Diagnostic accuracy of different urine dipsticks to detect urinary schistosomiasis: a comparative study in five endemic communities in Osun and Ogun States, Nigeria.

The diagnostic accuracy of urine dipsticks was investigated using two different brands in five endemic communities of south-western Nigeria. The BM-5L test was used in 1992 to screen 566 subjects in two communities in Ogun State, while 1457 subjects in three other communities in Osun State were screened with the Combur-9 test in 2006. Haematuria gave a higher prevalence of infection than proteinuria irrespective of which strip brand was used (e.g. BM-5L test: 58.3 and 36.2%; Combur-9 test: 46.5 and 41.9%, respectively). Compared with egg microscopy (gold standard), haematuria identified over 90% of egg-positive samples using either the BM-5L test in 1992 or the Combur-9 test in 2006. The corresponding values for proteinuria were 58% using the BM-5L test and 82% using the Combur-9 test. Sensitivity of haematuria to infection was higher using the BM-5L test (92.4-93.5%) than Combur-9 (58.6-73.3%), while sensitivity of proteinuria to infection was higher using Combur-9 (55.5-80.4%) than BM-5L test (26.0-58.3%). However, both strip brands have comparable specificity for haematuria (BM-5L test, 88.3-99.5%; Combur-9, 88.9-100%) and proteinuria (BM-5L test, 94.4-100%; Combur-9, 98.7-100%) to infection. Based on these results we conclude that neither brand nor manufacturer has a significance effect on the performance of chemical reagent strips. However, the diagnostic value of both haematuria and proteinuria varied according to the positivity level adopted, intensity of infection and age, but was not affected by sex and village of residence.

Acute Otitis media, malaria and pyrexia in the under five age group.

BACKGROUND: Acute Otitis media is one of the most common childhood infections. It is responsible for every third visit to a pediatrician in a developed world. However, in Nigeria there is scanty knowledge about the incidence of Acute Otitis Media (AOM). OBJECTIVE: This study aimed at determining the incidence of AOM among under five year old children presenting with pyrexia, and to compare the incidence of AOM as a cause of pyrexia with the incidence of malaria in pyrexic children. DESIGN: It is a cohort study of 200 children of between the ages of 2 weeks and five years with a rectal temperature of 38 degrees C and above, seen over a period of 3 months. SETTING: The study was conducted at the Obafemi Awolowo University Teaching Hospital (OAUTHC) Comprehensive Health Centre, Eleiyele, and the children emergency room of the OAUTHC, Ile-Ife. PATIENTS AND METHODS: A questionnaire to collect information on the demographic data was administered to each mother/guardian of the patient. Otoscopic examination using a battery-operated hand held otoscope and magnifying lenses were done in addition to general systemic physical examination. Thin and thick blood smears were made for malaria parasite. The dried slides were examined under the microscope using the X 100 objective. Sixteen of the patients' slides were lost after processing. RESULTS: Out of the 200 patients that were studied, 58 (29%) had AOM. The highest incidence was recorded in the age group 12-24 months while the least age of occurrence was found to be the age group 4-5 years. Malaria parasitemia was found in 81 (43.5%) while 21 (25.9%) of those with parasitemia also had AOM. But 76 (36%) of the study population had neither AOM nor malaria parasitemia. CONCLUSION: Acute Otitis media was found in 29% of under five years old presenting with pyrexia. It was found to be highest in the first and second year of life, and was found to be least in the 5th year of life. Malaria was found in 81 (43.5%) of the children, and 21 (10.5%) of the children had malaria with a co-existing AOM.

Effect of water supply and sanitation on the prevalence and intensity of Ascaris lumbricoides among pre-school-age children in Ajebandele and Ifewara, Osun State, Nigeria.

The relationship between Ascaris lumbricoides infection and provisions for safe water supply and excreta disposal was investigated in Ajebandele and Ifewara, 2 peri-urban communities near Ile-Ife, Osun State, Nigeria, from September 1998 to December 1999. Although there were more facilities for safe water supply (pipe-borne and shallow wells) and sanitation (flush toilets and pit latrines) in Ajebandele than in Ifewara, they were not evenly distributed and only a few families, mainly in Ajebandele, were well provided for. Our results indicated that the prevalence of A. lumbricoides was significantly higher in Ifewara (21.2%) than in Ajebandele (13.1%), and within villages was much lower in houses with tap water and flush toilets. However, the mean intensity of infection was unexpectedly higher in Ajebandele (166.5 +/- 692.0) than in Ifewara (153.1 +/- 485.8) suggesting that the present level of investment in Ajebandele is probably not sufficient to reduce morbidity. These findings confirm suggestions that there is a threshold level of investment below which interventions on water supply and sanitation may not significantly improve human health. Sustainable ascariasis control in the study communities will require significant improvements to existing water supplies and sanitation facilities and any future interventions should incorporate a programme of health education to ensure that the facilities provided are properly used and hygienically maintained.

Pediculocidal and scabicidal properties of Lippia multiflora essential oil.

The essential oil from the leaves of Lippia multiflora Moldenke (Verbenaceae) was tested for its pediculocidal and scabicidal activites against bodylice, headlice and scabies' mites. The 'knockdown' times obtained for bodylice and headlice using lippia oil preparations were comparatively shorter than those obtained using benzyl benzoate and Delvap Super, a brand of dichlorvos. The lethal effect of the lippia oil on headlice was increased when applied in an enclosed system that prevented volatilization of the oil while allowing maximum contact of the vapour with the headlice. A 20% v/v preparation of lippia oil applied to scabietic subjects for 5 consecutive days gave 100% cure compared with 87.5% cure obtained for benzyl benzoate preparation of the same concentration. The GC-MS analysis of oil revealed, among others, the presence of terpineol, alpha- and beta-pinene which are known to be lethal to body and headlice.

Disinfectants/antiseptics in the management of guinea worm ulcers in the rural areas.

The effectiveness of trichlorophenol (TCP), chlorhexidine gluconate plus cetrimide (Savlon) and Izal in inhibiting the growth of bacterial isolates from guinea worm ulcers was investigated. Using an adaptation of the method of Russell and Furr (Russell, A.D., Furr, J.R., 1977. The antibacterial activity of a new chloroxylenol preparation containing ethylenediamine tetraacetic acid. J. Appl. Bacteriol. 43, 253-260) the minimum inhibitory concentration (MIC) values of the three anti-microbial agents for each of the isolated bacteria was determined. Water drawn from the rural guinea worm endemic sites was autoclaved and used for the various dilutions of the anti-microbial agents. At the manufactures' recommended use-dilutions in cases of wounds/cuts/sores, Savlon showed greater effectiveness than Izal and TCP in this order. Probable organic and inorganic inhibitors in water that is usually employed in diluting anti-microbial agents in the rural areas for the dressing of guinea worm ulcers very likely had greatest effect(s) on TCP and least effect(s) on Savlon.

Prevalence of dracunculiasis among Nigerian school children as an index of prevalence in their communities of origin.

A survey of dracunculiasis was carried out among pupils in their schools and among adults in the communities from which the pupils came, to determine whether the prevalence of infection in the pupils was a good index of the prevalence in their village. No significant difference was observed between the prevalence of current infection in pupils and that in their village of origin, although in some instances there were significant differences between the prevalence of previous infection in pupils and that in the corresponding village communities. The relevance and possible benefits of the rapid assessment of the prevalence of dracunculiasis obtained by a survey of school children are discussed.

Socio-cultural problems in the execution of a Guinea worm control programme. A case report.

It is a known fact that dracunculiasis (guinea worm infection) can be controlled through the provision of clean water. This case report elucidates some of the problems militating against the effectiveness of such a control method in a rural and illiterate community. These problems are borne from inappropriate equipment, health education and cultural prejudices. Solutions to these problems are suggested.