Cohort event monitoring of patients treated for uncomplicated malaria with artemisinin-based combination therapies in selected hospitals and community pharmacies in Nigeria.

AIMS AND OBJECTIVES: The study was designed with the broad objective of determining the safety profile of artemisinin-based combination therapies amongst Nigerian population. PATIENTS AND METHODS: This was a cohort event monitoring (CEM) programme involving monitoring adverse events (AEs) in malaria patients treated with either artemether-lumefantrine (AL) or artesunate-amodiaquine (AA) in healthcare facilities in Nigeria. The study involved continuous enrolment of patients with malaria and treated with either AL or AA at the various sites until a total cohort of 600 patients were enrolled at each site. Patients were monitored from the onset of therapy, and on days 3 and 7 from the first day of treatment to identify AEs that may occur. RESULTS: A total of 6102 AEs were recorded in 10,259 patients monitored during the programme. Of 4896 patients who received AA, 4233 (86.5%) patients reported at least one AE while 1869 (34.8%) AEs out of 5363 patients who received AL were reported (P = 0.010). The predominant incidence of each specific AE reported in each group among the patients who received AA and AL includes body weakness 30.8%/7.5%, dizziness 10.3%/3.9%, restlessness 5.02/1.12%, vomiting 3.5/1.03% and drowsiness 3.1/1.5% for AA and AL, respectively. There were more AEs among patients with co-morbid conditions and patients in the younger age groups (9-<15 years), P = 0.000. CONCLUSIONS: Various types of AEs were seen and documented during the CEM programme. The findings suggested that the AA/AL monitored during this programme was generally safe and remarkably well tolerated among the Nigerian populations.

Human sleeping sickness in the Gboko endemic area of Nigeria.

Human infection with Trypanosoma gambiense in the Gboko endemic area was first reported in May, 1974 although T. gambiense sleeping sickness had been present there since the turn of the century. The disease is associated with the presence of the tsetse Glossina tachinoides and Glossina palpalis which is plentiful and widespread throughout the division as well as in thickets along the streams in the area. No successful attempt has been made to control the tsetse vector in the Division. The incidence and geographical distribution of cases of T. gambiense sleeping sickness in the Gboko area are described in this report. Cases were treated with Antrypol Tryparsamide mixture and Mel B. The highest number of cases of infection is usually picked up just before the start of the rains in early April. It is suggested that, for meaningful control of the disease a quick method should be devised to rid the area of the insect vector.

Mel B toxicity in human trypanosomiasis in the Gboko endemic area of Nigeria.

Nine cases of Mel B (a melaminyl arsenical used in treating sleeping sickness patients who have developed central nervous system involvement) treated patients who developed reactions to the drug are described. They all developed high temperatures, pyrexia, diarrhoea, vomitting or itching and some had convulsions. Three of the nine described patients died. It is recommended that extra care and caution is needed while treating patients with Mel B.