Malaria Infection among Blood Donors in Onitsha Urban; Southeast Nigeria

Blood safety is a major issue of global concern in transfusion medicine especially in developing countries; where national blood transfusion policies and services as well as financial resources are lacking or inadequate. Transfusion-transmitted malaria is a potential health hazard but is often neglected in many malarious areas. Malaria infection among blood donors in Onitsha urban; Southeast Nigeria was studied between August and October 2008. Venous blood of donors was screened for malaria parasites using Giemsa-stained thick and thin blood films. The ABO and Rhesus phenotypes were classified using a haemaglutination standard test and demographic data of donors documented. Of the 410 blood donors analysed; 304 (74.1) were infected. Plasmodium falciparium was identified in all positive cases and mixed infection with P. malariae was seen in 5(1.6) cases. Infection significantly varied with age and not with sex and occupation (p0.05). People with blood group O+ showed significantly higher rate of infection (p0.05). Since there is scarcity of voluntary donors in Nigeria; donor deferral done in non-malarial endemic regions cannot be practiced in Nigeria. The high prevalence of asymptomatic malaria in this area; suggests the need for careful screening of blood samples for malaria parasites. Positive samples should be indicated on the blood packs and transfusion of malaria positive blood requires the administration of curative dose of antimalarials to the patient. Commercial donors should be freely given mosquito treated bed nets and be encouraged to sleep under them

Reproductive Health Knowledge and Practices among Junior Secondary School Grade one Students in Enugu State: Threat to Achieving Millennium Development Goals in Nigeria

Objective: This was designed to provide background information for the implementation of family life and HIV/AIDS education in post primary schools in the Enugu State. Methods: A cross sectional survey of the reproductive health knowledge and practices of 412 junior secondary school pupils from 12 schools in Enugu State; Nigeria was undertaken using a uniform set of structured self-administered questionnaire. Results: The results revealed that while the pupils demonstrated fair knowledge of human biology; they lacked knowledge of selfprotective mechanisms as it related to sexual health. About (50) of the participants reported that they have had sex; at the age of less than 11 years when they must have been in the primary school and most (89.3) at age 11-14 years. Half (50.9) of the respondents hold the belief that a girl would not get pregnant in her first sexual encounter. Statistically more of those who have ever had sex were betrayed this ignorance (p=0.004). The boys were less certain about what constitutes the wrong ideas about reproductive health systems than the girls (p=0.042). In the same vein; there was a difference (p0.0001) in the proportion of the rural residents; vis-a-vis their urban counterparts that could correctly identify the wrong ideas about human reproduction. Conclusion: This situation urgently calls for concerted efforts at addressing the poor reproductive health knowledge of these sexually active young people; for the millennium development goals (MDGs) target to be realized in Nigeria

Onchocerciasis in pre-primary school children in Nigeria: lessons for onchocerciasis country control programme.

There is limited data on the prevalence of onchocerciasis in young children in Nigeria, partly because treatment with the effective drug Ivermectin has been contra-indicated in children less than 5. As the risk of complications of onchocerciasis is related to duration and intensity of infection, it would be beneficial to know the prevalence in young children for design of control programmes. A study was therefore undertaken to determine the prevalence of onchocerciasis in 642 children 0-4 years old in a rain forest endemic community in South East Nigeria. The overall onchocerciasis prevalence (positive skin snips) for children 0-4 years old in three Local Government Areas in Enugu State, Eastern Nigeria was 15.7% with no significant difference in infection rates between male and female children. There was no detectable infection in children less than 1 year old. Characteristic onchocercal rash was identified in 11.1% of the children and presence of typical onchocercal subcutaneous palpable nodules in 4.6%. Total prevalence for adults in the same population was found to be 26.9%. This indicates that in onchocerciasis endemic communities, everybody may be at risk of infection irrespective of age.

A school-based schistosomiasis and intestinal helminthiasis control programme in Nigeria: acceptability to community members.

In a population with high prevalences in schoolchildren of infection with hookworm (32.4%), Ascaris (22.9%) and Trichuris (2.5%), visible haematuria (17.9%), micro-haematuria (17%) and proteinuria (47.3%), the knowledge about transmission of schistosomiasis and acceptability of a school-based control programme were assessed. The community perceived schistosomiasis (80.6%) and intestinal helminthiasis (66.5%) as important health problems in school-age children and most people would prefer placement of the control programme in school because it would eliminate transportation cost to the health facility. They welcomed the idea of using teachers for detection of infection and drug administration. The health staff, on the other hand, were willing to work with teachers, but emphasized that teachers should be limited to organizational and supervisory roles while they do tests and administer the drug. This view was also shared by the officials in the state ministries of health and education.

Results of a large scale onchocercosis survey in Enugu State, Nigeria.

The prevalence of onchocercosis was determined in three Local Government Areas (Ezeagu, Oji-River and Uzo-Uwani) in Enugu State, Eastern Nigeria between March 1989 and June 1990. Enugu State was shown to be mesoendemic for onchocercosis. A total of 7472 (26.9%) persons out of 27,831 examined were positive for skin microfilariae. There was no significant difference in infection rates between males (27.6%) and females (26.2%). Of the 118 villages surveyed only five had no inhabitant with skin microfilariae. There was a progressive increase of prevalence to the second decade of life, although 96.6% of cases with skin microfilariae had only a light infection. Onchocercomata prevalence was recorded as 27.3% which tallies with the prevalence of skin microfilariae at 26.9% hence onchocercomata prevalence may be used as a yardstick for predicting skin microfilariae prevalence.

The diagnostic value of haematuria and proteinuria in Schistosoma haematobium infection in southern Nigeria.

Haematuria and proteinuria as detected by chemical reagent strips correlated moderately (r = 0.7) with prevalence and intensity of infection with Schistosoma haematobium in an area of Anambra State, Nigeria. Differences attributable to age and sex were also reflected in a similar pattern, all peaks occurring in the 5-14 year age group. The differences observed with varying levels of intensity and haematuria at both 10 and 50 erythrocytes/microliter (p < 0.001) and proteinuria at 0.3 g/dl (p < 0.01) were statistically significant. At a proteinuria level of 1 g/dl, the observed differences were however not statistically significant (p > 0.5). The percentage of specimens from children (0-14 years) positive for S. haematobium eggs and with at least traces of haematuria and proteinuria (63.4% and 95%, respectively) was higher than in adults (33.3% and 80.2%, respectively). All individuals with more than 50 eggs/10 ml of urine were correctly identified using both indices either separately or in combination. For egg counts of less than 50 eggs/10 ml of urine, false diagnosis occurred in only 5% of all specimens examined. The sensitivity and specificity of haematuria and proteinuria at trace quantities was very high, but haematuria had a higher predictive value for a positive test (PvPt) and was considered the overall better indicator. A combination of both indices did not significantly increase the PvPt. When trace haematuria and moderate proteinuria were combined, both the sensitivity, specificity and PvPt were all above 90%, giving the best overall values in all the combinations made.

The effectiveness of combined control measures on the prevalence of guinea worm disease in Anambra State, Nigeria.

The prevalence of guinea worm Dracunculus medinensis was determined in communities in Anambra State, Eastern Nigeria during the 1984-1985 guinea worm season. Thereafter combined intervention measures which included health education and community participation in pond treatment were introduced in one of the two communities. There was a decrease in disease prevalence from 88.7% to 33% in Group A (372 households) and from 88% to 53% in Group B (368 households), two years after control measures were introduced in Igbeagu community. However, in 345 households in Mpu community without control measures, any decrease was not significant (from 88.7% to 86.5%). Health Education combined with pond disinfection proved to be a much better intervention measure, contributing to the change in attitude and therefore decrease in disease prevalence, than pond disinfection alone.

Strongyloides papillosus: prenatal and transmammary infection in ewes.

The absence of larvae in lambs of six infected and controlled ewes immediately killed at birth without suckling may indicate the absence of prenatal infection. The ewes had larvae in their milk immediately prior to lambing and several hours afterwards. The persistence of infection, even after intestinal infection was removed with thiabendazole at 50 mg/kg body weigh, may be due to the pool of inhibited larvae. All the suckling lambs had patent infections within 4 to 5 days. Infection of suckling lambs with Strongyloides papillosus via milk from their ewes demonstrates the transmammary route of infection of this nematode.

Endemicity, focality and seasonality of transmission of human schistosomiasis in Amagunze Village, eastern Nigeria.

The pattern of transmission of human schistosomiasis was studied in Amagunze Village, eastern Nigeria, during 1986-1987. The prevalence of Schistosoma haematobium in 119 schoolboys aged 5-12 years was 79%. The geometric mean of intensity of infection was 49 eggs/10 ml urine and the frequency of visible haematuria was 25.2%. No S. mansoni infections were demonstrated. A marked seasonality in population density of Bulinus truncatus, B. forskalii and Biomphalaria pfeifferi was demonstrated with reduced densities during the late rainy and early dry seasons. Schistosoma sp. infected B. truncatus were found in the late dry and early rainy seasons in 2 out of 7 major human water contact sites studied. Seasonality and focality of transmission of S. haematobium and its high endemicity in the area were thus demonstrated.

The development of the free-living stages of Strongyloides papillosus. I. Effect of temperature on the development of the heterogonic and homogonic nematodes in faecal culture.

Temperature had a significant effect on the proportion of free-living females and infective larvae of Strongyloides papillosus developing from faecal culture. The number of free-living males recovered from cultures incubated at 20 degrees C and 30 degrees C was fairly constant. However, females were most numerous at 30 degrees C and infective larvae at 20 degrees C, with the sum of the two approximately the same at both temperatures. This indicates that infective larvae and females are developing from genetically identical eggs. The critical period by which the course of development has been fixed occurs between 4 and 5 h at 30 degrees C, but between 4 and 24 h at 20 degrees C.

The migration of Strongyloides papillosus in rabbits following infection by the oral and subcutaneous routes.

For the first 66 hours after the subcutaneous injection of rabbits with the infective larvae of Strongyloides papillosus, larvae spread gradually from the injection site to other parts of the body musculature. Their number and distribution suggests that they do so by the direct penetration of the tissues as the majority remain close to the site of injection. By 90 hours, however, the appearance of larvae in the lungs, trachea and oesophagus suggests that migration is taking place within the circulation. Although some 90% of the total worms recovered were already established in the intestine by 8 days post-infection, significant numbers of larvae continued to be present in the muscles at 14 and 21 days. Even by 35 days the muscles of 1 of 2 rabbits still contained 43 larvae. This prolonged presence of Strongyloides papillosus in the muscle of rabbits uniformly at the early fourth stage may be analogous to the arrested development of other nematodes. While there is evidence to suggest that immunity is a major factor in the aetiology of arrested development in Strongyloides ransomi, it is an unimportant factor in the case of Strongyloides papillosus in rabbits.

Chromatin diminution and a chromosomal mechanism of sexual differentiation in Strongyloides papillosus.

Eggs obtained from feces of rabbits infected with Strongyloides papillosus were squashed and the karyotypes were determined. They contained cells with either two long and two medium sized chromosomes (2L2M), or one long, three medium and one short chromosome (L3MS). Two types of parasitic female gonad could be distinguished on the basis of oocyte chromosome morphology at prometaphase of the maturation division. All the oocytes in a gonad contained either two upaired long chromosomes and two unpaired medium sized chromosomes, or two unpaired medium sized chromosomes and two unpaired chromosomes segmented into beads in one region. At the maturation division in mitotic parthenogenesis the beads appear to be lost from one of the chromosomes. This generates a medium sized and a shorter chromosome, which together with the undiminished chromosomes make up the L3MS karyotype. Animals with beaded oocyte chromosomes lay eggs that develop into males. It is suggested that males are heteromorphic for the long homologue due to chromatin diminution, that occurs in the maturation division of mitotic parthenogenesis.