Health system challenges: An obstacle to the success of isoniazid preventive therapy.

BACKGROUND: The researchers identified infection with HIV as the strongest risk factor in the reactivation of latent tuberculosis (TB) infection or progression to active disease. Isoniazid preventive therapy (IPT) is one of the interventions recommended by the World Health Organization and the South African (SA) National Department of Health to prevent progression to active TB disease in people living with HIV. Adherence to IPT is therefore the responsibility of healthcare clients and clinicians. OBJECTIVES: To describe the incidence of TB among clients who received IPT, rates of completing and not completing IPT among those who started it, and the reasons for non-completion. METHODS: A quantitative, non-experimental, descriptive retrospective cohort study was undertaken. The clinic records of 104 HIV-positive adults receiving care at a clinic in SA who started IPT between 1 July 2010 and 30 November 2011 were analysed. RESULTS: Sixty-six of 104 study respondents (63.5%) completed the IPT course. None of the respondents who completed IPT was diagnosed with TB, and 86.8% of the respondents who did not complete the programme did so because of the poor quality of healthcare they received, and not by their own choice. CONCLUSION: The study results strengthened the findings of similar local and international studies that IPT is advantageous in the prevention of TB. The finding that so many patients did not complete the programme as a result of drug dispensing or prescription problems is alarming, and revealed a major shortcoming in the healthcare system.

Urinary schistosomiasis among schoolchildren in Ibadan, an urban community in south-western Nigeria.

The current status of urinary schistosomiasis was assessed in Ibadan, an urban community in south-western Nigeria. Of 1331 children examined for eggs of S. haematobium in their urine, 17.4% were infected. Prevalence in postprimary schoolchildren was significantly (P < 0.01) higher (22.4%) than in primary schoolchildren (12.0%). Intensity of infection based on geometric mean egg count per 10 ml of urine was also higher in postprimary (36.7 eggs/10 ml urine) than primary pupils (29.9 eggs/10 ml urine). Boys had a significantly (P < 0.01) higher infection rate (24.1%) than girls (8.5%), and the intensity of infection was also higher (P < 0.01) in males (39.0 eggs/10 ml urine) than in females (22.1 eggs/10 ml urine). The overall geometric mean intensity of infection was highest (38.8 eggs/10 ml urine) in the 11-15 years age group. 42% of infected children excreted > 50 eggs/10 ml urine. 2.2% excreted S. mansoni eggs in urine. Water contact activities were more frequent (P < 0. 01) in males (31.8%) than females (38.2%). Nine species of snails were encountered, with B. (p) globosus being the the most abundant and widespread. These results show that urinary schistosomiasis is still being actively being transmitted in Ibadan.

Septic tank mosquitoes: competition between species in central Nigeria.

Exit traps, placed over the air vents of septic tanks, were used to examine species diversity and relative abundance of mosquitoes breeding in ammonia-rich waters of septic tanks. Of the six species found, Culex decens Theobald and Culex cinereus Theobald appeared to be competing successfully with Culex quinquefasciatus Say during the wet season but not during the long dry season. The seasonal timing of their displacement by Cx quinquefasciatus was variable and did not correlate well with climatic factors. The three other species present, generally during the wet season and early dry season, were Culex tigripes G. & C., Culex horridus Edwards and Aedes aegypt (L.). Experimental bucket ovitraps were used to assess preference towards covered (dark) septic tank water in comparison with sunlit septic tank water, covered and sunlit compost water. These were colonized by Cx quinquefasciatus, Cx decens, Ae. aegypti and Ae. vittatus Bigot. The covered septic tank water was more abundantly colonized by Cx quinquefasciatus and marginally so by the two Aedes species. Cx decens appeared to colonize the exposed compost water more readily in the dry season, but changed to the covered septic tank water in the wet season. The discussion centres around competition between these mosquitos species and concludes that it would be useful to know what environmental factors, or what aspects of competition, lead to severe natural reductions in the abundance of the major pest species Cx quinquefasciatus.