Perception of malaria infection in two rural communities in Nigeria.

This investigation was concerned with how and when parents and other members of two rural communities (Awi and Ikot Edem Odo) in Cross River State, Nigeria, recognized malaria infection, what they do to prevent the disease, and what triggers their treatment seeking behaviour (cue to action). The psychological and sociocultural contexts of these complex factors were considered. Focus group discussion (FGD) techniques were employed. A total of eight groups selected using theoretical sampling matrix method were categorized. A thirty-three-item FGD battery of guide questions was used. Information and data on knowledge, attitude, and practice (KAP) and the perception of malaria infection were generated. Analysis showed that both communities recognized the symptoms, morbidity and mortality of malaria infection in both adults and children. The mosquito vector was identified among numerous other causes of malaria. The pervasive role of ethnomedical sociocultural, and belief systems on KAP and perception of malaria were revealed. Both communities will likely benefit from health education interventions which recognize the belief systems of the two communities.

Knowledge, attitude and practice of family planning in rural communities in Nigeria.

Maternal and infant mortality rates, coupled with a high population growth rate, are unacceptably high in Nigeria. More recently, the Nigerian government endorsed the promotion of reproductive health, including family planning, through maternal and child health services. The Ohaozara Local Government Area (LGA) introduced a Five-Year Action Plan (FYAP) in 1989. To appraise the Ohaozara Five-Year Action Plan, 600 persons stratified by geographical location and sex were interviewed in three randomly selected autonomous communities in the Ohaozara Local Government Area to determine their knowledge, attitude and practice (KAP). The findings in this study showed a high awareness level with a moderately positive attitude and generally low level of practice. Comprehensive reproductive health education (RHE), budgetary increase, evaluation of FYAP, and program coordination are recommended.

PIP: In 1989, the Ohaozara Local Government Area (LGA) in Abia State (216,342 population), Nigeria, implemented a Five-Year Action Plan (FYAP) that aims to promote reproductive health and to check the high population growth rate. In the autonomous communities of Okposi, Uburu, and Ugwulangwu, interviews were conducted with 600 randomly selected adults in 1991 to learn about their knowledge, attitude, and practice of family planning. 97.3% knew about family planning. This figure is more than 140% higher than the level of awareness targeted for 1992. 67.8% had a positive attitude towards family planning. 36% used family planning methods. Men were less likely to have a positive attitude towards family planning than women (46.3% vs. 98.7%; p 0.001). The Moslem community was significantly less likely to know about, to have a positive attitude towards, and to practice family planning than other faith groups (p 0.001). For example, only 5.8% practiced family planning, compared to 44.9% for Protestants, 33.9% for Catholics, and 44% for traditional groups. Higher income groups were more likely to know about, to have a positive attitude towards, and to practice family planning than lower income groups (p 0.001). Sex and educational levels together influenced knowledge, attitude, and practice of family planning (p 0.001). Occupation had a significant influence on knowledge, attitude, and practice of family planning (p 0.001). For example, artisans and farmers were least likely to know about, to have a positive attitude towards, and to practice family planning. Family planning services were available in Ohaozara LGA but the personnel to provide and monitor activities was inadequate. There was also insufficient funding allocated for health and social welfare efforts. Based on these findings, the researchers recommend comprehensive reproductive health education, a budget increase, evaluation of the FYAP, and program coordination.

Perceived health needs of secondary school students in Uyo, Akwa Ibom State, Nigeria.

Nigeria generally has overlooked the health needs of its adolescents. To determine student perceptions of their health-related needs, some 600 students in Uyo, the capital of Akwa Ibom State, were surveyed, and they identified several concerns. Their responses provided the basis to offer five recommendations for action: improve the quality of school health service facilities and personnel available in the secondary schools; implement a comprehensive national program of drug education and control; provide a healthful school environment; assess the quality and quantity of food provided to students, especially in boarding schools; and implement a comprehensive school health education program in Nigerian schools.

Upsurge of malaria-related convulsions in a paediatric emergency room in Nigeria. Consequence of emergence of chloroquine-resistant Plasmodium falciparum.

From January through December 1988 the causative factor of each case of childhood seizure seen in the Children's Emergency Room of the University of Calabar Teaching Hospital, Calabar, Nigeria, was prospectively studied with a focus on the relative importance of malaria-related seizures. Of the 134 seizure cases seen, febrile convulsion (FC) formed the majority (55%) with cerebral malaria (CM) as the only major (33%) rival. Other conditions such as meningitis, epilepsy, hypoglycaemia and drug poisoning together (12%) played a minor role. Malaria was the dominant cause (73%) of FC; 81% of these cases did not respond to chloroquine. On comparing the number of cases of CM accumulated in the same unit from 1986, there was a significant increase (P < 0.001) in the proportion of yearly CM admissions from 1986 through 1988. The study confirms the premier position of malaria in the causation of childhood seizures and also suggests a possible upsurge in the prevalence of CM in the environment. This upsurge probably derives from the emergence of chloroquine-resistant Plasmodium falciparum (CRPF) reported in Nigeria which appeared to have been identified in the present study. While more studies are needed to confirm this hypothesis, clinicians in areas of CRPF are alerted about a possible upsurge in CM in their locality.

Halophilic Vibrio spp. associated with hard clams (Mercenaria spp.) from the Calabar river estuary.

One hundred and ten hard clams (Mercenaria spp.) harvested from the Calabar river estuary were examined for total platable heterotrophic bacteria and Vibrio spp. in their mantle fluids using estuarine salts agar and thiosulphate citrate bile salts sucrose agar plates respectively. The mean counts of heterotrophic bacteria and vibrios were 7.9 x 10(6) organisms/ml and 2.5 x 10(2) vibrios/ml respectively. The rate of vibrio infection was 58.2%. Of the clams positive for vibrios, 54 (84%) harboured dual infections (V. alginolyticus and V. parahaemolyticus) of the moderate grade (greater than or equal to 10(3) to 10(5) vibrios/ml). Single infections due to V. alginolyticus or V. parahaemolyticus, found in 16% of clams, were either low (less than 10(3) vibrios/ml), moderate (greater than or equal to 10(3) to 10(5) vibrios/ml), or high (greater than 10(5) vibrios/ml). Dual infections only were detected in clams with mantle fluid volumes greater than 30 ml.