Viral Haemorrhagic Fevers and Malaria Co-Infections Among Febrile Patients Seeking Health Care in Tanzania

Background: In recent years there have been reports of viral haemorrhagic fever (VHF) epidemics in Sub-Saharan Africa where malaria is endemic. VHF and malaria have overlapping clinical presentations making differential diagnosis a challenge. The objective of this study was to determine the prevalence of selected zoonotic VHFs and malaria co-infections among febrile patients seeking health care in Tanzania. Methods: This facility-based cross-section study was carried out in Buhigwe, Kalambo, Kyela, Kilindi, Kinondoni, Kondoa, Mvomero, and Ukerewe districts in Tanzania. The study involved febrile patients seeking health care from primary healthcare facilities. Blood samples were collected and tested for infections due to malaria, Crimean-Congo haemorrhagic fever (CCHF), Ebola virus disease (EVD), Marburg virus disease (MVD), Rift Valley fever (RVF) and yellow fever (YF). Malaria infections were tested using rapid diagnostics tests while exposure to VHFs was determined by screening for immunoglobulin M antibodies using commercial enzyme-linked immunosorbent assays. Results: A total of 308 participants (mean age=35±18.9 years) were involved in the study. Of these, 54 (17.5%) had malaria infection and 15 (4.8%) were positive for IgM antibodies against VHFs (RVF=8; CCHF=2; EBV=3; MBV=1; YF=1). Six (1.9%) individuals had both VHF (RVF=2; CCHF=1; EVD=2; MVD=1) and malaria infections. The highest co-infection prevalence (0.6%), was observed among individuals aged 46-60 years (p<0.05). District was significantly associated with co-infection (p<0.05) with the highest prevalence recorded in Buhigwe (1.2%) followed by Kinondoni (0.9%) districts. Headache (100%) and muscle, bone, back and joint pains (83.3%) were the most significant complaints among those infected with both VHFs and malaria (p=0.001). Conclusions: Co-infections of VHF and malaria are prevalent in Tanzania and affect more the older than the younger population. Since the overlapping symptoms in co-infected individuals may challenge accurate diagnosis, adequate laboratory diagnosis should be emphasized in the management of febrile illnesses.

A Review on Secondary Immune Thrombocytopenia in Malaysia

Immune thrombocytopenia (ITP) is an acquired autoimmune disease that occurs in adults and children. In Malaysia, the clinical practice guideline (CPG) for the management of ITP was issued in 2006, which focused almost exclusively on primary ITP (pITP), and only a few secondary ITP (sITP) forms were addressed. All published (twenty-three) sITP articles among children and adults in Malaysia, identified on the academic databases were retrieved. The articles were published between 1981 and 2019, at a rate of 0.62 publications per year. The publications were considered low and mainly focused on rare presentation and followed-up of secondary diseases. This review revealed that sITP in Malaysia is commonly associated with autoimmune diseases (Evan’s syndrome, SLE and WAS), malignancy (Kaposi’s sarcoma and breast cancer) and infection (dengue haemorrhagic fever, Helicobacter pylori and hepatitis C virus). The relationship between ITP and autoimmune diseases, malignancy and infections raise the question concerning the mechanism involved in these associations. Further studies should be conducted to bridge the current knowledge gap, and the further information is required to update the existing CPG of management of ITP in Malaysia.

THE EFFECT OF HEALTH EDUCATION ON INCREASING BEHAVIOR FOR THE PREVENTION OF DENGUE HEMORRHAGIC FEVER IN THE COMMUNITY

Background: One form of prevention of dengue haemorrhagic fever is through increasing public knowledge and understanding of the incidence of dengue haemorrhagic fever. Objective: This study was carried out with the aim of knowing the effect of health education on increasing behaviour for the prevention of dengue hemorrhagic fever in community. Methods: This study used a research design in the form of a pre experimental design with one group pre-post test design approach. This research was conducted on September 5, 2021 at RT 01 Kali Pecabean Village, Candi Sub-District, East Java Province, Indonesia. The population of this research is all families who live in RT 01 Kali Pecabean Village. The number of research samples was 26 families that were determined by using a sampling technique in the form of purposive sampling. Families who became respondents in this study were represented by one of the family members who participated in social gathering activities. The inclusion criteria used were families who participated in health education activities conducted at regular social gatherings. The instrument used is The Dengue Haemorrhagic Fever Prevention Questionnaire (DHFPQ). The result of reliability test was .550 and the validity was .84. Analysis of the data used is the Wilcoxon Signed Rank Test with p-value < .05. Result: The results showed that there was an effect of health education on increasing behaviour for the prevention of Dengue Haemorrhagic Fever in the community (p-value .0000). Conclusion: With the results of this study, it is hoped that health workers are expected to increase public understanding through the provision of health education as a preventive measure against the incidence of Dengue Haemorrhagic Fever. In addition, health workers are also expected to provide assistance to the community.

CRIMEAN HAEMORRHAGIC FEVER IN A CHILD AFTER A VISIT TO CRIMEA

This article contains additional information on the features of the clinical picture of Crimean hemorrhagic fever (CHF) in children, the ongoing activity of CHF virus circulation in the territory of the Republic of Crimea, confirms the possibility of imported cases of CHF in non-endemic regions, which is associated with the likely risks of nosocomial and intrafamilial cases of this infection. The data on the course of the disease, clinical and laboratory diagnostic examination of a child infected with CHF in the Crimea are presented.

Liver Function Derangement and Bleeding Morbidity in Dengue Fever and Dengue Haemorrhagic Fever in a tertiary Hospital in Bangladesh

Background: Dengue is a major international health concern that is prevalent in tropical and sub tropical countries. Study of dengue infection and its Liver complications are scarce from countries like India. This study was done to assess the frequency and spectrum of liver dysfunction and bleeding morbidity in Dengue infection patients. Methods: A Cross sectional prospective observational study was performed in the of Department of Medicine Sir Salimullah Medical College Mitford Hospital. All the inpatients who were diagnosed with dengue infection between July 2015 to July 2016 were included in this study. A total of 70 patients were included in the study. Results: Patients were classified as classical dengue fever (DF) 61.5.% dengue haemorrhagic fever (DHF) 38.5%. The mean age was 28.607±10.45 years in DF group and 26.78±11.78 years in DHF group and male: female ratio was 3:1. Deranged serum glutamic-oxaloacetic transaminase (SGOT) and/or Serum glutamic pyruvic transaminase (SGPT) was present in most of the patients. Elevation of ALT level occured more in DHF group patient (81%) than DF group (46%). Out of 70 patient 28(40%) patient were within normal value. 42 (60%) patient had elevated ALT level which is statistically significant (p value-<0.05)..The degree of rise of SGOT, SGPT,and Bilirubin was significantly more in DHF and DSS, as compared to DF. About bleeding morbidity, purpura was a mentionable finding 29(41%) but gum bleeding 15(21%), echymosis 14(20%), are less in both DF and DHF group. Major bleeding like hematomesis 5 (7%), melaena 4 (5%) and haematuria 1 (1%) also occured in both group of patients. Conclusion: Liver dysfunction in the form of raised SGPT was seen in almost all patients. Preferentially high SGOT may serve as an early indicator of dengue infection while high values of bilirubin, SGOT, SGPT,may be an indicator of severe disease and poor prognosis. Bangladesh J Medicine July 2022; 33(1) : 44-51

Pendampingan Kader Kesehatan Dalam Deteksi Dini Penyakit Degue Haemoraghic Fever (DBD) Di Dusun 1 Desa Sukabanjar Kecamatan Gedong Tataan Kabupaten Pesawaran Bandar Lampung

ABSTRAK Deteksi Dini penyakit Dengue Haemoragic Fever di Dusun 1 Desa Sukabanjar Kecamatan Gedong Tataan Kabupaten Pesawaran Bandar Lampung belum dilakukan dengan baik di Wilayah Kerja Puskesmas Bernung. Hambatan yang ditemukan yakni pengetahuan kader kesehatan tidak adekuat, belum tersedianya informasi yang adekuat tentang deteksi dini penyakit dengue haemoragic fever (DBD) pada kader kesehatan. Pelibatan kader kesehatan dalam edukasi mengenai deteksi dini penyakit DBD menentukan keberhasilan dalam penanganan awal DBD. Tujuan kegiatan pengabdian masyarakat yang dilakukan dalam pendampingan kader kesehatan untuk meningkatkan pengetahuan dan peran kader kesehatan dalam masyarakat dalam deteksi dini DBD. Kegiatan dilakukan di Kantor Kelurahan Dusun 1 Desa Sukabanjar Kota Bandar Lampung pada bulan Desember 2018. Metode yang dilakukan yakni ceramah, diskusi, praktek cara melakukan rumpled test. Hasil dari kegiatan pengabdian masyarakat ini didapatkan peningkatan pengetahuan kader kesehatan tentang deteksi dini DBD. Kegiatan pengabdian masyarakat yang dilakukan adalah bentuk upaya dalam deteksi dini DBD dengan melibatkan kader kesehatan. Kata Kunci : Deteksi Dini, Kader Kesehatan, Rumpled Test ABSTRACT Early detection of dengue haemoragic fever in Dusun 1, Sukabanjar Village, Gedong Tataan Subdistrict, Pesawaran Regency, Bandar Lampung, has not been carried out properly in the Work Area of the Bernung Health Center. The obstacles found were inadequate knowledge of health cadres, inadequate information on early detection of dengue haemorrhagic fever (DHF) among health cadres. The involvement of health cadres in education regarding early detection of dengue disease determines the success in the initial handling of dengue. The purpose of community service activities carried out in mentoring health cadres is to increase knowledge and the role of health cadres in the community in early detection of dengue fever. The activity was carried out at the Subdistrict Office of Dusun 1, Sukabanjar Village, Bandar Lampung City in December 2018. The methods used were lectures, discussions, practice on how to do a rumpled test. The results of this community service activity were found to increase the knowledge of health cadres about the early detection of dengue. Community service activities carried out are a form of effort in early detection of dengue by involving health cadres. Keyword : early detection, Health cadres, rumpled test