Malaria Prevalence and Drug Management in Pregnant Women Attending Remotely Located Daura General Hospital, North West Nigeria (Published)
Health authorities in Nigeria have for many years promoted national malaria control measures such as the use of insecticide treated bed nets (ITNs), indoor residual spray of insecticides (IRS), intermittent preventive treatment (IPTp) for pregnant women and children and the use of artemisinin combined therapy (ACT) as first line of treatment to reduce the prevalence of the disease in the country. In order to evaluate the effectiveness of these control measures, there is the need for continued disease monitoring and management across different zones of the country, especially among high risk cohorts such as children and pregnant women at remote locations. A 13 months study (July 2014 to July 2015) was carried out to establish the current prevalence of malaria among female patients attending Daura General Hospital in North West Nigeria, using standard laboratory procedures. Daura is a remotely located town that lies in the semi-arid zone of northern Nigeria at the intersection of roads from Katsina, Kano and Zinder in Niger Republic, with coordinates of 130 2’11’’ North, 80 19’4’’ East and 1,558 feet (474 meters) above sea level. Of the 8413 patients that tested positive for malaria parasite during the period, 1119 (13.30%) were children, 3721 (44.23%) were women, 2609 (30.99%) were men and 966 (11.48%) were the elderly. Among the infected women population, 2105 (56.57%) were pregnant (PGW), while 1616 (43.23%) were non-pregnant (NPW) women, indicating statistical significance in malaria prevalence between the two cohorts (p<0.05). Age related prevalence was significantly higher (p<0.05) in the 11 – 20 years group (32.68%) of the PGW and 21 – 30 years group (44.43%) of the NPW than the 25.89% recorded in the 21 – 30 years group and 21.05 and 20.38% recorded in the 31 – 40 years and 41 – 50 years groups of the PGW respectively. The highest seasonal prevalence rate was recorded during the late rainy season (LRS) months of July to September (10.86% for PGW and 8.83% for NPW) followed by the 7.73% recorded for PGW and 7.24% recorded for NPW during the early dry season (EDS) months of October to December. The lowest rates (5.67 and 5.46% for PGW and 6.50% for NPW) were recorded during the early rainy (ERS, April – June) and late dry season (LDS, January – March) months respectively. Monthly prevalence rates were highest during August (15.63%), September (15.11%) and October (11.26%) for the PGW, while corresponding prevalence figures for these months among the NPW were significantly lower (p<0.05) at 8.29, 9.22 and 7.80% respectively. Major drugs prescribed for the prevention of malaria during the second and third trimesters once foetal quickening is noticed include sulphadoxine/pyrimethamine given monthly, while for cure and treatment during all trimesters quinine SO4, arthessunate, α-β arteate and arthessunate/lumefantrim were prescribed. Analgesics, electrolytes and vitamins were also indicated. Malaria is a major cause of hospital visits pregnant women especially during the rainy season months, indicating the need to improve advocacy on intervention control measures among these groups in the study area.
Antimalarial drug toxicity is viewed different, depending on if the clinical indication is for treatment or prophylaxis. In drug therapy of Plasmodium falciparum malaria, which has a high mortality if untreated, a greater risk of adverse reactions to antimalarial medication is inevitable. The effect of the administration of Artesunate on the liver of wistar rats was studied. Study design was experimental and deployed clinical laboratory assessments. Four groups of wistar rats, each of five animals weighing between 100-150 g were used. Group 1 served as the control and was administered normal feed and drinking water. Group 2, 3 and 4 received 0.24mg/kg, 0.34mg/kg and 76mg/kg body weight Artesunate daily respectively, orally for four weeks. Serum Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP) activities and Bilirubin were determined at the end of the treatment. Results showed that in group 3 and 4, there was a significant increase in serum AST and ALT and a significant decrease in serum ALP. The results also showed that at mild doses (0.24mg/kg and 0.34mg/kg), Artesunate promoted weight gain and at highest dose (76mg/kg), it appeared to result in reduced percentage weight gain suggesting perhaps that high doses were toxic. It is concluded, that administration of high doses of Artesunate by the oral route produced considerable damage to the liver.
Collaborative Identification of the Health Needs/Assets of Ikot Ishie Community, Calabar, Nigeria (Published)
Background: Identification of health needs within Nigeria has often been done with a top-down approach where policy and funding determines what health needs to focus on for interventions. Communicable diseases such as malaria have been studied extensively however; lack of cohesiveness and continuity often derails the gains achieved.
Objectives: To work collaboratively with stakeholders in Ikot Ishie Community in identifying their health needs/assets.
Methodology: A community organizing exercise using Key Informant Interviews, observation and Focus Group Discussions (FGD) was implemented.
Findings/Results: As a community embedded in a malaria endemic area, people are aware of malarial signs and symptoms and can easily identify its management/preventive measures. Persistent self-diagnoses/treatment of malaria, lack of information about the causes, signs/symptoms of other conditions and poor patronage of the primary health centre for preventive and early diagnoses of diseases were the identified needs. Collaborative identification of needs/assets builds trust and ownership of interventions, encouraging continuity.
THE 19TH CENTURY EUROPEAN MISSIONARIES AND THE FIGHT AGAINST MALARIA IN AFRICA (Review Completed - Accepted)
Malaria once turned Africa into the “missionaries’ graveyard” as many European missionary personnel and families perished planting the Gospel in the Continent in the 19th century. The situation, however, is not completely different today in many rural African communities. The purpose of this research is to present a social challenge to the present day Christian missionaries in Africa by describing the landmark achievement of the 19th century missionaries in the fight against mosquito plague in Africa, namely their introduction of the first ever drug for malaria treatment in the continent. Central and West Africa are used as a case for this study. This research applied descriptive analysis to the health and life situation that faced the early European missionaries as they laboured to evangelize the people of Africa
Nigeria: Can Cross River State Achieve The Millennium Development Goals (MDGs) In The Health Sector By 2015? (Published)
The paper reviews outcomes of efforts made by the Cross River State Government towards the achievement of MDGs in the health sub-sector in Nigeria. Using descriptive statistics and comparative analysis to illustrate deviations from set targets the paper reveals that, in spite of the robust effort of government, achieving the MDGs in the health sub-sector in Cross River State by 2015 will be very challenging, partly due to inadequate responses to bring about the required decrease in the burden of malaria, tuberculosis and HIV/AIDS in the State. To bridge the observed gap, the paper recommends rehabilitation of health facilities and provision of equipment and personnel in existing health facilities; increased budget provision for health care services; building strong and robust partnership with support agencies and other sector actors; development of effective health sector policy in the State, as possible quick wins.