Predictors of road traffic accident, road traffic injury and death among commercial motorcyclists in an urban area of Nigeria

Background: Road traffic accidents, injuries and deaths remain important public health problems in both developed and developing countries. These problems have since escalated with the introduction of the new phenomenon of commercial motorcycle transportation such as is found in the urbanizing slum of Nnewi, Anambra state of Nigeria. Method: Using a semi-structured, interviewer administered questionnaire, relevant data on socio-demographic and motorcycle characteristics were collected from a sample of 291 commercial motorcyclists selected by systematic sampling technique. Data on RTA, RTI and death were also collected from them over a period of three months. Result: The result showed that young commercial motorcyclists {<30 years of age}, experienced higher fatal injury rate than older ones {>30 years of age}, {p<0.01}. Motorcyclists with some formal education experienced RTA and RTI incidence rates that were significantly lower than those of motorcyclists with no formal education, {p<0.01}. In the same vein, medical condition and social vices such as alcohol intake among the motorcyclists were found to be obvious predictors of RTA, RTI and death. Furthermore, motorcyclists who used >100cc engine capacity motorcycles had significantly higher RTA incidence rate {478.8/100 MCY}, RTI rate {223.2/100MCY}and FIR {410/100MCY} than users of <100cc engine motorcycles who recorded RTA incidence of 258.9/100MCY, RTI rate of 49/100MCY and zero fatal injury respectively {p<0.01, p<0.001, p<0.001 respectively}. Conclusion: A careful consideration of all these predictors individually and collectively, will enable stakeholders in transport industry plan effective RTA, RTI and death control measures. Rather than an outright ban of motorcycle transportation, evening classes can be organized for the motorcyclists at subsidized rates to improve their literacy levels to run side by side with road safety informational lessons delivered at their places of work

Possible biochemical impact of malaria infection in subjects with HIV co-infection in Anambra state, Nigeria.

BACKGROUND & OBJECTIVES: The present study was designed to determine possible contributory impact of malaria infection on some biochemical markers in subjects with HIV co-infection in order to know if they are adverse or protective. METHODS: Participants were recruited at the Voluntary Counseling and Testing Unit, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria and grouped into: (i) Malaria and HIV co-infection group (n = 45); and (ii) HIV infected group without concurrent malaria infection (n = 57). Standard laboratory methods were used for the HIV and Plasmodium falciparum antigen screening, malaria parasite density, CD4+ T-cell count, packed cell volume, white blood cell count, serum iron and albumin concentrations. RESULTS: The results showed that serum iron and albumin were significantly reduced and raised respectively in 'Malaria-HIV co-infection group' compared with 'HIV infection group' (p < 0.05 and p < 0.05). A positive association was observed between age and serum iron concentration in malaria and HIV co-infected group (r = 0.580; p < 0.05) while negative associations were observed between PCV and serum iron (r = - 0.388; p < 0.05) and between CD4+ T-cells and serum iron concentration (r = -0.362; p < 0.05) in malaria and HIV co-infected group. The CD4+ T-cell count, WBC count, PCV were not significantly different between the Malaria-HIV co-infection group and HIV infection group. INTERPRETATION & CONCLUSION: In the present study serum iron and albumin concentrations were the most sensitive indicators that showed the contributory impact of malaria infection on biochemical index in HIV co-infected subjects. The findings suggest that at the defined stage of HIV infection in the present study, malaria co-infection may moderate the impact of HIV infection on iron metabolism and hepatic synthesis of albumin.

Prevalence of malaria as co-infection in HIV-infected individuals in a malaria endemic area of southeastern Nigeria.

BACKGROUND & OBJECTIVE: The present study was conducted on the prevalence of malaria as co-infection amongst 'asymptomatic HIV' and 'symptomatic HIV' subjects to see if such prevalence deviated from that commonly reported in apparently health individuals in same locality. METHODS: A prospective study that involved 196 participants grouped according to their HIV status as: 'asymptomatic HIV seropositive group' (n = 101); 'symptomatic HIV seropositive group' (n = 48) and 'control HIV-seronegative group (n = 47). Blood samples collected from the participants were used for double HIV screening by rapid immunoassay technique and immunochromatographic technique, and for the diagnosis of Plasmodium falciparum malaria using rapid P. falciparum antigen detection method. RESULTS: The result showed that the prevalence of P. falciparum malaria as a co-infection amongst the asymptomatic HIV seropositive group was 12 (11.8%) and amongst the symptomatic HIV seropositive group was 16 (33.3%). However, the prevalence rate of P. falciparum malaria amongst the control HIV seronegative group was 5 (10.6%) and the combined burden of P. falciparum malaria amongst both groups of HIV seropositives was 28 (18.9%). INTERPRETATION & CONCLUSION: The present study observed different prevalence rates of P. falciparum malaria amongst the three groups. The prevalence was tripled in symptomatic HIV seropositive group. This shows a clear departure from possible obtainable prevalence of malaria infection alone in this malaria endemic area. Due to the mortality rates associated with malaria infection in an endemic area, it may be necessary that routine malaria screening be adopted as part of the management policy to check the co-infection.