Transactions of the Royal Society of Tropical Medicine and Hygiene
-
Trans. R. Soc. Trop. Med. Hyg. · Nov 2007
Water handling, sanitation and defecation practices in rural southern India: a knowledge, attitudes and practices study.
Diarrhoea and water-borne diseases are leading causes of mortality in developing countries. To understand the socio-cultural factors impacting on water safety, we documented knowledge, attitudes and practices of water handling and usage, sanitation and defecation in rural Tamilnadu, India, using questionnaires and focus group discussions, in a village divided into an upper caste Main village and a lower caste Harijan colony. Our survey showed that all households stored drinking water in wide-mouthed containers. ⋯ Hand washing with soap after defecation and before meals was common only in children under 15 years (86.4%). After adjusting for other factors, perception of quantity of water received (P<0.001), stated causation of diarrhoea (P=0.02) and low socio-economic status (P<0.001) were significantly different between the Main village and the Harijan colony. Traditional practices may pose a significant challenge to programmes aimed at toilet usage and better sanitation.
-
Trans. R. Soc. Trop. Med. Hyg. · Oct 2007
Case ReportsConcurrent dengue and malaria due to Plasmodium falciparum and P. vivax.
Concurrent infections of dengue and malaria are rare. We report a case of dengue fever with acute malaria due to Plasmodium falciparum and P. vivax in which the presence of mixed infection with P. vivax was overlooked and confirmed later on during recurrence of the fever that had initially responded to conventional antimalarial treatment and symptomatic treatment for dengue fever. We suggest that in concurrent infections of dengue and malaria, possibility of mixed infection with various Plasmodium species should be excluded to ensure a better treatment outcome.
-
Trans. R. Soc. Trop. Med. Hyg. · Aug 2007
Randomized Controlled Trial Comparative StudyRandomized, controlled, double-blind trial with ivermectin on Loa loa microfilaraemia: efficacy of a low dose (approximately 25 microg/kg) versus current standard dose (150 microg/kg).
Neurological serious adverse events (SAEs) following ivermectin treatment may occur in individuals harbouring high Loa loa microfilarial densities and are of major concern in the context of mass ivermectin distributions organized in Africa for onchocerciasis and lymphatic filariasis control. As those SAEs are induced by the rapid and massive microfilaricidal effect of a standard dose of ivermectin (150 microg/kg), we performed a randomized, controlled, double-blind trial to determine whether ivermectin given as: (a) a single low dose of 1.5mg (i.e. 25 microg/kg for a 60 kg person); or (b) two doses of 1.5mg given at a 2 week interval leads to a more progressive decrease in Loa microfilarial loads compared with the standard dosage. A low dose of ivermectin brought about a significantly smaller decrease in Loa microfilaraemia than the standard dose. ⋯ A second low dose of ivermectin given 15 days after the first dose did not lead to a further decrease in Loa microfilaraemia. Lastly, the variability in the response observed in the group treated with 25 microg/kg suggests that even lower doses would have no effect on a significant number of patients. Ivermectin given at a low dose (
-
Trans. R. Soc. Trop. Med. Hyg. · Oct 2006
Case ReportsRelapsing fever in a traveller from Senegal: determination of Borrelia species using molecular methods.
We describe a case of a febrile patient returning from Senegal in which haemoscopic and molecular investigation confirmed tick-borne relapsing fever (TBRF), suggesting Borrelia crocidurae as the causative agent. This case emphasises the need to include TBRF in the differential diagnosis of fever following a journey from endemic countries, including malarial areas.