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EPIDEMIOLOGY, PATHOGENESIS, MANAGEMENT AND CONTROL OF

SOME TROPICAL DISEASES.

Tropical diseases: - these diseases have been diagnosed as diseases of poverty

ignorance and warn climate.

 They are common and peculiar to the tropics because of the high level of
poverty illiteracy, superstition, and temperature prevalence in tropical
countries.
 Most of these diseases are now prevalent in non-tropical countries because of
global warning and high rise of immigration from tropical to non-tropical
countries.

Some of these tropical diseases include;

A. Malaria B. Tuberculosis. C. Leprosy. D. Cholera. E. Typhoid. F.

Trypanosomiasis. G. HIV/AIDS. H. Viral hemorrhagic fever (yellow fever, Ebola
fever, dengue fever, Lassa fever, filariasis, schistosomiasis, leishmaniasis,
draconculiasis).

MALARIA

According to WHO, world malaria report 2018, there were about 219 million case
of malaria globally in 2017 compared with 217 million cases in 2016, And 239
million cases in 2010 respectively? From these estimates, 80% of these numbers
occur in sub – Sahara Africa with Nigeria bearing the largest burden.

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Due to malaria as an infection us disease, spread to humans through the bite

of infected female Anopheles mosquito it may cause severe complication and dead
if left untreated.

For this reason the roll back malaria (RBM) was established in 1998 by WHO,
UNICEF, UNDP and the World Bank to reduce half the global malaria death by
2010 and 2015. In addition, world leaders in 2015 adopted the sustainable
development goals of which SDG 3.3. More than target to end the epidemics of
AIDS, tuberculosis, Malaria, neglected tropical diseases and water borne disease

The world malaria day created in May 2007 by 60th session of world health assembly
to increase effort in the global fight against malaria prevention and treatment
especially in endemic countries.

Actually, the world Malaria day is celebrated on April 25th to commemorate the
birth day Anniversary of Prof Ronaldo Ross who discovered that Malaria MP is
transmitted from person to person by the bite of female Anopheles mosquito (FAM).
Malaria is spread in water and the pathogenic agent is the protozoa. The mosquito
vector carries protozoa which is pathogenic. Human Malaria is a protozoan that
occurs word wide.

 Etiologic agents of Malaria include

A. Plasmodium falciparum.

B. Plasmodium vivax

C. Plasmodium Malariae.

D. Plasmodium ovale

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 Epidemiology: - Malaria is found in regions lying mostly between 600N and

400S. It is commonly found throughout most of Africa, the sub Saharan
Africa, Middle East, south East Asia, western pacific and South America.

The burden of the disease amounts to 300-500 million clinical cases per year. 80%
of which occur in Africa. It is responsible for 1million deaths per year due to P.
falciparum, 90% of which are in Africa. 1 in 15 children suffer from severe Malaria
between the age of 5 years in Kenya, 19% of children die between 5 years in Gambia
while in Malawi, Malaria is responsible for 1/3 of pediatric admissions and 1/3 of
malaria deaths Malaria deaths.

 Malaria vector: Arthropod host i.e. female anopheles mosquito which

transmits plasmodium falciparum.
 Clinical features/presentation:

A. Fever chilis, myaglia.

B. Hepatomegaly.

C. Spleenomegaly.

D. Verying degree of Anaemia

E. Sweating.

F. Headache.

G. Nausea and vomiting

H. Restless tongue

I. Dry skin and tongue.

J. General malaise.

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K. Joint pain

J. Loss of appetite

M. Bitter taste in the mouth.

 Management:-
 Taking treatment, investigation, blood film (thin& thick)
 RDT; Rapid diagnosis test (PCU)

 Pathogenesis:- Life cycle of Malaria parasite; The presence of parasite

transmitted by the bite of female anopheles mosquito which acts as host and
vector. Mosquito exhibit a sexual life cycle and asexual cycle.

1. Sexual cycle (in mosquito) :- the female anopheles mosquito bites a person
infected with malaria and sucks blood containing sexual forms called gametocytes
(male and female parasite gametes).

A. Gametocytes enters the stomach of mosquito.

B. This develop into sexual from (sporozoite)

C. the sporozoite enters the salivary glands of mosquito which are transmitted into
the next person.
2. Asexual cycle (in man):- has 3 stages
A. pre-erythrocytic stage:- the sporozoite develops in the parenchymal cells of the
liver which rupture to release spotozoite into the blood cells (erythrocytes) as pre-
erythrocytic schizonts. In 3-9 days, asexual multiplication takes place and no
symptoms of malaria are experienced here.
B. Erythrocytic cycle:- the merozoites are produced and rupture from liver cells
which invade the blood cells initiating the erythrocytic cycle. They mature and

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destroy the red cells which rupture causing haemolytic anaemia releasing the
parasites (merozoites) in to the plasma, causing rigor.
The majority of merozoites re-enter the new blood cells (RBC) and the cycle is
repeated every 48hrs in tertian malaria and every 72hrs in quartan malaria.
Some merozoite are released after erythrocytic stage. Schizontcy develop into male
and female gametocytes which is sucked by the next mosquito to perpetuate the
cycle, so it begins again

C. Exo-erythrocytic cycle:- is responsible for reappearance of symptom after

chemical cure due to parasites ability to persist on the tissue. This phase attacks
blood stream to reinvade the RBC producing relapse

 Control/prevention: The primary health care approaches control of malaria

are in 2 ways;
a) Prevention approaches
b) Curative approaches.

Prevention:

 Good environmental sanitation to get rid of mosquito breeding

 Cut grasses in and around the compound
 Eliminate stagnant water by filling the path holes with sand and emptying cans
 Put wire mesh over your windows
 Spray your house with insecticides
 Wear long sleeve shirts in the evening to protect yourself from mosquito bite
 Rub anti-mosquito cream to protect yourself especially from long night shirt

What are the complications of malaria?

 Severe dehydration

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 Anemia
 Abortion
 Splamome yely
 Hepatomegaly
 Gastro intestinal disturbances
 Cerebral symptoms
 Tits (conclusion in little children), drowsiness, coma, acute renal failure, black
water fever due to severe.
 Chemical features of malaria

Uncomplicated malaria Complicated malaria

Fever Cerebral malaria
Chills Severe anaemia
Headache Thrombocytopemia
Body ache Hypoglycemia
Stomach pain Hypotension
Malaise Abnormalities in blood
Cough Coagulation
Nausea Acute renal failure
Vomiting Acute respiratory distress
Joint pain Syndrome
Conea

What is the diagnosis of malaria?

Clinical findings demonstration of M.P in blood films, thick and thin blood films,

Rapid diagnostic test (RDT).

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NB: RDT is more accurate than blood film at predicting the presence of M.P.

Malaria prevention and control measures recommended by WHO include;

1. Vector control: it involves the use of insecticides, treated bed net.

2. Indoor residual spraying and larvae control.
3. Rapid diagnostic test or use of microscopy to conform malaria.
4. Anti-malaria treatment using the Antemisium-base combination therapies
(ACT)
5. Chemoprevention: intermittent preventive therapy for pregnant women.

TUBERCULOSIS
Tuberculosis (TB) is an infectious disease caused by a gram positive
organism.
 Etiologic agent: Mycobacterium tuberculosis (tubercle bacilli)
 Epidemiology: Before in Nigeria, it used to be dreaded till was included on
NIP (National Immunization Program). There seems to be a resurgence of the
disease as a result of HIV pandemic. TB is a worldwide public health problem
that is closely associated with; poverty, malnutrition, overcrowding,
substandard housing, inadequate healthcare, poor and inadequate water
supply and sanitation.
 Pathogenesis: Types; There are two main types, viz: M. tuberculosis and M.
bovis are two types that are acid fast bacilli because they resist the
decolorizing action of the acid on the specimen to show the tubercle bacilli
under microscope.
 Mode of transmission:

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1. The human tuberculosis: This is transmitted from person to person by droplet

infections through coughing, sneezing or spitting, talking. When these
particles are inhaled by a healthy person, the person develops it in his lungs
(pulmonary). This is the most common type.
2. The bovine type: this is introduced into the intestinal tract through the
ingestion of contaminated milk food from infected cow or object(s) placed in
the mouth of the cow. The type of infection has been almost eliminated
completely by pasteurization of milk and control of cows. Any cattle type of
TB is responsible for the TB of joints, bones, skins, meninges and lymph
glands.
3. The third type is through the skin and mostly seen among butchers, and
veterinary surgeons.
 Pathological lesions: It affects many organs and tissues of the body,
producing active and chronic lesions.
 Tubercle formation: is a collection endothelial cells and lymphocytes around
the bacilli showing typical “giant cells”. This can gather, affecting a wide
area which can cause two things:
a. Caseation
b. Fibrosis
a. Caseation: there is a breakdown or necrosis of tubercles into a cheesy mass
which liquefies into a tubercle pus, e.g if it is in the lung, it can rupture into
bronchus leaving a cavity. If it is in lymph gland, it cab ulcerate with a
discharge of tubercle pus forming a sinus.
b. Fibrosis: Active fibrous tissue can occur around the tubercle which is an
attempt by the body to well off infection and heal the lesion by scar-tissue
formation. Sometimes these two occur together.

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What are the risk factors to TB infecton?

i. Close contact with someone who has TB infection.

ii. Immune Compromised Status e.g elderly, cancer, cortiscoteroid therapy,
HIV.
iii. PLP lacking inadequate healthcare
e.g Homelessness, impoverished children and young adults.
iv. Pre-existing medical condition e.g. DM, chronic renal failure, silicosis, and
malnourishment.
v. Immigrants from countries with high incidence of TB e.g. Haiti, SE. Asia.
vi. Institutionalization (long time care prison).
vii. Living in overcrowded homes.
viii. Occupation; healthcare workers, especially those performing high risk
jobs.
 Management: This involves taking good treatment, examination and
investigation.
 Clinical Presentations:
a. Low grade fever
b. Cough
c. Night sweats
d. Fatigue
e. Weight loss despite food intake
f. Nonproductive cough which can progress into a mucoprulent sputum
with haemoptisis (coughing of frank blood).
 Investigations:
a. Chest x-ray
b. Sputum culture

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c. Acid-fast bacilli test; smear

d. Quanti-seron-TB gold (QFT-G)
e. TB skin test (mantoux test)

Others are;

f. Urine in renal TB
g. Pus: from suspected aux
h. Pleural extrusion
i. Fluid from pleural cavity
j. Cerebrospinal fluid (CSF) in case of TB of meninges.
 Treatment of TB:
TB is primarily treated with AVM-TB-Drugs for 6-12 months. The prolong
therapy is necessary for complete eradication and to prevent relapse.
Chemoprophylaxis, rifampicin, ethanbutol, pyrazinamide, isomiazide are
drugs of choice.
 DOTS-recommended by WHO:

This is a strategy-Direct observation therapy shortcourse- this consist of 2 months

of isoniazide, rifampicin, pyrazinamide, and ethanbutol given daily, followed by 4
months isomazide, then rifampicin given thrice weekly.

 Prevention and control of TB

 Instruct patient on hygiene measures including mouth care i.e. covering the
mouth and nose while coughing, there should be a proper hand washing and tissue
paper disposed.
 Teach patient on the risk of spreading TB to other parts of the body.
 Monitor patient with military TB, note the spikes in the temperature as well as
changes in cognitive toxins.

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 Report TB cases to health department so that contacts can undergo screaning and
possible treatment.
 Do physical examination on the chest of patient that has severe cough dyspnoea
 Nurses, doctors, medical students, lab workers and children In TB environment
should be vaccinated.
 BCG should be given to babies at birth.
 Once disease is established, treat patient in a government controlled program
institution.
 Health workers should be trained to recognize clinical treatment of TB, and send
sputum is suspected cases to the Lab for culture and smear examination
 Chest X- ray should provide a presumptive evidences and the physician should
prescribe the multiple drug therapy with good nutrition and improved sanitation;
TB will be eradicated.

CHOLERA

Cholera: is an acute illness with profuse watery diarrhea

 Etiologic agent: Vibrio cholerae - a comma or bacillus bacteria.

The diarrhea contains shirred of mucous membrane called “rice water stools of
cholera”

 Incubation period: - is from a few hours to 5 days and last for about 2- 3
days.
 Pathogenesis:
 Mode of transmission: cholera is transmitted by the fecal oral route due
to the ingestion of contaminated food and water.

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 Epidemiology: - cholera causes about 100,000 death per year or may

produce rapid progressive epidemics and can be sporadic in endemic areas.
There has been resurgence of cholera in Africa since the mid – 1980’s
where 80% of the world’s cases occur, in 1999, with majority of cases
being within, January and April.

What are the risk factors of cholera?

 Eating or drinking of contaminated foods like uncooked sea food or shell fish
from estuarine waters
 Continuous lack of access to safe water and food suppliers
 Contacts with people who died of cholera and other enteric diarrhea

In 5 years old, cholera is due to Rota virus, Bacteria (E. coli, Salmonella, Shigella,
campylobacter) and parasites (giardia, entamoeba) they cause watery stool and the
laboratory stool culture shows the specific causative agent.

What are the signs and symptoms of cholera?

a) The passage of protrude watery diarrhea especially in 2 years and above or

death on a 5 years old diarrhea
b) Severe dehydration which shows restlenessness, irritability, cramp due to loss
of salts and dehydration, sunken eyes, thirst.
c) Skin pinch goes back slowly and specifically lethargy , unconsciousness and
inability to drink

What is the prevention and management of cholera?

a) Report a case based on information statistics

b) Isolate and manage patient according to physician’s orders
c) Conduct investigation to confirm outbreak

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d) Enhance strict hand washing procedures

e) Collect stool or rectal swab from 5 patients within 5 days of onset

What is the treatment of cholera?

a) Report watery diarrhea before administration of antibiotic

b) The treatment of cholera lies on the urgent relief of dehydration via
intravenous infusion and given of antibiotic as prescribed by the Doctor

How is cholera investigated?

a) Stoll culture in clear medium

b) Isolation of vibrio cholera O1 or O139 in the stool

What is pathogenesis of cholera?

Cholera is an infection of small intestine that is caused by bacteria vibrio cholerae.

Transmission occurs primarily by drinking water or eating food that has been
contaminated by faeces of infected asymptomatic person. The bacteria, vibrio
cholera grows in the small intestine and produce an exotoxin called cholera toxin
which causes host cell to secrete water and electrolyte especially potassium ion. This
result in watery stocks causing masses of intestinal mucus and epithelial cell
commonly called “rice water stools”

What is the diagnosis of TB?

The bed rock of pulmonary TB (diagnosis) is the identification of mycobacterium

tuberculosis in the sputum of a presumptive TB case (people with symptoms of TB).

Bacteriological diagnosis may involve expert MTB/RIF (Gene expert), microscopy,

culture as well as X-ray. Gene expert is the first line diagnostic test for TB according
to national TB and leprosy program.

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NB: on TB (tuberculosis)

 World tuberculosis (TB) day is 24th March

 Robert Koch identified microbes that causes tuberculosis, mycobacterium
tuberculosis on march 24, 1882

What is epidemiology of TB?

One in seven residents of USA and European died from TB - during this time period,
the world’s dead last infectious killer is still tuberculosis.

Every day, about 45,000 people die from TB, and close to 30,000 more contact this
avoidable and treatable illness. Since 2000, the mortality rate of TB has decreased
by 42% and estimated 54 million lives have been spared because of global efforts to
fight the disease.

Note; - when a person with TB diseases coughs, speaks or sings, the disease is
transferred through the air.

What are classification of TB?

a) Pulmonary TB
b) Extra pulmonary TB
 Pulmonary TB: is that TB that affects primarily the lungs.
 Extra pulmonary TB: is dependent on the affected organ.

What are other symptoms of TB?

 Weight loss
 Nighty sweat
 Fever

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LEPROSY

Leprosy is often known as Hansen’s disease (HD). It is a chronic infection brought

about by an etiologic agent; mycobacterium leprae, or mycobacterium leprematosy.

 Epidemiology: between 2011 and 2015, the nations of African reported more
than 100 new cases of Hansen’s disease to WHO.

The countries were Democratic Republic of Congo, Ethiopia, Madagascar,

Mozambique, Nigeria, Tanzania, also included in the report are the Asian nations
like Bangladesh, India, Indonesia, Nepal, Philippines, Srilanka. Every year on the
last Sunday in January people all round the world mark leprosy day to raise
awareness of Hansen’s disease.

What are the clinical features of leprosy?

A. Its specifically targets the nerves in the body’s Calder region such as hands, feets
and face
B. Painless skin ulcer
C. Skin nodules
D. muscles weakness
E. Eye problems that might lead to blindness

What are the complications?

These include;

 Permanent sensory loss

 Permanent paralysis of some muscles
 Nerve degradations
 Deformities caused by huge, ugly nodules.
 Loss of fingers and toes

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 Destruction of the nose and loss of eye brows

Ques. What are the diagnosis of Leprosy?

The various diagnosis method consist of

 Skin biopsy
 By finding acid fast bacilli in the skin
 By employing PCR biopsy to find the bacterial DNA
 Using the skin scrapping test and staining, bacteria can be seen under a
microscopy.

How to distinguish 2 from of Leprosy.

The 2 from of Leprosy are.

a) Lepromatous Leprosy
b) Tuberculoid Leprosy

What are the treatment of leprosy?

Leprosy is nit treated with anti-Leprosy medications over a course of treatment that
can last between 6-24 months. Additionally surgery and physical treatment may be
used.

Type of leprosy drug treatment: WHO recommended multidrug therapy (MDT)

regimen. The drugs include;

i) Paucibacilliary refampian 600mg aproned 6 (100mg)

ii) Multibacilliary rifampian 600mg aproned (100mg)
iii) Multiband colliery ciotazimme 300mg 12 (100mg)

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Drug resistance is stopped through multi-drug therapy. Once the allocated

time has passed, and the infection has been eliminated, it should be confirmed
under regular assessment.

To stop granuloma formation and stop further nerve damage, anti-

inflammatory medications like aspirin or steroids like prednisone are utilized.

 Prevention of leprosy:
a) At the moment, there is no available leprosy vaccination. Avoid prolong
contact with any leprosy patients.
b) Leprosy (Hansen’s disease) through a chronic disease is curable illness.
Prompt diagnosis and suitable disease treatment will stop the disease from
progressing to problems.
c) Leprosy education promotes a positive view of the disease and cause
knowledge of it among the general public. This will make it easier to
concentrate on the affected people’s strengths rather than their usability.

TYPHOID FEVER

Typhoid fever: - is a bacterial disease spread through the ingestion of food or water
contaminated by faccal matter or sewage.

 Etiological agent: is salmonella typhi

 Clinical manifestation:

Patients exhibits sustainable high fevers, malaise, headache, constipation or

diarrhea, rose color spot on the chest and enlarged spleen and liver. These
symptoms develops 1-3 weeks after the exposure and may be mild or severe.

The three 3 etiologic agents of typhoid:

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 Salmonella typhi
 Salmonella enteritis
 Salmonella cholerae

Salmonella as a genius organism contains;

a) somatic (o) or cellular antigen

b). flagella (a) or capsular (k)

Antigen in the cell wall, Antigen is heart stable and stimulates the production of
antibodies.

Salmonella is a gram negative non-spore forming, mostly motile rod. Salmonella are
aerobic and facultative anaerobic.

What is pathogenesis of typhoid fever (salmonellosis)?

The organism salmonella produces on endotoxin. The toxin is located in the cell-
wall and is composed of phospholipid, carbohydrate and proteins
(lipopolysaccharide). The toxin is liberated when the cell disintegrates. The toxin
can inhibits phagocytosis an also can provide E. coil type of diarrhea.

What are the signs and symptoms of salmonellosis (typhoid)?

Children and aged are most susceptive. Salmonellosis is characterized by:

1. Septicemia (i.e. presence of bacteria in the blood)

2. Anorexia (loss of appetite).

3. Leucopenia (decrease of white blood cell).

4. Bronchitis and pneumonia.

5. Nausea.

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6. Vomiting.

7. Cramp.

8. Diarrhea.

9. Headache.

10. Muscular weakness.

How does a clinician diagnosis or detect the organism salmonella?

The organism can be detected by incubating the;

1. Suspected food.
2. Stool.
3. Fecal swab.
4. Environmental swab
5. Tissue paper swab.
In lactose broth for 48hrs, at a temperature of 350 C-37 0C. The suspected
colonies are inoculated into tetrathionate broth. Incubate for 24hrs and
transfer to borillant green sulfodiazine ager and then to fraple sugar iron ager
and confirm by observing darkish colonies.

How to control salmonellosy:

1. Salmonella is destroyed by heating at 800C for 10mins.

2. Human and animal carriers, contamination, particularly contaminated eggs
should be avoided.

3. We should also avoid contaminated soil and water.

4. Avoid employing sub clinically ill and carrier workers in food establishment.

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VIRAL HEMORRHAGIC FEVER

E.g. yellow fever, lassa fever, ebola, dangue fever, west nile fever.

 Yellow fever: - it is a viral disease found on tropical regions of Africa and

America. It principally affects humans and monkeys.
 Etiologic agents: - Aedes aegypti, mosquito is what transmit the virus.
It can produce devastating outbreak which can be prevented and
controlled by mass vaccination campaigns.

What is the clinical presentation of yellow fever?

A. First symptoms of disease usually appear 3-6 days after infection.

The first phase is characterized by;

a) Fever.
b) Muscle pain.
c) Headache.
d) Shivering.
e) Loss of appetite
f) Nausea
g) Vomiting.

In few cases, the disease enter a toxic phase, fever reappear and the patient develop
jaundice and sometimes heading with blood appearing in the vomit. About 50% of
patients who enter the toxic phase die within 10-14 days.

 Lassa fever:- it is on acute contagious viral disease of central west Africa, It

is a severe form of epidemic. hemorragic deseases were recognixed in Nigeria
in 1969.
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 Etiologic agent:- Lassa virus.

The reservoir host of Lassa virus is a multimammate rat; Matomys matalensis. This
rat serves as a reservoir, but person to person transmission is also common. People
become infected by eating this infected rat or by eating food contaminated by rat
excretion.

Person to person transmission also occur by direct contact. Contamination by skin

breaks with infected blood and aerosol spreads.

 Epidemiology: - Lassa fever occur in countries such as Sierra leon,

Congo, Liberia and Nigeria. Nigeria has outbreak of lassa fever
between December-2011 and march 2012. It affected 11 state which
includes Lagos, Taraba, Ondo, Rivers, Yobe, Plateau, Ebonyi state.

 Ebola virus disease: - the disease is caused by an etiologic agent Ebola Virus.

Ebola virus is named for Ebola River in the democratic republic of Congo
(DRC, formaly Zaire) where the virus was first identified. 3 strains of ebola virus
that was often fatal to humans and are also named for the areas in which they are
first recognized. These are ebola-zaire, ebola-sudan, and ebola-cote d’voire’.

Ebola viruses belongs to the family filo viridae and genus-filo virus.

Ebola virus was first identified for the first time in 1978 when 2 epidemic of
hemorrhagic fever occur.

 Epidemiology: Hemorrhagic fever occur in Zaire now called

democratic Republic of Congo and also in Sudan 1979. The combine
outbreak account for more than 550 cases, and 340 deaths. Another
large epidemic of ebola hemorrhagic fever occur in Kikwit of

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Democratic Republic of Congo in 1995, infecting 315 people, and 250

people died.

What is the diagnosis of Ebola?

A. Each outbreak has been traced to an index case. An infected person who come
into contact with a reservoir host, An animal or arthropod involves in the life
cycle of the virus of all the diseases causing human virus , the Ebola and its
relatives Marburg which also cause hemorrhagic fever are the only one
remaining for which the host and the natural transmission cycle remains
unknown. The Ebola virus is diagnosed using enzyme linked immunosorbant
Assay (ELISA) that searches for specific Antigen viral proteins or anti bodies
made by infected patient.

What are the signs and symptoms of Ebola virus?

A. The incubation period for the transmitted Ebola virus is 3-7 days and that for
person to person transmitted disease is 6-12 days. It is characterized with:
severe hemorrhagic fever, chills, headaches, muscles aches, loss of appetite.
When the disease progresses the patient experiences Diarrhea, rash, sore
throat, vomiting, abdominal pain, chest pain, the patient has limited kidney or
liver treatment, the patient have internal and external bleeding, the blood does
not clot, which can cause a serious problem; it causes capillaries to bleed into
the surrounding tissues . The dead of the patient occurs within 8- 17 days after
the infection. The mortality rate is between 70- 90% of those infected.

What is the treatment and control of Ebola?

There is no vaccine or drug that exists currently for treatment of Ebola virus.

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1. Those that are infected need intravenous fluids due to

constant dehydration.
2. Doctors should put special precaution that may be used to
control the outbreaks of Ebola. They are: Gloves masses
and protective soils for doctors and researchers when
working with an Ebola patient victim.
3. There should be proper sterilization of equipment
4. An infected person must be isolated
5. All disposable material must be burnt and any reasonable
material properly sterilized after use.

Ebola is the most lethal virus known, it mystery and ferocity has come to
symbolize the growing risk from the emerging and re-emerging pathogens.

HIV/AIDS

This is one of the communicable diseases in Nigeria. Communicable diseases

are illness caused by microorganism and transmitted from one person to animal
to another person to animals. They are also the diseases that can pass from one
host to another that is a host may be human or non-human.

Most diseases spread through contact or close proximity because the causative
bacteria or viruses are airborne, that is they can be expelled from use or mouth
of the infected person or inhaled by anyone in the vicinity. Such disease include:
Diphtheria, Measles, Mumps, whooping cough, Influenza, small pox

malaria, HIV/AIDS, chicken pox, TB, hepatitis A,B,C , Gonorrhea, Syphilis.

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 Definition: HIV / AIDS is one of the most important communicable disease

in Nigeria. It is an infection associated with serious Morbidity, Stigmatization
of infected person, higher cost of treatment and care, significant mortality and
high number of potential years of life loss. AIDS is caused by an infectious
virus called Human immunodeficiency virus (HIV)
 Epidemiology: in 2011, about 70,000 babies were born infected with HIV in
Nigeria –a complete preventable situation. In Nigeria estimated 3.6% of the
population are living with HIV/AIDS.

HIV in Nigeria however, is much lower than other African countries such as:
South Africa and Zambia. According to AVERT, an international AIDS
organization, Sub Sahara Africa is the region most infected by HIV /AIDS.

 Pathogenesis: HIV/AIDS is spread through blood, milk and through sexual

contact such as semen and vaginal fluid.
 Routes of transmission: There are three main HIV transmission route in
Nigeria;
a. Heterosexual sex: 80 – 90% of HIV infection in Nigeria is as a result of
heterosexual sex. Women are particularly most affected by HIV.
b. Blood transfusion: unsafe blood account for second largest source of HIV
infection in Nigeria.
c. Mother to child transmission.
HIV virus has to do specifically with behaviors that result in contact with
infected blood or secretions. The behaviors include; sexual intercourse and
injection drugs uses the presence of sores in the genital areas like those
caused by herpes make it easier for the virus to pass from person to person
during intercourse. HIV has been spread with needles to healthcare
workers through accident sticks with needles contaminated with blood

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from HIV infected people or broken skin comes in contact with infected
blood or secretions.
 Symptoms of HIV:
1. Significant unexplained weight loss.
2. Pneumonia due to pneumocystic jeroveci.
3. TB is one of the most common infectious diseases associated with AIDS.
4. Seizure, weakness and night sweating.
5. Mental changes due to toxoplasmosis.

Toxoplasmosis: - is a parasite that infect the brain

7. Universal cancers like Kiposis sarcoma

8. Lymphoma of the brain and other type of lymphoma.

Others may develop confusion or sleepiness night (i.e. HIV encephalopathy)

Note: - HIV infection is dangerous in pregnancy

S/N DISEASE AGENT TREATMENT

1. Acquired Human immune Antiretroviral agents
immunodeficiency virus (HIV) (zidovudine, lamivudine,
syndrome nevirapine)
2. Malaria Plasmodium Anti-malaria e.g. quinine,
species ACT.
3. Typhoid Salmonella species Antibiotics, ciprofloxacin
4. Tuberculosis Mycobacterium Antikoch’s, e.g.
tuberculosis rifampicin, isoniazide.

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5. Leprosy Mycobacterium Dapsone, clofazamine

leprae
6. Cholera Vibrio cholerae Rehydration and antibody
7. Trypanasomiasis Trypanasoma Suramin, nifurtimx
specie
8. Schistosomiasis Schistosoma specie Praziquentel
9. Viral haemorrhagic Ebola virus No known treatment yet
fever (ebola, lassa Lassa virus
fever, yellow fever) Yellow fever virus

CONTROL OF TROPICAL DISEASES

1. Tropical diseases are largely preventable even without vaccines.

2. Clean water, sanitary food, handling and good food hygiene can prevent
diseases.
3. Control of vectors and hosts through mass spraying of insecticide where
vectors breed or gather before they become parasite carriers.
4. Health education, especially of the risk at population.
5. Access to health care vaccination.
6. Political will.

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