Open Access Review Article

Systematic Review of Visceral Leishmaniasis in Central Africa

Demba Kodindo Israël, Cheick Amadou Coulibaly, John C. Beier, Gunter C. Muller, Seydou Doumbia

Asian Journal of Medicine and Health, Page 8-20
DOI: 10.9734/ajmah/2021/v19i730341

In underdeveloped countries, infectious diseases remain one of the most important public health challenges. Visceral leishmaniasis, also known as Kala-azar, is a lethal vector-borne parasitic disease with an increasing number of cases. However, it remains one of the most neglected diseases in the world. It is the most severe form of leishmaniasis and is endemic in 75 countries. Around 95% of the patients live in seven countries: Brazil, Ethiopia, India, Kenya, Somalia, South Sudan, and causes about 20,000-40,000 deaths per year of which 50-70% are children. In Central Africa, this pathology is little known and less documented, making it difficult to access information. We have performed this study to characterize the knowledge on the epidemiology of visceral leishmaniasis in Central Africa. We reviewed the literature on visceral leishmaniasis in Central Africa on the number of reported cases, identified parasites, reservoirs and vectors. The documents consulted came from WHO reports, publications of scientific journals, reports of research institutions and abstracts of scientific conferences consulted online on Pubmed and Google Scholar. The information covers the period from the first reporting of cases in each country until December 2020. The review of the situation of visceral leishmaniasis revealed that it is not a significant public health problem in Central Africa. However, a lot of work remains to be done especially surveillance and research in order to present the exact situation of the disease in this part of the continent. This work would include the underreporting of cases inherent to the weaknesses of the surveillance system in these countries, the clarification of the transmission dynamics of human visceral leishmaniasis, canine leishmaniasis, the identity of parasites and vectors.

Open Access Review Article

A Review on Current Status and Future Prospectus of Oral Vaccines

Adil Patel, Ria Ramani

Asian Journal of Medicine and Health, Page 21-37
DOI: 10.9734/ajmah/2021/v19i730342

The second leading reason of mortality worldwide is communicable diseases. The highly cost effective approach for disease prevention in case of communicable disease is vaccination. It is need of the hour to design and develop novel as well as safe vaccine delivery systems to safeguard against present incurable and emerging diseases. For various factors, the production of orally administered vaccines is superior to conventional injection-based formulations, including increased protection and compliance, and simplified processing and administration. In comparison, the oral route helps humoral and cellular immune responses to be activated at both systemic and mucosal sites to create larger and longer-lasting defence. This review addresses the reasoning for oral vaccines here including important biological and physicochemical implications for the design of oral vaccines for the next decade.

Open Access Review Article

Compliance with the Informed Consent to Blood Transfusion: Constraints and Physic for the Developing Africa

Joseph Aondowase Orkuma, George N. Ayia, Mernan Roselynda Ikwue, Joseph Ojobi, Gomerep Samuel Simji

Asian Journal of Medicine and Health, Page 78-91
DOI: 10.9734/ajmah/2021/v19i730346

The informed consent to blood transfusion is a patient centered care where the health care provider is ethically obliged and legally compelled to disclose the details, alternatives and consequences of a procedure such as blood donation or transfusion and obtain from the patient a prior consent before it is carried out. However, this newly evolving practice is largely constrained in many developing countries of Africa and this study sought to identify constraints and advance remedies. Literature search on PubMed, PubMed Central, Google Scholar, and African Journal on Line (AJOL) as well as print material literatures where applicable was used to retrieve 66 publications whose contents met the criteria for inclusion into the study. Constraints range from nondisclosure or defective disclosure, knowledge gaps of health care providers and non-comprehension of consent-based information by patients, illiteracy, religious and cultural practices, poor funding and administrative bottlenecks like non provision of consent forms or consent-based information materials as well as weak structures of effective oversight for compliance of health institutions by governmental regulating agencies. Physic like deployment of contentious professional development (CPD) activities for different professionals, focused training on consent-related guidelines, public awareness and education on prevailing social, religious and cultural impediments, research and localization of institution specific challenges. Additionally, proactive economic policies like the deployment of insurance indemnity covers for healthcare workers with negligent liabilities in order to dissuade health care providers from practicing defensive medicine which is inimical to quality health care delivery. There is a need for more researches on constraints prevalent in each developing country in Africa for a more appreciable advancement of the practice.

Open Access Original Research Article

Vitamin C in the Prevention of Contrast-induced Nephropathy among High-risk Patients Undergoing Coronary Angiogram: A Meta-analysis

Rainnier Y. Ong, Lou Andrew Palanca, Leana Agustin

Asian Journal of Medicine and Health, Page 38-45
DOI: 10.9734/ajmah/2021/v19i730343

Background: Contrast-Induced nephropathy (CIN) is one of the leading causes of acute kidney injury. The most common procedures associated with CIN are coronary angiography and contrast enhanced computed tomography (CT) [1].  The most common definition in use is an increase in serum creatinine (SCr) of >25% of the baseline values occurring following the intravascular administration of contrast media without an alternative explanation [2]. Generation of reactive oxygen species is thought to play a role in the pathogenesis of CIN, hence researches have been conducted into the potential role of antioxidants in the prevention of contrast-induced nephropathy [3]. Vitamin C, a potent antioxidant in humans has the ability to oxidize free radicals, and has been studied in different trials to measure its ability to prevent CIN among patients undergoing coronary angiogram.

Objective: To determine if vitamin C prevents CIN among High-risk patients (Creatinine Clearance <60 ml/min/m2, Diabetics, and on administration of high-volume contrast media).

Methodology: All studies, limited to randomized clinical trials were sought for this analysis through PubMed, the Cochrane Library, Database was searched using the terms “vitamin C”, “Prevention”, “acute kidney injury” and “contrast-induced nephropathy”. Adult patients (40-90 years old) with Creatinine Clearance of <60 ml/min/m2 or baseline creatinine >1.2 mg/dl, Diabetes Mellitus Type II, and were administered with high-volume contrast media (>100ml) undergoing coronary angiogram were included in the study. Exclusion Criteria were patients with normal baseline renal function, without risk factors for CIN, with EGFR < 30 ml/min/m2, with regular intake of Vitamin C and were on dialysis. Statistical data were obtained using Review Manager (RevMan) Version 5.3 freeware program.  P Value was obtained using the Cochran–Mantel–Haenszel test (CMH).  Included patients were given Vitamin C at doses of 1 gram to 3 grams, taken orally or administered intravenously pre-and post coronary angiogram.

Results:  Seven hundred and one (N=701) patients were included in this meta-analysis.  CIN occurred in 3.5% of patients (N=25) in the ascorbic acid group and in 6% of patients (N= 42) in the placebo group (p value of 0.03).

Conclusion: Vitamin C given at doses 1 gram to 3 grams in combination with hydration prior to coronary angiogram may have a significant effect in the prevention of CIN in high-risk patients.

Open Access Original Research Article

Morphological and Biochemical Effects of Aqueous Extract of Moringa oleifera Leaf on Cobalt Chloride-Induced Cerebral Damage in Adult Wistar Rats

A. J. Ajibade, A. E. Okeleye, I. A. Ogunmola

Asian Journal of Medicine and Health, Page 46-57
DOI: 10.9734/ajmah/2021/v19i730344

Cobalt induces hypoxia in the brain which leads to oxygen deprivation resulting in cognitive disturbance and decreased motor control. This study evaluated the effect of Moringa oleifera extract on the cobalt chloride-induced cerebral cortex of adult male wistar rats.

 40 male wistar rats weighing (90 ± 120g) were used for the study and they were divided into 5 groups with each group containing 8 rats. Group A served as control which received distilled water, Group B was treated orally with Cobalt chloride at dose 45 mg/kg, Group C received cobalt chloride 45 mg/kg + low dose of Moringa oleifera extract 250 mg/kg for 52 days, Group D treated with cobalt chloride 45 mg/kg + high dose of Moringa oleifera extract 500 mg/kg and Group E treated with 500 mg/kg Moringa oleifera extract only and rats were sacrificed on the 53rd day by cervical dislocation. The brain of each rat was removed and weighed before half was fixed in formol calcium for histological analysis and the second half was used for oxidative stress parameters. The mean body weight of the wistar rats in group C and E increased significantly (P <0.05) while it decreased significantly (P <0.05) in group D. The biochemical analysis shows a significant increase (P<0.05) in the level of MDA in group B and a significant decrease (P<0.05) in group E. additionally, NO level shows a significant increase (P<0.05) in group B compared with control. SDH activity decreased significantly in group C, D, and E. Microscopic examination of the cerebral cortex in group B, C and D showed degenerative changes compared with normal histological features in A and E.

The study concluded that cobalt chloride induced cerebral cortical damage while administration of Moringa oleifera extract attenuated the toxic effect of cobalt chloride in wistar rats.

Open Access Original Research Article

Risk Factors Associated with Respiratory Infections in Poultry in Peri-Urban Areas of Dakar and Thies (Senegal)

M. C. Kadja, J. Anitcheou, G. J. Djossa, S. Sourokou Sabi, F. X. Laleye, Y. Kane, Y. Kaboret

Asian Journal of Medicine and Health, Page 69-77
DOI: 10.9734/ajmah/2021/v19i730345

The objective of this study is identifying the main risk factors for the emergence of respiratory diseases in poultry farms in the Senegalese region of Niayes. It took place in the period from August 2018 to February 2019 in 45 modern poultry farms in the regions of Dakar and Thiès. The analysis of the results of our study showed that the farms are very close to houses and accessible to foreign people in

44.4% and 53.1% of cases respectively. Litter was treated before use in only 24.4% of farms. Respiratory diseases are the most frequent diseases (75.6%) and are found in

80% of broiler farms. The diagnosis of respiratory diseases was made by poultry advisors (75.6%) and was based mainly on memoranda, clinical signs and autopsy. The training of poultry farmers in poultry farming (p < 0.1), the proximity of farms to homes (p < 0.05), and the accessibility of the farm to outsiders (p < 0.01) influence the occurrence of respiratory problems on poultry farms.  Similarly, factors such as type of poultry speculation (p < 0.01), number of birds (p < 0.1), type of buildings (p < 0.01), bedding treatment (p < 0.05), and watering system (p < 0.05) appeared to be strongly related to the history of respiratory problems on poultry farms. Recommendations were made to improve environmental conditions and biosecurity measures to reduce the pressure of respiratory infections in poultry farms.

Open Access Original Research Article

Prevalence of HBV and HCV among Pregnant Women Attending Kumasi South Hospital (KSH), Ghana

Samuel Sarpong Osei, Albert Kumi Awuku, Maxwell Kwasi Kporxah, Samuel Ashie Amon, Precious Kwablah Kwadzokpui

Asian Journal of Medicine and Health, Page 58-68
DOI: 10.9734/ajmah/2021/v19i730348

Background and Aim: Both HBV and HCV infections have for decades remained serious public health concerns infecting thousands of people and claiming the lives of millions. The detrimental effects of these viral agents on the gravid women, the infants and the general population are well known and cannot be underestimated. Adequate and quality information on the disease prevalence remain one of the surest ways to tackling the infection head-on. This study therefore assessed the seroprevalence of HBV and HCV among pregnant women who received antenatal care services from the Kumasi South Hospital of the Kumasi Metropolis in the Ashanti Region of Ghana.

Materials and Methods: A semi-structured questionnaire designed to capture participant’s demographic and gestational data including age, occupation, marital status, educational status and gestational period was administered by the researcher to 200 pregnant women to collect the data for this study. About 2-3mls of whole blood was drawn into an ethylenediamine tetraacetic acid (EDTA) and tested for HBsAg using Alere Determine HBsAg® test strip (sensitivity=95-100% and specificity=96-100%; Abbott Japan Co., Ltd.) and HCV antibodies using Serodia® HCV (sensitivity=100% and specificity=91.5%; Serodia, Fujirebio Inc., Tokyo, Japan) following standard procedures. Due to the lack of more advanced testing facilities such as PCR, each positive test result was repeated in order to reduce the possibility of false positive results. Data was analyzed using Microsoft Excel 2016 and IBM SPSS vs 25. Chi-square and Fisher’s exact test statistic were used to determine statistical associations between explanatory and outcome variables. Logistics regression was employed to determine potential demographic and gestational risk factors of HBV and HCV infection among the pregnant women. P-value of less than 0.05 was considered statistically significant.

Results: Seroprevalence of HBV and HCV infection was 20.0% and 2.5% respectively. HBV infection increased with advancement in age from the least 7.1% among pregnant women aged < 20 years to the highest 22.0% among pregnant women aged 30-39 years until a sharp decline among those forty years and above. HCV prevalence generally declined with increase in age with the highest prevalence (14.3%) recorded among the <20 years old group. Unemployed (22.2%), married (20.3%), basic level educated (20.9%) and multiparous (21.3%) pregnant women recorded the highest HBV prevalence rates whereas unemployed (11.1%), unmarried (5.8%), basic level educated (3.4%) and multiparous (3.2%) pregnant women recorded the highest HCV prevalence rates. None of the demographic or gestational risk parameters was significantly associated with HBV infection in this study (p>0.05) however, age was significantly associated with HCV infection yet posed not significantly high likelihood to HCV infection among the pregnant women.

Conclusion: The HBV prevalence as recorded is highly endemic and therefore requires urgent round table discussions to be properly addressed. Despite the low HCV prevalence, the futuristic detrimental effects it may pose to the general wellbeing of the citizenry cannot be in doubt owing to the high prevalence dominating among the younger pregnant women. Measures such as intensified public education coupled with mass screening and vaccination and treatment of HBV seronegative and positive individuals respectively is therefore advised to mitigate further spread of the disease.

Open Access Original Research Article

Health Impacts of Alcohol Consumption: Report on Focus Group Findings

M. M. Theingi, S. K. Sakthiavelan, R. Kirtisha, R. Jeswary, R. Gowsshalya, S. K. Praveen

Asian Journal of Medicine and Health, Page 96-105
DOI: 10.9734/ajmah/2021/v19i730350

Introduction: Alcohol is one of the most widely used drug substances in the world. Most people drink a small or moderate amount of alcohol to make them calm and enhance their social activities. Alcohol have become many individuals’ livelihood and that itself is a major catastrophe for some people. This study aims to obtain perspectives in regards to Alcohol consumption among participants of different age groups, education backgrounds, religions, races and social statuses.

Methods: A focus group discussion consists of 3 male and 3 female Malaysians with age range from 16 to 45 was conducted. It consists of a mix group of alcohol consumers and non-alcohol consumers, students and adults from different racial backgrounds, genders and age groups. The participants were approached through qualitative research where they were asked both open-ended and close-ended questions based on various themes regarding the subject matter.

Results: In this study, peer pressure is one of the root causes that made most of the participants to initially try alcohol. Family’s acceptance towards alcohol drinking becomes a confounding factor that gives the child to do as they wish. Those who are still in school or universities showed that they consumed more alcohol. The realization of the younger age group towards health implications of alcohol consumption is still poor compared to those of the older age group. Although participants were well aware of the social problems, it is limited to their experiences as well as social backgrounds.

Conclusion: Participants’ knowledge regarding alcohol consumption has to be improved. Further analysis on the alcohol drinking behaviour on a larger scale might be needed to alleviate all the problems caused by alcohol consumption.

Open Access Minireview Article

Understanding Benefits of Curcumin on Cognitive Function from Molecular Aspect: A Review

A. A. A. Putri Laksmidewi, Richard Suherlim

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/ajmah/2021/v19i730340

Cognitive function has a significant impact on individuals’ quality of life. Over time, human cognitive function tends to decline. The importance of cognitive function in everyday life has led many researchers to seek alternative treatments to maintain and improve cognitive function. Some studies show that curcumin can improve cognitive function and prevent cognitive decline in humans.  This review focuses on the benefits of curcumin on cognitive function and the mechanism of how it works from molecular aspect. According to some studies, one of the factors leading to cognitive decline is chronic low-grade systemic inflammation. This review will focus on antioxidant, anti-inflammatory, neuroprotective effects, and β amyloid aggregation inhibition properties of curcumin that can improve cognitive function or delay cognitive decline. It is important to understand the basic reasons why curcumin can have benefits on cognitive function, this can be seen from the mechanisms that are reflected in the biomolecular aspect.

Open Access Letter to the Editor

Intravenous L- Carnitine in HD patients and some of its benefits: A single-center Observation

Abir Farouk Megahed, Ghassoub Mustafa Hles, Amany S. Elbahnasawy, Nagy Sayed-Ahmed

Asian Journal of Medicine and Health, Page 92-95
DOI: 10.9734/ajmah/2021/v19i730347


The “Type of Article” of this paper is “Letter to the Editor”. This paper discuses about: “Intravenous L- Carnitine in HD patients and some of its benefits: A single-center Observation”. No formal abstract is available. Readers are requested to read the full article.