Knowledge, attitude, perception of malaria and evaluation of malaria parasitaemia among pregnant women attending antenatal care clinic in metropolitan Lagos, Nigeria.

Background & objectives: Little information exists on the compliance of pregnant women to malaria management in malaria endemic countries. This study was designed to access knowledge, attitude, perception and home management of malaria among consenting pregnant women attending antenatal care (ANC) clinic. Methods: In total, 350 pregnant women were randomly recruited during their ANC Clinic in Lagos. Structured questionnaires were administered in a two-stages research design; first during their early months of ANC visit and the second approximately 1–2 months before delivery. Information on occupation, parity, symptoms used to recognise malaria, treatment sources, control measures, knowledge factors, anti-vector measures, health-seeking practices, malaria parasitaemia and packed cell volume (PCV) were recorded. Results: The results revealed that 78.9% of the pregnant women identified infected mosquitoes as the cause of malaria while 86% of the pregnant women identified stagnant water as its breeding sites. Knowledge of the benefit of insecticide-treated mosquito bednets was less prominent as most of the selected subjects decried its high market price. Our data also showed that educational programme targeted on potential mothers is beneficial. Overall, 27.4% (96/350) of the pregnant women had peripheral malaria infection with 88.5% (85/96) of the parasite positive women infected with Plasmodium falciparum and 11.5% (11/96) with P. malariae. PCV ranged from 20–40% (median 33.9%) with 25.7% (90/350) of the pregnant women being anaemic with PCV <33%. We found an association between malaria infection and occupation, and this association was not influenced by parity. Interpretation & conclusion: Our findings revealed that improvement in knowledge and education of women of child-bearing age has an influential impact on malaria control.

Polymorphism and virulence factors in the pathogenesis of amoebiasis

Amoebiasis is one of the world's most prevalent infectious diseases of developing world. E. histolytica and E. dispar are two morphologically identical but genetically distinct species. Infection with E. histolytica may be symptomatic and asymptomatic. E. dispar is non-pathogenic. Both innate and acquired immune responses limit amoebic infection while different strains of E. histolytica and its virulence have been described and virulence factors of E. histolytica such as cysteine proteinases; Gal/GalNAc-inhibitable lectin and ameobapore are known to be involved in E.histolytica pathogenesis. Proteolytic enzymes and cysteine proteases facilitate tissue invasion while Gal/GalNAc-inhibitable lectin aids adherence and amoebapores are involved in lysis of target cells. Three new strains of E. histolytica (Rahman; HK-9; and 200: NIH) have been described as well as the previously known strain (HM 1 IMSS). This review highlights the newly described strains and virulent factors involved in the pathogenesis of E. histolytica

The community-based treatment of onchocerciasis in Shao, Kwara State, Nigeria.

Community acceptance of and compliance with annual ivermectin treatment in Shao, a sub-urban community in Kwara State, Nigeria, were remarkably high. Of 890 subjects from 204 randomly selected households, 832 (93.5%) had taken ivermectin at least once during the six-year treatment period. An average community acceptance rate (ACAR) of 88.77% (range 85.4 - 91.9%) was recorded during this period; a community compliance rate (CCR) of 74.76% was recorded. Overt refusals, covert refusals and those excluded from treatment were low and insignificant (p > 0.05). The mean compliance age was 37.47 +/- 16.52 years. Of the subjects studied, 40.67% reported adverse reactions to ivermectin during the first round of treatment (Tx1); this number decreased significantly (p < 0.05) to 15.43% during the sixth round of treatment (Tx6). Though considerable adverse reactions were reported in the community, these did not seem to have negatively affected acceptance of and compliance with annual ivermectin treatment; in some cases, the adverse reactions were believed by the villagers to demonstrate the efficacy and effectiveness of the drug. The community showed great awareness of the disease, its treatment with ivermectin and the distribution of the drug. On the basis of the high acceptance and compliance rates, it was concluded that Shao will benefit greatly from the current African Program for Onchocerciasis Control Strategy: Community-Directed Treatment with Ivermectin (CDTI) using Community-Directed Distributors (CDDs).

Intestinal helminthiases and their control with albendazole among primary schoolchildren in riverine communities of Ondo State, Nigeria.

A study to establish the prevalence of intestinal helminthiases among schoolchildren of riverine communities in the Ilaje-Ese Odo Local Government Area of Ondo State, Nigeria was conducted. Ninety-four percent of the children studied were infected with intestinal helminths. Trichuris trichiura infection was the commonest (84%), followed by Ascaris lumbricoides (75.3 %) and hookworm (7.6 %). Dual helminthic infections were recorded, with Ascaris-Trichuris having the highest prevalence among the children. Poor environmental sanitation and personal hygiene combined with the absence of potable water and a lack of awareness of the effects of nematode infection were identified as the possible reasons for the high rate of infection. Treatment with albendazole (200 mg) brought about reductions in the level of Trichuris trichiura (to 41.7%), Ascaris lumbricoides (to 4.2%) and Hookworm (to 0.7%). The estimated rates of reduction were 94.4%, 49.7%, and 90.2% for Ascaris lumbricoides, Trichuris trichiura and hookworm respectively. Post-treatment helminthic reduction, as found in this study, is expected to enhance the mental and physical development of the children. Community mobilization with health education messages aimed at improving personal and community hygiene was initiated with an emphasis on creating a sustained reduction in the burden of helminthic infection.