Current Trends in Disease and Health Vol. 3

EVD is a disease of humans and other non-human primates caused by Ebola viruses, which was first discovered in 1976. Between 1976 and 2013 there had been 24 outbreaks of the disease. The recent outbreak is the 26^th and has seen more deaths than all other outbreaks from the disease combined. This outbreak in West Africa occurred in five countries: Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. In the present research article, the authors reviewed various studies and current research on EVD. EVD was initially restricted to West Africa when the outbreak was first identified but later was reported in several countries around the world, including the USA. Researchers have begun to use mathematical analysis from previous outbreaks to construct the Atangana's Beta Ebola System of Equations (ABESE), which is being used to predict the spread of future outbreaks. The pathophysiology and transmission factors, including the basic and effective reproduction numbers, R₀ and R_e are discussed in detail. Prevention and control measures, such as proper hygiene techniques (both preventative and post-exposure), education (including educating communities on proper burial techniques), reduction in the consumption and exposure to bush meat, and controlled prevention of the spread of the disease (proper personal protective equipment and protocol upon exposure or in high-risk environments), are outlined. The history and current outbreak are reviewed in detail, which compares the differences in previous outbreaks compared to the current. Earlier (and less deadly) outbreaks have also been traced to the ZEBOV strain, and researchers suggest that the evolutionary rate of gene mutations was accelerated in this current outbreak. Death occurs in approximately 40% of affected individuals within 7-12 days after the onset of initial symptoms and is most often associated with multi-organ failure. Researchers outline the WHO’s criteria for screening and diagnosis, including primary, secondary and entry screening.  There is currently no approved cure for EDV, only supportive and experimental treatment and a currently FDA approved vaccine from Merck & Co’s. There are ongoing trials on the following vaccinations: ZMapp, TKM-Ebola, Favipiravir, cAd3, rVSVΔG-ZEBOVGP12, REGN-EB3 and mAb-114. This review article will attempt to summarize the current state of understanding on EVD and explore the most recent and accepted information including the epidemiology of the disease, etiology and pathophysiology, transmission, prevention and control, history, recent outbreaks in West Africa, clinical manifestations, screening and diagnosis, and treatment and clinical trials.

Background: Prevention of mother-to-child transmission of HIV (PMTCT) programmes provide antiretroviral treatment to HIV-positive pregnant women to reduce the likelihood of their infants acquiring the HIV. However despite concerted efforts to scale-up PMTCT services in Nigeria, the coverage and uptake of the service by pregnant women remain low.  

Aim/Objective: This study was carried out to assess the utilization and factors associated with the uptake of PMTCT Services among pregnant women at a tertiary health facility in Akure, Ondo State.

Methodology: This research was an institutional based descriptive cross-sectional study conducted over a period of one month (May 2018). The study population included pregnant women accessing antenatal care at the University of Medical Sciences Teaching Hospital, Akure, Ondo State. Data was collected using interviewer administered questionnaire and analyzed using SPSS Windows 20. The main outcome measured was the utilization of PMTCT services. Factors associated with its utilization was assessed using binary logistic regression. Statistical significance was set at P<0.05.

Results: A total of 400 pregnant women were interviewed with 100% response rate. The mean age of the women was 32 years ± 4.8. The majority of them with their spouses were educated up to the tertiary level. Their mean gestational age was 28 weeks ± 2.2 standard deviation. Among the respondents, 252 (63.2%) had been tested for HIV in the index pregnancy while 148 (36.8%) were not yet tested, those not tested identified lack of counsellors as their main reason. The average time spent before the patients were seen at the clinic was reported to be too long in 287 (71.7%), so 368 (92.5%) of the women were not satisfied with the service. Factors found to be positively associated with PMTCT utilization were the educational level of the women and their partners which could be in favour of their utilizing PMTCT services and inadequate counsellors which may not be in favour of utilization of the service.

Conclusion: All the respondents did not utilize the PMTCT services in the index pregnancy and the main reason being inadequate number of counsellors. There is the need to improve the quality of PMTCT services in the study setting.

Background: Malaria is a major contributor to deaths in children especially in sub-Saharan Africa. Children less than five years of age are susceptible to malaria infection in endemic regions leading to serious complications. Malaria causes death in children either directly through Cerebral Malaria (CM) and Severe Malaria Anaemia (SMA) or indirectly through co-morbidity with pneumonia or a sequela like hypoglycaemia.

Methods: This retrospective study examined malaria-related deaths among children at Effia-Nkwanta hospital within a study period of 3 years.

Results: A total of 1,416 medical records were reviewed, out of which 223 were medical records of children with fatal outcomes. Deaths over the study period due to all causes were 15.7% (223/1416) and confirmed malaria was 13.7% (40/292). Deaths due to all causes and confirmed malaria decreased from 21.6% and 24.3% in 2010 to 11.1% and 4.4% in 2012, respectively. Anti-malarial testing was done for 152 of the children with 40 positive and 112 negative results. Seventy-one children had no malaria testing done on them, with 23.4% in 2010 40.3% in 2011 and 35.5% in 2012. Anti-malarial treatment was administered to 83% of children who tested negative and 80% of children without anti-malarial testing.

Conclusion: Deaths in the children declined from 2010 to 2012 in this study. Despite this improvement, there was poor anti-malarial testing and improper use of anti-malarial treatment. National malaria programs should ensure improvement in anti-malarial testing and strict adherence to the anti-malarial treatment protocol.

The hospital staff need to be competent to utilize the disaster plan to cope up with an emergency situation. Therefore, the present study has aimed to assess the knowledge of hospital staff of Dhahran Al Janoub General Hospital regarding the disaster management during Hazm Storm Support 1436/2015 in Saudi Arabia. The study has employed quantitative research design to assess the disaster management of hospital staff by recruiting 84 individuals (physicians, nurses, technicians, officers and housekeepers) from Dhahran Al Janoub General Hospital. A questionnaire was given to respondents to gather information about disaster management. The obtained data was analysed using SPSS through chi-square analysis. The study results clearly depicted that the hospital staff with fewer years of experience had lesser knowledge about the disaster assessment as compared to the experienced employees. There was no statistically significant relationship identified between different job categories in the hospital and the level of knowledge about presence or absence of the emergency response plan. However, there was a statistically significant association found between different job professions and level of awareness regarding presence or absence of hospital command centres. The study concluded that the knowledge of emergency preparedness among the hospital staff was moderate and the hospital staff should participate and seek opportunities to prepare assessment for disaster management.

Persistence of antibiotics in the aquatic environment has raised concerns regarding their potential influence on potable water quality and human health. This study analyzes the presence of antibiotics in potable water from two treatment plants in Baghdad City. The collected samples were separated using a solid-phase extraction method with hydrophilic-lipophilic balance (HLB) cartridge before being analyzed. The detected antibiotics in the raw and finished drinking water were analyzed and assessed using high-performance liquid chromatography (HPLC), with Fluorometric detector and UV-detector. The results confirmed that different antibiotics, including fluoroquinolones and B-lactams were detected in the raw and finished water. The most frequently detected antibiotics were ciprofloxacin with highest concentration of 1.270 µg L^-1 in the raw water of AL-Wihda plant, whereas, the highest concentration of levofloxacin was 0.177 µg L^-1, while, amoxicillin did not detect in this plant. In contrast, ciprofloxacine was found in both raw water and finished water of AL-Rasheed plant and recorded highest concentration of 1.344 and 1.312 µg L^-1 respectively. Moreover, the residual amount of Levofloxacin in the raw water was up to 0.414 µg L^-1, whereas, amoxicillin showed to be the most detectable drugs in the raw water of AL-Rasheed plant, with a concentration of 1.50 µg L^-1. The results of this study revealed the existence of antibiotic drugs in raw and finished water, and should be included in the Iraqi standard for drinking water quality assessment.

The purpose of this study is to evaluate the influence of sex, residence area, age group, school enrollment, poverty status and income quintiles variables on the prevalence of stunting among Yemeni children and adolescents. The investigation was done on all children and adolescents (3004) aged 5-19 years that included in the last Yemeni household Budget Survey (YHBS) data of 2005/2006. The data included a classification to the poverty status of surveyed households. The cutoff of -2 z scores of the height-for-age reference suggested by NCHS, was used to calculate the prevalence rate of stunting. Descriptive, categorical testing, logit modelling statistical analysis tools were used in the investigation. The statistical analysis shows the overall prevalence rate of stunting as 49.5% and the prevalence of stunting among males is higher than females. The prevalence of stunting among rural children and adolescents is higher than the urban children and adolescents and among children and adolescents who were not enrolled is higher than those enrolled. Children and adolescents of poor households were suffering from stunting (52.8%) as comparing to children and adolescents of non-poor households (47.7%). Children and adolescents living with the poorest, second and middle-income households were 1.76, 1.73 and 1.46 times more likely to be stunted respectively. The research provides an evidence that the childhood health situation in Yemen is chaotic and needs careful and effective cooperation and efforts both nationally and internationally to divert the foreseen danger looming.

Introduction: The coverage of sanitation and access to safe drinking water in Ethiopia especially in Wolaita Sodo town are not well studied. Therefore, the main objective of this study was estimating access to drinking water supply, sanitation and hygiene facilities in Wolaita Sodo town, southern Ethiopia, in reference to national coverage.

Methods: A community based cross-sectional study design method was employed in the study in 588 households of Wolaita Sodo town inhabitants. Face-to-face interview to household owners, in-depth interview to key informants, reviewing secondary data and observational check lists were used to collect data. Districts were selected using simple random sampling techniques, while systematic random sampling technique was applied to select households. Data was analyzed using Epi Info version 3.5.4 and SPSS version 16 statistical software. Bivariate and multivariable logistic regression analysis was carried out.

Results: The community has access to improved water supply which was estimated to be 67.9%. The main water sources of the town were tap water within the yard, which was estimated to be 44.7% and tap water in the community was 40.0% followed by private protected well which was 14.5%. Ninety-one percent of the households had at least one type of latrine in their homes. The most common type of latrine available to households was pit latrine with superstructure which was estimated to be 75.9% followed by a pit without superstructure, 21.3% and more than half of the respondents had hand washing facilities in their compound. Occupational status, educational status and training on water, sanitation and hygiene related topics were significantly associated with use of improved water source, improved sanitation and hygiene facilities.

Conclusion: In order to address the demand of the town, additional water, sanitation and hygiene programs are required.

Introduction: Culex quinquefasciatus is a mosquito of importance to public health, as it represents a potential risk for the transmission of pathogens to humans, such as some arthropod-borne viruses and nematodes that cause filariasis. In Brazil, three municipalities in Pernambuco (state of Northeast of Brazil) that are endemic for lymphatic filariasis conducted control actions targeting this vector. With the aim of contributing novel C. quinquefasciatus collection strategies, a sticky trap capable of collecting eggs and imprisoning mosquitoes was investigated.

Methods: We adapted the oviposition BR-OVT trap to collect culicids eggs and adult C. quinquefasciatus and evaluated the performance of the sticky BR-OVT trap in two neighborhoods of Olinda-PE-Brazil (Caixa d’Água and Passarinho) between August 2011 and June 2012. Sixty traps were installed in the indoor areas of residences in the two districts.

Results: During the 11-month study, more than 100 Culex egg rafts, 1,430 C. quinquefasciatus. Additionally, 363 Aedes mosquitoes were caught by sticky BR-OVT traps. In these collections, female specimens were predominated in the traps: 59% of C. quinquefasciatus and 96% of Aedes spp. Conclusions: The results demonstrated that the sticky BR-OVT trap is a useful tool for the collection of adult culicids of medical importance and offers an innovative way to collect C. quinquefasciatus eggs and adults in a single trap.

Herbal medicine has gained a rapid growth in the past years, in the field of medicine worldwide. India is the greatest producer of medicines in the world as compared to other countries. The aim of the present study was to analyze and evaluate antibacterial activity of herbal plants against pathogenic bacteria isolated from diarrheal patients. The main focus of the paper was on varied advantageous characteristics of herbs as anti-diarrheal agents. In the study it is cleared that the medicinal plants play a vital role against diarrhea diseases. Various herbal plants and plants extract has a significant anti-diarrheal activity. Boerhaavia diffusa and Phyllanthus amarus were the main plants in research work against bacteria Staphylococcus, Pseudomonas and E. coli and out of which Phyllanthus amarus showed more zone of inhibition against Staphylococcus bacteria while both the plants showed similar results for Pseudomonas and E. coli.

Parasitic infections may be commonly found in global distribution in endemic areas. Parasitic infections are associated with a serum IgE response and peripheral eosinophilia. Strongyloides and Ascaris infections are examples of parasitic infections and pulmonary disease. The combined presence of parasitic infections and high immunoglobulin level E (IgE) levels can be found in isolation or as a clinical manifestation of certain immune defects.

The Hyper-IgE syndromes (HIES) as a group of distinct primary immune disorders should be considered in the differential and treatment of parasitic disease. The aim of this study was to highlight the importance of recognizing underlying immune defects in the clinical setting of parasitic infection, including HIES.

Background: Bite mark analysis is an imperative area of forensic odontology and considered the commonest form of dental evidence presented in the criminal court. The process of comparing bite marks with a suspect’s dentition includes analysis and measurement of shape, size and position of an individual’s teeth. The present study was aimed to evaluate the bite marks of males and females using a novel indirect computer assisted method and explicate its application in forensic odontology.

Materials and Methods: 60 subjects (30 males and 30 females) with normal occlusion were included in the present study. Bite registrations were obtained with help of modelling waxes and positive replica prepared with dental stone and barium powder. Intra oral periapical radiographs were taken for the same. The radiographs obtained were scanned and analyzed by measuring tools using Sidex is next generation software. Intercanine distance (ICD), line AB, angle ABX and angle ABY were measured. Kruskal-Wallis test was performed to compare the bite marks of males and females.

Results: The mean ICD of males and females was found to be 32.95 mm and 29.84 mm respectively and statistically highly significant with a p value < 0.001. The mean ICD, line AB and angle ABX were found to be higher in males when compared to females.

Conclusion: Analysis of bite marks using this novel computer assisted method is a simple, reliable, easily reproducible and economical technique with confidentiality of identity of the participants involved.

The neutralization or mopping up of reactive species produced during oxidative stress is achieved by synergistic actions of endogenous and exogenous antioxidants, including antioxidant vitamins. The sources, functions and effects of toxic and deficiency levels of these antioxidant vitamins are reviewed using information obtained from research articles, textbooks, monographs and internet platforms. Findings show that these antioxidants are commonly available in our daily meals and are therefore easily obtained if adequate diets are taken. However, some disease conditions can cause their deficiencies, while reduced or excessive (especially through supplementations) intake can produce disease states. It is suggested that assessment of these antioxidant vitamins be individualized, especially in critical situations like pregnancy.

This research is a descriptive analytical study investigating the factors affecting surgical delay in the surgical department at one of general (public) hospital at Jeddah city, Saudi Arabia. The research proposes and tests four independent variable factors affecting surgical delay. These factors are: clinical, administrative, hospital capabilities and care givers, while surgical delay is the dependent variable. In order to explore this issue, a quantitative method was used to collect primary data through designing a self-administered questionnaire, which was administered at the hospital. The research targeted the surgical department’s doctors at the hospital, who are the decision makers with regards to surgeries in their specialties; they total 106 doctors, and because of the small number of the research population the total number was taken as the research sample. The research retrieved 91 valid questionnaires (96.46%). Results show that the four factors are significantly important, demonstrating a positive statistical relationship between the four factors and surgical delay. This research recommends activating the clinical coordinators’ position in all surgical departments in turn, to improve the communication channels between all the concerned departments and the patients in order to run out the patients’ appointments and surgery booking. Moreover, it is vital to frame, develop and manage all the surgical waiting lists in all surgical departments for easy access and control.

As technology advances in recruitment and selection, it provides job seekers with more options for finding a career in the healthcare industry. At the same time, it helps organizations to streamline the hiring process. Internet job sites like CareerBuilder, Monster and Hot Jobs allow job seekers to post resumes which employers can view online and select qualified candidates. In addition, online candidate-tracking systems are helpful to employers. Social media forums like Facebook and LinkedIn are useful sources when selecting proper candidates for the healthcare industry. This research set aims to analyse the role of information technology in the healthcare recruitment process. The literature review demonstrates the impact of IT on the recruitment process in the healthcare sector. Literature from different secondary sources, such as books and journals, are discussed in this research. The methodology applied in this research takes a descriptive analytical and deductive approach. In the data collection and analysis part, the data were collected from 130 human-resource employees from different healthcare organizations in Makkah city. A quantitative data analysis method has been followed in order to analyse the raw data obtained in the survey. This helps to get appropriate outcome for the research by fulfilling its research aims and objectives. The outcome results from this study were as follows: First, that using information technology will be very useful in the recruitment process, because it will provide a better outcome than traditional methods. Second, there will be improvement in the quality of recruitment when using information technology in the recruitment process. Third, there will be a small improvement in communication when IT is used in the recruitment process rather than traditional methods. Finally, using IT in the recruitment process will be much more effective than the traditional way. The recommendations made from this study are the following: As outcome is one of the major components in the healthcare industry recruitment system, the applications for providing care must not vary between institutions. In order to improve quality in the healthcare recruitment process, it is necessary to apply IT in the proper way. For instance, those applications that have security issues and may lead to data leakage of candidates must be avoided. Using social media could be useful in enhancing communication in the healthcare recruitment process. The government has an important role to play in setting up standards for organizations. In turn, following these standards could be helpful in guaranteeing the effectiveness of the system.

Diabetes mellitus is a major public health problem that can cause a number of serious complications. Foot ulceration is one of its most common complications. Poor foot care knowledge and practices are important risk factors for foot problems among diabetics. The present study was undertaken in the diabetes outpatient department of a tertiary care hospital to assess the practices regarding foot care in diabetes, find out the determinants of foot ulcer in diabetics, and offer suggestions to improve care. After informed consent, a total of 124 diabetics were interviewed to collect all relevant information. The diabetic foot care practice responses were converted into scores and for the sake of analysis were inferred as poor (0–5), fair (6-7) and good (>7) practices. Of the study population, 68.5% (85/124) consisted of men. The disease was diagnosed within the last 5 years for 66% (81/124) of the study participants. Of the study subjects, 83% (103/124) were on oral hypoglycemic agents (OHAs), 15.3% (19) on insulin and 2 on diet control only. Among them about 18.5% had a history of foot ulcer. 37.9% reported using special slippers, 12% diabetics used slippers indoors and 66.9% used slippers while using toilet. Of the study subjects, 67.8% said that feet should be inspected daily. 27.4% said they regularly applied oil/moisturizer on their feet. There is a need on part of the primary or secondary physician and an active participation of the patient to receive education about foot care as well as awareness regarding risk factors, recognition, clinical evaluation and thus prevention of the complications of diabetes.