Malaria prevention practices among mothers delivering in an urban hospital in southwest Nigeria.

BACKGROUND & OBJECTIVES: The pregnant woman is more prone to malaria than her non-pregnant counterpart with grave consequences for both mother and baby. This study aims at determining the malaria prevention practices among pregnant women in an area hyper-endemic for malaria. METHODS: For the study 983 parturient mothers were enrolled in Ibadan, southwest Nigeria. Information was collected on sociodemographic characteristics, use of malaria chemoprophylaxis, use of anti-vector measures, and malaria parasitaemia. RESULTS: Most mothers [956/972 (98.4%)] reported the use of anti-vector measures for malaria prevention. These include, window screens (78.9%), insecticides spray (69.9%), mosquito coils (25.3%), untreated bednets (2.5%), and insecticide-treated nets (1.1%). Most mothers used anti-vector measures either singly or in combination. About 86% (840/972) of the mothers used drugs for chemoprophylaxis. Thirteen (1.3%) mothers used chemoprophylaxis alone (CP), 135 (13.9%) used anti-vector measures alone (AV) while 820 (84.4%) used chemoprophylaxis plus anti-vector (CPAV). Weekly dose of pyrimethamine [214 (25%)] and intermittent preventive treatment with sulphadoxine-pyrimethamine [598 (71.2%)] were the widely used chemoprophylactic drugs. The prevalence of patent parasitaemia at delivery was 7.7% (1/13), 12.1% (99/820) and 16.3% (22/135) among CP, CPAV and AV groups respectively. Geometric mean parasite densities among the respective groups were 7840/microl, 1228/microl and 8936/microl. CONCLUSION: Window screens and insecticide sprays were widely used for malaria prevention while the use of ITN was very low among enrolled mothers. There is a need to pay concerted efforts to improve ITN usage rate in Nigeria.

Prevalence of malaria at booking among antenatal clients in a secondary health care facility in Ibadan, Nigeria

The prevalence of malaria parasitemia at booking was studied in 1,848 pregnant women in a secondary hospital in Ibadan, Nigeria. Main outcome variables were patent parasitemia and fever. 8.4% had patent malaria parasitaemia. Most clients (89%) with parasitemia were asymptomatic. Febrile subjects booked at an earlier gestational age [22.7 versus 24.2 weeks] than afebrile patients (p = 0.0052). Anemia was more prevalent among patients with patent parasitemia than those without (58.1% versus 22.6%, p<0.0001). Malaria parasitaemia was higher among nulliparous women than other parity groups (p<0.0001). Symptomatic malaria was associated with early booking for antenatal care and malaria parasitemia was a significant determinant of anemia. The prevalence of malaria parasitaemia in this study is much lower than in previous reports. (Afr J Reprod Health 2008; 12[2]:141-152)

Profile of chloroquine - induced pruritus in Nigerian children resident in Ibadan, Nigeria

Chloroquine is still the first-line drug in the treatment of malaria in Nigeria and West- Africa sub-region. A major drawback to the use of chloroquine is pruritus. We studied a total of 175 children aged 1­15 years with a view to assessing some factors that may influence chloroquine induced pruritus and the possible impact on therapy with this drug. The mean age was 5.2+4.0 and there were 87 females and 88 males. Chloroquine-induced pruritus was found in 43/175 (24.6%). All the subjects experienced the itching within 24 hours of ingestion of the drug and median duration of the itching was 2 days. Majority of those who itched still used chloroquine to treat malaria for various reasons. There was positive family history in 34/43 (79%) of those who itched and 57/132 (43%) of those who did not itch to chloroquine. Those who had chloroquine-induced pruritus were relatively older (mean age 6.90+3.68 years versus 4.64+4.00; p< 0.05) and mean age onset of chloroquine-induced pruritus was positively associated with mean age of the children r = 0.91; 95% confidence limits: 0.71< r < 0.91. We concluded that chloroquine-induced pruritus in this group of children evolved with increasing age and was associated with positive family history