Asian Pacific Journal of Tropical Medicine

Issue 6,2023 Table of Contents

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  • 1  One Health practice in Hainan, China
    Tingchan Liang Hong Tan Yuan Qi
    2023(6):241-242. DOI: 10.4103/1995-7645.379132
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    2  R21 vaccine: A ray of hope for malaria elimination
    Nitika Nitika Shrikant Nema Praveen Kumar Bharti
    2023(6):243-244. DOI: 10.4103/1995-7645.378560
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    3  Knowledge and awareness of human mpox infection among healthcare workers: A cross-sectional study in southwestern Nigeria
    Paul Oladapo Ajayi Deborah Tolulope Esan Tope Michael Ipinnimo Moronkeji Temitope Olanrewaju Oluremi Olayinka Solomon Olajumoke Oyewumi Atanda-Owoeye
    2023(6):245-252. DOI: 10.4103/1995-7645.378566
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    Objective: To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria. Methods: A cross-sectional study was conducted in Ekiti State, southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling. Data were collected with the aid of a semi-structured, self-administered questionnaire. The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables. The significance level was set at P-value <0.05. Results: Two hundred and twenty-two (70.3%) of the respondents were aged ≤40 years, mean age (36±9) years, 189 (59.8%) were female, 306 (96.8%) were Christians, and 203 (64.2%) were married. Three hundred and fourteen (99.4%) of the respondents were aware of mpox infection. Main sources of information about mpox were medical education (44.0%), radio/television (32.0%) and newspaper (21.0%). However, among those aware of the disease, 209 (67.0%) demonstrated poor knowledge levels. Longer than 5 years’ experience of medical practice was the only significant predictor of higher knowledge level of the disease (OR1.76, 95% CI 1.01-3.06; P=0.046). Conclusions: Despite the high awareness level of mpox infection among healthcare workers, there still exists a huge knowledge gap. It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.
    4  Behaviour and perception of parents on irrational use of antibiotics in children at primary care level: A cross-sectional study from Turkey
    Burak Mete Tarik Salcan Hakan Demirhindi
    2023(6):253-260. DOI: 10.4103/1995-7645.378562
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    Objective: To investigate the perception of antibiotics, the frequency of inappropriate antibiotic use, and the factors that lead to inappropriate antibiotic use by parents who apply to primary healthcare organizations. Methods: This cross-sectional study included 973 parents who applied to primary healthcare centers. We analyzed basic concepts related to antibiotics prescribed for their children, antibiotic administration, and antibiotic resistance, as well as parents' knowledge and attitudes towards antibiotic use, and their experiences, practices, and perceptions related to purchasing antibiotics without prescription. Results: In the past one year, 78.9% of the parents gave antibiotics to their children at least once, and 39.1% gave antibiotics three or more times. Some of the participants (7.1%) reported having forced the physician to prescribe antibiotics and purchased antibiotics without a prescription (13.2%). The knowledge about antibiotics and awareness about antibiotic resistance were found to be more frequent; among parents who had university degrees, higher income levels, two or fewer children, social insurance and negative behaviours were lower in those who received information about antibiotics from healthcare professionals. The probability of taking antibiotics without prescription was lower in that of with higher income level (OR 0.460; 95% CI0.219-0.965), and the probability of forcing antibiotic prescription was higher in those with 3 or more children (OR 6.94; 95% CI 2.37-20.26). The score obtained from the awareness of antibiotic resistance sub-dimension was found to negatively affect the behavior of forcing antibiotic prescription (OR 0.852; 95% CI0.732-0.993) but the score obtained from the behaviour sub-dimension was positively affect this behaviour (OR 1.136; 95% CI 1.011-1.276). Conclusions: Inappropriate antibiotic use appears to be a problem with negative perception, lack of knowledge and socioeconomic dimension. Studies should be conducted to increase antibiotic knowledge in parents and to expand the scope of social insurance.
    5  Excess mortality in Northeast Iran caused by COVID-19: Neglect of offset community transformations of health
    Nayereh Esmaeilzadeh Seyed Javad Hoseini Majid Jafari Nejad-Bajestani Mohammadtaghi Shakeri Zahra Izadi Mood Hamidreza Hoseinzadeh Mohammad Hasan Derakhshan Dooghaee
    2023(6):261-267. DOI: 10.4103/1995-7645.378563
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    Objective: To make evidence-based decisions based on broad mortality trends for Razavi Khorasan province, Iran. Methods: In order to determine the baseline number of deaths, we used univariate time series analyses for monthly data from the monthly vital statistics reports (From April 2015 to March 2022). For excess mortalities, these baselines were subtracted from reported deaths with a 95% prediction interval. To compare time and causes, a P-score was calculated. Results: From March 2020 to March 2022, there were 61 949 registered deaths, and the estimated deaths with a 95% confidence interval (CI) were 43 246.16 (35 718.28, 50 774.05). So, in 2020- 2021 and 2021-2022, the death counts were 35.15% and 51.33% higher than projected. A total of 18 666 cardiovascular diseases were reported and a total of 15 704.46 (12 006.95, 19 401.96) was estimated. The P-score for this duration was 14.49% and 23.23% higher than expected. Infectious and parasitic diseases plus COVID-19 were 16 633 and estimated to be 1 044.87 (456.77, 1 632.96). A total of 4 420 diseases of the respiratory system were reported, and 4 564.94 deaths were predicted (2 277.43, 6 852.43). In the first year of the pandemic, the P-score dropped to -35.28% and in the second year, it jumped sharply to 22.38%. Conclusions: Excess mortality, along with cause-specific mortality, can be helpful for monitoring trends and developing public health policies at the local, national, and international levels.
    6  Chryseobacterium/Elizabethkingia species infections in childre
    Aysun Yahsi Gulsum Iclal Bayhan Tugba Erat Ahmet Yasin Guney Seval Ozen Kubra Konca Belgin Gulhan Saliha Kan?k Yuksek Asl?nur Ozkaya Parlakay
    2023(6):268-275. DOI: 10.4103/1995-7645.377759
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    Objective: To investigate the clinical and epidemiological features and outcome of Chryseobacterium and Elizabethkingia spp. infections in children, together with antimicrobial susceptibilities. Methods: This retrospective study was conducted at a tertiary pediatric hospital in Turkey. All patients infected with Chryseobacterium/Elizabethkingia spp. among those presenting to Ankara City Hospital between March 2014 and March 2022 were included. Results: A total of 49 cases were included and 29 cases were identified as Elizabethkingia. The median age was 14 (0.2-185.0) months. The majority (89.8%) of these patients had an underlying disease, including malignancy (42.9%). Bacteremia (46.9%) and central line-associated bloodstream infection (28.6%) were the most common infections. The thirty-day all-cause mortality rate was 12.2%. The most commonly used antibiotics were ciprofloxacin and trimethoprim-sulfamethoxazole (TMP-SMX). Forty-five (91.8%) isolates were susceptible to ciprofloxacin, 44 (91.6%) to TMP-SMX, and 21 (87.5%) to levofloxacin. Conclusions: Chryseobacterium and Elizabethkingia spp. are emergent, nosocomial pathogens and the majority of cases were older than the neonatal period. They were mainly seen in patients with long hospital stays, indwelling devices, and those who have received antibiotics within the last month, especially carbapenems. In addition, they were associated with bloodstream infection and malignancy. The most commonly useful antibiotics according to the resistance patterns were ciprofloxacin and TMP-SMX. nclusions: Chryseobacterium and Elizabethkingia spp. are emergent, nosocomial pathogens and the majority of cases were older than the neonatal period. They were mainly seen in patients with long hospital stays, indwelling devices, and those who have received antibiotics within the last month, especially carbapenems. In addition, they were associated with bloodstream infection and malignancy. The most commonly useful antibiotics according to the resistance patterns were ciprofloxacin and TMP-SMX.
    7  Magnetic resonance imaging evaluation of head and neck involvement in IgG4- related disease
    Umur Anil Pehlivan Kamil Karaali Hatice Deniz Ilhan Mehmet Soy Didem Arslan Omer Kaya Rabia Miray Kisla-Ekinci Burcak Cakir-Pekoz Ummuhan Cay Arbil Acikalin Ahmet Muhtesem Agildere
    2023(6):276-283. DOI: 10.4103/1995-7645.378564
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    Objective: To evaluate the radiological features of IgG4-related disease (IgG4-RD) in the head and neck region. Methods: In this radiology-based study, radiological features, clinical, laboratory, pathological findings, and prognosis of nine patients with head and neck involvement diagnosed with IgG4-RD were investigated retrospectively. Results: The median age of the patients was 38 years (range: 2.5- 79 years), and there were six males and three females. The most common symptoms and clinical findings of the patients were eyelid and lacrimal gland swelling, painless exophthalmos, and ophthalmoplegia. The most common site of involvement on MRI was the orbit. Orbital involvement was followed by branches of the trigeminal nerve, sinonasal cavity, cervical lymph nodes, and dural involvement. The most common and remarkable imaging features were T2 hypointensity and diffuse homogeneous contrast enhancement. Results: Head and neck involvement of the IgG4-RD, has specific imaging features that can help with diagnosis. Thus, early diagnosis and better outcomes can be achieved with increasing awareness of these features of this relatively new pathology.
    8  Disseminated tuberculosis presenting as meningitis and spondylodiscitis in an immunocompetent adult
    Jeyapraniya Arumugam Shamila De Silva
    2023(6):284-286. DOI: 10.4103/1995-7645.378567
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    Rationale: Disseminated tuberculosis involves the central nervous system in up to a third of cases. However, meningitis and spondylodiscitis due to miliary tuberculosis rarely occur together, particularly in the immuno-competent population. Patient concerns: A 37-year-old immunocompetent male presented with altered level of consciousness for one week and lower back pain with evening pyrexia for one month. Examination revealed spastic paraplegia and left hemiparesis. Diagnosis: Disseminated tuberculosis presenting with meningitis and spondylodiscitis. Interventions: Category I anti-tuberculous therapy with a tapering regimen of intravenous dexamethasone was administered. Outcomes: There was clinical improvement after nine months of treatment. Lessons: Tuberculosis may present with atypical clinical manifestations. Contrast enhanced computed tomography scan or magnetic resonance imaging combined with histopathological features, a high index of suspicion and clinical improvement with anti-tuberculous treatment can confirm the diagnosis in the absence of microbiological evidence, especially in extrapulmonary tuberculosis.
    9  Association between the extent of public health measures and other respiratory infectious diseases cases amidst the COVID-19 pandemic in Thailand
    Yutong Ji Ziyun Zhuang Zicheng Liao
    2023(6):287-288. DOI: 10.4103/1995-7645.378568
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