Geospatial distribution and predictive modeling of onchocerciasis in Ogun State, Nigeria.

Onchocerciasis caused by infection with Onchocerca volvulus is a disease of public health importance and is highly associated with disability. As Nigeria is aiming at eliminating onchocerciasis by 2030, there is a need to develop newer tools to map disease prevalence and identify environmental factors driving disease prevalence, even in places that have not been previously targeted for preventive chemotherapy. This study produced predictive risk-maps of onchocerciasis in Ogun State. Georeferenced onchocerciasis infection data obtained from a cross-sectional survey at 32 locations between March and July 2015 together with remotely-sensed environmental data were analyzed using Ecological Niche Models (ENM). A total of 107 field occurrence points for O. volvulus infection were recorded. A total of 43 positive occurrence points were used for modelling. ENMs were used to estimate the current geographic distribution of O. volvulus in Ogun State. Maximum Entropy distribution modeling (MaxEnt) was used for predicting the potential suitable habitats, using a portion of the occurrence records. A total of 19 environmental variables were used to model the potential geographical distribution area under current climatic conditions. Empirical prevalence of 9.3% was recorded in this study. The geospatial distribution of infection revealed that all communities in Odeda Local Government Area (a peri-urban LGA) showed remarkably high prevalence compared with other LGAs. The predicted high-risk areas (probability > 0.8) of O. volvulus infection were all parts of Odeda, Abeokuta South, and Abeokuta North, southern part of Imeko-Afon, a large part of Yewa North, some parts of Ewekoro and Obafemi-Owode LGAs. The estimated prevalence for these regions were >60% (between 61% and 100%). As predicted, O. volvulus occurrence showed a positive association with variables reflecting precipitation in Ogun State. Our predictive risk-maps has provided useful information for the elimination of onchocerciais, by identifying priority areas for delivery of intervention in Ogun State, Nigeria.

Status of Intestinal Helminth Infection in Schools Implementing the Home-Grown School Feeding Program and the Impact of the Program on Pupils in Anambra State, Nigeria.

PURPOSE: Intestinal helminthiasis among pupils is a major impediment to their well-being and development. This 2-year study determined how home-grown school feeding programme (HGSFP) impacted on pupils' school attendance and created opportunity for more children to assess interventions geared towards the prevention and possible elimination of intestinal helminthiasis. METHODS: Faecal samples were collected from 1677 consented pupils and examined for helminths using Kato-Katz technique. Pupils were treated with 40 mg Levamisole (anti-helminthic) and re-examined. Structured questionnaires and focus group discussions were used to determine anthropometric indices and risk factors. RESULTS: A 6% prevalence rate which was not significant with respect to sex or age was observed. Helminth parasites observed were Ascaris lumbricoides (4.4%), Trichuris trichiura (0.8%), Hookworm spp. (0.2%), and Taenia spp. (0.5%). Two pupils (1.98%) recorded high intensity of infection (epg) while 98.02% had light infection. Ascaris lumbricoides voided following treatment were 290. The Body Mass Index (BMI) indicated that infected pupils had lower values (14.6317) compared to uninfected pupils (19.2003). The HGSFP significantly improved school attendance by 30%. Lack of knowledge about transmission (P = 0.0004), hand hygiene (P = 0.01) and usage of toilet (P = 0.01) were risk factors observed. CONCLUSION/SIGNIFICANCE: Intestinal helminthiasis remains a public health problem among pupils because environmental and behavioural risk factors persist. HGSFP improved school attendance and created opportunity for more inclusive participation of school-aged children for deworming. This has great potential in fast-tracking the elimination of intestinal helminthiasis. The present study consequently advocates the need to sustain HGSFP in schools.

Analysis of Schistosomiasis and soil-transmitted helminths mixed infections among pupils in Enugu State, Nigeria: Implications for control.

BACKGROUND: Schistosomiasis and Soil-transmitted helminthiasis cause considerable morbidity and mortality in developing countries, especially among children. To this end it, a cross-sectional survey to determine the pattern of Schistosomiasis and Soil-transmitted helminthiasis co-infection was undertaken among primary school pupils in Oduma Community in Enugu State, Nigeria. METHODS: Fresh urine and stool samples were collected from pupils. The urine and stool samples were examined using sedimentation and Kat-Katz techniques respectively. RESULTS: Of the 236 pupils examined, 137 (58.1%) were found positive for at least one helminth infection. Ascaris lumbricoides was the most prevalent soil-transmitted helminth (STH), with a prevalence rate of 40.3%, followed by Trichuris trichiura (15.3%) and hookworm (8.9%). Infection with Schistosoma haematobium was detected in 13.6% of the pupils while Schistosoma mansoni infection prevalence was 7.2%. Age group 4 -7 years recorded the highest prevalence for S. haematobium, A. lumbricoides, T. Trichiura and hookworm infections. Multiple infections were also recorded, with 22.9% having double infections and 2.5% having triple infections. The most common double infection was A. lumbricoides with T. trichiura (8.9%), while the most common triple infection was A. lumbricoides, S. haematobium and hookworm (1.7%). CONCLUSION: The results from the present study revealed an evident need for the systematic and sustained administration of school-based chemotherapy program targeting the control of STH infection and Schistosomiasis using Albendazole and Praziquantel respectively in the community, instead of a one-off approach that was carried out.

Assessment of community knowledge and participation in onchocerciasis programme, challenges in ivermectin drug delivery, distribution and non-compliance in Ogun State, southwest Nigeria.

BACKGROUND: This study reports knowledge of onchocerciasis and surrounding factors from the perspective of community members, Community drug distributors and health workers in eight endemic LGAs of Ogun State, Nigeria. METHODS: Using structured questionnaires and Focus Group Discussion, a total of 417 community members, 37 health workers and 42 CDDs across 16 communities participated in the study. RESULTS: Majority (70.7%) of participants knew the disease by its local name, "Inarun". Community members (62%) identified severe itching as a symptom of the disease while (35.9%) (17.6%) and (9.8%) of participants associated bites of black-flies, physical-exertion on farm and allergies to peanuts as the cause of the disease. Majority (62.2%) of health workers reported the insufficiency of drug-storage facilities at community-health centres. Drug distributors also decried the paucity of funds to facilitate wide therapeutic-coverage. Compliance with drug use was affected by adverse reaction by (4%) Community members, pregnancy (9%) and inability to swallow pills (11.6%). CONCLUSION: To improve onchocerciasis control in Ogun State, public-health-education regarding the disease aetiology needs to be improved. Also, treatment rounds need to be increased to accommodate members who unwillingly missed treatment. Finally, government provision of transport logistics to CDDs for ease of logistics is very important.

Malaria infection at parturition in Abeokuta, Nigeria: Current status and pregnancy outcome.

BACKGROUND: There is dearth of information on perinatally acquired malaria, as well as its burden in Nigeria. We determined the prevalence of pregnancy-associated malaria and its burden among parturients in Abeokuta, Ogun State. MATERIALS AND METHODS: Blood films from 211 parturients were prepared, stained with 10% Giemsa and examined using microscopy. Relevant demographic information was recorded from study participants. Chi-square tests were used to analyse data using SPSS version 20.0. RESULTS: Prevalence of maternal peripheral, placenta and cord blood parasitaemia were 40.8%, 19.0% and 5.7% respectively, and these were significantly correlated with age and gravidity. Prevalence of maternal anaemia was 45.0%, and was significantly associated with malaria infection. The occurrence of Low Birth Weight (LBW) was 10%. Maternal, placental and cord infections with malaria were associated with LBW, with the highest percentage of LBW occurring in babies with high placental malaria parasite density. Preterm delivery and stillbirth were significantly associated with placenta and cord malaria. CONCLUSIONS: Impact of malaria on the mother and the newborns, notably anaemia and LBW, solicits the need for promoting use of available malaria prevention during pregnancy. These include LLINs and IPTp.

Risk factors associated with occurrence of placental malaria in a population of parturients in Abeokuta, Ogun State, Nigeria.

Background: Placental malaria has long been acknowledged as a complication of malaria in pregnancy, and has been associated with poor pregnancy outcome in malaria-endemic areas. This study was conducted to determine the risk factors associated with occurrence of placental malaria in a population of parturients in Abeokuta Ogun State, Nigeria. Materials and Methods: Maternal and placenta blood samples were collected from 211 parturients. Blood films were prepared, stained with 10% Giemsa and microscopically analysed for the presence of parasites. Demographic characteristics were recorded in case record forms. Chi-square tests and a regression model were computed to analyse risks, using SPSS version 16.0. Results: Overall, 40.8% (86 of 211) of the parturients had malaria at the time of delivery, with 19.0% (40 of 211) having placental malaria. We identified being within the age range of 18-22 years [OR = 4.4, 95% CL = 1.1-17.4, P = 0.046], being primigravid [OR = 2.1, 95% CL = 0.9-5.1, P = 0.028] and living in a congested apartment [OR = 1.6, 95% CL = 0.4-6.0, P = 0.029] as significant risk factors for placental malaria. Non-usage of intermittent preventive treatment (IPT) [OR = 2.6, 95% CL = 1.2-5.4, P = 0.018], long-lasting insecticidal nets (LLINs) [OR = 2.7, 95% CL = 1.3-5.5, P = 0.005] were also risk factors for placental malaria. Conclusions: In Abeokuta, the proper use of LLIN and IPT for pregnant women is essential to curb the scourge of malaria, associated risks and poor pregnancy outcomes.

Comparative repellent activities of some plant extracts against Simulium damnosum complex.

The root and leaf extracts of four plants, Occimum gratissimum, Azadirachta indica, Pterocarpus santalinoides, and Pistia hyptis, were studied for repellent activities against the adults of Simulium damnosum sensu lato. The leaves and roots were extracted with 95% ethanol and the stocks were diluted with paraffin. The repellent activities of the extracts were investigated using human baits along the banks of River Oyan and River Ogun in southwestern Nigeria. The results showed that the root extract of O. grattissium and leaf extract of P. hyptis had highest repellent potentials with 78% and 78.1% protection against S. damnosum sensu lato, respectively, whereas the root and leaf of P. santalinoides recorded the least. Although there were significant differences in the percentage of protection of the extracts of the plants (p < 0.05), the variations in the percentage of protection of the leaf and root extracts were not statistically significant (p > 0.05). The study concludes that there exist some repellent efficacies in the extracts of the plants, most importantly O. grattissimum and P. hyptis. The plant extracts can further be developed in the prevention of man-vector contact in onchocerciasis endemic communities.

Awareness, possession and use of insecticide-treated nets for prevention of malaria in children under five in Abeokuta, Nigeria.

AIM: A survey was carried out to assess awareness, possession and use of insecticide-treated nets (ITN) by mothers in preventing malaria among children under 5 years old. METHODS: Pretested questionnaires were administered by trained research assistants to women that have had a child in the last 59 months, irrespective of place of child delivery. RESULTS: Malaria was considered dangerous by almost all respondents (98.5%); the level of awareness of ITN as a malaria preventive tool was 75.1% while possession was 45%. Awareness and possession of ITN were positively and significantly influenced by high educational qualification of mothers and attendance of a public hospital for antenatal care. Hospitals were identified as the major source of awareness among respondents; women that delivered their babies in traditional birth home displayed least awareness (38.6%) and recorded low possession (10%). There was no significant relationship between ITN usage, birth order and age of child. Heat experienced while sleeping under ITN and problem of how to hang the net were major limitations identified in the use of ITN. CONCLUSION: The need to involve women receiving antenatal care outside the hospital in malaria control intervention is hereby recommended. Methods of bridging ITN possession and use needs to de developed.

Biting behaviour of Simulium damnosum complex and Onchocerca volvulus infection along the Osun River, Southwest Nigeria.

BACKGROUND: Studies on biting behaviours and infectivity status of insect vectors are pre-requisites in understanding the epidemiology of the vector- borne diseases and planning effective control measures. A longitudinal study was carried out to investigate the transmission index of Simulium damnosum complex species along Osun River, South Western Nigeria. Adult flies were collected on human attractants from 07:00 to 18:00 hours for two consecutive days from February 2008 to June 2009 at three communities: Osun Eleja, Osun Ogbere and Osun Budepo. The infectivity rate was determined by dissection and Polymerase Chain Reaction amplification (PCR) of 0-150 genes of Onchocerca parasite using the pool screening technique. RESULTS: The results indicated that the majority of the flies collected at the three sampling points were nulliparous as they accounted for 53.90%, 57.86% and 59.58% of the flies dissected at Osun Budepo, Osun Ogbere and Osun Eleja, respectively. The parous rate was higher during the dry season than the wet season but the difference was not statistically significant (p < 0.05). The biting activity of the parous flies showed two peaks at Osun Budepo and three peaks at Osun Eleja and Osun Ogbere. Of the 1,472 flies dissected and 1,235 flies screened by molecular method, none was infected with Onchocerca parasite at the three sampling points however the annual biting rates at the three communities were higher than 1,000 considered as tolerable value for a person living in an onchocerciasis zone by Word Health Organization. CONCLUSION: The study has provided the baseline data for further study on onchocerciasis transmission dynamics and the need to intercept man- simuliid vector contact at the study area.

Urinary schistosomiasis among preschool children in a rural community near Abeokuta, Nigeria.

BACKGROUND: The control of schistosomiasis in Nigeria is mainly by mass treatment with praziquantel through the school system, with an absence of any provision for pre-school children. We therefore determined the prevalence and intensity of urinary schistosomiasis in pre-school children between the ages of 1-6 years in Ilewo-Orile a rural and endemic community, near Abeokuta, Nigeria as part of providing information on the neglected tropical diseases among this age group. Two urine samples were collected from each pre-school child. The samples were tested for microhaematuria using reagent strips and then processed and examined with a microscope for Schistosoma haematobium ova. RESULTS: Of the 167 children examined 97 (58.1%) had infection, with no significant difference (P = 0.809) in infection rates between boys (57.1%) and girls (59.2%). Both prevalence and intensity of infection did not increase significantly with age (P = 0.732). The overall geometric mean egg count was 1.17 eggs/10 ml urine. There was no significant association (P = 0.387) between intensity in boys (1.16 eggs/10 ml urine) and girls (1.19 eggs/10 ml urine). 47.4% of the children had microhaematuria which did not increase significantly with age (P = 0.526). Focus group discussions with guardians and caregivers revealed that infection of pre-school children early in life was due to exposures through bathing in the stream by their mothers, while the older children would visit the stream for washing, fetching of water, bathing and swimming. CONCLUSION: Community participatory health education is needed in this community as a first step in reducing infection and transmission of the disease, while the rehabilitation and repair of the existing water borehole system in the community should be effected. The results of this study have shown that pre-school children also harbour infection and are a source of transmission of schistosomiasis in endemic communities. Planning and provision for their treatment should be considered in control programmes.