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.

The bowel habits of adolescents in Nigeria.

Background: The implications of defaecation patterns to health are important. The abnormalities can be readily recognized and treated only if the normal pattern is known. Methods: This cross sectional study involved 1115 adolescents enrolled using a stratified multi-stage random sampling technique. A self-administered and semi-structured questionnaire was used to obtain information on stool frequency, volume, colour and consistency. Data were compared between low and high across socioeconomic strata. Results: There were 481 males (overall mean age: 15.2+1.9 years). Participants were on mixed carbohydrate rich diet with both high and low fibre content.. Stool frequency was at least once daily in 77.3%, once in alternate days (17.4%) and once in >3days (5.3%). There was no association between stool frequency and gender (p=0.141) or age (p=0.345). More participants from the high (64.9%) than the low (35.1%) social classes opened their bowels once in >3days (p=0.048). More males produced larger stool volumes (>200ml) than females, (p=0.000). More than half (50.5%) of the participants reported passing brownish stool, 46.3% yellow stool and 3.2% greenish brown stool. Passage of soft stool was reported by 74.9% of the participants. Overall, 3.4% of participants had passed blood in their stool at some time. Conclusion: Majority of Nigerian adolescents passed 25-200 ml of soft stool atleast once daily and age and gender did not affect stool frequency. High socioeconomic status was associated with passage of hard stool and less frequent bowel opening. This data could facilitate early recognition of deviation from normal bowel habits in Nigerian adolescents.

Non-protective immunity against tetanus in primiparous women and newborns at birth in rural and urban settings in Ibadan, Nigeria

Introduction: Nigeria remains among the few countries that are yet to achieve eradication of neonatal tetanus in the world despite the availability of an effective vaccine. This study investigated immunity against tetanus in primiparous mothers and neonates at birth, and identified associated factors.Methods: this cross-sectional study involved consecutive selection of 244 primiparous mother-neonate pairs (119 from rural areas, 125 from urban areas, 137 male neonates and 107 female neonates) delivered at primary healthcare facilities in Ibadan, Nigeria.. Socio-demographic characteristics, obstetric history, immunisation and birthweight were obtained from mothers by interview. A validated immunochromatographic rapid diagnostic test kit was used to test for immunity against tetanus. Positive and negative results were interpreted as protective immunity against tetanus (PIaT) and non-protective immunity against tetanus (NPIaT), respectively. Data were analysed using descriptive statistics, Chi-square and logistic regression at p = 0.05.Results: the mean age of mothers was 27.9±3.4 years (range: 20-33) and median birthweight was 2700g (range: 1760-3300). Of the 244 mothers, 198 (81.1%) received at least two doses of tetanus toxoid injection during pregnancy and prevalence of NPIaT and PIaT was 28.7% and 71.3%, respectively. The prevalence of PIaT was significantly higher among mothers in urban areas (n= 96; 80.7%) than rural (n=78; 62.4%), p<0.001. The prevalence of NPIaT among neonates was 36.5% (n= 89). Predictors of NPIaT among neonates were residence in rural LGA (OR = 2.22; 95% CI = 1.23-3.99) and maternal tetanus immunisation <2 doses (OR = 11.68; 95% CI = 4.05-21.75.Conclusion: lack of protective immunity against tetanus among neonates of primiparous women in Ibadan is prevalent and a more conscientious enforcement of routine tetanus prevention practices is needed