Risk assessment of waterborne infections in Enugu State, Nigeria: Implications of household water choices, knowledge, and practices.

This research investigated the prevalence of waterborne infections (WBIs) and the risks associated with household drinking water choices, knowledge, and practices. A cross-sectional multi-stage sampling research design was employed. A well-structured questionnaire was used to sample 403 individuals representing 115 household; and stool samples collected and subjected to standard parasitic and bacterial diagnostic methods. From the 403 samples, 344 (85.4%) were positive for at least one waterborne pathogen of nine isolates: E. coli (38.0%), Giardia lamblia (35.2%), E. histolytica (33.0%), Salmonella typhi (19.9%), Proteus spp. (13.2%), Shigella dysentery (9.4%), Klebsiella spp. (7.4%), Enterobacter spp. (5.5%), and Cryptosporidium spp. (5.2%). Prevalence of WBIs was >75% in all age groups, but decreased with age. Prevalence of WBIs was >80% in all communities. Risk was not biased by gender. Odds of infection from public well (OR = 2.487; CI95: 1.296-4.774) and borehole/vendor (OR = 2.175; CI95: 1.231-3.843) users was over two times greater than non-users. Risk of WBDs was significantly reduced by 60% in sachet water drinkers (OR = 0.392; CI95: 0.217-0.709; p < 0.05). Surprisingly, river/stream water users had a significant reduced risk of WBDs than non-users (OR = 0.335; CI95: 0.150-0.749; p < 0.05). Poor hygiene was the most important determinant of WBIs; poor sanitary practice increased odds of WBIs by 400% (OR = 4.945; CI95: 2.358-10.371; p < 0.05). This study shows that most household water choices are vulnerable to contamination at many points in their journey from source to mouth; and advocates adequate provision of safe water, "point of use" household water treatment, and good storage methods to effectively curb WBIs.

Corrigendum: Mapping of Urinary Schistosomiasis in Anambra State, Nigeria.

This article details a correction to the article: Ndukwe, Y.E., Obiezue, R.N.N., Aguzie, I.O.N., Anunobi, J.T. and Okafor, F.C., 2019. Mapping of Urinary Schistosomiasis in Anambra State, Nigeria. Annals of Global Health, 85(1), p. 52. DOI: http://doi.org/10.5334/aogh.2393.

Mapping of Urinary Schistosomiasis in Anambra State, Nigeria.

BACKGROUND: Mapping the distribution of parasitic diseases in time and space has a pivotal role to play in their control. OBJECTIVE: This study mapped urinary schistosomiasis in Anambra State. METHODS: Sampling covered the three senatorial districts, Anambra North, Anambra Central and Anambra South. However, only nine of the 21 local government areas (LGAs) and one town in each LGA were covered. A geographic information system (GIS) was used to map the distribution of schistosomiasis in the state. With the aid of GIS, the distance of the towns to water bodies was calculated. A total of 450 urine samples collected from the nine LGAs were examined for haematuria and Schistosoma haematobium eggs. A questionnaire was used to assess exposure and risks status to infection. The urine samples were examined for haematuria using dipstick and microscopy. FINDINGS: Overall prevalence of infection in the study was 2.9% and 5.5% for microscopy and haematuria, respectively. Prevalence of schistosomiasis was different between the districts, and this was statistically significant (χ² = 7.763, p = 0.021). Prevalence of urinary schistosomiasis in the towns had a significant negative linear relationship with distance to water body (r = -0.767, p = 0.016). Based on infection status from microscopy, the adjusted odds of infection in fishers was over 103 times higher than in students; the difference was significant statistically (AOR = 103.0443, 95% CI = 4.6278-7093.972, p = 0.0114). People who washed things in stream had 12 times significantly greater odds of infection than those that did not (AOR = 12.4585, 95% CI = 1.9590-258.8108, p = 0.02542). The distance of respondents to stream was a major determinant of infection with urinary schistosomiasis in the state. Those who lived close to water were approximately 1131% more likely to be infected than those who lived far from water bodies (AOR = 11.3157, 95% CI 2.2473-90.6889, p = 0.00713). CONCLUSION: Anambra State is endemic for urinary schistosomiasis. There is therefore a need for focal studies; and there may probably be a need to design a health program aimed at controlling the infection in focal areas in the state. The study also provides relevant information for designing a plan of action for the selective integrated and targeted control of urinary schistosomiasis in the LGAs.

Improved infant hemoglobin (Hb) and blood glucose concentrations: The beneficial effect of maternal vitamin A supplementation of malaria-infected mothers in Ebonyi State, Nigeria.

One hundred and fifty-two malaria-infected pregnant women whose pregnancies had advanced to the 6th month were randomised into two study groups - supplemented and placebo groups, after obtaining their approved consents. Ten thousand international units of vitamin A soft gels were administered to the supplemented group three times per week. Vitamin A soft gels devoid of their active ingredients were administered thrice weekly to the placebo group. Two hundred thousand international units of vitamin A was administered to the supplemented groups within 8 weeks postpartum. Placebo was given to the control group at same time after delivery. The regimen was continued in the two groups at three-month intervals until 12 months. Quarterly, 3 ml of venous blood was collected from each infant in the two groups and was used for the estimation of hemoglobin concentrations and determination of blood glucose levels. Hemoglobin concentrations were estimated using hemiglobincyanide method while the blood glucose levels were determined with a glucometer. Analysis of variance, Fisher's least significant difference and t-test were used for data analysis. Statistical significance was established at p < 0.05. Both hemoglobin concentrations and blood glucose levels were significantly (p < 0.05) higher in the supplemented group than in the placebo group. The malaria infection mitigating effects of maternal vitamin A supplementation have been established in the present study and supported by previous studies. Vitamin A supplementation, fortification of foods with vitamin A and diversification of diets, are advocated for maintenance of good health and protection against some infectious diseases.

Ultrasonographic screening of urinary schistosomiasis infected patients in Agulu community, Anambra state, southeast Nigeria.

BACKGROUND: The pathology of Schistosoma haematobium infection in 60 infected primary school children in Agulu community, Anambra State, southeast Nigeria, with over 50 ova/10 ml urine was assessed. METHODS: The ultrasonographic examination was done using a sector scanner with convex probe. World Health Organisation method was used for classification and scoring of lesions. T-test and Coefficient of determination were used in analysis. RESULTS: The pathologic effects due to S. haematobuim identified among the study group included irregularity of the bladder wall (25%), thickening of the bladder wall (10%) and massing of the bladder wall (3.3%). About 4(6.7%) and 1(1.7%) of the patients had the right pelvis and left pelvis of their kidney moderately dilated respectively. Identified bladder wall lesions had 69 scores while kidney dilation had 30 scores. The number of individuals with lesions correlated with intensity of infection. Male pupils (65.2%) had more lesions than females (34.8%). The difference observed in lesion distribution among males and females was found to be significant (df = 6, p < 0.05). All bladder and kidney lesions responded favorably to treatment with praziquantel (40 mg/kg-body weight). CONCLUSION: Health education campaign including showing the community members evidence of damages to the organs (from the ultrasound pictures) will go a long way in the control and prevention of the disease in this community.