African Journal of Tropical Medicine and Biomedical Research
The African Journal of Tropical Medicine and Biomedical Research is a multidisciplinary and international journal published by the College of Health Sciences, Delta State University of Abraka, Nigeria. It provides a forum for Authors working in Africa to share their research findings on all aspects of Tropical Medicine and Biomedical Sciences and to disseminate innovative, relevant and useful information on tropical medicine and biomedical sciences throughout the continent... Continue Reading. Instruction for Authors | Current Issue | Past Issue | Contact/Support
College of Health Sciences, Delta State University, Abraka, Nigeria
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Section: CASE REPORTS Keywords: Chronic myeloid leukaemia, pregnancy, haematological malignancy, Nigeria Introduction: Chronic myeloid leukaemia (CML) is a haematological malignancy characterized by the accumulation of monoclonal myeloid cells in the peripheral blood and bone marrow, often with splenic infiltration. CML in pregnancy presents an intriguing challenge because first-line therapy with tyrosine kinase inhibitors (TKIs) is contraindicated due to potential fetal complications. Case Report: A 37-year-old unbooked woman presented with features of hypermetabolism, postpartum haemorrhage, and elevated white blood cell count. Following hysterectomy and haematologic investigations, a diagnosis of CML (chronic phase) was made. She was managed with hydration, allopurinol, haematinics, and hydroxyurea, which resulted in significant improvement and normalization of clinical symptoms. Conclusion: CML in pregnancy is rare and presents unique diagnostic and therapeutic challenges. Hydroxyurea and interferon-alpha may be considered safe alternatives to TKIs during pregnancy, while timely diagnosis and multidisciplinary management are crucial to optimizing maternal and fetal outcomes.
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The Impact of Traditional Practices and Customs on Pregnant Women and Newborn Mothers’ Healthcare-Seeking Behaviors at Primary, Secondary, and Tertiary Health Levels
Section: ORIGINAL ARTICLES Keywords: Traditional practices, maternal health, Sierra Leone, healthcare-seeking behavior, primary healthcare, cultural beliefs, Cultural Sensitivity, Newborn Health Subjects: Traditional Practices, Healthcare-Seeking Behavior, Maternal Health, Newborn Health, Sierra Leone, Sub-Saharan Africa, Primary Healthcare, Cultural Sensitivity Disciplines: Public Health Introduction: This study investigates the influence of traditional practices and customs on healthcare-seeking behaviors among pregnant women and newborn mothers across different healthcare levels in Bo District, Sierra Leone. Understanding the impact of these customs is crucial for developing culturally sensitive maternal and neonatal health strategies. Materials and Methods: A mixed-methods approach was applied, involving 500 participants (pregnant women and newborn mothers) from urban and rural settings. Data was collected using the Ona mobile application through structured surveys. Quantitative analysis included descriptive statistics, Chi-Square tests, ANOVA, and multinomial logistic regression to evaluate primary, secondary, and tertiary healthcare utilization. The qualitative analysis explored the cultural context of healthcare decisions. Results: Traditional practices were acknowledged by 52.40% of respondents, and 40.40% actively participated in customs such as herbal remedies, ceremonies, and traditional birthing practices. These practices significantly influenced the preference for primary (OR = 2.45, p < 0.01) and secondary (OR = 1.78, p < 0.05) healthcare facilities. Regression analysis indicated that integrating traditional practices into healthcare policies positively impacted healthcare-seeking behavior (β = 0.42, p < 0.01). Conclusions: Traditional beliefs play a significant role in healthcare-seeking behavior, particularly at primary and secondary health levels. Integrating these practices into modern healthcare policies is essential for improving maternal and newborn health outcomes and fostering a more culturally sensitive healthcare system.
Traditional Practices, Healthcare-Seeking Behavior, Maternal Health, Newborn Health, Sierra Leone, Sub-Saharan Africa, Primary Healthcare, Cultural Sensitivity
Sweet Bitterness: Diabetes Mellitus and the Assault on Man's Dignity and Fecundity
Section: EDITORIAL Keywords: Diabetes mellitus, male infertility, reproductive physiology, Nigeria In his seminal 107th inaugural lecture delivered at Delta State University, Abraka, Prof. Eze Kingsley Nwangwa embarks on a deeply personal and scientifically rigorous journey to interrogate the dual menace of diabetes mellitus and male reproductive dysfunction. Framed under the thought-provoking title “Sweet Bitterness: Unmasking the Thief of Man’s Dignity and Fecundity,” the lecture explores the socio-medical implications of diabetes, especially its understudied impact on fertility, fecundity, and quality of life. The lecture traces the historical, physiological, and psychosocial dimensions of diabetes—from ancient medicine and the discovery of insulin to its modern epidemic in sub-Saharan Africa. With Nigeria now home to over 11.2 million diabetics, the lecture highlights how lifestyle-induced hyperglycemia not only burdens the healthcare system but undermines manhood, reproduction, and societal stability. Through experimental and clinical evidence, Prof. Nwangwa demonstrates that diabetes disrupts the hypothalamic-pituitary-gonadal axis, reduces testosterone, LH, and FSH levels, and causes marked degeneration in testicular histology. The lecture also delves into the compounding effects of stress and endocrine-disrupting chemicals on fertility and reproductive health. Offering hope, Prof. Nwangwa presents research-backed therapeutic strategies—intermittent fasting, exercise, antioxidant-rich foods (like coconut water and vitamin E), and plant-based therapies—that can restore hormonal balance and improve reproductive outcomes. Ultimately, the lecture is both a scientific exposition and a moral call to reclaim man’s dignity, urging clinicians, researchers, and policymakers to confront diabetes not just as a metabolic disorder but as an existential threat to fecundity and societal continuity.
Silent Strangulation: A Case Report of the Unseen Threat of Nuchal Cord Discovered During Caesarean Section
Section: CASE REPORTS Keywords: Nuchal cord, Caesarean section, Fetal distress, Umbilical cord, Silent strangulation Background: Nuchal cord one or more loops of umbilical cord around the fetal neck is a common finding, with global incidence ranging from 3% to 38%. Although typically benign, multiple or tightly wound loops may cause significant perinatal complications. Case Presentation: We report a rare case of a 36-year-old primiparous woman induced at 41 weeks for postdatism and reduced fetal movements. Despite normal antenatal findings, persistent variable decelerations during labour prompted emergency caesarean section. Intraoperatively, three tight nuchal cord loops were discovered. The male neonate was delivered with moderate asphyxia (1-minute Apgar score 5) but responded to resuscitation, attaining 5-minute and 10-minute Apgar scores of 8 and 10, respectively. Discussion and Conclusion: The case highlights the diagnostic limitations of routine antenatal ultrasonography in detecting tight nuchal cords, particularly in low-resource settings. It emphasizes the importance of individualized clinical assessment, vigilant monitoring during labour, and maintaining a high index of suspicion when fetal distress persists despite conservative interventions.
Framework Influencing Healthcare Services Utilization
Section: ORIGINAL ARTICLES Keywords: Health-seeking Behavior, Protective Factors, Alleviating Factors, Healthcare Utilization, Maternal health, Sierra Leone, aggravating factors Subjects: Maternal healthcare utilization Disciplines: Public Health Introduction: Maternal and neonatal mortality remain critical challenges in Sub-Saharan Africa, with Sierra Leone among the worst-affected countries. Barriers such as socio-cultural norms, financial constraints, and limited infrastructure hinder healthcare-seeking behaviors among pregnant women and mothers in rural areas. This study examines the influence of protective, alleviating, and aggravating factors on healthcare-seeking behavior among pregnant women and newborn mothers in Bo District, Sierra Leone. Materials and Methods: A mixed-methods study was conducted among 500 participants, including 294 pregnant women and 206 newborn mothers, at Bo Government Hospital and Tikonko Village Health Center. Data were collected via structured questionnaires and analyzed using Chi-Square, logistic regression, and Structural Equation Modeling (SEM) to assess relationships among influencing factors. Results: Protective factors, including health education and preventive care awareness, significantly influenced healthcare-seeking behavior, reported by 97.2% of participants. Alleviating factors such as access to healthcare (20.29%) and financial support (15.1%) promoted high antenatal care utilization (100%) and facility-based delivery (99.03%). Aggravating factors like cultural barriers and perceived risks negatively impacted care-seeking, with SEM showing a significant indirect effect (β = -0.45, p < 0.001). Conclusion: Health education, accessibility, and financial support are critical for improving maternal and neonatal health outcomes. Addressing socio-cultural barriers and enhancing risk communication are essential for further progress. Policymakers should prioritize integrated strategies to reduce maternal and neonatal mortality in Sierra Leone.
Diagnostic Delay in Intestinal Malrotation Presenting During Adolescence
Section: CASE REPORTS Keywords: adolescence, Intestinal malrotation, recurrent abdominal pain, Ladd’s procedure Introduction: Intestinal malrotation refers to any variation in the rotation and fixation of the gastrointestinal tract during development. While most cases present in infancy with acute obstructive symptoms, a significant number remain undiagnosed until later in childhood or adulthood, often exhibiting vague or nonspecific symptoms that complicate timely diagnosis and management. Case Report: A 10-year-old boy presented with recurrent abdominal pain of 5 years’ duration, recent onset of bilious vomiting, and constipation. Barium meal and follow-through imaging revealed a markedly distended stomach and proximal duodenum that ended blindly. Exploratory laparotomy confirmed intestinal malrotation with midgut torsion, and Ladd’s procedure was performed. The patient recovered uneventfully and has remained asymptomatic on follow-up. Conclusion: This case emphasizes the importance of considering intestinal malrotation as a differential diagnosis in older children with recurrent abdominal pain. Early recognition may prevent catastrophic complications such as bowel ischemia, chronic midgut volvulus, malnutrition, and short bowel syndrome.
Pattern of Microscopic Urine Examination in a Single Nigerian Centre
Section: ORIGINAL ARTICLES Keywords: haematuria, urine microscopy, UTI Subjects: Haematuria,Urinary tract infecion,urine analysis Disciplines: Nephrology Introduction: Urine microscopy is a relevant, inexpensive, and non-invasive investigation. However, its usefulness depends on the availability of appropriate equipment and expertise, often lacking in low-resource countries. This study aimed to describe the pattern of urinary abnormalities, the frequency of urinary tract infections (UTI), the pattern of microorganisms causing UTI, and their antibiotic sensitivities. Materials and Methods: A retrospective cross-sectional study was conducted in a tertiary institution in southern Nigeria using urine microscopy results of all patients tested over a 6-month period. Data were collated using Microsoft Excel and analyzed on IBM SPSS version 20. Results: The frequency of haematuria and pyuria were 19% and 52.3% respectively. Pyuria was higher in females than males (64% vs 42%, p=0.003, χ²=9.09). Haematuria was more frequent in males than females (60.7% vs 32.4%, χ²=5.16, p=0.023). Casts were seen in 2.7% and crystals in 6.5% of samples. Among 152 patients, 47.1% had significant cultures, with E. coli (40%) being the most common organism. UTI was more frequent in males (53.6%) compared to females (41.7%, p=0.188). E. coli was most sensitive to Amoxicillin/Clavulanic acid (48.3%). Conclusion: The frequency of haematuria and pyuria is higher compared to casts and crystalluria. Haematuria was significantly commoner in males, while pyuria was more frequent in females. E. coli was the most common organism implicated. There is a need for phase-contrast microscopes in Nigerian hospitals to improve diagnosis of urine sediments.
Haematuria,Urinary tract infecion,urine analysis
Gilles De La Tourette Syndrome in One of a Set of Phenotypically Identical Twins
Section: CASE REPORTS Keywords: Tourette's Syndrome, Tics, Neuropsychiatry, Neurodevelopmental,, Phenotypically Identical Twins Introduction: Gilles de la Tourette’s syndrome (GTS), or Tourette’s syndrome (TS), is a neurodevelopmental/neuropsychiatric movement disorder characterized by multiple motor and one or more vocal/phonic tics. It has a childhood onset, and a diagnosis is usually made when symptoms have persisted for more than a year. Case Presentation: A 24-year-old female, one of a pair of phenotypically identical twins, presented with verbal and motor tics, social difficulties, and obsessive-compulsive disorder. Symptoms first appeared at age nine. There was no family history of tics, and her twin sister exhibited no symptoms. Discussion: The aetiopathogenesis of GTS includes genetic and environmental factors such as infections, neuro-immunological factors, and perinatal complications. Earlier onset is associated with more severe symptoms. Females with GTS are less likely to experience remission during adolescence and may have greater functional impairment. Conclusion: Individuals with GTS may experience learning and cognitive impairments. Clinicians should evaluate patients presenting with tics to ensure early diagnosis and appropriate management to reduce psychosocial impact.
Bacteria Associated with Hospital Waste of Federal University Teaching Hospital, Owerri
Section: ORIGINAL ARTICLES Keywords: Hospital waste, bacteria, resistance Introduction: Hospital waste management is critical for minimizing health risks and environmental damage, particularly in developing countries where inadequate training and resources exacerbate these issues. The Federal University Teaching Hospital, Owerri, serves as a case study to determine the bacteria associated with hospital waste. Objectives: This study aimed to determine the bacterial contamination in hospital waste. Materials and Methods: An experimental study design was employed. The hospital waste samples were analysed for bacterial contamination via microbiological standards. Results: The infectious waste had the highest total viable count (9.86±0.28 CFU/g), indicating a high level of microbial presence, whereas the sharps waste presented a much lower total viable count of 5.40±0.52 CFU/g. The highest number of infectious waste isolates was 45 (30.2%), followed by general waste 41 (27.5%) and chemical waste 8 (5.4%). Among the infectious waste, Enterobacter cloacae (50%) was the most common bacterium, followed by Staphylococcus scuri ssp. lentus (32%). Among the sharps waste, Staphylococcus gallinarum (12%) was the most common, followed by Staphylococcus xylosus and Escherichia coli (11%). In general waste, Pantoea ananatis (100%) was the most prevalent bacterium, followed by Escherichia coli (38.9%), and the least prevalent was Staphylococcus scuri ssp. lentus (20%). Conclusion: This study highlights the need to mitigate the spread of resistant pathogens. Continuous monitoring and updated waste management strategies are essential to protect public health and the environment.
Uniportal Video-Assisted Thoracoscopic Bullectomy for Recurrent Spontaneous Pneumothorax
Section: CASE REPORTS Keywords: Pneumothorax, Uniportal-VATS, Bullectomy, Lung bullae, Uniportal Video-Assisted Thoracoscopic Surgery Introduction: Spontaneous pneumothorax has several causes; one important cause is lung bullae, which typically occur at the apices of the lungs and can rupture, causing pneumothorax. Resection of these bullae is indicated to prevent recurrence. Case Report: A 25-year-old man presented with recurrent breathlessness and cough. Clinical and radiological evaluation revealed a left pneumothorax, for which a chest tube was inserted. A chest CT scan revealed bilateral apical lung bullae. He experienced a recurrence two weeks later, requiring repeat tube thoracostomy and surgical intervention. Surgery was performed using a uniportal video-assisted thoracoscopic (VATS) approach — a relatively novel technique in the institution. The patient was discharged four days postoperatively. Discussion: The clinical presentation of ruptured bullae causing pneumothorax is typical, as the patient was a young male with sudden onset of symptoms. Uniportal VATS offered advantages over open thoracotomy, including reduced pain, improved cosmetic outcomes, and early discharge. Conclusion: Spontaneous pneumothorax resulting from lung bullae can be safely managed surgically using the uniportal VATS approach in resource-limited settings.
Uniportal Video-Assisted Thoracoscopic Surgery
Microanatomy of Term PlacentaInsights from Human and Wistar Rat Studies
Section: ORIGINAL ARTICLES Keywords: Term placenta, microanatomy, human, Wistar rat Subjects: Term Placenta, Microanatomy, Human, Wistar rat Disciplines: Basic Medical Sciences Introduction: The placenta is crucial for the development and survival of the maturing foetus. Wistar rat models are widely used in biomedical research to study human biological responses. However, there is limited open-access literature on the histology of the Wistar rat placenta. Materials and Methods: Young adult male and nulliparous female Wistar rats were obtained, acclimatized, and allowed to mate overnight. On the 20th day of gestation, the pregnant rats were euthanized, and placentas were collected and fixed in 10% neutral buffered formalin. Human placentas were sampled from patients who had normal vaginal deliveries. All samples were processed using haematoxylin-eosin, Masson trichrome, periodic acid–Schiff (PAS), and reticulin stains. Results and Conclusion: Both human and Wistar rat placentas were haemochorial, meaning the trophoblasts in both species are in direct contact with maternal blood. Differences were observed at the foetal–maternal interface and in the presence of the yolk sac. The highly vascularized labyrinth of the rat placenta features maternal and embryonic blood spaces separated by a trilaminar trophoblast layer and embryonic endothelial cells. In contrast, human-term placental villi consist of thin-walled capillaries lined by endothelial cells surrounded by a syncytiotrophoblast layer and an inconspicuous cytotrophoblastic layer. The basal plate and chorion of the human and Wistar rat placentas have similar anatomical positions, though their morphologies differ. The distribution of PAS positivity, collagen, and reticulin fibres varies between the two species. Caution is advised when extrapolating findings from rat toxicological studies to humans.
Term Placenta, Microanatomy, Human, Wistar rat
Investigation of Antibacterial Potential of Bacillus and Actinomycetes Isolated from Soil Against Drug-resistant Clinical Isolates
Section: ORIGINAL ARTICLES Keywords: Actinomycetes, antibacterial activity, clinical isolates, multidrug resistant, UV induction Background: Bacillus and Actinomycetes are well-known antibiotic-producing soil isolates. However, there is limited information on their activity against drug-resistant clinical isolates from Nigeria. This study aimed to investigate the antibacterial potential of Bacillus and Actinomycetes isolated from soil against drug-resistant clinical isolates. Methods: Soil samples were collected from the rhizosphere of mango trees within Caleb University, Lagos, between January and March 2024. Targeted isolation of Bacillus and Actinomycetes was performed, and clinical isolates of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Salmonella typhi were subjected to antibiotic susceptibility testing. The crowded plate method screened for antibiotic-producing isolates, and UV-induced mutation (2-hour and 4-hour exposures) was applied to assess changes in antibacterial activity. Results: Bacillus species (71.4%) were the most prevalent soil isolates. All clinical isolates showed multidrug resistance. Before UV exposure, only Actinomycetes exhibited antibacterial activity against Pseudomonas aeruginosa and E. coli. After UV exposure, all soil isolates showed inhibitory activity against at least one clinical isolate. Conclusion: The antibacterial activity of antibiotic-producing soil bacteria can be enhanced through UV induction, suggesting a promising strategy for developing new antimicrobial compounds.
Effect of Methanol Extract of Costus lucanusianus Root on Oxidative Stress, Liver Function and Haematological Markers in Malaria-infected Wistar Mice
Section: ORIGINAL ARTICLES Keywords: Wistar mice, Haematological parameters, Malaria, Costus lucanusianus, Oxidative stress, Liver function Background: Malaria is associated with oxidative stress, haematological alterations, and organ damage. Costus lucanusianus is traditionally used in the management of fever, but its antimalarial potential is not well established. Materials and Methods: The methanol root extract of C. lucanusianus was evaluated in Plasmodium berghei-infected mice using the 4-day suppressive test. Acute toxicity (Lorke’s method), parasitemia suppression, survival time, haematological indices, oxidative stress markers, liver function tests, and histopathology were assessed. Results: The extract was safe up to 5000 mg/kg. It produced dose-dependent parasite suppression, with 500 mg/kg achieving 50% inhibition, though less effective than chloroquine (62.5%). Treated mice showed prolonged survival, improved antioxidant enzyme activity, and reduced lipid peroxidation. Haematological parameters indicated increased WBC and platelet counts with reduced neutrophils. Liver function markers remained largely stable, while histopathology showed milder hepatic distortion compared to untreated controls. Conclusion: Costus lucanusianus root extract demonstrates significant antimalarial, antioxidant, and immunomodulatory activities, supporting its ethnomedicinal use and potential as a source for new antimalarial agents