Factors associated with malaria treatment failures in Ibadan.

This study aims to find out factors associated with anti-malarial drug resistance in some selected areas in Ibadan. One thousand one hundred and two subjects were interviewed using a semi structured questionnaire. Respondents were put into two groups (high and low resistant areas). The Results revealed a high level of drug use for treating malaria particularly choloroquine and sulfadoxine-pyrimethamine ("Fansidar"). The Results also showed that the two groups were not significantly different with respect to clearance of infection, but there was a significant difference between clearance of infection and whether or not the respondent completed the course of treatment in each group (P<0.05). When both groups were combined, the Mantel-Haenszel test showed that the response difference between the two groups was significant. (OR = 3.44 (CI = 1.8 to 6.51)) i.e those that completed the treatment were 3 times more likely to have their infection cleared than those that did not complete the treatment. A significant finding was that non-compliance with treatment was a major factor associated with treatment failure The prevalence of drug resistance was a little higher in the high resistant group compared to the low resistant group; but this difference was not statistically significant. These results underscore the need for adequate health education about the treatment of malaria and the importance of compliance in this community.

Efficacy of herbal remedies used by herbalists in Oyo State Nigeria for treatment of Plasmodium falciparum infections--a survey and an observation.

In the course of evaluating the contribution of phytomedicine to possible drug discovery of antimalarial drugs, an ethnomedical survey of specialized children traditional clinics was done. In the observational multi center study, efficacy of eight different herbal remedies, each consisting of 3-8 ingredients and administered by herbalists were investigated in clients enrolled in the six traditional clinics in Oyo (urban center) and Otu (rural center) of Oyo State, Nigeria. The clients, aged between six months and fifteen years with clinical symptoms of malaria were enrolled in the clinics of the herbalists, as their usual practice. Oral informed consents were obtained from their parents or guardians. Microscopic diagnosis of malaria infection was used to evaluate parasitaemia and validate efficacy of herbal remedies. Results of the analysis showed that, of the 163 clients of the herbalists, only 62 (30 from Oyo, 32 from Otu) had microscopically confirmed P. falciparum infection. Only results from 54 clients (29/30 (Oyo) and 25/32 (Otu) with P. falciparum infection could be evaluated. Plasmodium falciparum infection in 88% (23/29) of clients from Oyo responded to treatment with the herbal remedies while cure rate in clients from Otu was 42% (13/25). Parasite densities ranged from 171 to 53,613 parasites/microl blood and 87 to 36,209 parasites/microl blood in patients from Oyo and Otu respectively. The herbalists administered the remedies and Gossypium arboreum, Anarcadium occidentalis, Citrus medica, Phyllanthus amarus and Lippia multiflora were the main ingredients in the efficacious remedies. The herbalists gave detailed descriptions of each of the 8 herbal remedies proffered. The results confirm the efficacy of two of the eight herbal remedies, thereby validating the role of ethnomedicine as a possible source for the discovery of new chemotherapeutic agents in the treatment of P. falciparum malaria.

Cultural categorization of febrile illnesses in correlation with herbal remedies used for treatment in Southwestern Nigeria.

The ethnographic study was conducted in two communities in Oyo State in Southwestern Nigeria. The study sites consisted of a rural and an urban local government area located in the tropical rain forest zone of Nigeria. The study was designed to obtain information on febrile illnesses and herbal remedies for treatment with the aim of identifying potential antimalarial drugs. The study revealed that fever is a general term for describing illnesses associated with elevated body temperature. The indigenous Yoruba ethnic population has categorized fever based on symptoms and causes. The present communication is the result of focus group discussion and semi-structured questionnaire administered to traditional healers, herb sellers, elders and mothers. This was on types of fevers, symptoms and causes of febrile illnesses. The investigation also included use of traditional herbs in the prevention and treatment of the illnesses in the two communities.A total of 514 respondents were interviewed. This was made up of 266 (51.8%) from Atiba local government area (LGA), an urban centre while 248 (48.2%) respondents were interviewed from Itesiwaju LGA, a rural community. The LGAs are located in Oyo State of Nigeria. The respondents proffered 12 types of febrile illnesses in a multiple response answering system in Yoruba language. The most common ones (direct translation into English) were: yellow fever (39.1%), typhoid (34.8%), ordinary (28.8%), rainy season (20.8%) and headache (10.5%) fevers, respectively. Perceived causes of each of the febrile illnesses included stress, mosquito bites, unclean water, rains and over exposure to the sun. Methods of fever prevention were mainly with the use of herbal decoctions, powdered herbs, orthodox medications and maintenance of proper hygiene. Of a total of 112 different herbal remedies used in the treatment of the febrile illnesses compiled from the study, 25 recipes are presented. Recipes consisted of 2-7 ingredients. Oral decoctions (84%), oral powders (63%), use as soaps and creams (40%) in a multiple response system, were the most prevalent routes of administration of prepared herbs used in the treatment of the fevers. Boiling in water or alcohol was the most common method used in the preparation of the remedies. The four most frequently mentioned (multiple response system) plants in the Southwest ethnobotany for fevers were Azadirachta indica (87.5%), Mangifera indica (75.0%), Morinda lucida (68.8%) and Citrus medica (68.8%).

Perceived susceptibility to noise induced hearing loss and attitude towards preventive care among metal workers at Gate, Ibadan: a pilot study.

Audiometric assessment was carried out on 26 metal workers at the spare parts market, Gate Ibadan to corroborate their perceived susceptibility to noise induced hearing loss. Of the 26 studied, 13 (50.0%) indicated non-susceptibility, 11 (42.3%) indicated susceptibility while 2 (7.7%) did not know. Otology symptoms mentioned by those who indicate susceptibility were tinnitus (63.6%), hearing loss (36.4%), otalgia (18.2%), headache (9.1%), and post-aural pain (9.1%). Audiometric results showed 10 (76.9%) of non-susceptible subjects, 5 (45.5%) of susceptible subjects and 1 (50.0%) of undecided group had normal hearing bilaterally. Unilateral high frequency hearing loss was observed in 4 (36.4%) of the susceptible subjects. Implications of the findings for taking preventive action are discussed.