Aliyu, H.

Bello, M.M.

Dalhat, M.M.

Gwaram, B.A.

Habib, A.G.

Habib, Z.G.

Karaye, K.M.

Muhammad, H.

Sadauki, A.H.

Sarkin-Fada, F.

Vandi, Z.G.

Yakasai, A.M.

International Journal of Infectious Diseases

Elsevier - Publisher Connector 

Malaria among sickle cell anaemia (SCA) patients in a nomadic population 

M.M. Dalhat

B.A. Gwaram

H. Muhammad

Z.G. Habib

M.M. Bello

A.M. Yakasai

A.H. Sadauki

H. Aliyu

Z.G. Vandi

F. Sarkin-Fada

K.M. Karaye

A.G. Habib

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Malaria among sickle cell anaemia (SCA) patients in a nomadic population

242 16th ICID Abstracts / International Journal of Infectious Diseases 21S (2014) 1–460
Subcontinent. Our results not only add new insights on the evolu-
tionary history of cholera, but also provide valuable information to
modulate the public health response to the disease.
http://dx.doi.org/10.1016/j.ijid.2014.03.923
Type: Poster Presentation
Final Abstract Number: 52.007
Session: Epidemiology and Public Health II
Date: Friday, April 4, 2014
Time: 12:45-14:15
Room: Ballroom
Misdiagnosed outbreak of bartonella
bacilliformis in Peruvian Amazon department
A. Cornejo1, V. Casabona2, C.S.P. Gomes3,∗, C.
Tinco4, S. Martinez-Puchol5, L. Suarez6, J. Ruiz7,
J. del Valle8
1 Universidad Peruana de Ciencias Aplicadas (UPC) e
Instituto de Investigaciòn Nutricional (IIN), Lima, PE,
Peru
2 Universidad Peruana de Ciencias Aplicadas.
Instituto de Investigación Nutricional, Lima, Peru
3 Barcelona Centre for International Health Research,
Barcelona, Spain
4 Instituto de Investigación Nutricional, Lima, Peru
5 Barcelona Centre for International Health Research,
Barcelona, Spain
6 Facultad de Ciencias de la Salud, Universidad
Peruana de Ciencias Aplicadas, Lima, Peru
7 Centre de Recerca en Salut Internacional de
Barcelona, Hospital Clinic/Institut d’Investigacions
Biomèdiques August Pi i Sunyer, Barcelona, Spain
8 Instituto de Investigación Nutricional (IIN) y
UPC-Perú, PERU, PE, Peru
Background: In March 2013, the presence of an outbreak of
Bartonella bacilliformis in the Rodriguez de Mendoza (Amazonas
department, Peru) was reported. B. bacilliformis is an endemic
pathogen of the Andean region, responsible for Carrion’s disease.
One of themainproblemsof this illness is the lack of adequate tech-
nical and human resources for proper diagnosis in endemic rural
areas. The objective of this study was to characterize a supposed
B. bacilliformis outbreak, internationally informed in Rodriguez de
Mendoza province.
Methods & Materials: Fifty-three blood samples were recov-
ered frompeoplediagnosedwithCarrion’s disease, either byoptical
microscopyand/or clinicalmanifestations. Inall casesepidemiolog-
ical and clinical data were recorded. The samples were cultured on
Columbia Agar adding 10% of sheep blood and incubated at 28 ◦C
for a period of 10 weeks. Every 14 days the plates were visually
inspected to detect any bacterial growth. Additionally, the DNA
was directly extracted from blood and 2 different16S rRNAPCR
schemes were used, one speciﬁc forBartonellagenus and other
using universal primers. Twenty-six ampliﬁed products of univer-
sal16S rRNAwere randomly recovered and sequenced.
Results: The main clinical presentations reported were
headache (51%), physical discomfort (51%), chill (32%) and fever
(24, 5%). Only 3 blood cultures were positive. No positive PCR was
obtained when using theBartonella speciﬁc PCR either on blood
or on cultured bacteria. However, all the PCR with the universal
primerswere positive. The sequenced 26 (49%) sampleswere iden-
tiﬁed as Sphingomonas spp. being this microorganism the causative
agent of this outbreak. In 17% of the cases, patients were reported
to have aquatic activities.
Conclusion: Several Sphingomonas spp. infections in humans
have been reported, mostly limited to sporadic case reports or
intra-hospitalary outbreaks, but as far as we know this is the ﬁrst
outbreak of Sphingomonas spp. described in a non-hospital envi-
ronment. The association between 17% of patients with aquatic
activities suggests that thiswas themost feasible transmissionway.
Training of health staff and development of new diagnostic able
to be implemented in rural endemic areas is urgent in order to
overcome wrong diagnostics and avoid wrong treatments.
http://dx.doi.org/10.1016/j.ijid.2014.03.924
Type: Poster Presentation
Final Abstract Number: 52.008
Session: Epidemiology and Public Health II
Date: Friday, April 4, 2014
Time: 12:45-14:15
Room: Ballroom
Malaria among sickle cell anaemia (SCA)
patients in a nomadic population
M.M. Dalhat1,∗, B.A. Gwaram2, H. Muhammad3,
Z.G. Habib4, M.M. Bello5, A.M. Yakasai6, A.H.
Sadauki7, H. Aliyu7, Z.G. Vandi7, F. Sarkin-Fada5,
K.M. Karaye8, A.G. Habib8
1 Aminu Kano Teaching Hospital, Kano, Kano, Kano,
Nigeria
2 Bayero University, Kano, Kano, Kano, Nigeria
3 Bayero University Kano, Kano, Kano, Nigeria
4 University of Abuja Teaching Hospital,
Gwagwalada, Abuja, Gwagwalada, Abuja, Nigeria
5 Bayero University, Kano, Kano, Nigeria
6 Murtala Muhammed Specialist Hospital, Kano,
Nigeria
7 Aminu Kano Teaching Hospital, Kano, Kano, Nigeria
8 Bayero University Kano, Kano, Nigeria
Background: Nigeria has one of the world’s highest burdens
of malaria in the world.Nomadic Fulanis in northern-Nigeria have
been identiﬁed as a vulnerable group, often neglected during
planning and implementation of health interventions. Nomadic
lifestyle, common practice of consanguineous marriages and poor
access to preventive and curative strategies against malaria make
sickle cell anaemia commonandexpose them todevastating effects
of malaria. We conducted a cross-sectional study in a nomadic
Fulani setting inKanostate,Nigeria todetermineburdenandeffects
of malaria in the community.
Methods & Materials: We administered structured ques-
tionnaires to individuals 15 years and above to obtain socio-
demographic information, consanguinityandsymptomsofmalaria.
We conducted on-the-spot malaria rapid diagnostic test (RDT) and
collected blood sample for haematocrit and haemoglobin elec-
trophoresis. We also conducted Focussed Group Discussions (FGD)
with selected members of the community to determine knowl-
edge, attitudeandpreventivepractices againstmalaria andSCA.We
compared prevalence of malaria, consanguinity and haemoglobin
genotypes within the community.
Results: A total 229 subjects were interviewed, among
which100 (43.7%) were females. Median age (range) was 35 yrs
(15 – 80 yrs). More than two-thirds of the women 72 (72.0%)
were of reproductive age. Symptoms of malaria and positive RDT
16th ICID Abstracts / International Journal of Infectious Diseases 21S (2014) 1–460 243
were found among 97 (42.4%) and 24 (10.5%) subjects respectively.
Among those with positive RDT, 13 (48.0%) were women of repro-
ductive age. Haemoglobin AS was found among 53 (23.1%) of the
subjects; nonehadhaemoglobin SS. Themedian (range) hematocrit
was 36% (4.0 – 52%). The FGD revealed that respondents considered
malaria as an important cause of ill-health but lack knowledge of
appropriate preventive measures against it. None of the partici-
pants was aware of SCA as a disease not to talk of how to prevent
it.
Conclusion: The high prevalence of malaria, haemoglobin
AS, and absent haemoglobin SS implies devastating effect of
malaria decimating individuals with haemoglobin SS in early
childhood. This could signiﬁcantly impact food production. Public
health authorities should devise innovative measures to reach this
neglected, vulnerable population. The impact of high prevalence of
malaria parasitaemia to poor foetal outcomes and early childhood
deaths in the community should be further evaluated.
http://dx.doi.org/10.1016/j.ijid.2014.03.925
Type: Poster Presentation
Final Abstract Number: 52.009
Session: Epidemiology and Public Health II
Date: Friday, April 4, 2014
Time: 12:45-14:15
Room: Ballroom
Sources of water deterioration in the rural
department of Yoro, area of Honduras
G.E. Halder1, G. Bearman2,∗, K. Sanogo3, M.P.
Stevens3
1 Virginia Commonwealth University School of
Medicine, Richmond, USA
2 Richmond, VA, USA
3 Virginia Commonwealth University, Richmond, Va,
USA
Background: The contamination of tested fecal-free drinking
water following its collection from improved water sources has
been documented. Post-collection water deterioration has been
linked to fecal contaminated ﬁngertips and storage containers. The
published WHO Guidelines for Drinking Water Quality emphasizes
a holistic approach - from the point of distribution to the point of
consumption - as ameansof increasing the safety of drinkingwater.
This study aimed to compare and contrast the sanitation of water
containers, container lid usage, and hand sanitation among the
suburban community of Coyoles and the rural and geographically
distinct communities of La Hicaca and Lomitas in the Department
of Yoro area of Honduras.
Methods & Materials: A total of 263 randomly selected indi-
viduals receiving care from a June 2011 medical brigade to the area
completed a 20-item, anonymous, brief, interviewer-administered
water sanitation questionnaire in Spanish. We assessed self-
reported practices for the sanitation of water transport and storage
containers, water container lid use, and hand sanitation prior to
ﬁlling water containers.
Results: The use of chlorine and soap for the sanitation of con-
tainers for water transport and storage was signiﬁcantly different
among the three communities (<0.01). Coyoles most commonly
employed chlorine for sanitizing water transport (68.8%) and stor-
age (73.9%) containers. La Hicaca and Lomitas most commonly
used soap for sanitizing both container types. Although 86% of par-
ticipants in Lomitas identiﬁed using a lid on their water storage
containers, lid-use in this community was signiﬁcantly less com-
pared to the communities of Coyoles and LaHicaca,where over 95%
of participants identiﬁed their use (p=0.02). Lomitas also had the
fewest respondents (29.5%) placing a lid on water containers at the
water source site (p<0.01). Over 97% of all individuals at each site
identiﬁed washing their hands with soap and water prior to ﬁlling
water containers (p=0.57).
Conclusion: Across the three Honduran communities, water
container sanitation method and lid usage varied, while hand
sanitation remained relatively constant. These data suggest that
sanitationpractice interventionsareof least importance in themost
suburban area of Coyoles, and in most need in the remote and rural
communities of La Hicaca and Lomitas.
http://dx.doi.org/10.1016/j.ijid.2014.03.926
Type: Poster Presentation
Final Abstract Number: 52.010
Session: Epidemiology and Public Health II
Date: Friday, April 4, 2014
Time: 12:45-14:15
Room: Ballroom
Suspected outbreak of shigellosis in Nelson
Mandela Bay Health District, Eastern Cape
Province - South Africa, November 2012 to
February 2013
G.M. Ntshoe1,∗, J. Thomas1, A. Cengimbo1, N.
Muvhango2, P. Ekermans3, F. Fourie4
1 National Institute for Communicable Diseases
(NICD) of the National Health Laboratory Service
(NHLS), Johannesburg, South Africa
2 University of Pretoria, Pretoria, South Africa
3 National Health Laboratory Service, Port Elizabeth,
South Africa
4 Department of Health, Nelson Mandela Bay Health
District, Port Elizabeth, South Africa
Background: In November 2012 a sudden increase of Shigella
cases was reported in Nelson Mandela Bay Health District, with 12
cases reported between 23 and 26 November 2012. The National
OutbreakUnit (NOU) assisted theDistrict Outbreak Response Team
(DORT) with the outbreak investigation and response.
Methods & Materials: Public and private healthcare facilities
instituted active case ﬁnding and stool specimen collection from
patients with illness suggestive of shigellosis. A subset of cases
was interviewed to interrogate possible common risk factors. Stool
specimens underwent routine bacteriology testing and Shigella spp
isolates were referred to the Centre for Enteric Diseases (NICD-
NHLS) for characterisation. Water samples collected at strategic
sites were serially tested for quality indicators.
Results: From 1 November 2012 to 28 February 2013, a total
of 69 cases (63 laboratory-conﬁrmed, 1 probable, and 5 possible)
with one death was reported. Children ≤5 years accounted for the
highest proportion (35%) of cases. The median age was 13 years
(range 7 days to 83 years). The majority (48%) of cases resided in
two neighbouring suburbs but shared no other common risk expo-
sures. Diarrhoea was reported in 98% of cases, which in 38% was
bloody. Of laboratory-conﬁrmed cases, 90% were Shigella ﬂexneri,
68%ofwhichwereShigellaﬂexneri type1b.Water testingconducted
on 19 November 2012 in the two suburbs with most cases showed
higher than acceptable E. coli counts and sub-standard chlorine lev-
els. Following intensiﬁed efforts to improve water chlorination, a


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Malaria among sickle cell anaemia (SCA) patients in a nomadic population

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