Millions of Nets : But are they being used?

The year 2010 was targetted at the 2000 Abuja Malaria Summit as the time when 80of vulnerable groups (pregnant women; children below 5 years of age) would be sleeping under insecticide-treated nets (ITNs).1 Subsequently the US President's Malaria Initiative (PMI) raised the bar to 85in its 15 focus countries.2 Most recently; the United Nations3 broadened the scope of ITN use and stressed that 2010 would be the year of Universal Coverage (UC). UC is variously interpreted in each endemic country and can mean one net distributed for each two people in the population to two nets per household. Ultimately it has been recognised that in order to reduce the burden of malariadisease; everyone should sleep under an ITN; or as now being used; a long-lasting insecticide-treated net (LLIN)

Management of childhood febrile illness prior to clinic attendance in urban Nigeria.

Parents and caregivers often try various treatment modalities for their sick children before bringing them to clinic. Many community-based studies have documented home and self-treatment practices, often with the aid of patent medicine vendors, but less is known about prior treatment behaviour of caregivers who actually reach a government clinic. This study, therefore, aimed at documenting the treatment provided by caregivers prior to their attendance at a public hospital. Beginning in April 1996, a year-long study was conducted among 1,943 sick children and their caregivers who attended the largest government-owned paediatric hospital in Lagos, Nigeria. The major complaints mentioned by the caregivers included fever, cough, and diarrhoea. Most (89%) caregivers had administered some form of medicine to the child prior to the clinic visit, and on average, 2.5 medications had been given. Associations were found between major complaint and type of medicine given: fevers were associated with antimalarial drugs and analgesics (antipyretics), cough was associated with cough syrup and analgesics, while diarrhoea was associated with antidiarrhoeal drugs. Although one-fifth of the children had received an antibiotic, provision of antibiotics was not associated with a particular complaint/illness. Since caregivers appeared to use perceived complaints/illnesses as a treatment guide, this can form the basis of safer and more appropriate recognition of illness and home management. In addition, the information obtained in this study can be used for training clinicians to inquire about home management and, thus, for making more informed decisions about their own treatment and prescribing practices.