Identification of three members of the Simulium damnosum (Diptera Simuliidae) group in South Western Nigeria.

Identification of the specific Simuliium species at play in the transmission of Onchocerca volvulus is important because it helps to explain the epidemiology and clinical presentation of the disease and guides in monitoring of long term impact of ivermectin treatment on onchocerciasis transmission. The study therefore sought to use molecular markers for vector identification. A combination of Polymerase Chain Reaction (PCR) assay and Restriction fragment Length polymorphism (RFLP) was used to identify members of Simulium damnosum complex in forest area of south western Nigeria. The results revealed the presence of three members of the Simulium damnosum complex: S. yahense, S. sirbanum and S. damnosum ss. S. yahense was the predominant and major vector in the study sites. This provides baseline data for future monitoring vector of human onchocerciasis in the area.

Sociocultural aspects of mass delivery of praziquantel in schistosomiasis control: the Abeokuta experience.

BACKGROUND: Schistosomiasis is a public health problem in Nigeria. Although there is an ongoing national program for its control, disease control programs in other countries have shown the need to understand the sociocultural aspects of disease transmission, prevention, and treatment in endemic communities before control efforts are undertaken. OBJECTIVE: To describe sociocultural factors that influence the distribution process of praziquantel for the mass treatment of schistosomiasis infection. METHODS: Data for the study were collected through focus group discussions held separately with adult males and females, male and female adolescents (13-19 years), and male and female children (5-12 years). In-depth interviews were similarly held with the drug distributors of praziquantel for mass treatment and with community/opinion leaders of six hyperendemic communities in Ogun State, Southwest Nigeria on mass treatment using praziquantel. These focus group discussions and in-depth interviews were held both before and following the drug distribution. The data were analyzed using the textual analysis program, Textbase Beta. RESULTS: Following a 3-week period of mass treatment in six communities, we observed an increased awareness of rivers/streams as a source of schistosomiasis. In addition, the communities reported overwhelming support for the mass treatment after receiving treatment. The reasons for this acceptance appear to include the perceived efficacy of praziquantel against the disease and its availability free of charge. The drug's distributors adhered to the originally specified systems-based protocol for mass treatment in only two of the six communities. The systems-based protocol adhered to strict distribution through primary health centers and schools. The four other communities used a community-based approach for mass treatment with praziquantel and attained greater coverage of treatment as a result. CONCLUSION: Obtaining community support and involvement before the implementation of mass treatment of schistosomiasis with praziquantel contributes to an effective treatment strategy for this disease. A detailed assessment of a community's health needs, before the initiation of the control efforts against endemic infections, should be undertaken.

Height as a substitute for weight for estimating praziquantel dosage.

The study evaluated height and weight measurements of 750 school children from five rural communities in western Nigeria. The measurements were taken by 12 trained community members designated as distributors in determining treatment dose with praziquantel for these children. A very strong correlation value, r=0.97, was obtained for the weight of treated children measured by the distributors and the research team. The distributors obtained a correlation coefficient value of r=0.87 on weight and height measurements, showing that height can be used by community distributors in lieu of weight for correct dose determination.

Willingness to pay for praziquantel treatment in a hyperendemic community of Ogun State, Nigeria.

BACKGROUND: Schistosomiasis is highly endemic in Nigeria. However, very little is known about the usage and social marketing of praziquantel in the control of schistosomiasis in endemic communities and on the persons willingness to pay for the drug to support its extensive use and thus aid control efforts in Nigeria. OBJECTIVE: The study examined the willingness of people in a hyperendemic community, to pay for treatment with praziquantel before and after provision of the drug, with a view to assess the feasibility of achieving widespread coverage. METHODS: Data were collected through focus group discussions among household heads and other adult family members and through the use of a questionnaire to survey household heads in Imala-Odo, a community hyperendemic for schistosomiasis, in southwest Nigeria. The main outcome measure was the respondents' willingness to pay for schistosomiasis treatment. RESULTS: The results showed that in contrast to the 92.3% of respondents who expressed willingness to buy the drug in the preintervention study, only 46.5% actually purchased the drug during intervention for the treatment of their infected household members. The respondents' level of education, occupation, and income influenced their willingness to pay (P<.05). Statistical tests showed that those willing to pay for treatment had a higher income score than those unwilling to do so. Most respondents preferred their community head and reliable persons chosen by the community as convenient outlets for drug distribution. The number of household members respondents were willing to treat increased from 4 to 6 at N320.00 (US $2.52) in the preintervention and postintervention phases, respectively. Gender factor was found to influence the respondents' perceived average treatment cost; the females wanted N300.00 (US $2.36) against N100.00 (US $0.79) among the males. CONCLUSION: Efforts need to be made and sustained to ensure that all families can afford to praziquantel drug to achieve the ultimate goal of controlling the infection in endemic communities of Nigeria.

An assessment of parent-child communication on sexuality in lagos, Nigeria.

This study is the first phase of a project designed to help parents acquire skills necessary for comfortable and effective communication about adolescents' sexuality. It assessed parent-child communication on sexuality among the in-school adolescents in Lagos, Nigeria. It was observed that a high proportion of the adolescents interviewed receive information on sexuality from friends and the mass media and also communicate more with their friends on sexuality than with their parents.

Herbal remedy in the treatment of malaria: cross sectional survey of residents of Lagos State, Nigeria.

Semi structured questionnaires. designed to capture information on the type. composition, method of preparation. dosage, mode of administration. and frequency of use of herbal preparations in malaria treatment, were administered to 1,593 adults of the 3 main ethnic groups and a forth group comprising other smaller ethnic groups designated as "others", all resident in Lagos metropolis in a cross sectional survey. The 1,593 respondents were made up of 892 males and 701 females and their ages ranged from 19 to 60 years. A high percentage in all the ethnic groups especially the Yorubas admitted to the use of herbs in treating malaria [Yoruba (69%), Hausa (47%). others (32%) and Igbo (30%)1. Effectiveness of herbs in treating malaria episodes featured as the major factor for their use. as claimed by the majority (>50%) of the respondents in each of the ethnic groups, while cost consideration was the next most important factor. Other factors mentioned included the absence of side effect in herbal use. to avoid the itchy side effect and ineffectiveness of chloroquine and some other anti-malarials. An appreciable percentage across the ethnic groups had no idea of the constituents of the herbal remedies they use for treating their malaria episodes since they buy these from traditional herbalists. Varied combinations of these herbs in combination with different types of fruits and other substances are claimed to be used, the main ones of which are Azardiracha indica and pineapple. A large majority of respondents in all the ethnic groups claimed to use the same herbs for the treatment and prevention of malaria and great improvement is experienced after use [Hausas (90%). Igbos (83%). Yorubas (77%) and the others (88%)]. There is usually no specific dose or dose regimen. however a high proportion in all the ethnic groups use herbal preparation thrice a day and a few of the respondents take unspecified measures at arbitrary intervals. The lack of standards in the use of these herbal preparations needs to be urgently addressed especially as use continued until the malaria symptoms and signs are deemed to have disappeared. There is also need to standardize the usage of herbs if they are to play a significant role in malaria prevention and treatment.

Distribution of the molecular forms of Anopheles gambiae and pyrethroid knock down resistance gene in Nigeria.

We investigated the distribution of the molecular M and S forms of Anopheles gambiae and the knock down resistance (kdr) gene associated with pyrethroid and DDT resistance in A. gambiae s.s. at 13 localities across Nigeria. Two-three days old adult female mosquito reared from larval collections were tested using standard WHO procedures, diagnostic test kits and impregnated papers to assess their pyrethroid resistance status. Specimens were identified by PCR assays and characterized for the kdr gene. DNA from adult A. gambiae s.s. collected from human dwellings were also tested for the presence of the kdr gene. The overall collection was a mix of the molecular M and S forms across the mangrove (63:37%), forest (56:44%), and transitional (36:64%) ecotypes, but almost a pure collection of the S form in the Guinea and Sudan-savanna. Results of insecticide susceptibility tests showed that mosquitoes sampled at seven localities were susceptible to permethrin, deltamethrin, and DDT, but populations of A. gambiae resistant to these insecticides were recorded at six other localities mainly in the transitional and Guinea-savanna ecotypes. The kdr gene was found only in the molecular S forms, including areas where both forms were sympatric. The overall kdr frequency was low: <47% in forest, 37-48% in the transitional, and 45-53% in Guinea-savanna. The data suggest that pyrethroid resistance in A. gambiae in Nigeria is not as widespread when compared to neighbouring West African countries.

Effectiveness of different approaches to mass delivery of praziquantel among school-aged children in rural communities in Nigeria.

Schistosomiasis is hyperendemic in Nigeria. The national policy on schistosomiasis control has adopted praziquantel as the main drug of use in the control strategy aimed at reducing morbidity. However, the best delivery channel for praziquantel in schistosomiasis control in Nigeria is yet to be determined. This study assessed different channels for praziquantel delivery in a mass treatment effort. Three groups, each of two communities, were assigned to one of the following three channels: health facility (HF), school, and community for mass delivery of praziquantel to school-aged children. Distributors were trained on all aspects of praziquantel distribution and sufficient praziquantel tablets were provided for the drug distribution within 3 weeks following which an evaluation of the drug distribution by the different treatment channels was conducted. Overall, the community channel of delivery achieved the best coverage of 72.2% (range: 69-73%) compared to 44.3% (range: 39.5-62%) and 28.5% (range: 26.3-74.5%) for the HF and school channels, respectively. Community channel of praziquantel delivery as shown in this study ensures good coverage of both in and out-of-school children.

Endemicity of onchocerciasis in some local government areas of Niger state.

The established method of justifying the need for ivermectin delivery to a community is the use of Rapid Assessment Method (RAM). This method involves the clinical examination of 50 adult males, who have been resident in the community for at least five years, for onchocercal nodules and leopard skin. The values obtained for these indices will guide the classification of such a community as being hypoendemic, mesoendemic or hyperendemic. Those that fall within mesoendemic and hyperendemic category onchocerciasis qualify for ivermectin delivery. This study was carried out to determine the endemicity level of onchocerciasis in 74 communities of 8 Local Government Areas (LGAs) of Niger state to justify their inclusion or otherwise in the ongoing state wide mass treatment for onchocerciasis using ivermectin. The communities were selected using the Geographical Information System (GIS) data and following the World Health Organization (WHO) guideline for RAM. A total of 3000 subjects were examined comprising of 2395 (79.8%) males and 605 (20.2%) females. None of the LGAs, based on overall prevalence for nodules qualify for mass treatment with ivermectin. However the study identified communities within some of these LGAs that were mesoendemic for onchocerciasis and thus qualified for mass treatment with ivermectin.