scholarly journals Hematological Profile of Children With Malaria in Sorong, West Papua, Indonesia

2021 ◽  
Author(s):  
Syilvia Jiero ◽  
Ayodhia Pitaloka Pasaribu

Abstract Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria.Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77,42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5-10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group >10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p <0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in hogh endemic areas, such as West Papua.

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Syilvia Jiero ◽  
Ayodhia Pitaloka Pasaribu

Abstract Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria. Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77, 42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5–10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group > 10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p < 0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in high endemic areas, such as West Papua.


2020 ◽  
Author(s):  
Syilvia Jiero ◽  
Ayodhia Pitaloka Pasaribu

Abstract Background: Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Hematological changes such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the hematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria. Methods: A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results: One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children <5 years suffering from malaria had the highest number at 77 (42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had hemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5-10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group >10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Of the eight parameters of the hematological profile, there were five parameters that were significantly associated with the diagnostic criteria, namely hemoglobin, hematocrit, leukocytes, platelets and monocytes (p <0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a p value of 0.001. Conclusions: Children with malaria had changes in some hematological parameters, with anemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in our study area. These parameters could improve malaria diagnosis when used in combination with other clinical diagnoses and microscopy.


2021 ◽  
pp. 64-66
Author(s):  
Md Shoeb Alam ◽  
Rahul Ranjan ◽  
V N Jha

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major public health problem. COR PULMONALE describes the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance or increased pulmonary artery pressure. Hypoxic pulmonary vasoconstriction, hypercapnia, respiratory acidosis and pulmonary vascular remodeling in COPD can cause an increase in right ventricular (RV) after load, which in turn, results in RVfailure leading to COR PULMONALE AIM:The purpose of the study is to compare the ABG pattern in patients of COPD with or without COR PULMONALE. MATERIALS AND METHODS: This prospective observational study was conducted in the Department of Medicine of DMCH, Laheriasarai, Bihar. The study was conducted with duration of 2 years. Atotal of 100 patients admitted as a case of COPD with or without COR PULMONALE. The patients were put into two subgroups, COPD with and without COR PULMONALE. RESULT: The mean duration was 10.17 years and 9.20 years respectively in patients with and without COR PULMONALE. There was no statistically signicant difference regarding mean duration of disease (p value =0.304). Mean CAT score was 16.59 ± 6.26 and mean mMRC was 3.19± 0.45 in COPD patients with COR PULMONALE group. Mean CAT score was 14.06 ± 4.46 and mean mMRC was 3.10 ± 0.44 in COPD patients without COR PULMONALE group. We found no signicant difference among these variables between groups. Although COR PULMONALE patients had higher CATscore and mMRC score, the difference was not signicant (p value = >0.05). CONCLUSION:ABG ANALYSIS should be recommended for all patients of COPD with or without COR PULMONALE to assess the degree of hypoxemia, hypercapnea, respiratory acidosis and also, we can identify individuals who need more close monitoring and intensive treatment.


Author(s):  
Surabhi Porwal ◽  
Amita Sharma

Background: Pyrexia in pregnancy is major public health problem in India. Pyrexia in pregnancy is associated with resorption of the embryo, foetal deaths and potentially lethal malformations such as central nervous system defects, abdominal-wall defects, and cardiovascular malformations. This study was carried out to analyse clinical profile of women presenting with pyrexia during pregnancy.Methods: After approval by institutional ethical committee the prospective case control study was conducted in the department of obstetrics and gynecology, NSCB Medical College, Jabalpur (M.P.) from 1st June 2012 to 31st October 2013. Total 100 antenatal women with pyrexia taken as cases and 50 antenatal women without pyrexia taken as control were included and analyzed in this study. In women fulfilling inclusion criteria detailed history was taken and documented in proforma. Required investigations were sent to the department of pathology and virology laboratory of Indian Council of Medical Research, Jabalpur. Results were analyzed statistically by using t test and chi square test.Results: On analysis of clinical symptoms pyrexia, cough, malaise, rash, headache, nausea and vomiting, joint pain, anorexia, breathlessness and burning and frequency of micturition were significantly higher in cases as compare to control. Viral pathogens were responsible for most of the cases of pyrexia in pregnancy.Conclusions: Pyrexia in pregnancy is a high-risk situation, early identification and prompt treatment will reduce maternal and perinatal morbidity and mortality associated with pyrexia in pregnancy.


2018 ◽  
Vol 7 (1) ◽  
pp. 4-9
Author(s):  
Md Mahamudur Rahman ◽  
Md Akram Hossain ◽  
Shyamal Kumar Paul ◽  
Salma Ahmed ◽  
Md Murshed Alam ◽  
...  

Soil transmitted helminthes (STHs) infections are common throughout the tropics and subtropics and represents a major public health problem in developing countries. The rate of STHs infection found in the present study was very high in comparison to other countries of this Subcontinent, though they are taking antihelmintics every 6 months interval under Government National Health Program. The present study was carried out to see the Prevalence of STHs infection among the school children in Mymensingh, Bangladesh. A total of 500 stool samples from healthy individuals were collected during April, 2012 to February, 2013 from 20 schools comprising 10 rural and 10 urbans under Sadar upazila, Mymensingh, Bangladesh. The samples were examined in the department of Microbiology, Mymensingh Medical College using saline and iodine preparation microscopy and McMaster technique for the detection of ova of STHs.  The STHs prevalence irrespective of the age and sex of the individuals were 37.0% (185) out of 500 specimens where 68.0% (340/500) individuals were male represents the prevalence 38.0% (129/340) and 32.0% (160/500) individuals were female represents the prevalence 35.0% (56/160). Majority of the cases belonged to the age group >5-10 years 50.2% (251/500) of the total, constituted the prevalence 20.2% (101/500) of the total population and 40.2% (101/251) of the individual age group. The distribution of different STHs with their prevalence in the study population where Ascaris lumbricoides (AL) was 63.8% (118), Trichuris trichiura (TT) 37.3% (69), Enterobius vermicularis (EV) 8.1% (15), Ancylostoma duodenale (AD) 7.5% (14), and mixed infection was 15.1% (28). The upper socio-economic class constituted 5.0% (25/500) of the total study population with the prevalence of 20.0% (5/25). The middle socio-economic class constituted 50.0% (250/500) of the total study population with the prevalence of 37.2% (93/250) and the lower socio-economic class constituted 45.0% (225/500) of the total study population with the prevalence of 38.6% (87/225). The urban population constituted 34.0% (170/500) of the total population representing the prevalence 31.2 % (53/170) and rural population constituted 66.0% (330/500) of the total population representing the prevalence 40.0% (132/330).  In this study, STHs detection by McMaster method was satisfactory. Thereby, McMaster method could be adapted for rapid detection and quantification of STHs. Moreover, one more frequent administration of antihelmintics with close monitoring of drug administration may reduce the prevalence of STHs infection in Bangladesh. CBMJ 2018 January: Vol. 07 No. 01 P: 04-09


2021 ◽  
Vol 12 ◽  
Author(s):  
Le-Le Ma ◽  
Hui-Min Liu ◽  
Chuan-Hong Luo ◽  
Ya-Nan He ◽  
Fang Wang ◽  
...  

The coronavirus disease, 2019 (COVID-19), has spread rapidly around the world and become a major public health problem facing the world. Traditional Chinese medicine (TCM) has been fully committed to treat COVID-19 in China. It improved the clinical symptoms of patients and reduced the mortality rate. In light of the fever was identified as one of leading clinical features of COVID-19, this paper will first analyze the material basis of fever, including pyrogenic cytokines and a variety of the mediators of fever. Then the humoral and neural pathways of fever signal transmission will be described. The scattered evidences about fever recorded in recent years are connected in series. On this basis, the understanding of fever is further deepened from the aspects of pathology and physiology. Finally, combining with the chemical composition and pharmacological action of available TCM, we analyzed the mechanisms of TCMs to play the antipyretic effect through multiple ways. So as to further provide the basis for the research of antipyretic compound preparations of TCMs and explore the potential medicines for the prevention and treatment of COVID-19.


2021 ◽  
Vol 104 (2) ◽  
pp. 233-239

ackground: Tuberculosis (TB) is a major public health problem, including Thailand. Anti-TB drugs are very effective treatment, but they can cause hepatotoxicity. Data on the prevalence of anti-TB drug-induced hepatotoxicity (DIH), as well as the contributing risk factors, are scarce in Thailand. Objective: To measure the prevalence and identify risk factors associated with first-line drugs (FLD) induced hepatoxicity in TB patients. Materials and Methods: The present study was a retrospective study design in TB clinic of Suratthani Hospital, in Southern Thailand. All patients diagnosed with TB and received FLD between January and December 2017, were eligible for the study. Hepatoxicity defined as the following criteria: serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >5x upper limit of normal (ULN) without symptoms, or AST or ALT >3x ULN with clinical symptoms. Results: Of all the 198 TB cases, 18 were identified as DIH. Prevalence of DIH was 9.1%. Hepatitis after FLD was independently associated with age>60 years (adjusted OR [aOR] 28.49, 95% CI 2.68 to 302.95, p=0.005) and serum albumin <3.5 g/dL (aOR 20.97, 95% CI 2.11 to 208.51, p=0.009). Conclusion: Age of more than 60 years and low serum albumin of less than 3.5 g/dL were significant risk factors associated with first-line anti-TB drugs induced hepatoxicity. Keywords: Hepatoxicity, Anti-tuberculosis drug, Risk factor, Thailand


2021 ◽  
Vol 18 (2) ◽  
pp. 55-58
Author(s):  
Anil Shrestha ◽  
Aasim Kidwai ◽  
Richa Shrestha ◽  
Suman KC

Introduction: Organophosphorus (OP) compounds are the most commonly used pesticides worldwide and Organophosphorus poisoning has become the major public health problem especially in developing countries.The case fatality rate following ingestion of Organophosphorus pesticides in developing countries in Asia is 5-20%.Due to limited availability of facilities and resources in Nepal, it is important to prioritize treatment based on severity of poisoning as all patients can’t be managed in Intensive Care Unit. Aims: To study the correlation between serum cholinesterase level and clinical severity based on Peradenya organophosphorus poisoning scale in Organophosphorus poisoning. Methods: The study was conducted in the department of Medicine, Nepalgunj Medical College, Kohalpur, Banke from November 2019 to November 2020. It is based on the descriptive study of 66 patients with Organophosphorus poisoning attending to the emergency department. All patients with history of exposure to Organophosphorus poisoning were included in the study. Peradenya Organophosphorus Poisoning scale was used to assess the clinical severity as mild, moderate and severe. At the same time venous blood samples were collected for serum cholinesterase level. Results: Age group ranged from 16-60 years and majority of patients were in the age group of 20-29 years (34.85%). 53% were females. 74.2% of the patients were from lower socioeconomic status. 83.3% of the patients consumed poison with suicidal intention. Majority of the patients were from tharu ethinicity (40.9%) and were farmers (30.3%). It was observed that there is significant correlation between serum cholinesterase level and severity of poisoning based on Peradenya Organophosphorus Poisoning scale at initial presentation (p value <0.001). Conclusion: There is significant correlation between severity of poisoning and degree of derangement of serum cholinesterase level at the initial presentation. As the facility for the estimation of serum cholinesterase level is not available in all regions of Nepal.


2019 ◽  
Author(s):  
Merhawit Gebremeskel Hagos ◽  
Teferi Gebru Gebremeskel ◽  
Selam Shushay Kassahun ◽  
Birhane Hailu Gebrezgi ◽  
Manay Kifle Woldegebriel

Abstract Background: Delay in receiving immunization is a major public health problem that has been associated with vaccine-preventable disease epidemics. In Ethiopia, many children have not received the benefits of age-appropriate immunization; thus more than 90% of child deaths are largely due to preventable communicable diseases. Therefore, the aim of this study to assess the magnitude and factors associated with delayed immunization among 12 -23 months old children’s in Edagahamus Town, Tigray, Ethiopia, and 2018 G.C. Methods: A community-based Cross-Sectional study was carried out on July1-30, 2018. A simple random sampling method was used to select study participants. Information was collected using a structured, pre-tested questionnaire. Vaccination dates were obtained from children’s immunization cards and timeliness assessed based on the recommended age ranges. Data were entered and analyzed using SPSS version 20.0. Variable with P-value < 0.2 in bivariate was exported to multivariate. The strength of association was identified using the odds ratio with a 95 % confidence interval (CI) and the P-value of <0.05 in multivariate was taken statistically significant. Results: In this study, the overall magnitude of delayed immunization was 29.5% (95%CI 26.7-45). Private firm work of mothers (AOR=0.205 95% CI 0.068-0.617) and Mothers who attend tertiary education (AOR 0.169, 95% CI 0.032-0.882) and secondary education (AOR 0.269, 95% CI 0.114-0.636) had the protective effect of delayed immunization. But the sickness of the child (AOR= 11.8, 95% CI 6.16-22.65) was a risk for delayed immunization. Conclusions: From the study, it is concluded that the magnitude of delayed immunization for children aged 12-23 months is high (29.5%) in Edagahamus. Delayed immunizations of children were predicted by the Mother's occupation, education, and the mother considered the child was too ill to undertake vaccination when it was due. Keywords: Child immunization, Delay to be immunized, Vaccine-preventable diseases


2020 ◽  
Author(s):  
Sashimali Wickramasinghe ◽  
Nalika Gunawardena ◽  
Dhanusha Punyadasa ◽  
Shanthi Gunawardena ◽  
Champika Wickramasinghe ◽  
...  

Abstract Background Unintentional injuries among adolescents is a major public health problem the world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; it is also the leading cause of death among adolescents in the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13-17 years using data from the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka. Methods A cross-sectional survey was conducted using a self-administered questionnaire, among 3,262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected using probabilities proportional to school enrollment size, from all schools in the country that have classes in grades 8-12 . Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. The weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates. Results During the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured one or more times. The injuries were more common among males, but were equally common among the two different age groups (13-15 age group vs 16-17 age group). The most common type of injury was cut or stab wounds (5.5%), followed by broken bones/dislocated joints (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as being of the male sex, being bullied, being physically attacked, and/or being in a physical fight. Conclusion This study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration when designing school-based interventions to prevent adolescent injuries.


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