ABSTRACT
The pattern of antimalarial dispensing by Patent Medicine Dealers (PMD) was studied in 17 villages of Gokana (Ogoni Land) in Rivers State of Nigeria. Of the 40 PMDs studied only eight (20%) had had formal health training and only eight could understand doctor's prescriptions. In total, 19 different types of antimalarials could be obtained from the individual ranges of antimalarials displayed by the 40 PMDs in the study. Chloroquine phosphate was the most frequently available. Twenty-three (57.5%) of PMDs administered Chloroquine at below the recommended dose of this drug. Twelve (30%) PMDs, eight with formal training and four others, administered the correct dose whilst five (12.5%) gave too much. All 40 of the PMDs studied knew how to dispense Daraprim and Fansidar correctly. We conclude that malaria control through prevention and treatment would be more effective if PMDs were to receive training on antimalarial dispensing alongside Community Health Workers.
Subject(s)
Antimalarials/supply & distribution , Malaria/drug therapy , Pharmacists/standards , Rural Health Services , Antimalarials/administration & dosage , Antimalarials/classification , Humans , Malaria/prevention & control , Nigeria , Pharmacists/statistics & numerical data , Professional Competence , Surveys and Questionnaires , WorkforceABSTRACT
Phenotype and gene frequencies of ABO and RH (D) systems were studied in 37,846 random blood donors in five zone of Nigeria (South West) (Yoruba)--Zone A, North West (Hausa-Fulani)--Zone B, Plateau (Birom)--Zone C, South East (Igbo)--Zone D and North East (Kanuri)--Zone E). We assessed the micro differences of genetic markers of ABO and RH blood groups between the ethnic groups in the ABO and RH blood group systems. Gene frequencies were ABO *O = 0.7068, ABO *A = 0.1490, ABO *B = 0.1443, RH *D = 0.8150 and results are similar to those earlier reported. Phenotype frequencies of the blood groups were in agreement with Hardy-Weinberg equilibrium expectations, except in two zones B and C where deviation was thought to be due to a high frequency of blood group AB.
Subject(s)
ABO Blood-Group System/genetics , Black People/genetics , Ethnicity/genetics , Gene Frequency/genetics , Rh-Hr Blood-Group System/genetics , Adult , Blood Donors/statistics & numerical data , Blood Transfusion , Female , Genetics, Population , Humans , Male , Needs Assessment , Nigeria , Phenotype , Population Surveillance , Residence Characteristics/statistics & numerical dataABSTRACT
Hyperreactive malarial splenomegaly (HMS) is found in geographical association with B cell lymphoproliferative disorders such as 'African' chronic lymphocytic leukaemia (CLL) and splenic lymphoma with villous lymphocytes (SLVL). It is sometimes not easy to make a differential clinical diagnosis between these conditions. We have previously used Southern blotting as a definitive method for the diagnosis of monoclonal lymphoproliferation in these disorders, but this is expensive, lengthy and technically difficult. In the present paper we have compared Southern blotting with polymerase chain reaction (PCR) amplification of the immunoglobulin heavy chain gene. We found an excellent correlation between the 2 methods in demonstrating monoclonal populations of lymphocytes in patients with a clinical diagnosis of CLL or SLVL. We have further demonstrated monoclonality in a patient who could not be classified as CLL or SLVL on clinical criteria alone. In contrast, patients with well defined HMS or with non-B cell proliferations all showed polyclonal rearrangements. We propose that the immunoglobulin gene PCR is a useful tool for the investigation of tropical splenomegaly of uncertain origin.
Subject(s)
Genes, Immunoglobulin , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Lymphoma/diagnosis , Malaria/complications , Polymerase Chain Reaction , Splenic Neoplasms/diagnosis , Splenomegaly/diagnosis , Adult , Aged , Diagnosis, Differential , Female , Genes, Immunoglobulin/genetics , Ghana , Humans , Male , Middle Aged , Splenomegaly/etiologyABSTRACT
Plasma Fibrinopeptide-A (FpA) concentrations were determined using Enzyme-linked Immunosorbent Assay (ELISA) in patients with acute Plasmodium falciparum malaria infection and in 30 healthy controls. The mean FpA levels of the malaria patients were significantly raised (p < 0.001). The patients' FpA level correlated positively with malaria parasitaemia, but negatively with plasma fibrinogen concentration. A week after commencement of chloroquine therapy and subsequent disappearance of malaria parasites from the thick blood films, the patients' FpA levels decreased significantly from pre-treatment values. It is suggested that the elevated FpA and reduced plasma fibrinogen levels in the patients probably indicate a more widespread existence of overt coagulation defect in acute malaria infection.
