Contribution of groundwater to dietary requirements of essential metals in Lagos and Ogun States, Nigeria.

Knowledge of dietary intakes of essential elements in groundwater is important for proper assessment of the actual contribution of drinking water to daily nutrient requirements. This study assessed the daily intake of nutritional elements in drinking groundwater of Lagos and Ogun States of Nigeria. One hundred and seventy (170) water samples were collected and analyzed for thirteen (13) nutritional elements (K, Mg, Ca, Co, Fe, Cu, Zn, Mo, Se, Na, Mn, Cr, and I) by Inductively Coupled Plasma-Mass Spectrometry (ICP/MS). Chronic daily intake CDI of the nutritional elements was higher for children and infants than adults in all cases. Percentages of tolerable daily intake reference value (TIRV) obtained for Lagos State groundwater were Mg 0.425%, Ca 0.309%, Fe 14.0%, Cu 1.84%, Zn 6.25%, Mo 0.057%, and Mn 1.08%; for Ogun State groundwater, % TIRV were Mg 1.99%, Ca 0.586%, Fe 81.1%, Cu 2.12%, Zn 9.21%, Mo 1.16%, and Mn 0.023%. The order of dermal absorption by an adult in Lagos when the water is used for bathing daily was Cr > Mn > Fe > Zn > Cu while the order in Ogun was Fe > Mn > Zn > Cu > Cr. The research concluded that groundwater alone cannot provide enough essential elements for human dietary needs in the study area.

In vivo anthelmintic potentials of Gongronema latifolium and Picralima nitida against gastrointestinal parasite (Heligmosomoides bakeri).

Gastrointestinal parasites which are responsible for soil-transmitted helminthiases cause illness globally. The control of helminthiasis depends on mass distribution of anthelmintics which has been reported for its resistance, toxicity and low efficacy. In this study, anthelmintic potentials of Gongronema latifolium and Picralima nitida which have wide application in traditional medicine were determined in vivo using Heligmosomoides bakeri a naturally occurring gastro-intestinal parasite of rodents that is closely related to highly prevalent human nematode parasites. Extracts of P. nitida at 500 mg/kg had higher (p< 0.05) chemosuppression (92.45 %) than extracts of G. latifolium (65.82 %) and was highly comparable to albendazole (92.61 %). As the dose of the extracts increased from 300 to 500 mg/kg body weight, chemosuppression of 84.91 % and 92.45 % (P. nitida) and 43.54 % and 65.82 % (G. latifolium) respectively were produced. The extract of P. nitida gave deparasitization rates (p<0.05) of 72.60 % and 77.16 % at 300g/kg and 500mg/kg of body weight respectively. The glucose level and protein content reduced (p<0.05) in mice treated with extract of P. nitida when compared with extract of G. latifolium and untreated mice. Phytochemical screening revealed that P. nitida and G. latifolium contained flavonoids, alkaloids, saponins, tannins and polyphenols. Acute toxicity studies showed that Gongronema latifolium and Picralima nitida have no apparent toxic effect in mice even at the dose of 5000 mg/kg. Extracts of P. nitida and G. latifolium have anthelmintic properties that are dose-dependent, and this could offer potential lead for the development of safe, effective and affordable anthelmintics.

Cultural adaptation and psychometric evaluation of the Yoruba version of the Health Literacy Questionnaire.

Background: Health literacy is an important multidimensional concept of public health concern and a determinant of health outcomes and access to healthcare which requires robust measurement. The objective of this study was to culturally adapt and establish the psychometric properties of the Yoruba version of the Health Literacy Questionnaire. Methods: A cross-sectional survey of Nigeria Yoruba speaking adults was conducted with the Health Literacy Questionnaire following its translation and adaptation. Data were subject to psychometric evaluation (confirmatory factor analysis, composite reliability, Cronbach's alpha, intra class correlation) and association with sociodemographic variables. Results: A total of 258 adults with mean age 26.7 years participated in the study. The easiest scale to score highly was 'Actively managing my health' and hardest was 'Ability to find good health information' and 'Navigating the healthcare system'. Six one-factor models fitted well without correlated residuals but the other three had a good fit after model modification. Composite reliability and Cronbach's α of ≥ 0.7 were observed for all scales, suggesting good internal consistency of the scales. Test-retest reliability of the Yoruba translation of the Health Literacy Questionnaire was moderate to good in all scales, intra class correlation ranging from 0.66 to 0.76. Conclusion: The Health Literacy Questionnaire was successfully translated and culturally adapted and demonstrated good content and construct validity and high composite reliability. The Yoruba translation of the Health Literacy Questionnaire has the potential of being a useful clinical tool for the assessment of health literacy, especially among Yoruba speaking community of Nigeria. Thereby helping to improve the health outcomes through access to healthcare.

Translation and psychometric evaluation of the Yoruba version of the STarT Back tool among persons with long-term non-specific low-back pain.

Conclusion: The Y-SBT have acceptable psychometric properties. It is recommended for use among Yoruba speaking patients with LBP. Background: Translating questionnaires into local languages is essential as it aids easy accessibility and understanding of such questionnaires by patients and their health caregivers. The STarT Back Tool (SBT), validated tool used to classify subgroups of persons with Low-Back Pain, has few translated versions. We translated the STarT Back Tool into the Yoruba language and established its psychometric properties among patients with long-term non-specific Low-Back Pain. Methods: Following the Lenz protocol, the SBT was successfully cross-culturally adapted into the Yoruba language. One hundred consenting patients (mean age = 57.0±11.43 years, 55% females) took part in the validation phase, while 53 of them participated in the test-retest phase. Psychometric indices of the Y-SBT assessed showed internal consistency, intraclass correlation coefficient (ICC), ceiling and floor effects and divergent validity. Results: The sub- and total Cronbach's α score for Y-SBT was 0.704 and 0.857, respectively. The test-retest reliability of the sub- and total scores of the Y-SBT yielded an ICC of 0.82 (95% CI: 0.74 - 0.87) and 0.89 (95% CI: 0.84 - 0.93), respectively. The divergent validity for sub- and total-scores of the Y-SBT based on Quadruple Visual Analogue Scale score for on-going pain was r = 0.374 (p = 0.001) and r = 0.432 (p = 0.001), respectively. The Y-SBT had no ceiling or floor effects.

Varying levels of protection against Plasmodium falciparium infection were conferred on non-users of long lasting insecticidal nets (LLINS) sleeping in rooms where different number of LLINS were hung in hyper endemic state of West Africa.

The use of Long Lasting Insecticidal Nets (LLINs) has greatly reduced the health and economic impact posed by malaria. This study evaluated the residual effect of LLINs on malaria parasite infections among non-LLIN users sleeping in rooms where nets were hung. This study was carried out at Federal University of Agriculture Abeokuta, Ogun State, Nigeria. A total of 259 students were systematically recruited into this study and were classified into two groups of LLINs users and non-users. The LLIN users were further classified according to the proportion of net usage and this includes; < 50%, exactly 50% and > 50% respectively. Finger prick blood samples were collected from the participants and microscopically analysed for the presence of parasites. Demographic characteristics were also recorded. A general prevalence of 40.5% positivity for malaria was recorded among the study population. A significantly high prevalence (p < 0.05) of malaria was recorded among non-users of LLINs compared to users (AOR 4.66, 95%CI 1.27-17.06). A significantly low prevalence of malaria parasite infection was recorded among non-users of LLINs occupying rooms where LLINs was hung compared with non-users from rooms where LLIN were not used. Furthermore, a reduction in prevalence of malaria and parasite densities was observed among non-users of LLINs (occupying rooms where LLINs was hung) as the proportion of LLIN usage increased in such rooms (p < 0.05). This study showed that some level of protection may be conferred on non-users of LLINs staying in rooms where LLINs are hung.

Translation, cross-cultural adaptation and psychometric evaluation of yoruba version of the short-form 12 health survey.

Conclusion: This is the first study to assess the psychometric properties of the Y-SF-12. It appears to be valid and may be an appropriate tool for assessing health-related quality of life among Yoruba population. The tool may help to improve the health outcomes of individuals, and redress health inequalities in low and middle-income countries. Background: Short Form 12 (SF-12) health survey has found its utility in clinical and research settings because of its short length that spares time. Though several translations into other languages do exist there is none available in Yoruba language. Hence, this study's objective was to culturally adapt and determine the reliability and validity of the Yoruba translated version of the SF-12. Methods: Forward and backward translations of SF-12 into Yoruba version of SF-12 (Y-SF-12) were done using the International Quality of Life Assessment Project Guidelines. Healthy participants were assessed using both English and Yoruba versions of SF-12 for the validation phase, and two weeks later were reassessed with the Y-SF-12 for the reliability phase. Results: Participants were 225 males and 171 females. The mean scores for each scale range from 73.4 to 86.1, with no gender difference. All scale and domain scores evidenced a negative skew and ranges from -1.79 to -0.62. Concurrent validity (0.879 - 0.938) and convergent validity (0.786 - 0.907) appeared to be good as reflected by their correlation values. The internal consistency of Y-SF-12 was good as Cronbach's Alpha ranged between 0.899 and 0.968, while the Intraclass Correlation Coefficient (ICC) ranged between 0.775 and 0.949.

Cross-cultural adaptation and psychometric evaluation of the Yoruba version of the Back beliefs questionnaire among patients with chronic low-back pain.

PURPOSE: To translate, culturally adapt and conduct a psychometric evaluation of the Yoruba version of the Back Beliefs Questionnaire (BBQ) among patients with chronic low-back pain. METHODS: The English version of the BBQ was translated into the Yoruba language through a process of forward-backward translation, reconciliation and harmonization of the reconciled items sequentially. Thereafter, Cronbach's Alpha, Intra-Class Correlation (ICC), Bland-Altman's analysis were used to determine the internal consistency, test-retest reliability and limits of agreement of the Yoruba version of the BBQ (BBQ-Y). Other psychometric properties of the BBQ-Y explored comprised acceptability, standard error of measurement (SEM), minimal detectable change (MDC), convergent validity and floor and ceiling effects. While 119 respondents participated in the validity testing, only 51 of them were involved in the reliability testing of the BBQ-Y. Data were analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05. RESULTS: The mean age of the respondents all the respondents was 56.8 ± 8.5 years. The BBQ-Y had excellent acceptability with a global Cronbach Alpha score of 0.71. The SEM and MDC of the BBQ-Y were 2.3 and 6.4. The BBQ-Y ICC score for test-retest was 0.89, while the Bland-Altman analysis showing limits of agreements for the test-retest reliability were - 6.84 and 5.70. The convergent validity of the BBQ-Y showed a weak correlation (r = 0.273, p = 0.001) with pain intensity using the visual analogue scale. CONCLUSION: This is the first study to culturally adapt the BBY-Y and determined its psychometric properties. The BBQ-Y has adequate psychometric properties and it is an appropriate outcome measure for use among Yoruba speaking patients with chronic low-back pain.

Elemental enrichment of sediments in an unprotected shallow groundwater of Lagos and Ogun States, Nigeria.

Sediments quality is a good indicator of pollution in a water body where various elements were concentrated. Limited information is available on sediments from hand-dug wells. The present study evaluates sediment samples collected from groundwater of Lagos and Ogun States, Southwest Nigeria. Twenty sediment samples were collected from shallow groundwater, and ten rock samples were also collected from the vicinity of recently dug wells. Trace elements were determined in both the sediments and the rock samples using inductively coupled plasma-mass spectrometry. The enrichment factor was calculated for different elements using Fe, Ti, Mn and Cu as normalizing elements. The order of sediment contamination with each normalizing elements are Cu > Mn > Ti > Fe. The geo-accumulation (Igeo) indexes for Cr, Pb, Cu and Ni are 1.31, 1.05, 1.94 and 1.85, respectively. The Igeo for Lagos sediments is in the order Cr > Pb > Ni > Cu, while in Ogun sediments the order is Cu > Ni > Cr > Pb. The results were compared with Canadian Council of Ministers of Environment values of threshold effect level and probable effect level, which shows the sediments are not toxic. The pollution load index and ecological risk index values are 2.463 and 0.0014, respectively, which further indicates the sediments are not toxic in nature. The major source of most elements in sediments is the host rocks found in the vicinity of the groundwater while high level of some elements recorded in sediments are from the anthropogenic sources.

Type 1 immune-mediated polyarthritis in dogs and lack of a temporal relationship to vaccination.

OBJECTIVES: To investigate whether there is a temporal relationship between vaccination and the onset of type 1 immune-mediated polyarthritis in dogs. MATERIALS AND METHODS: Retrospective case-control study: 39 dogs from a referral hospital with a diagnosis of type 1 immune-mediated polyarthritis were age-matched with 78 control dogs with other diagnoses. A temporal association between vaccination and polyarthritis was considered positive if recent vaccination had been performed within 28 days of the onset of clinical signs of immune-mediated polyarthritis. The odds ratio association of recent vaccination with immune-mediated polyarthritis was calculated using matched case-control methods. RESULTS: Of the 39 dogs in the type 1 immune-mediated polyarthritis group, four had been vaccinated within 28 days before onset of clinical signs compared to six dogs in the control group. The odds ratio for a dog developing type 1 immune-mediated polyarthritis if vaccinated within the last 28 days was estimated to be 1·44 (95% confidence interval 0·25 to 8·24, P = 0·88). CLINICAL SIGNIFICANCE: There was no evidence of a temporal relationship between vaccination and type 1 immune-mediated polyarthritis, although the large confidence interval on the odds ratio suggests a need for larger studies to confirm this finding.

Evaluation of rare earth elements in groundwater of Lagos and Ogun States, Southwest Nigeria.

Rare earth elements in our environment are becoming important because of their utilization in permanent magnets, lamp phosphors, superconductors, rechargeable batteries, catalyst, ceramics and other applications. This study was conducted to evaluate the level of rare earth elements (REE) and the variability of their anomalous behavior in groundwater samples collected from Lagos and Ogun States, Southwest, Nigeria. REE concentrations were determined in 170 groundwater samples using inductively coupled plasma-mass spectrometry, while the physicochemical parameters were determined using standard methods. Lagos State groundwater is enriched with REE [sum REEs range (mean ± SD)]; [0.365-488 (69.5 ± 117)] µg L-1 than Ogun State groundwater [sum REEs range (mean ± SD)]; [1.14-232 (22.6 ± 41.1)] µg L-1. Boreholes are more enriched with REEs than wells. Significant (P < 0.05) positive correlation (R = Pearson) was recorded in Lagos State groundwater between sum REEs and Fe (R = 0.55). However, there were no significant correlations between sum REEs, pH (R = 0.073) and HCO32- (R = 0.157) in Ogun State groundwater. Chondrite-normalized plot shows that Lagos groundwater exhibits positive Ce anomaly, while Ogun State groundwater does not. The source of REE in Lagos State may be from the ocean and leaching from wastes dumpsites, while the source in Ogun State groundwater may be from the rocks.

Dengue virus specific Immunoglobulin G antibodies among patients with febrile conditions in Osogbo, Southwestern Nigeria.

Dengue fever is becoming one of the major public health problems in the world and its distribution has been premised on the migration of people from infected regions. This study was carried out to determine the prevalence of dengue virus IgG antibody among the patients with febrile conditions attending health facilities in Osogbo metropolis, Southwestern Nigeria. The blood samples collected between July and September, 2014 were tested for Plasmodium falciparum and the sera were subsequently subjected to Enzyme Linked Immunosorbent Assay (ELISA) to detect the dengue virus IgG antibody. Of the hundred consented participants screened, 77% were sero-positive for dengue virus IgG antibody while 41% were positive for P. falciparum. Thirty-three (33%) of the participants were positive for both dengue virus IgG antibody and P. falciparum. No significant difference was found in the prevalence of dengue virus IgG antibody and malaria among the participants (P>0.05). The high prevalence of dengue virus IgG and malaria signifies the need by the government of Osun State to sensitize residents and institute urgent measures to mitigate the resultant effects of morbidity and mortality due to dengue fever and dengue hemorrhagic fever which has hitherto appeared to be alien to the area.

Toxic elements in groundwater of Lagos and Ogun States, Southwest, Nigeria and their human health risk assessment.

A good quality drinking water is essential for human survival. However, a large percentage of the populations in most developing countries (Nigeria inclusive) do not have access to potable water. This study was therefore conducted to assess the extent of risk arising from consumption of toxic elements in groundwater samples collected from Lagos and Ogun States, Southwest, Nigeria. Twelve toxic elements concentrations (As, Mn, Cd, Cr, Pb, Ni, Al, Ti, V, Hg, Li, and Sn) were determined from 170 groundwater samples using inductively coupled plasma-mass spectrometry, and the physicochemical parameters were determined using standard methods. The pH results revealed that most of the water samples were slightly acidic. Of the twelve toxic elements, only Mn, Cd, Pb, Ni, and Al have concentrations higher than the WHO recommended limit in drinking water. The average dose of Mn and Al consumed daily from groundwater by an adult in Lagos state is 3.4 and 23.2 (µg/kg body weight), respectively. Similarly, an adult in Ogun State consumed an average daily dose of 6.09 and 25 (µg/kg body weight) Mn and Al, respectively. A greater threat was posed to children and infants. The order for risk of cancer in groundwater from Lagos State was Pb > Cr > As > Cd while the order in Ogun State groundwater was Cr > Cd > As > Pb. The relative high concentrations of Mn, Al, and Pb obtained in this study can be attributed to industrial and anthropogenic activities in the study area. Treatment of groundwater before consumption is recommended to avoid possible adverse cumulative effect. Improved waste disposal methods and regular monitoring of toxic elements in groundwater of the study area should be adopted to safeguard human health.

Transcatheter closure of patent ductus arteriosus and atrial septal defect without on-site surgical backup: a two-year experience in an African community.

Congenital heart disease contributes significantly to the health burden of children in Nigeria. Interventions for congenital heart disease have been available in the developed world since the first report on device closure of patent ductus arteriosus (PDA) in 1967 by Porstmann. However, this did not start in Nigeria until October 2010. This study aimed to document the profiles of the patients who had undergone interventions for congenital heart diseases since the availability of the procedure, the challenges encountered, and the prospects associated with the interventions at the study site. All the patients referred to undergo interventions for congenital heart disease at the study center between October 2010 and 2012 were studied. The profile of the patient, including diagnosis at referral, indication for interventions, and interventions performed, were documented. The patients ranged in age from 3 to 62 years (mean age, 13.54 ± 17.7 years), and the male-to-female ratio was 1:3. The diagnosis at referral included PDA in 10 (83 %) of the 12 patients and secundum atrial septal defect in 2 patients (17 %). They all had transcatheter closure of the defects. Interventional procedures for congenital heart diseases currently are available locally, but the high degree of manpower training required, the cost, and the local availability of consumables are major factors limiting their use. Regional and international collaboration could be mutually beneficial.

Physical inactivity is associated with low self efficacy and social support among patients with hypertension in Nigeria.

BACKGROUND Physical inactivity is a major factor in the development of many chronic illnesses, including hypertension. Evidence highlighting links among physical activity participation and psychosocial constructs such as self efficacy, social support and perceived barriers among hypertensive patients in the Nigerian population is scarce. This study explored the associations between physical activity and each of self efficacy, social support and perceived barriers. METHODS Two hundred and twelve patients receiving treatment in two tertiary health institutions located in Ekiti State, Nigeria were surveyed cross-sectionally. Physical activity level, self efficacy, social support and perceived barriers were measured with the International Physical Activity Questionnaire, Exercise Self-Efficacy Scale, Medical Outcomes Social Support Scale and Exercise Benefits and Barrier Scale respectively. RESULTS Level of physical activity was significantly associated with self efficacy (r(s) = 0.67, p < 0.01, = 0.45) and social support (r(s) = 0.80, p < 0.01, = 0.64), with most participants (56.1%) being physically inactive. However, no association was found between physical activity level and perceived barriers (r(s) = 0.07, p > 0.01, = 0.005). CONCLUSION Most of the hypertensive patients presented with low levels of physical activity. Physical activity was associated with psychosocial constructs including self efficacy and social support but not with perceived barriers.

Comparative Study on the Effects of Chloroquine and Artesunate on Histopathological Damages Caused by Plasmodium berghei in Four Vital Organs of Infected Albino Mice.

The aim of the present study was to investigate the positive influence of chloroquine and artesunate on the pathological damages caused by Plasmodium berghei on vital organs of mice in an established infection. Healthy adult albino mice with average weight of 25 g were used for the study. Treated group was administered orally with 100 mg/kg of chloroquine and artesunate, respectively. Control animals were given water for the same period. Histological examination of the liver, spleen, lungs, and kidney revealed absence of accumulation of iron (haemosiderosis) in the liver, thickened alveolar wall, and interstitial mononuclear cells infiltration in the lungs of the artesunate group, while absence of emphysema in the lungs and megakaryoblast hyperplasia in the spleen was observed in the chloroquine group. Lymphoid hypoplasia in the chloroquine group and megakayoblast hyperplasia in the artesunate group were observed but not in the control group. Thus, the use of these drugs especially under the practice of self-medication should be prohibited in lands where they are still in use as antimalaria medicine.

Effects of intrathecally administered fentanyl on duration of analgesia in patients undergoing spinal anaesthesia for elective caesarean section.

BACKGROUND: Intrathecal opioids have gained popularity in obstetrics; they augment the analgesia produced by local anaesthetic agents. The aim of this study is to determine the duration of analgesia following addition of fentanyl to bupivacaine during elective Caesarean section. METHOD: This is a prospective randomized study comparing the effect of addition of 25 microg of fentanyl to 2.5 mls of 0.5% hyperbaric bupivacaine intrathecally on sixty healthy women of American Society ofAnaesthesiologist (ASA) physical status I scheduled for elective Caesarean section at the UCH, Ibadan. Patients were randomized to group B, n=30 and group FB, n=30. Maternal heart rate, blood pressure, respiratory rate, sensory level, motor block, pain score (NRS) and side effects were observed every 2 minutes for first 15 minutes, then at 5 minutes interval for the remainder of the operation. Thereafter at 30 minutes interval until the first complaint of pain. RESULTS: Complete analgesia (time from injection of intrathecal drug to first report of pain) lasted longer in group FB (240 +/- 29 minutes) than group B (99 +/- 12 minutes) with a p-value of 0.002. The duration of effective analgesia (time from injection of intrathecal drug to first request for analgesic) in group FB (276 +/- 26 minutes) while group B was (121 +/- 10 minutes) with a p-value of 0.001. Both were statistically significant. CONCLUSION: We conclude that the addition of 25 microg of fentanyl to bupivacaine intrathecally for elective Caesarean section increases the duration of complete and effective analgesia thereby reducing the need for early postoperative use of analgesics.

Subclavian perivascular block for open reduction and internal fixation of left midshaft humeral fracture--a case report.

Traumatic injuries affecting bones of the hand and forearm often require peripheral nerve blocks for analgesia and surgical intervention. The successful use of subclavian perivascular block as a sole anaesthetic for orthopaedic surgery has not been reported in our environment. We report the use of this technique for open reduction and internal fixation of a left midshaft humeral fracture. The trunk of the brachial plexus was localized by a Polystim II nerve stimulator. Complete sensorimotor block was achieved within 15 minutes and surgery lasted 55 minutes without complications. This technique obviated the use of general anaesthesia with its risks. The surgeon and the patient were satisfied with the quality of the anaesthesia.

Population dynamics of indoor sampled mosquitoes and their implication in disease transmission in Abeokuta, south-western Nigeria.

BACKGROUND & OBJECTIVES: A longitudinal study was carried out to investigate the species composition, seasonal abundance, parity and feeding preference of indoor sampled mosquitoes in Abeokuta, south-western Nigeria. METHODS: The mosquitoes were sampled weekly from five stratified locations using Center for Disease Control (CDC) light-traps between August 2005 and July 2006. The mosquitoes were examined for abdominal condition and dissected for age composition. Microscopic and precipitin techniques were also employed for the determination of host blood source. RESULTS: A total of 2969 mosquitoes which belong to 10 species of mosquitoes were collected during the study period. Mansonia africana (35.65%) constituted the most abundant species followed by Culex quinquefasciatus (32.23%) and Anopheles gambiae complex (13.52%). Other species in decreasing order of abundance were Coquilletidia maculipennis (8.2%), Aedes albopictus (5.9%), Ae. aegypti (1.93%), M. uniformis (1.81%), Cx. duttoni (0.25%), Cx. tigripes (0.25%) and An. funestus (0.25%). Seasonal abundance revealed a significant difference (p <0.05) in the population of mosquito vectors collected during the wet season as compared to the dry season and their abundance was positively correlated with rainfall. The results showed that the majority of the vector species collected were unfed and nulliparous. Moreover, the blood meal test was positive for human blood. CONCLUSION: The preponderance of mosquitoes observed in the study is of public health concern since they serve as vectors of most tropical diseases including malaria.

Perceptions and home management practices of malaria in some rural communities in Abeokuta, Nigeria.

A survey was carried out in five rural communities that enjoy agricultural extension services from the University of Agriculture Abeokuta. Questionnaires and focus group discussions (FGDs) were used to assess perceptions and home management practices of malaria infection. The inhabitants considered malaria (which they refer to as "Iba Otutu") has the least dangerous of other types of common fever such as yellow fever and typhoid fever. A vast majority of the respondents (73%) attributed malaria infection to doing of strenuous jobs in the hot sun, while only 11.7% attributed it to mosquito bites. Hunger, eating or drinking of contaminated food or water were other sources of malaria infection mentioned by the respondent. During the FGDs, another source of infection of malaria identified was excessive exposure to heat of fire used in frying cassava (garri), therefore those frying garri and those spreading cassava flakes in the sun were identified as most vulnerable to malaria infection. During the FGD, high level of malaria infection in children was attributed to children playful activities in the sun. It is believed that malaria infection will occur even without mosquito bites but with exposure to these other factors especially the intense heat of the sun. Respondents showed good knowledge of malaria symptoms even in infants and children. However, in the event of malaria infection consumption of herbal preparations is the first line of treatment. Drug hawkers that sell modern drugs in the communities were mainly consulted for malaria treatment. The antimalarial drugs bought were often wrongly used and none of the respondents were aware of the current trend in malaria management with modern drugs. Hospital visitation is usually after many days of persistent illness without improvement despite all forms of self medication. The main measure used against malaria vectors was insecticide coils (74.6%). None of the respondents used insecticide treated net (ITN). Distance, cost and poor quality of hospital treatment were reasons for refusal to seek proper medical care. Health education and improved health care services are recommended for these farmers in order for them to be able to translate extension services provided into maximum agricultural yields.

Traditional birth home attendance and its implications for malaria control during pregnancy in Nigeria.

A longitudinal survey was carried out to assess prevalence of malaria infection among attendees of a traditional birth home (TBH) in the metropolis of Abeokuta, Nigeria. Malaria prevalence was 62.4%, and various degrees of anaemia were recorded in 80.3% of pregnant women. Patronage by pregnant teenagers was 10.8%, with all of them anaemic and 73.9% infected with malarial parasites. Knowledge of malaria transmission and prevention were generally poor, with the emphasis placed on exposure to direct rays and heat from the sun. Avoidance of the sun's heat was therefore considered to be an effective preventive measure; another was the consumption of specially prepared and packaged herbal tea, which the pregnant women were expected to drink daily. Only 36.3% of the women associated malaria infection with mosquito bites. The use of insecticide-treated nets (ITNs) was not recorded among the women, although a large proportion (91.3%) showed a willingness to buy ITNs. The cost of receiving antenatal care at the TBH was higher than that in public hospitals. Patronage of TBHs was observed to be linked more with cultural beliefs than poverty. This study suggests that there is a need to extend malaria control interventions to women attending TBHs.