rapid diagnostic test. The sensitivity of ParaHIT-f was 10.7(95CI, 6.7-14.7) and specificity was 100(95CI, 97.4-102), with positive and negative predictive values (PPV and NPV) of 100(95CI, 99.1-100.2) and 70.9(95CI, 66.9-74.9) respectively. Sensitivity of ParaHIT-f increased with increasing P. falciparum density (P 0.003) from 5.8(95CI, 0-12.9) at 100 parasites/µl to 20.5(95CI, 13.5-27) at = 100 parasites/µl. Conclusions: Sensitivity of the ParaHIT-f rapid test was very low in this setting, therefore concomitant use of rapid diagnostic tests and microscopy is recommended. In the case of positive test results, confirmation by parasitological techniques is not necessary. Further monitoring of ParaHIT-f in various epidemiological settings in Tanzania is warranted. Electronic Access :  Full Text-1

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Record No. 11696 Record ID 011696 Publication type Journal Article Title Knowledge of Blood-Borne Transmission Risk is Inversely Associated with HIV Infection in Sub-Saharan Africa Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Brewer, Devon D. Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2011 Volume and n° 5(3) Pages 182-198, fig., tab. Language English Descriptor Education, Public Health Professional; Blood-Borne Pathogens; HIV Infections; Iatrogenic Disease Descriptor-Geographic Africa South of the Sahara Abstract Introduction: Accurate, comprehensive knowledge of an infectious pathogen's modes of transmission helps people to avoid infection. Growing evidence suggests that blood-borne HIV transmission is widespread in sub-Saharan Africa. Methodology: I examined the association between knowledge of blood-borne HIV risk and prevalent HIV infection in Demographic and Health Survey data from 16 sub-Saharan African countries. I also searched three online databases for evidence of public education campaigns focused on blood-borne HIV risks in these countries. Results: Knowledge was moderately to strongly inversely related to HIV prevalence at the national level (i.e., countries in which many respondents were aware of blood-borne risk had lower HIV prevalence than countries in which few respondents were aware of such risk). At the individual level, respondents who knew about blood-borne HIV risks were modestly less likely to be infected than those who did not show awareness of this risk, independent of demographic and sexual behavior variables. This relationship was stronger in southern Africa than in west, central, and east Africa. In parallel analyses, knowledge of condom use as a way to prevent HIV was positively associated with prevalent HIV infection at both the national and individual levels. West, central, and east African countries with low to moderate HIV prevalence had implemented public education campaigns that included a focus on blood-borne transmission risks. Such campaigns were absent from high prevalence countries in southern Africa. Conclusion: These findings suggest that knowledge of blood-borne HIV risk protects against HIV infection and that public education campaigns are important for spreading that knowledge

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Record No. 11695 Record ID 011695 Publication type Journal Article Title HIV-Infected Women of Burkina Faso: a Reservoir of Mycoplasma Infection Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Djigma, Florencia; Ouedraogo, Charlemagne; Sagna, Tani; Ouermi, Djeneba; Sanogo, Korotini; Bisseye, Cyrille; Kabre, Abdoulaye; Pietra, Virginio; Simpore, Jacques; Nikiema, Jean Baptiste; Musumeci, Salvatore Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2011 Volume and n° 5(3) Pages 176-181, tab. Language English Descriptor Mycoplasma Infections; Vaginosis, Bacterial; HIV Infections; Women Descriptor-Geographic Burkina Faso Abstract Introduction: The objective of this work was to assess the prevalence of bacterial vaginosis (BV) and genital mycoplasma colonization in 251 HIV-positive compared to 200 HIV-negative women at the Maternal and Child Health (MCH) service of Saint Camille Medical Center Ouagadougou (Burkina Faso). Methodology: After revealing the cervix with a speculum, we collected swabs of vaginal discharge for the detection of pathogenic bacteria. Results: Among HIV-positive and HIV-negative women, we identified respectively: Mycoplasma hominis (16.7versus 5.5); Ureaplasma urealyticum (16.3versus 0.0); co-infection M. hominis with U. urealyticum (13.14versus 0.0); Candida albicans (21.11versus 41.5); E. coli (9.96versus 4.0); and the presence of abundant vaginal discharge (27.5versus 5.0) respectively. The Nugent's score, utilized for the diagnosis of BV, was significantly higher in HIV-positive women (p 0.001) associated with poor vaginal hygiene practices (p 0.01) and no use of condoms (p 0.01). Enterobacter, Klebsiella pneumonia, Klebsiella oxitocica, Staphylococcus epidermidis and Staphylococcus aureus, Streptococcus agalactiae, Trichomonas vaginalis, and Gardnerella vaginalis were also isolated, but in a low prevalence ranging from 0to 5. Conclusion: These results demonstrate that the HIV-positive women of Burkina Faso are frequently affected by BV and represent a reservoir for mycoplasma infection. Since these germs can lead to sterility and premature delivery, it is important to develop a policy of screening.

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Record No. 11694 Record ID 011694 Publication type Journal Article Title Pandemic Influenza A(H1N1) 2009 Virus Outbreak among Boarding School Pupils in Madagascar: Compliance and Adverse Effects of Prophylactic Oseltamivir Treatment Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Rajatonirina, Soatiana; Heraud, Jean-MicheI; Randrianasolo, Laurence; Razanajatovo, Norosoa; Ramandimbisoa, Tombo; Ratsitorahina, Maherisoa; Richard, Vincent Journal Title Journal of Infection in Developing Countries ISSN 1972-2680 Place of Publication Liverpool Publisher Pan-African Thoracic Society Date of publication 2011 Volume and n° 5(3) Pages 156-162 Language English Descriptor Influenza A Virus, H1N1 Subtype Disease Outbreaks Oseltamivir-adverse effects; Patient Compliance Schools Descriptor-Geographic Madagascar-Antananarivo; Abstract Introduction: In October 2009, the first outbreak of pandemic influenza A(H1N1) 2009 virus in Madagascar occurred at a school in Antananarivo. Among the first 12 cases, five were reported in boarding pupils at the school. The school closed 10 days into the outbreak. Mass oseltamivir prophylactic treatment was used to contain the outbreak. This study aimed to determine the transmission of infection among boarding school pupils and to evaluate the adverse effects of oseltamivir chemoprophylactic treatment and their impact on compliance.Methodology: After conducting an initial investigation of the outbreak we administered a questionnaire to 132 boarders who were present after the school re-opened. Questions addressed symptoms of influenza-like illness, compliance with chemoprophylaxis, and adverse effects. Results: Of 59 boarders, 20 (45.0) had confirmed pandemic influenza A (H1N1) infection. Among the asymptomatic boarders, compliance with oseltamivir chemoprophylaxis was moderate: 56.2took the full 10-day course, and 66.9completed at least seven days. In contrast, among symptomatic boarders, only two did not take the full course of oseltamivir. Fifty percent of the boarders receiving oseltamivir experienced symptoms such as fatigue (38.7), difficulty concentrating (22.6) and headaches (19.4). Bad compliance was not associated with adverse effects.Conclusion: Since the symptoms of pandemic influenza A(H1N1) 2009 virus were generally mild, the burden of adverse effects must be considered when deciding on mass oseltamivir chemoprophylaxis among teenagers.

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