1
|
Wagnild JM, Akhter N, Lee D, Jayeola B, Darko DM, Adeyeye MC, Komeh JP, Nahamya D, Kasim A, Hampshire K. The role of constraints and information gaps in driving risky medicine purchasing practices in four African countries. Health Policy Plan 2024; 39:372-386. [PMID: 38300508 PMCID: PMC11005838 DOI: 10.1093/heapol/czae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 12/22/2023] [Accepted: 01/30/2024] [Indexed: 02/02/2024] Open
Abstract
Substandard and falsified (SF) medical products pose a major threat to public health and socioeconomic development, particularly in low- and middle-income countries. In response, public education campaigns have been developed to alert consumers about the risks of SF medicines and provide guidance on 'safer' practices, along with other demand- and supply-side measures. However, little is currently known about the potential effectiveness of such campaigns while structural constraints to accessing quality-assured medicines persist. This paper analyses survey data on medicine purchasing practices, information and constraints from four African countries (Ghana, Nigeria, Sierra Leone and Uganda; n > 1000 per country). Using multivariate regression and structural equation modelling, we present what we believe to be the first attempt to tease apart, statistically, the effects of an information gap vs structural constraints in driving potential public exposure to SF medicines. The analysis confirms that less privileged groups (including, variously, those in rural settlements, with low levels of formal education, not in paid employment, often women and households with a disability or long-term sickness) are disproportionately potentially exposed to SF medicines; these same demographic groups also tend to have lower levels of awareness and experience greater levels of constraint. Despite the constraints, our models suggest that public health education may have an important role to play in modifying some (but not all) risky practices. Appropriately targeted public messaging can thus be a useful part of the toolbox in the fight against SF medicines, but it can only work effectively in combination with wider-reaching reforms to address higher-level vulnerabilities in pharmaceutical supply chains in Africa and expand access to quality-assured public-sector health services.
Collapse
Affiliation(s)
- Janelle M Wagnild
- Department of Anthropology, Durham University, South Road, Durham DH1 3LE, UK
| | - Nasima Akhter
- Department of Anthropology, Durham University, South Road, Durham DH1 3LE, UK
| | - Diana Lee
- Incidents and Substandard/Falsified Medical Products Team, World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
| | - Babatunde Jayeola
- Incidents and Substandard/Falsified Medical Products Team, World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
| | | | - Moji Christianah Adeyeye
- National Agency for Food and Drug Administration and Control, Plot 2032, Olusegun, Obasanjo Way, Zone 7, Wuse, Abuja, Nigeria
| | - James P Komeh
- Pharmacy Board of Sierra Leone, New England Ville, Freetown, Sierra Leone
| | - David Nahamya
- Secretary to the Authority, National Drug Authority, PO Box 23096, Kampala, Uganda
| | - Adetayo Kasim
- Department of Anthropology, Durham University, South Road, Durham DH1 3LE, UK
| | - Kate Hampshire
- Department of Anthropology, Durham University, South Road, Durham DH1 3LE, UK
| |
Collapse
|
2
|
Perumal V, Kannan S, Alford L, Pittarate S, Mekchay S, Reddy GVP, Elangovan D, Marimuthu R, Krutmuang P. Biocontrol effect of entomopathogenic fungi Metarhizium anisopliae ethyl acetate-derived chemical molecules: An eco-friendly anti-malarial drug and insecticide. ARCHIVES OF INSECT BIOCHEMISTRY AND PHYSIOLOGY 2023; 114:1-19. [PMID: 37497800 DOI: 10.1002/arch.22037] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/28/2023]
Abstract
Insect pests represent a major threat to human health and agricultural production. With a current over-dependence on chemical insecticides in the control of insect pests, leading to increased chemical resistance in target organisms, as well as side effects on nontarget organisms, the wider environment, and human health, finding alternative solutions is paramount. The employment of entomopathogenic fungi is one such potential avenue in the pursuit of greener, more target-specific methods of insect pest control. To this end, the present study tested the chemical constituents of Metarhizium anisopliae fungi against the unicellular protozoan malaria parasite Plasmodium falciparum, the insect pests Anopheles stephensi Listen, Spodoptera litura Fabricius, and Tenebrio molitor Linnaeus, as well as the nontarget bioindicator species, Eudrilus eugeniae Kinberg. Fungal crude chemical molecules caused a noticeable anti-plasmodial effect against P. falciparum, with IC50 and IC90 values of 11.53 and 7.65 µg/mL, respectively. The crude chemical molecules caused significant larvicidal activity against insect pests, with LC50 and LC90 values of 49.228-71.846 µg/mL in A. stephensi, 32.542-76.510 µg/mL in S. litura, and 38.503-88.826 µg/mL in T. molitor at 24 h posttreatment. Based on the results of the nontarget bioassay, it was revealed that the fungal-derived crude extract exhibited no histopathological sublethal effects on the earthworm E. eugeniae. LC-MS analysis of M. anisopliae-derived crude metabolites revealed the presence of 10 chemical constituents. Of these chemicals, three major chemical constituents, namely, camphor (15.91%), caprolactam (13.27%), and monobutyl phthalate (19.65%), were highlighted for potential insecticidal and anti-malarial activity. The entomopathogenic fungal-derived crude extracts thus represent promising tools in the control of insect pests and malarial parasites.
Collapse
Affiliation(s)
- Vivekanandhan Perumal
- Department of General Pathology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Swathy Kannan
- Department of Entomology and Plant Pathology, Faculty of Agriculture, Chiang Mai University, Chiang Mai, Thailand
| | - Lucy Alford
- School of Biological Sciences, Life Sciences Building, University of Bristol, Bristol, UK
| | - Sarayut Pittarate
- Department of Entomology and Plant Pathology, Faculty of Agriculture, Chiang Mai University, Chiang Mai, Thailand
| | - Supamit Mekchay
- Department of Animal and Aquatic Sciences, Faculty of Agriculture, Chiang Mai University, Chiang Mai, Thailand
- Innovative Agriculture Research Center, Faculty of Agriculture, Chiang Mai University, Chiang Mai, Thailand
| | - Gadi V P Reddy
- USDA-ARS-Southern Insect Management Research Unit, Stoneville, Mississippi, USA
| | - Dilipan Elangovan
- Department of Physiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ramachandran Marimuthu
- Department of Botany, School of Life Sciences, Periyar University, Salem, Tamil Nadu, India
| | - Patcharin Krutmuang
- Department of Entomology and Plant Pathology, Faculty of Agriculture, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|
3
|
Herman C, Leonard CM, Uhomoibhi P, Maire M, Moss D, Inyang U, Abubakar A, Ogunniyi A, Mba N, Greby SM, Okoye MI, Iriemenam NC, Maikore I, Steinhardt L, Rogier E. Non-falciparum malaria infection and IgG seroprevalence among children under 15 years in Nigeria, 2018. Nat Commun 2023; 14:1360. [PMID: 36914649 PMCID: PMC10011577 DOI: 10.1038/s41467-023-37010-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
Plasmodium falciparum (Pf) is the dominant malaria parasite in Nigeria though P. vivax (Pv), P. ovale (Po), and P. malariae (Pm) are also endemic. Blood samples (n = 31,234) were collected from children aged 0-14 years during a 2018 nationwide HIV survey and assayed for Plasmodium antigenemia, Plasmodium DNA, and IgG against Plasmodium MSP1-19 antigens. Of all children, 6.6% were estimated to have Pm infection and 1.4% Po infection with no Pv infections detected. The highest household wealth quintile was strongly protective against infection with Pm (aOR: 0.11, 95% CI: 0.05-0.22) or Po (aOR= 0.01, 0.00-0.10). Overall Pm seroprevalence was 34.2% (95% CI: 33.3-35.2) with lower estimates for Po (12.1%, 11.6-12.5) and Pv (6.3%, 6.0-6.7). Pm seropositivity was detected throughout the country with several local government areas showing >50% seroprevalence. Serological and DNA indicators show widespread exposure of Nigerian children to Pm with lower rates to Po and Pv.
Collapse
Affiliation(s)
- Camelia Herman
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.,BeVera Solutions, Atlanta, GA, 30341, USA
| | - Colleen M Leonard
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.,Oak Ridge Institute for Science and Education, US. Department of Energy, Oak Ridge, TN, 37831, USA
| | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Mark Maire
- U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Delynn Moss
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Uwem Inyang
- U.S. President's Malaria Initiative, United States Agency for International Development (USAID), Abuja, Nigeria
| | - Ado Abubakar
- Institute of Human Virology (IHVN), Abuja, Nigeria
| | | | - Nwando Mba
- Nigeria Centre for Disease Control (NCDC), Abuja, Nigeria
| | - Stacie M Greby
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - McPaul I Okoye
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Nnaemeka C Iriemenam
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Ibrahim Maikore
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Laura Steinhardt
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.
| |
Collapse
|
4
|
Awasthi KR, Jancey J, Clements ACA, Sah RK, Koirala MP, Chalise B, Leavy JE. Traditional Beliefs, Practices, and Migration: A Risk to Malaria Transmission in Rural Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16872. [PMID: 36554752 PMCID: PMC9779137 DOI: 10.3390/ijerph192416872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
The study aimed to explore sociocultural factors influencing the risk of malaria and practices and beliefs towards malaria prevention, transmission and treatment in a remote village in Khatyad Rural Municipality (KRM) of Nepal. A sequential exploratory mixed methods approach was used. Qualitative data were collected through 25 one-on-one, in-depth interviews followed by a face-to-face household survey (n = 218) among people from a village in KRM believed to have a high risk of malaria. Traditional practices such as Chhaupadi requiring the seclusion of women during menstruation and post-partum, transhumance, and reliance on traditional healers for the management of malaria were common practices in the village. The household survey found 98.1% of women faced menstrual exile either inside the house or in a separate hut, with 64.2% not having access to Long-lasting Insecticidal Nets (LLINs). Hardships and economic constraints compelled villagers to migrate seasonally for work to malaria-endemic areas in India, thereby exposing themselves to the risk of malaria. Persistent traditional beliefs and seasonal migration could threaten the elimination goals set by the national malaria program.
Collapse
Affiliation(s)
- Kiran Raj Awasthi
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Jonine Jancey
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Archie C. A. Clements
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
- Telethon Kids Institute, Perth, WA 6009, Australia
- Peninsula Medical School, University of Plymouth, Plymouth PL4 8AA, UK
| | - Rohit Kumar Sah
- National Malaria Program, Karnali Province Field Office, Nepalgunj 21900, Nepal
| | | | - Binaya Chalise
- Graduate School for International Development and Cooperation, Hiroshima University, Higasi-Hiroshima 739-8529, Japan
| | - Justine E. Leavy
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| |
Collapse
|
5
|
Appiah EO, Appiah S, Oti-Boadi E, Oppong-Besse A, Awuah DB, Asiedu PO, Oti-Boateng LE. Practices of herbal management of malaria among trading mothers in Shai Osudoku District, Accra. PLoS One 2022; 17:e0271669. [PMID: 35849609 PMCID: PMC9292099 DOI: 10.1371/journal.pone.0271669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background Malaria is one of the leading causes of morbidity in the world. It is a significant health concern in most developing countries, including Ghana. Even though there are several orthodox medications used for decades in treating malaria effectively, a substantial number of individuals in developing countries are resorting to the use of herbs in the treatment of malaria. The study aim at exploring the practices of herbal management of malaria among trading mothers in Shai Osudoku District, Accra. Methods A qualitative approach with an exploratory, descriptive design was adopted in analyzing the research problem. Purposive sampling technique was used to select twenty (20) participants to partake in a face-face interview, guided by a semi-structured interview guide. The data were transcribed verbatim and analysed by adopting content analysis. Results Two significant themes and seven subthemes were generated following the analysis of this study. The main themes were; preferences for herbal malaria treatment and the practices and effectiveness of herbal medicine used for malaria treatment. It was worth noting that the women’s cultural beliefs did not influence their preference for herbal malaria treatment. The main challenge associated with the herbal malaria treatment was inappropriate dosage specification. Conclusion This study discovered that several factors influenced participants’ preferences for malaria treatment. Participants further listed some traditional ways of treating malaria which implies that there is herbal malaria practice. However, literature in this area is inadequate, and most herbs lack specifications for use. It is therefore recommended that future research focus on scientific herbal malaria treatment. Also, regulating bodies should ensure that quality herbal drugs are sold for consumption.
Collapse
Affiliation(s)
- Evans Osei Appiah
- Department of Midwifery, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
- * E-mail:
| | - Stella Appiah
- Head of Nursing Department, School of Nursing and Midwifery, Valley View University, Accra, Ghana
| | - Ezekiel Oti-Boadi
- Department of Nursing, School of Nursing and Midwifery, Valley View University, Accra, Ghana
| | | | - Dorothy Baffour Awuah
- Department of Nursing, School of Nursing and Midwifery, Valley View University, Accra, Ghana
| | | | | |
Collapse
|
6
|
Adeyemo AO, Aborode AT, Bello MA, Obianuju AF, Hasan MM, Kehinde DO, Hossain MS, Bardhan M, Imisioluwa JO, Akintola AA. Malaria vaccine: The lasting solution to malaria burden in Africa. Ann Med Surg (Lond) 2022; 79:104031. [PMID: 35761818 PMCID: PMC9220753 DOI: 10.1016/j.amsu.2022.104031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/26/2022] Open
Abstract
Malaria is one of the deadliest infectious diseases in Africa. Many measures have been taken over the past few years to reduce the burden of malaria on public health following the recommendation of WHO, still, malaria has continued to rake devastation in Africa. Combating malaria in Africa has grown into an international concern. The eradication of malaia is a long-standing goal of public health initiatives globally. The development of vaccines will go a long way to provide the required immunity needed for the people living with malaria or vulnerable to malaria. It is imperative that a vaccine should be produced and rolled out for use, especially during the time of the COVID-19 pandemic when attention is given to mitigating the impact of the pandemic on public health. The malaria vaccine will reduce the number of hospital admission for malaria illness among children and other age groups. Africa will need to build strong innovations to overcome country-specific challenges in vaccination drive, human resources, and supply chain management. Accelerating education, sensitization, diagnosis, and eradication through joint efforts of the government, healthcare professionals and general population will help to prevent the dual synchronous epidemic of COVID-19 and Malaria in Africa.
Collapse
|
7
|
Awasthi KR, Jancey J, Clements ACA, Leavy JE. A qualitative study of knowledge, attitudes and perceptions towards malaria prevention among people living in rural upper river valleys of Nepal. PLoS One 2022; 17:e0265561. [PMID: 35303022 PMCID: PMC8932613 DOI: 10.1371/journal.pone.0265561] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/03/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Nepal has made significant progress in decreasing the number of malaria cases over the last two decades. Prevention and timely management of malaria are critical for the National Malaria Program in its quest for elimination. The study aimed to explore the knowledge, attitudes and behaviour towards malaria prevention and treatment among people living in rural villages of Khatyad Rural Municipality in Nepal. METHODS This qualitative study collected information through virtual in-depth interviews (N = 25) with female and male participants aged between 15 and 72 years. RESULTS More than half of the participants knew about the causes of malaria, were aware of the complications of untreated malaria and knew that anti-malarial medicines were provided for free at the public health facilities. Participants indicated that their first choice of health care were public health facilities, however limited supply of medications and diagnostics deviated patients to the private sector. While tertiary care costs were not financially viable, participants opted against traditional care for malaria. Factors such as cost of treatment, distance to the health facility and the decision making authority in households influenced health related decisions in the family. Although long-lasting insecticidal nets were distributed and indoor residual spraying was done periodically, several barriers were identified. CONCLUSION Increased awareness of malaria prevention and treatment among people living in malaria risk areas is important for the National Malaria Program in its quest for malaria elimination in Nepal.
Collapse
Affiliation(s)
- Kiran Raj Awasthi
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Jonine Jancey
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | | | - Justine E. Leavy
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| |
Collapse
|
8
|
Mukabane KD, Kitungulu NL, Ogutu PA, Cheruiyot JK, Tavasi NS, Mulama DH. Bed net use and malaria treatment-seeking behavior in artisanal gold mining and sugarcane growing areas of Western Kenya highlands. SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
9
|
Onah CK, Azuogu BN, Ossai EN, Agu AP, Azuogu VC, Alobu I, Ogah EO. Addressing constraints to informal providers' involvement in tuberculosis control: a qualitative study of patent medicine dealers and tuberculosis programme managers. Glob Health Res Policy 2021; 6:43. [PMID: 34743759 PMCID: PMC8574043 DOI: 10.1186/s41256-021-00227-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A major constraint to tuberculosis control is low case finding with under-reporting to national authorities. Evidence shows that Patent Medicine Dealers are first port of call for most people with symptoms of tuberculosis, yet there is poor referral of such clients to tuberculosis treatment facilities for further evaluation. This study investigated constraints to involvement of Patent Medicine Dealers in tuberculosis control. METHODS This was a cross-sectional qualitative study among Patent Medicine Dealers and Tuberculosis Control Programme Managers in Ebonyi State Nigeria. Sixty-four Patent Medicine Dealers and five Tuberculosis Control Programme Managers were interviewed using Focus Group Discussion and In-Depth Interview respectively. Data was collected with electronic audio-recording device and analyzed using thematic approach. RESULTS There are some knowledge gaps about tuberculosis signs, symptoms, free-treatment policy and mode of operation of care service among Patent Medicine Dealers. Patent Medicine Dealers and Tuberculosis Control Programme Managers are willing to collaborate in tuberculosis control effort but constant demand for incentives by Patent Medicine Dealers and inability of National Tuberculosis Control Programme to keep up with such demands are obvious constraints. CONCLUSIONS Knowledge gaps in tuberculosis, its control, constant demand for incentives by Patent Medicine Dealers and inability of National Tuberculosis Control Programme to satisfy such demands are constraints to involvement of Patent Medicine Dealers in tuberculosis control. More robust engagement of Patent Medicine Dealers in tuberculosis control with clear job description through tuberculosis education and provision of incentives to support them are recommended policy approaches to improve linkage of clients to tuberculosis treatment facilities.
Collapse
Affiliation(s)
- Cosmas Kenan Onah
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), P.M.B: 102, Abakaliki, Ebonyi State, Nigeria.
| | - Benedict Ndubueze Azuogu
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), P.M.B: 102, Abakaliki, Ebonyi State, Nigeria.,Department of Community Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria
| | - Edmund Ndudi Ossai
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), P.M.B: 102, Abakaliki, Ebonyi State, Nigeria.,Department of Community Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria
| | - Adaoha Pearl Agu
- Department of Community Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria.,African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria
| | | | - Isaac Alobu
- National Tuberculosis, Leprosy and Buruli Ulcer Control Programme, Ebonyi State Ministry of Health, Abakaliki, Nigeria
| | - Emeka Onwe Ogah
- Department of Paediatrics, AE-FUTHA, Abakaliki, Ebonyi State, Nigeria
| |
Collapse
|
10
|
Agu AP, Umeokonkwo CD, Eze NC, Akpa CO, Nnabu RC, Akamike IC, Okedo-Alex IN, Alo C, Uneke JC. Knowledge of malaria control and attitudes towards community involvement among female community volunteers: effect of capacity building in a rural community, Southeast Nigeria. Pan Afr Med J 2021; 39:151. [PMID: 34539948 PMCID: PMC8434785 DOI: 10.11604/pamj.2021.39.151.25685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 04/07/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction community volunteers have limited skills but are an important link between the community and health facilities. We determined the effect of a capacity building intervention on knowledge of malaria control and attitudes towards community involvement among female community volunteers as part of a larger community-based intervention study on pregnant women and children under five. Methods we conducted a before and after intervention study (no randomization or controls) among female community volunteers in Amagu community in Abakaliki Local Government Area. The intervention consisted of training sessions on knowledge of malaria and its control. The training took the form of lectures, role plays and practical demonstrations. Supportive supervision by trained community health extension workers was also provided during their field work. We compared pre-training test and post-training test scores after six months interval and analysed the data using paired t test at 5% level of significance with EPI INFO software version 7.2.3. Results the mean age of the participants was 28.5(± 6.0) years. All had a minimum level of secondary education. There was significant improvement in the mean scores of their knowledge of malaria signs and symptoms (p < 0.001), preventive measures (p < 0.001) and appropriate drug treatment (p < 0.001) in the post-training test when compared with the pre-training test. The overall mean knowledge scores pre and posttest were 147.8 and 169.8 respectively (p < 0.001) out of a maximum achievable score of 195. Also there was significant improvement in the perception of the participants on community involvement in promoting referral of pregnant women with fever (p = 0.001), the use of intermittent preventive therapy with sulphadoxine-pyrimethamine (p = 0.048) and funding initiatives to sustain activities (p = 0.037). Conclusion capacity building of female community volunteers coupled with supportive supervision by trained community health workers improved the female community volunteers´ knowledge of malaria, its control and their perception of community involvement in control activities. It is recommended that the use of community volunteers as a low cost health resource can be explored further for incorporation into existing policies on malaria control in resource constrained environments.
Collapse
Affiliation(s)
- Adaoha Pearl Agu
- African Institute for Health Policy and Health Systems Ebonyi State University Abakaliki, Abakaliki, Nigeria.,Department of Community Medicine, Ebonyi State University Abakaliki, Ebonyi State, Nigeria.,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Chukwuma David Umeokonkwo
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Nelson Chibueze Eze
- National Malaria Elimination Program Department of Public Health, Federal Ministry of Health Abuja, Nigeria
| | - Christian Obasi Akpa
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Richard Chukwuka Nnabu
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems Ebonyi State University Abakaliki, Abakaliki, Nigeria.,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Ijeoma Nina Okedo-Alex
- African Institute for Health Policy and Health Systems Ebonyi State University Abakaliki, Abakaliki, Nigeria.,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Chihurumnanya Alo
- Department of Community Medicine, Ebonyi State University Abakaliki, Ebonyi State, Nigeria.,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Jesse Chigozie Uneke
- African Institute for Health Policy and Health Systems Ebonyi State University Abakaliki, Abakaliki, Nigeria.,Department of Microbiology, Ebonyi State University, Abakaliki, Nigeria
| |
Collapse
|
11
|
Liu DY, Maki AW, Maitland A, Meyer ER, Sorensen JS, Galvin S. Enhancing Knowledge in Informal Settlements: Assessing Health Beliefs and Behaviors in Nigeria: A cross-sectional survey assessment of perceptions, practices, and resources in underserved urban communities in Lagos. Ann Glob Health 2020; 86:121. [PMID: 33024707 PMCID: PMC7518078 DOI: 10.5334/aogh.2648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Community Health Education (CHE) programs have been shown to be effective in relieving the burden on healthcare systems in Sub-Saharan Africa. Objective This project aimed to determine the baseline level of health literacy, behavioral practices, and accessibility to resources in a set of 16 informal settlements located around Lagos, Nigeria in order to identify topics that should be emphasized in a new teaching curriculum directed at local Community Health Educators. Methods In June of 2017, a unique cross-sectional survey composed of 37 questions was conducted in informal settlements around Lagos. Sites selected were areas in which future CHE trainings were planned to take place and survey participants were chosen by trained community health educators based on convenience sampling with snowball effect. Survey questions included both multiple-choice and open-ended questions and were asked in the local language. We collected demographic information and assessed health literacy, health behaviors, and community practices. Results were analyzed using descriptive statistics to assess for differences between demographic groups. Findings Our survey collected 348 total responses. Respondents displayed a high level of knowledge regarding the benefits of hand washing (97.1%) and childhood immunizations (81.0%). Knowledge around infectious diseases and reproductive health was lower, including a large proportion of people (50%) incorrectly indicating that HIV could be spread through a mosquito bite. Malaria was reported to be the most prevalent disease affecting both adults (40.0%) and children (58.3%). Health access was limited, with most people not reporting access to a nearby health center (55.8%). Conclusions Areas of knowledge that should be emphasized in future versions of CHE training curricula include infectious diseases, reproductive health, and reinforcement of the importance of sanitation and clean water. The curriculum should address the reality of limited health access and develop strategies to improve this.
Collapse
Affiliation(s)
| | | | - Anna Maitland
- Northwestern University Pritzker School of Law, Chicago, IL, US
| | - Elise R. Meyer
- Northwestern University Pritzker School of Law, Chicago, IL, US
| | | | | |
Collapse
|
12
|
Edagha IA, Ekpo AJ, Edagha EI, Bassey JV, Nyong TP, Akpan AS, Obeten RF, Okon AS, Ating BA. Investigating the Comparative Effects of Six Artemisinin-based Combination Therapies on Plasmodium-induced Hepatorenal Toxicity. Niger Med J 2019; 60:211-218. [PMID: 31831942 PMCID: PMC6892336 DOI: 10.4103/nmj.nmj_152_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 06/30/2019] [Accepted: 07/30/2019] [Indexed: 01/23/2023] Open
Abstract
Background Too many artemisinin-based combination therapies (ACTs) are available, thus creating a dilemma on the most preferred for the treatment of malaria. Aim We compared the effect of six ACTs in mitigating Plasmodium-induced hepatorenal toxicity in experimental malaria. Materials and Methods Forty adult male Swiss mice allotted into eight groups: Group 1 (normal control [NC] uninfected and untreated), Group 2 (parasitized nontreated - [PNT]), and Groups 3-8 received Plasmodium berghei inoculum. After 72 h, the initial parasitemia was established. Groups 3-8 were administered oral therapeutic doses of artesunate-amodiaquine (AA), artesunate-mefloquine (AM), artesunate-sulfadoxine-pyrimethamine (ASP), artemisinin-piperaquine (AP), dihydroartemisinin-piperaquine (DP), and artemether-lumefantrine (AL) per kg bodyweight, respectively, as standard regimen, and final parasitemia determined. Animals were euthanized via chloroform inhalation and blood collected for hepatorenal analysis. Liver and kidney were dissected out for histology. Results Parasitemia was significantly (P < 0.05) decreased in tests compared to PNT, except in ASP group. Liver enzymes were significantly (P < 0.05) increased in PNT compared to tests and NC. Hyperplastic cells and portal tract inflammation were prominent in ASP group, but mild to moderate in other treated groups. Urea-creatinine were significantly (P < 0.05) increased in PNT compared to treated groups. The Na+ and Cl- were significantly (P < 0.05) reduced in PNT, with significantly (P < 0.05) increased K+ compared to NC and treated groups. Glomerulonephritis and glomerulus splitting was observed in PNT, while moderate distortions were observed in treated groups. The AA and AM groups had good kidney histoarchitecture. Conclusion Parasitemia decreased in all the treatment groups except in PNT and ASP groups which had severe hepatorenal distortions. Hepatorenal histoarchitecture were mildly distorted in the AA, AM and AL-administered groups with lower hepatorenal indices comparable to NC. The least elevated liver enzymes were in AA and AM. In decreasing order ASP > DP > AL > AP > AM > AA.
Collapse
Affiliation(s)
- Innocent A Edagha
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria
| | - Arit J Ekpo
- Department of Biochemistry, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria
| | - Edelungudi I Edagha
- Department of Family Medicine, University of Uyo Teaching Hospital, Uyo, Nigeria
| | - Joy V Bassey
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria
| | - Titus P Nyong
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria
| | - Anthony S Akpan
- Department of Biochemistry, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria
| | - Rose F Obeten
- Department of Biochemistry, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria
| | - Anthony S Okon
- Department of Biochemistry, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria
| | - Blessing A Ating
- Department of Biochemistry, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria
| |
Collapse
|
13
|
Ayanore MA, Tetteh J, Ameko A, Axame WK, Alhassan RK, Adoliba Ayanore A, Mogre V, Owusu-Agyei S. Reproductive-Age Women's Knowledge and Care Seeking for Malaria Prevention and Control in Ghana: Analysis of the 2016 Malaria Indicator Survey. J Trop Med 2019; 2019:2316375. [PMID: 30891071 PMCID: PMC6390249 DOI: 10.1155/2019/2316375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/20/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Malaria is a major cause of morbidity and mortality worldwide, requiring individual and environmental level controls to prevent its adverse morbidity effects. This study examined reproductive-aged women's knowledge and care-seeking practices for malaria prevention and control in Ghana. METHODS The 2016 Ghana Malaria Indicator Survey data for reproductive-age women was analysed (n=5,150). Multilevel mixed-effects logistic regression model was used to determine factors associated with reproductive-aged women's knowledge and care-seeking practices for malaria. RESULTS 62.3%, 81.3%, and 64.6% knowledge levels on causes, signs/symptoms, and prevention of malaria were found, respectively, among respondents. Age, wealth and educational status, religion, region, and place of residence (rural) were found to significantly influence respondents' knowledge of causes, signs/symptoms, and care-seeking practices for malaria. A 15% differential among Insecticide Treated Nets (ITNs) awareness and use was found. Increasing age (≥35 years) was associated with increasing knowledge of malaria. Regional variations were observed to significantly influence knowledge of malaria treatment. CONCLUSION Though ownership of ITNs and knowledge of malaria prevention were high, it did not necessarily translate into use of ITNs. Thus, there is a need to intensify education on the importance and the role of ITNs use in the prevention of malaria.
Collapse
Affiliation(s)
- Martin Amogre Ayanore
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe campus, Ghana
| | - John Tetteh
- Centre for Health Policy Advocacy, Innovation & Research in Africa (CHPAIR-Africa), Ghana
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe campus, Ghana
| | - Asiwome Ameko
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe campus, Ghana
| | - Wisdom Kudzo Axame
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe campus, Ghana
| | - Robert Kaba Alhassan
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Augustine Adoliba Ayanore
- Department of Epidemiology and Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | - Victor Mogre
- Department of Health Professions Education and Innovative Learning, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana
| | - Seth Owusu-Agyei
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| |
Collapse
|