SD bioline malaria rapid diagnostic test performance and time to become negative after treatment of malaria infection in southwest Nigerian children

Context and Aim: Given the challenges of microscopy, we compared its performance with SD Bioline malaria rapid diagnostic test (MRDT) and polymerase chain reaction (PCR) and evaluated the time it took for positive results to become negative after treatment of children with acute uncomplicated malaria. Subjects and Methods: We present the report of 485 participants with complete MRDT, microscopy, and PCR data out of 511 febrile children aged 3­59 months who participated in a cohort study over a 12 month period in rural and urban areas of Ibadan, Nigeria. MRDT positive children received antimalaria and tested at every visit over 28 days. Speciation was also carried out by PCR. Results: With microscopy as the gold standard, SD-Bioline™ had 95.2% sensitivity, 66.4% specificity, 67.5% positive predictive value (PPV), and 94.9 negative predictive value (NPV), while with PCR the findings were 84.3% sensitivity, 66.5% specificity, 72.7% PPV, and 80.1% NPV. PCR speciation of malaria parasites revealed 91.6% Plasmodium falciparum, 18.9% Plasmodium malariae, and 4.4% Plasmodium ovale. Among the 47 children with P. malariae infections, 66.0% were coinfected with P. falciparum, while 54.6% cases of P. ovale occurred as coinfections with P. falciparum. The median time to a negative MRDT was 23.2 days, while the median time to a negative malaria microscopy was 3.8 days. The two survival curves were significantly different. Conclusions: The SD BiolineTM MRDT performed well, with remarkable persistence of rapid test-positive for an average of 23 days post treatment. The prevalence of P. malaria is somewhat greater than expected.

Breastfeeding Practices and Associated Factors among Mothers of Children Aged 6-23 Months in Konduga Local Government Area, North East Nigeria

Aims: To assess knowledge and practices of breastfeeding as well as identify associated factors among mothers of children aged 6-23 months in Konduga Local Government Area (LGA) in Borno State, Nigeria. Study Design: A descriptive cross-sectional study was conducted among mothers of children aged 6 to 23 months. Place and Duration of the Study: The study was conducted in Konduga LGA of Borno State, Nigeria in August, 2018. Methodology: The study focused on 224 mothers of children aged 6-23 months that have ever assessed the health facility for Micronutrient Powder (MNP) supplementation for their index child. A semi-structured interviewer-administered questionnaire was used to assess socio-demographic characteristics of respondents, knowledge of breastfeeding and their practices of breastfeeding. A point was assigned to correct response to each of the two questions used to assess breastfeeding practices, and respondents with two points were categorized as those with effective breastfeeding practice. Data were analyzed using descriptive statistics, Chi-square test and logistics regression, with the level of significance set at 0.05. Results: A total of 224 respondents were approached for interview and 218 responded, giving a response rate of 97%. Forty-six (21%) of the respondents knew that it is not appropriate to give semi-solid food or water to child that is 4 months old, and 98 (45%) knew that breastfeeding should not be discontinued for a child that is one year of age. Sixty-one (28%) of the respondents practice effective breastfeeding, which was significantly predicted by having formal education (AOR=14.0, 95% CI= 4.0 – 48.6), having a spouse that is educated (AOR=6.0, 95% CI= 2.1- 17.6) and having a male child (AOR=3.2, 95% CI= 1.3 – 8.0). Conclusions: The study findings suggest that effective breastfeeding practice is low among the study participants particularly among the less educated and those having a female child. Interventions targeted at strengthening Infant and Young Child Feeding counseling in the health facility and community are recommended.