Mosquito control at a tertiary teaching hospital in Nigeria.

BACKGROUND: Mosquitoes are vectors of numerous diseases, including malaria and yellow fever. Mosquito control is therefore a priority in many countries, especially in healthcare settings. Here we investigated the opinions of patients and staff regarding mosquito control at a hospital in Nigeria, and also gathered data on mosquito-control measures in this setting. METHODS: We conducted a cross-sectional questionnaire study of staff and patients and an observational approach to obtain data on mosquito-control measures used at a tertiary teaching hospital in Abakaliki, Nigeria. DISCUSSION: Both staff (N=517) and patients (N=302) reported experiencing more mosquito bites at the hospital than elsewhere. As well as contributing to discomfort, this exposure may put hospital staff and patients at risk of mosquito-borne infections. Complaints from patients about mosquitoes were reported by over 90% of staff, and over 50% of staff respondents were aware of patient discharge against medical advice due to mosquitoes. The most common control method was killing mosquitoes by hand. We observed a lack of door screens in all wards, window screens were absent or torn, and most beds did not have nets. In the children's wards none of the beds had nets. CONCLUSIONS: Current measures against mosquitoes in this hospital appeared inadequate, and healthcare staff and hospital patients may be at increased risk of mosquito-borne infections. Mosquito control in the hospital requires attention, and the needs for improvement in mosquito control in the healthcare setting more widely should be evaluated and addressed.

Apparent overuse of antibiotics in the management of watery diarrhoea in children in Abakaliki, Nigeria.

BACKGROUND: Diarrhoea remains an important cause of childhood mortality in Nigeria, with Rotavirus and Cryptosporidium reported to have the highest contribution. However, high use of antibiotics for treatment of paediatric diarrhoea has been observed, although World Health Organization guidelines discourage the use of antibiotics for treating acute diarrhoea. Here we investigated more closely management and treatment practices for acute paediatric diarrhoea, both in home and healthcare settings. METHODS: Children under 5 years of age (n = 199) presenting at healthcare centres in Abakaliki, Nigeria with acute watery diarrhoea were included in the study. Background information on the children was collected by questionnaire, including home treatments, and clinical information including symptoms and treatment were provided by the healthcare centres. Analysis of faecal samples from the children indicated that over 90% had Rotavirus infection and over 6% Cryptosporidium infection. Data were compiled in a spreadsheet and analysed for associations between variables and use of antibiotics using logistic regression analysis. RESULTS: Although most children were treated supportively (oral rehydration solution and intravenous fluids at home and in healthcare settings, respectively) over 15% were given anti-diarrhoea drugs at home and over 85% were also prescribed antibiotics at the healthcare centre, mostly ciproflaxin, but also metronidazole and gentamycin. The only variable positively associated with antibiotic prescription was diarrhoea more than three times per 24 h at admission. CONCLUSIONS: It is clear that young children presenting with acute watery diarrhoea to healthcare centres in Abakaliki are likely to be prescribed antibiotics, despite there being no obvious reason that this treatment is appropriate. Our study results support the need for institution-based antimicrobial stewardship being implemented in Nigeria.

Epidemiological Aspects of Blastocystis Colonization in Children in Ilero, Nigeria.

This study aimed to elucidate aspects of the epidemiology of Blastocystis in Nigerian school children, including the distribution of subtypes (STs) and ST alleles. A total of 199 genomic DNAs extracted from fecal samples from 199 Nigerian children aged 2-14 years were tested by real-time polymerase chain reaction for Blastocystis Positive DNAs were submitted to barcoding by PCR and sequencing to obtain information on STs and ST alleles. A total of 167 (84%) samples were positive for Blastocystis, with prevalence increasing by age. No association between Blastocystis colonization and gender (P = 0.51) or type/presence of toilet facilities (P = 0.21) was observed. Blastocystis carriers were more prone to using water collected from wells than from sachets (P = 0.0044). Moreover, Blastocystis positivity was associated with positivity for fecal-orally transmitted protozoa (P = 0.018) and helminths (P < 0.0001). A clear inverse association of Blastocystis colonization and malaria infection was observed (P < 0.0001); however, malaria-positive children being younger than malaria-negative children, this finding was attributed to the age effect of Blastocystis colonization. ST data were available for 127/167 (76%) samples. Fifty-one children were positive for ST1, while 42 and 33 children were colonized with ST2 and ST3, respectively; a single case of ST7 was observed. By and large, the ST alleles identified for ST1 and ST2 did not differ from those observed in humans in other regions of the world; meanwhile, the distribution of ST3 alleles was remarkably distinct and potentially specific to humans in sub-Saharan Africa.

Intestinal helminthiasis among school children in Ilie, Osun State, Southwest, Nigeria

A cross sectional study of intestinal helminthiasis among school pupils was undertaken in three primary schools in Ilie in Olorunda Local Government Area of Osun state in order to determine the prevalence and intensity of helminthic infections. The relationship between intestinal helminths and anthropometric indices and the factors that could favour the infection were also studied. Faecal samples from three hundred and four (304) randomly selected out of the four hundred and seven (407) school children in the study area were collected and analysed with the semi-quantitative Kato Katz technique and concentrated method. The intensity of infection was classified into light; moderate or high according to World Health Organisation (WHO) thresholds. The overall prevalence rate was 52.0 while five species of intestinal helminths were identified. Ascaris lumbricoides (36.2) was the most common; followed by Hookworm (10.5); Schistosoma mansoni (4); Strongyloides stercoralis (0.7) and Hymenolepis nana (0.7). Multiple helminthic infection were recorded with Ascaris -Hookworm (6.58) having the highest prevalence among the children. Female (56.6) were more infected than male (46.4) and the difference was statistically significant (P=0.0019). Seventeen percent (17) of the children were below the third percentile for weight (wasted) while fourteen percent (14) were below the third percentile for height (stunted). There was a relationship between intensity of infection and wasting since there were fewer underweight pupils (13) with normal stool than those moderately infected (35) (P0.05). There was statistically significant association between type of latrine use and prevalence of infection; and also between water treatment and infection. Periodic surveillance of school children for intestinal helminthiasis should be part of the public health activities while periodic deworming programme should be done routinely as this would reduce intensity of intestinal worm infection among school children