Open Access Original Research Article

Recurrence of Falciparum Malaria under Coartem Treatment in the City of Mâncio Lima, Acre, Brazil: A Retrospective Study

Andreus Roberto Schlosser, Saulo Augusto Silva Mantovani, Rayanne Alves de Arruda, Felipe Monteiro de Araújo, Rudi Nogueira, Cássio Braga e Braga, Breno Wilson Benevides Andrade, Mardelson Nery de Souza, Thasciany Moraes Pereira, Antonio Camargo Martins, Luiz Fernando Melo Lima, Mônica da Silva-Nunes

Asian Journal of Research in Infectious Diseases, Page 1-10
DOI: 10.9734/ajrid/2020/v4i230141

Background: Malaria remains a health problem in the Amazon and since 2005 the state of Acre has high incidence of malaria. Treatment with Coartem® for cases of falciparum malaria was introduced in Acre in August 2012. In Brazil, there is still no published study on the effectiveness of Coartem in endemic areas.

Methods: This study was conducted in Mâncio Lima, Acre, in the western Brazilian Amazon region. All malaria cases notified in Mâncio Lima between August 01st, 2012 and October 31st, 2013 were revised. The therapeutic response to Coartem in Mâncio Lima, Acre, was evaluated. A recurrence of falciparum malaria was defined as a malaria case occurring in the same patient in a maximum interval of 40 days between the day treatments was started and the day the next diagnosis was made.

Results: All malaria cases (7,171) notified between August 2012 and July 2013 were revised. About 23.72% (n = 1,701) were falciparum malaria. There were six cases of recurrent falciparum malaria that can be classified as treatment failure. All cases had low parasitemia. The minimum and maximum interval between the first and the recurrent malaria episode was 17 days and 33 days. Age range was 9 to 50 years. Two patients were from rural areas, while all others were from riverine areas.

Conclusion: Possible failure to Coartem treatment was identified, however causes are not clear. Further studies are needed.

Open Access Original Research Article

Detection of Multi-Drug Resistant Tuberculosis Using the Genotype MTBDR DNA Strip Assay and Lowenstein Jensen Proportion Method

Bosede Oyewumi Amuda, O. O. Oduyebo, Philip Abutu

Asian Journal of Research in Infectious Diseases, Page 11-22
DOI: 10.9734/ajrid/2020/v4i230142

Pulmonary tuberculosis (TB) remains a significant public health issue in low-middle income countries. Accurate and timely diagnosis is key to effective management. Diagnosing Multi Drug Resistance Tuberculosis (MDR-TB) is mostly done with phenotypic Lowenstein Jenson (LJ) proportion method with long turn around which delays treatment. The genotypic MTBDR plus was introduced by World Health Organisation (W.H.O) for the same purpose hence, this study aims to detect MDR-TB using both two methods. Sputum samples were collected from cases of pulmonary TB diagnosed with Genexpert and Ziehl Neelsen stain. Positive samples were subjected to MTBDR plus and the LJ proportion method with the LJ method considered gold standard. Chi square analysis was used to evaluate the Sensitivity, Specificity, Positive Predictive value (PPV), Negative Predictive value (NPV), of the MTBDR plus method compared to the LJ Proportion method. Kappa values were also estimated as a measure of agreement between the two methods. In evaluating the performance of MTBDR plus compared to the LJ proportion method, the sensitivity, specificity, PPV and NPV for the detection of rifampicin and isoniazid  was  93.7%, 90.2%, 92.5% ,91.7% and 88.5%, 95.5%,92.0% and 93.3% respectively, while evaluation MDR-TB was 74.5%, 94.4%,  88.4% and 86.6% with a Kappa value of 0.85,0.84 and 0.71 for Isoniazid, Rifampicin and MDR-TB which indicate almost perfect agreement for both rifampicin and isoniazid and substantial agreement for Multi Drug Resistance (MDR). Compared to LJ proportion method, MTBDRplus performed well in the detection of drug resistance to rifampicin, isoniazid and MDR-TB, hence, is a rapid and efficient tool for the diagnosis and initiation of treatment for MDR-TB.

Open Access Original Research Article

Simulations of Infectious Disease Propagation

William J. B. Oldham Jr.

Asian Journal of Research in Infectious Diseases, Page 33-44
DOI: 10.9734/ajrid/2020/v4i230144

Introduction and Objectives: The results of two simulations of the propagation of an infectious disease are presented. The objective of this research is to track the propagation of an infectious disease as a function of particle density and time. The results are given as a percentage of the population that is infected as a function of time.

Methods: The method here is to use computer simulation on a particle basis to track the progress of the infection. An uninfected particle becomes infected if it is closer than the critical distance to an infected particle. The movement of the particles is force driven in the first simulation while in the second each particle executes a random walk. In the second simulation the infection rates are given for different amounts of protection in the population.

Results and Discussion: These simulations show the entire population is at risk if proper measures are not taken early. For 400 particles the infection rate is 100% after approximately 100,000 iterations.  We give the results from one dual simulation in which protection was afforded for a significant part of the population and carried out until all of the unprotected were infected.  In the second part the protection was lifted to see how fast the total population was infected. For the cases of 50% protected it took 400,000 iterations to infect the unprotected particles. After the restrictions were lifted it took 140,000 to infect the other half. The simulations here are particle based which has the advantage of seeing individual particle involvement.

Conclusion: The propagation of the disease can be fast and depends on particle density. Protection is vital to containing the disease. Restrictions must be lifted carefully and slowly or the total population is again at risk.

Open Access Original Research Article

A Pilot Survey on the Use of Antimicrobal Agents in Poultry Farms in Kerala

Stelvin Sebastian, Antriya Annie Tom, Joyal Anna Babu, Merin Joshy

Asian Journal of Research in Infectious Diseases, Page 45-52
DOI: 10.9734/ajrid/2020/v4i230145

The extent of usage of antimicrobials is expected to increase markedly over coming years due to intensification of farming practices in most of the developing countries. The main aim of the study was to assess the pattern of farming practices and antibiotic use in the selected poultry farms in the Muvattupuzha region of the state of Kerala, India. A semi-structured interview was conducted among the farmers of the twelve randomly selected poultry farms. The use of antimicrobials for various purposes like treatment and prevention of infections, growth promotion, etc. was reported by 67% of farmers. Commonly used antibiotics were ofloxacin, enrofloxacin, levofloxacin, tetracycline, ceftriaxone, ciprofloxacin, oxytetracycline, neomycin sulphate, colistin. The survey concluded that none of the farmers were trained in poultry farming and they simply followed the instructions given by their supervisors who are also not aware of the consequences of improper farming practices. They used to give antibiotics for prevention and treatment of infections in chicken without the advice from a veterinarian and they used to get antibiotics from pharmacy shops and other shops without any prescriptions. Most of the farms surveyed were following the poultry recommendations and maintaining cleanliness which was enough to prevent outbreak of infections. Spread of mild infections can be prevented by isolating the sick poultry rather than giving antibiotic to the entire batch. Most of the farmers were aware of the presence of antibiotics as growth promoters in poultry feed and they prefer to use that for the tremendous increase of the weight of poultry.

Open Access Short Communication

COVID-19: Global Preparedness, Challenges and Impact

L. Macharia, M. N. Macharia

Asian Journal of Research in Infectious Diseases, Page 23-32
DOI: 10.9734/ajrid/2020/v4i230143

Corona virus COVID-19 is a pandemic whose devastating effects were felt in all corners of the world and by all humanity of whatever age, gender, economic and social status from the beginning of January 2020 and the intensity increasing day-by-day. The patients that had symptoms were isolated while waiting for results. In some countries, self-isolation was encouraged while in others, people had to be put in quarantine facilities to cut down the spread chain immediately. Different countries identified quarantine centers where individuals were quarantined for 14 days upon which they would be tested. A philanthropist Bill gates, the Microsoft billionaire, committed himself to donating resources for developing a vaccine. Research centers directed their focus to establishing a cure or a vaccine for the killer virus.  After four months of trials and tests, there was no sign of a cure. Many governments in the world applied a partial or full lockdown guided by the rate of infection and death. China was the first to call for a complete lockdown as it struggled with the new pandemic. The CoVID 19 pandemic has affected every facet of life; social, economic and mental. This has placed a lot of strain on governments and individuals. The economic status of many countries and individuals has been adversely affected and may take a long time before recovery.