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Hepatitis B and Asymptomatic Malaria Infection among Pregnant Women in a Semiurban Community of North-Central Nigeria. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:9996885. [PMID: 34876911 PMCID: PMC8645382 DOI: 10.1155/2021/9996885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 10/22/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022]
Abstract
Background The overlap of malaria and Hepatitis B Virus (HBV) infections present a major threat to public health throughout endemic countries of tropical and sub-Saharan Africa. There is a paucity of data on the prevalence and associated factors of malaria and HBV infections among pregnant women in Ejule, a semiurban area of Nigeria. Therefore, the current study was designed to assess the seroprevalence of malaria and HBV among pregnant women attending antenatal clinics in Ejule Metropolis. Materials and Methods In a hospital-based cross-sectional study, blood samples collected from 200 apparently healthy pregnant women at the Ilemona Clinic were screened for Plasmodium falciparum (P. falciparum) and HBsAg using histidine-rich protein 2 (HRP2) and hepatitis B surface antigen (HBsAg) rapid diagnostic tests (RDTs), respectively. Relevant sociodemographic and putative risk factor information was obtained with structured questionnaires. Results The prevalence of the infections was 44 (22%), 5 (2.5%), and 1 (0.5%) for P. falciparum monoinfection and HBV monoinfection and coinfection, respectively. Single and concurrent infections peaked at ages 31-40 years but decreased with older ages. High P. falciparum, 31 (59.62%), and HBV 2 (3.85%) infection were observed among those without formal education. Contrary to ages, occupation, and knowledge of infection, malaria parasitemia differed significantly with lower educational qualification (p ≤ 0.001), being single (p=0.001), and inconsistent use of insecticide-treated bed nets (ITNs) (p=0.04, OR = 5, CI: 0.10-0.47). History of blood donation (OR = 5, p=0.04, CI: 1.10-32.80) and multiple sex partners (OR = 11.9, p=0.01, CI: 0.01-0.93) were found to be significantly associated with hepatitis B surface antigenemia rate during pregnancy. No evidence of HBV infection was observed in women with a history of HBV vaccination. Conclusions Malaria is still highly prevalent among pregnant women due to high illiteracy and noncompliance to using ITNs. Therefore, routine screening and educating pregnant mothers are crucial in eliminating malaria in endemic settings. The low rate of hepatitis B and coinfection with malaria shows that further improvement in HBV vaccination could considerably reduce the disease burden among pregnant women.
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Vitex negundo L. Essential Oil: Odorant Binding Protein Efficiency Using Molecular Docking Approach and Studies of the Mosquito Repellent. INSECTS 2021; 12:insects12121061. [PMID: 34940149 PMCID: PMC8703855 DOI: 10.3390/insects12121061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/11/2021] [Accepted: 11/23/2021] [Indexed: 01/08/2023]
Abstract
Simple Summary Malaria fever kills millions of people annually in the tropical and subtropical countries of Africa and Asia. Because there is no effective vaccine, malaria prevention is exclusively dependent on avoiding human-vector interaction. The interaction of Vitex negundo essential oil constituents with Anopheles gambiae Odorant Binding Proteins (OBP), as well as its compositional variation, repellent efficacy, and toxicity profile, are investigated in this work. The oils were subjected to GC-MS analysis, a mosquito behavioral test, OBP-ligand interactions, Anopheles species authentication, and toxicity profile. Docking protocol validation was achieved by redocking the co-crystallized ligands and root mean square deviation (RMSD) calculation. The oil yields and compositions are climate–soil dependent with ≈71.39% monoterpenes and ≈16.32% sesquiterpene. Optimal repellency is achieved at 15 min at ED50 0.08–0.48% v/v while the RMSD was estimated to be within 0.24–1.35 Å. Strong affinities, −6.4 to −5.4 kcal/mol, were demonstrated by α-pinene, citronellal, linalool, and myrcene for OBP1, OBP7, OBP4, and OBP. respectively. The hydrophobic interactions involve Leu17, Cys35, ALA52, Leu73, Leu76, Ala88, Met91, Lys93, Trp114, Phe123, and Leu124 receptors on α-helixes 1–7 within the binding cavities, and may block the olfactory receptors resulting in disorientation. α-pinene, linalool, and myrcene are safe and suitable for use in the development of green and innovative repellents because their ligand efficiency metrics, ADME/tox, and repellency screening are all within the threshold values. Abstract (1) Background: Malaria fever affects millions of people yearly in Africa and Asia’s tropical and subtropical areas. Because there is no effective vaccine, malaria prevention is solely dependent on avoiding human-vector interaction. (2) Aim: This study examines the interaction between the constituents of Vitex negundo essential oil and Anopheles gambiae Odorant Binding Proteins (OBP) as well as the compositional variation, repellent efficacy, and toxicity profile. (3) Methods: The oils were subjected to GC-MS and mosquito behavioral analysis. OBP–ligand interactions, Anopheles species authentication, and the toxicity profile were determined by molecular docking, PCR assay and in silico ADME/tox tool. Docking protocol validation was achieved by redocking the co-crystallized ligands into the protein binding pocket and root mean square deviation (RMSD) calculation. (4) Results: The oil yields and compositions are climate–soil dependent with ≈71.39% monoterpenes and ≈16.32% sesquiterpene. Optimal repellency is achieved at 15 min at ED50 0.08–0.48% v/v while the RMSD was estimated to be within 0.24–1.35 Å. Strong affinities were demonstrated by α-pinene (−6.4 kcal/mol), citronellal (−5.5 kcal/mol), linalool (−5.4 kcal/mol), and myrcene (−5.8 kcal/mol) for OBP1, OBP7, OBP4, and OBP; respectively. The hydrophobic interactions involve Leu17 (α-helix 1), Cys35 (α-helix 2), ALA52 (α-helix 3), Leu73, Leu76 (α-helix 4), Ala88, Met91, Lys93, Trp114 (α-helix 5), Phe123 (α-helix 6), and Leu124 (α-helix 7) receptors within the binding cavities, and may cause blocking of the olfactory receptors resulting in disorientation. (5) Conclusion: The ligand efficiency metrics, ADME/tox and repellency screening are within the threshold values; hence, α-pinene, linalool, and myrcene are safe and fit-to-use in the development of a green and novel repellent.
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Prusty D, Gupta N, Upadhyay A, Dar A, Naik B, Kumar N, Prajapati VK. Asymptomatic malaria infection prevailing risks for human health and malaria elimination. INFECTION GENETICS AND EVOLUTION 2021; 93:104987. [PMID: 34216796 DOI: 10.1016/j.meegid.2021.104987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 01/09/2023]
Abstract
There has been a consistent rise in malaria cases in the last few years. The existing malaria control measures are challenged by insecticide resistance in the mosquito vector, drug résistance in parasite populations, and asymptomatic malaria (ASM) in healthy individuals. The absence of apparent malaria symptoms and the presence of low parasitemia makes ASM a hidden reservoir for malaria transmission and an impediment in malaria elimination efforts. This review focuses on ASM in malaria-endemic countries and the past and present research trends from those geographical locations. The harmful impacts of asymptomatic malaria on human health and its contribution to disease transmission are highlighted. We discuss certain crucial genetic changes in the parasite and host immune response necessary for maintaining low parasitemia leading to long-term parasite survival in the host. Since the chronic health effects and the potential roles for disease transmission of ASM remain mostly unknown to significant populations, we offer proposals for developing general awareness. We also suggest advanced technology-based diagnostic methods, and treatment strategies to eliminate ASM.
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Affiliation(s)
- Dhaneswar Prusty
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Bandarsindri, Kishangarh, Ajmer, 305817, Rajasthan, India.
| | - Nidhi Gupta
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Bandarsindri, Kishangarh, Ajmer, 305817, Rajasthan, India
| | - Arun Upadhyay
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Bandarsindri, Kishangarh, Ajmer, 305817, Rajasthan, India
| | - Ashraf Dar
- Department of Biochemistry, University of Kashmir, Hazaratbal, Srinagar 190006, Jammu and Kashmir, India
| | - Biswajit Naik
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Bandarsindri, Kishangarh, Ajmer, 305817, Rajasthan, India
| | - Navin Kumar
- School of Biotechnology, Gautam Buddha University, Greater Noida, 201308, UP, India
| | - Vijay Kumar Prajapati
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Bandarsindri, Kishangarh, Ajmer, 305817, Rajasthan, India
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Ojifinni OO, Popoola OA. Pregnancy experiences and maternal health service utilisation among female traders in Ibadan, Nigeria. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01120-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Balami AD, Md Said S, Mohd Zulkefli NA, Bachok N, Audu B. Determinants of uptake of first dose of intermittent preventive treatment among pregnant women in a secondary health Centre in Maiduguri, Nigeria. BMC Pregnancy Childbirth 2020; 20:726. [PMID: 33238901 PMCID: PMC7687802 DOI: 10.1186/s12884-020-03388-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 10/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background Studies on uptake of first dose of intermittent preventive treatment in pregnancy (IPTp) are lacking, despite it being a predictor of subsequent doses. This study aimed at assessing the determinants of uptake of first dose of IPTp among pregnant women at the State Specialist Hospital, Maiduguri. Methods A cross-sectional study was conducted, in which respondents were selected using a systematic random sampling method, and structured questionnaires were used to obtain information from them. Chi-squared test was used to determine factors associated with uptake of first IPTp dose, while a further multivariate logistic regression was performed to determine its predictors. Results Three hundred and eighty respondents answered the survey, whose ages ranged from 15 to 45 years, and 86.8% were multigravid. Sixty five percent of them were aware of IPTp, and 34.7% believed that IPTp could be harmful to their pregnancies. Over a half of the respondents (52.9%) believed that taking all their IPTp medicines was very good for their pregnancies, while 45.0% felt that taking their IPTp medicines was very pleasant. Only two respondents (0.5%) stated that it was very untrue that their significant others thought that they should take all their IPTp medicines. Half of the respondents said it was very easy for them to take all their IPTp medicines even if they were experiencing mild discomforts while taking them. Less than a half (42.37%) had received their first dose of IPTp. In bivariate as well as multivariate analysis, only higher level of knowledge was significantly associated with uptake of first IPTp dose. Those with better knowledge of IPTp were about twice more likely to have taken their first dose of IPTp, compared to those with lower knowledge of IPTp (AOR = 1.85; 95% CI: 1.17–2.92). Conclusions Knowledge of IPTp as well as its uptake, were sub-optimal in this study. Since knowledge of IPTp significantly predicts uptake of the first dose of IPTp, there is the need to implement health education campaigns to raise the awareness of pregnant women and their families on the need to receive and comply with it. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03388-8.
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Affiliation(s)
- Ahmed Dahiru Balami
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | - Salmiah Md Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia.
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | - Norsa'adah Bachok
- Unit of Biostatistics and Research Methodology, School of Medical Sciences , Universiti Sains Malaysia , Kubang Kerian , 15200 , Kota Bharu , Kelantan , Malaysia
| | - Bala Audu
- Department of Obstetrics and Gynaecology, University of Maiduguri, PMB 1069, Maiduguri, Borno State, Nigeria
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Akinyotu O, Bello F, Abdus-Salam R, Arowojolu A. A randomized controlled trial of azithromycin and sulphadoxine-pyrimethamine as prophylaxis against malaria in pregnancy among human immunodeficiency virus-positive women. Trans R Soc Trop Med Hyg 2020; 113:463-470. [PMID: 31140565 DOI: 10.1093/trstmh/trz028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/14/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Malaria and human immunodeficiency virus (HIV) infections in pregnancy are important and major contributing factors to maternal morbidity and mortality in sub-Saharan Africa. Prevention of malaria in HIV-positive pregnant woman will reduce the burden of malaria-HIV comorbidity. The objective of this study was to compare effects and safety of azithromycin (AZ) with sulphadoxine-pyrimethamine (SP) for intermittent preventive therapy for malaria in HIV-positive pregnant women. METHODS We performed a randomized, controlled, open-label pregnancy trial of 140 HIV-positive pregnant patients attending antenatal clinics at the University College Hospital and Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria. Participants were enrolled from a gestational age of 16 weeks and randomized to receive AZ or SP. The primary outcome was peripheral parasitaemia at delivery. Secondary outcomes were drug tolerability, foetal outcome and birthweight. The χ2 test (or Fisher's exact test, as appropriate) and Student's t test were used in the per-protocol analysis. The level of statistical significance was p<0.05. RESULTS A total of 123 participants (87.9%) completed the study: 60 participants received AZ and 63 received SP. The incidence of malaria parasitaemia at delivery in the AZ group was 6 (10.0%), compared with 7 (11.1%) in the SP group (relative risk 0.89 [95% confidence interval 0.28 to 2.82], p=0.84). Placental parasitization was demonstrated in 1 (1.6%) participant in the SP group compared with 3 (5.0%) in the AZ group (p=0.36). CONCLUSIONS The findings suggest that AZ is comparable to SP in malaria prevention and safety in HIV-positive pregnant women.
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Affiliation(s)
- Oriyomi Akinyotu
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Folasade Bello
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Rukiyat Abdus-Salam
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.,Adeoyo Maternity Teaching Hospital, Yemetu, Ibadan, Oyo State, Nigeria
| | - Ayodele Arowojolu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Gontie GB, Wolde HF, Baraki AG. Prevalence and associated factors of malaria among pregnant women in Sherkole district, Benishangul Gumuz regional state, West Ethiopia. BMC Infect Dis 2020; 20:573. [PMID: 32758164 PMCID: PMC7405459 DOI: 10.1186/s12879-020-05289-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background Malaria during pregnancy leads to serious adverse effects on mothers and the fetus. Approximately 25 million pregnant women in sub-Saharan Africa live at risk of malaria. This study would help to achieve Sustainable Development Goals (SDGs) by improving programs that deal with the prevention of malaria. Therefore, this study aimed to assess the prevalence and associated factors of malaria among pregnant women. Methods A community-based cross-sectional study was conducted from July to August 2018 in Sherkole district, West Ethiopia. A multi-stage sampling technique was used to select 504 pregnant women. The interviewer-administered semi-structured questionnaire was used for data collection. Malaria was also diagnosed using a rapid diagnostic test. The data was entered using EPI info version 7.2.2.2 and transferred to SPSS version 20 for analysis. Descriptive statistics were done using frequency and percentages. Both bivariable and multivariable logistic regression models were employed. Variables having p-value < 0.2 were included in the final multivariable model. Variables having p-values < 0.05 from the multivariable model were considered to be significantly associated with the dependent variable. The adjusted odds ratio with its 95% confidence interval (CI) was used as a measure of association. Results Of the total 498 pregnant women who participated in this study, 51(10.2, 95% CI: 7.72–13.24) were found to have malaria. Of these, 46 (90.2%) and 5 (9.8%) were caused by Plasmodium falciparum and Plasmodium vivax, respectively. Decreasing Age (Adjusted Odds Ratio (AOR) 0.78; 95% CI 0.67–0.911), not using insecticide-treated bed net (ITN) (AOR 12.5; 95% CI 4.86–32.21), lack of consultation and health education about malaria prevention (AOR 7.18; 95% CI 2.74–18.81), being on second-trimester pregnancy (AOR 7.58; 95% CI 2.84–20.2), gravidae II (AOR 5.99; 95% CI 1.68–21.44) were found to be significantly associated with malaria during pregnancy. Conclusion Malaria is still a public health problem among pregnant women in the Sherkole district. Age, ITN use, gravidity, gestational age, and health education had a significant association with malaria. Screening pregnant women for asymptomatic malaria infection and educating and consulting on the appropriate malaria preventive methods shall be provided.
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Affiliation(s)
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Effect of Impregnated Mosquito Bed Nets on the Prevalence of Malaria among Pregnant Women in Foumban Subdivision, West Region of Cameroon. J Parasitol Res 2020; 2020:7438317. [PMID: 32733698 PMCID: PMC7383309 DOI: 10.1155/2020/7438317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/02/2020] [Accepted: 05/09/2020] [Indexed: 11/18/2022] Open
Abstract
Background Malaria is one of the major public health problems in many tropical developing countries including Cameroon. Impregnated mosquito bed nets are one of the control measures put in place by the WHO and adopted by the Cameroon's Ministry of Public Health to fight against malaria in pregnancy. This study was a population-based cross-sectional study that investigated the level of adherence, respondent's knowledge, altitude, and practices toward malaria prevention and control. Methods To investigate this, a sample size of 410 pregnant women who were inhabitants of Foumban Subdivision was examined. Data on net ownership versus usage, pregnancy status, and socioeconomic background were collected using a questionnaire. Parasitological tests for malaria parasites were carried out using peripheral blood samples obtained from finger pricks of the pregnant women for the preparation of thick blood smear and RDTs. Results Two hundred and eighteen tested positive (53.4%) with the highest prevalence occurring during the first trimester (79.6%) and in primigravidae (68.8%). Participants believed that mosquito bed nets can protect them against malaria infection. The highest number (81.0%) of the women who had mosquito nets acquired them during antenatal visits. Among those who possessed nets, 42.7% adhered to sleeping under them and few (50%) experienced problems of sweating, discomfort, and heat. Also, the study revealed a high prevalence rate of 63.8% for those who did not use nets during pregnancy as compared to those who owned and used them. Conclusion The findings indicated that increased access to impregnated mosquito bed nets is required to lower the risk of malaria infection amongst pregnant women. The Cameroon government should improve health education to families within the locality and pursue an integrated approach to fight against mosquitoes during the rainy season.
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Jajosky RP, Jajosky AN, Jajosky PG. "Dual-gene" malaria-resistance: Therapeutically-rational exchange (T-REX) of group-O sickle trait and group-O C-traittrait red blood cells can be evaluated in Benin and Nigeria. Transfus Apher Sci 2020; 59:102733. [PMID: 32019737 DOI: 10.1016/j.transci.2020.102733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 01/06/2020] [Accepted: 01/17/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Using indicators of disease severity, clinicians can predict which Plasmodium falciparum (Pf) malaria patients being treated with artesunate or quinine are likely to die despite these drugs. Effective "rescue adjuncts" are needed when drugs alone are inadequate. "Therapeutically-rational exchange" (T-REX) of special malaria-resistant red blood cells (RBCs) has been proposed to optimize adjunctive exchange transfusion. METHODS Studies were reviewed that (1) quantified how group-O status and "sickle-trait" (HbAS) and "C-trait" (HbAC) hemoglobins affect Pf mortality, risk of thrombosis, or birth outcomes for women with pregnancy associated malaria (PAM), (2) reported prevalences of "dual-gene" malaria-resistant RBCs, or (3) reflected the level of exchange-transfusion and malaria-related expertise in Benin and Nigeria. RESULTS Data show that the malaria- and thrombosis-resistance of RBCs depend on specific genes and the patient's clinical status and medical history. In malaria-endemic Benin and Nigeria, prevalences of "dual-gene" malaria-resistant group-O HbAS and group-O HbAC RBCs are substantial, and both malaria- and exchange-related expertise are outstanding. CONCLUSIONS T-REX of "dual-gene" malaria-resistant RBCs is feasible in Benin and Nigeria and warrants evaluation as a rescue adjunct for 3 subsets of Pf-malaria patients. For therapeutic use, group-O HbAS RBCs are likely to be more effective than non-O HbAS RBCs for Pf-infected patients who (1) have a history of thrombosis or (2) are taking birth-control hormones while group-O HbAC RBCs may substantially improve birth outcomes for women with PAM. Studies suggest it is prudent to assume - until proven otherwise - that T-REX of "dual-gene" malaria-resistant RBCs can improve ("personalize") rescue of these patient subsets.
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Affiliation(s)
- Ryan Philip Jajosky
- Emory University, Department of Pathology and Laboratory Medicine, Atlanta, GA, USA; Biconcavity Inc., Retired USPHS Officer at Centers for Disease Control and Prevention,1106 Spring Mill Dr. SW, Lilburn, GA 30047, USA.
| | - Audrey N Jajosky
- Case Western Reserve University, University Hospitals Cleveland Medical Center, Department of Pathology, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Philip G Jajosky
- Biconcavity Inc., Retired USPHS Officer at Centers for Disease Control and Prevention,1106 Spring Mill Dr. SW, Lilburn, GA 30047, USA.
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Bhalla D, Cleenewerck L, Okorafor Kalu S, Abubakar Gulma K. Malaria Prevention Measures among Pregnant Women: A Population-Based Survey in Nnewi, Nigeria. ScientificWorldJournal 2019; 2019:6402947. [PMID: 31827414 PMCID: PMC6881563 DOI: 10.1155/2019/6402947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/24/2019] [Accepted: 08/30/2019] [Indexed: 11/21/2022] Open
Abstract
We examined factors related to the uptake of two malaria prevention measures, insecticide-treated bed-nets and prophylactic sulphadoxine-pyrimethamine (SP), among pregnant women in Nnewi, Nigeria. The survey had a quantitative and qualitative part. For each part, the subjects meeting our inclusion criteria were systematically identified in a population-based manner. For the qualitative part, focused group discussions, in-depth interviews with a wide variety of stakeholders (e.g., health workers, males whose wives are pregnant, and drug and net sellers), and key informants including doctors and nurses were held. All data covered various aspects related to the topics. A total of 384 subjects participated. The mean age was 28.9 years (95% CI 23.4-34.5). The primigravidae (odds 1.8-2.3) and illiterates (odds 4.1-13.5) were less likely to sleep under the net. Primigravidae were 2.0x less likely to uptake adequate SP. The uptake was also associated with having adequate knowledge on SP (2.4x), completing usual (≥4 visits) antenatal visits (3.9x), and being in the best (≥9 visits) antenatal visit scenario (10.5x). Other barriers identified were thermal discomfort, lack of availability, cost, and unsupervised uptake of SP. Based on a representative sample, systematic procedures, and within current evaluation limits, we conclude that primigravidae and those with no formal education and inadequate antenatal visits should be the foremost group for encouraging uptake of malaria prevention measures. The policymakers should resolve issues of thermal discomfort, availability, cost, unsupervised uptake, and inadequate awareness and confidence on SP prophylaxis. The solutions are available and should be actively sought.
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Affiliation(s)
- Devender Bhalla
- School of Global Health and Bioethics, EUCLID (Pôle Universitaire Euclide/Euclid University), Bangui, Central African Republic
| | - Laurent Cleenewerck
- School of Global Health and Bioethics, EUCLID (Pôle Universitaire Euclide/Euclid University), Bangui, Central African Republic
| | - Stephen Okorafor Kalu
- School of Global Health and Bioethics, EUCLID (Pôle Universitaire Euclide/Euclid University), Bangui, Central African Republic
| | - Kabiru Abubakar Gulma
- School of Global Health and Bioethics, EUCLID (Pôle Universitaire Euclide/Euclid University), Bangui, Central African Republic
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Olugbade OT, Ilesanmi OS, Gubio AB, Ajayi I, Nguku PM, Ajumobi O. Socio-demographic and regional disparities in utilization of intermittent preventive treatment for malaria in pregnancy - Nigeria demographic health survey 2013. Pan Afr Med J 2019; 32:13. [PMID: 30949287 PMCID: PMC6441474 DOI: 10.11604/pamj.supp.2019.32.1.13345] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 01/20/2018] [Indexed: 11/24/2022] Open
Abstract
Introduction malaria in pregnancy can lead to medical emergencies. Utilization of intermittent preventive treatment for prevention of malaria in pregnancy with Sulphadoxine- Pyrimethamine (IPTp-SP) has remained low in developing countries in sub-Saharan Africa. This study aimed to identify the factors determining uptake of IPTp-SP in Nigeria using the 2013 Nigeria Demographic Health Survey. Methods we conducted a secondary analysis of data extracted from the National Demographic Health Survey 2013 which used a three stage stratified sampling method to select respondents. Independent variables considered were age, marital status, the level of education of respondents and their spouses, region, location of residence, wealth-index and birth order. The dependent variable was the use of two or more doses of SP for IPTp in the two years before the survey. Descriptive statistics for socio-demographic and selected characteristics was done. Chi-square test was used to test associations between sociodemographic characteristics and IPTp-SP uptake. Multiple logistic regressions at 95% confidence interval were used to determine predictors of IPTp utilization using STATA version14 software. Results of the 38,948 women interviewed 12,473 (32%) had given birth two years preceding the survey and 15% used at least two doses of SP for IPTp. Women aged 30 years and above [aOR 1.4, C.I:1.1-1.7], in the middle class or higher wealth index [aOR 1.5, CI: 1.1-2.0], with two or more ANC visits [aOR 4.2, CI: 1.4 - 12.5], were more likely to use IPTp. Conclusion late initiation of IPTp after the second trimester was a contributory factor for poor SP utilization. Interventions targeted at ensuring pregnant women attend ANC and use of IPTp-SP after quickening should be promoted.
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Affiliation(s)
| | | | - Aishatu Bintu Gubio
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.,National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Ikeoluwapo Ajayi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Patrick Mboya Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Olufemi Ajumobi
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.,National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
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Igweonu OU, Onyeneho NG. Anemia in Pregnancy: Urban-Rural Comparison of Management and Prevention Among Women of Child-Bearing Age in Anambra State, Nigeria. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 39:155-161. [PMID: 30596326 DOI: 10.1177/0272684x18819975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We explored management and prevention practices concerning anemia in pregnancy (AIP) in Anambra State, Nigeria from a cross-sectional survey of 600 women of child-bearing age through a multistage random selection process. The objective is to identify factors that influence recognition and management of AIP. A knowledge index of 45 points was developed with the mean score of 5.9 points (5.9 ± 6.1 SD). Furthermore, 49.3% of the respondents had good knowledge. The urban respondents had good knowledge (66.7%) compared with their rural counterparts (32%). There were misconceptions on the causes, management, and prevention of AIP during pregnancy. Multiple regression analyses revealed that variables such as religious affiliation, education, and residence influenced the knowledge about AIP. A unit increase in the educational level of the women will bring about 0.644 units of increase in the knowledge of AIP ( p = .003). A unit change from urban to rural locality would lead to 1.536 units increase in correct practices to prevent AIP ( p < .001). A unit change to being married would lead to 0.936 unit increase in correct practices to prevent AIP ( p = .025). Knowledge about the management and prevention of AIP was poor. Anemia-related education to improve knowledge and practice should be provided during antenatal care. Living in an urban community was associated with the odds ratio of 4.3 (95% CI [3.07, 6.07]) and 7.42 (95% CI [2.0, 27.6]) for knowledge and prevention of AIP, respectively.
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Affiliation(s)
- Obianuju U Igweonu
- 1 Social Science Unit, School of General Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Nkechi G Onyeneho
- 2 Department of Sociology/Anthropology, University of Nigeria, Nsukka, Enugu State, Nigeria.,3 Takemi Program in International Health, Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
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Owoeye DO, Akinyemi JO, Yusuf OB. Decomposition of changes in malaria prevalence amongst under-five children in Nigeria. MALARIAWORLD JOURNAL 2018; 9:3. [PMID: 34532246 PMCID: PMC8415053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Malaria remains a major public health problem in Nigeria. Changes in malaria prevalence can be attributed to three major control interventions: insecticide treated nets (ITNs), indoor residual spraying (IRS) and intermittent preventive treatment in pregnancy (IPTp). Use of ITNs has proven to be a practical, highly effective, and cost-effective intervention against malaria. Although, several studies have assessed the utilisation of ITNs, its impact on the prevalence of malaria over time is yet to be documented in Nigeria. Therefore, this study was conducted to decompose changes in malaria prevalence amongst under-five children between 2003 and 2013. MATERIALS AND METHODS A retrospective analysis of the 2003 and 2013 Nigeria Demographic Health Survey (NDHS) dataset was conducted. Occurrence of fever was used as a proxy for malaria. Percentage change in both outcome and explanatory variables between 2003 and 2013 was estimated. A multivariate decomposition technique was used to partition changes in malaria prevalence into two components: contribution of changes in determinants and changes in the effect of determinants. RESULTS A total of 5204 and 28634 records of children under-five were available in 2003 and 2013 respectively. Malaria prevalence declined from 31.8% to 13.1% between 2003 and 2013 (p<0.001). Changes in determinants contributed 4.7% and changes in the effect of determinants contributed 95.3% to the change in malaria prevalence. CONCLUSIONS There was a decline in the prevalence of malaria amongst children under five in Nigeria in the last ten years. Ownership of ITNs and their utilisation were the most contributing factors to the decline in malaria prevalence. Continued efforts should be made in promoting ITNs and their consistent and appropriate utilisation.
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Affiliation(s)
- Deborah O. Owoeye
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria,*
| | - Joshua O. Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria
| | - Oyindamola B. Yusuf
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria
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Ojurongbe O, Nguetse CN, Fayemiwo SA, Falade CO, Ojurongbe TA, Thomas BN, Meyer CG, Velavan TP. High prevalence of dihydrofolate reductase gene mutations in Plasmodium falciparum parasites among pregnant women in Nigeria after reported use of sulfadoxine-pyrimethamine. Pathog Glob Health 2018; 112:86-92. [PMID: 29318942 DOI: 10.1080/20477724.2017.1422615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
This study assesses the prevalence of asymptomatic Plasmodium falciparum parasitemia positivity and P. falciparum dihydrofolate reductase (pfdhfr) mutations in parasite isolates among pregnant women in Southwest Nigeria. Plasmodium falciparum parasitemia was confirmed by microscopy and nested PCR in 200 pregnant women attending antenatal care. The prevalence of pfdhfr polymorphisms was determined by direct sequencing of the gene fragments containing the C50R, N51I, C59R, S108N, and I164L mutations. Information on the use of antimalarial drugs and methods applied to prevent malaria were obtained by a questionnaire. The prevalence of asymptomatic P. falciparum infection was 30% (60/200). The frequency of the pfdhfr triple-mutant alleles (N51I, C59R, and S108N) was 63% (38/60); none of the isolates carried the I164L mutation. Among the investigated pregnant women, 40% used un-prescribed antimalarials such as dihydroartemisinin (18%), chloroquine (14%) or pyrimethamine (9%), while only 20.5% used sulfadoxine-pyrimethamine for prevention and 39.5% did not use any drug. The prevalence of P. falciparum parasitemia (37%) was higher among pregnant women who had not taken any antimalarial drugs. A significant difference in the prevalence of the pfdhfr triple-mutant alleles was observed among women who took SP (90%) compared to those who did not take any drug (82%) and women who took dihydroartemisinin (67%) p = 0.007). Poor adherence to the World Health Organisation (WHO) strategies for malaria prevention among pregnant women was observed in addition to high prevalence of pfdhfr mutations. These findings underline the need to improve control of malaria among pregnant women in the study area.
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Affiliation(s)
- Olusola Ojurongbe
- a Department of Medical Microbiology and Parasitology , Ladoke Akintola University of Technology , Osogbo , Nigeria.,b Institute of Tropical Medicine , Eberhard Karls University of Tübingen , Tübingen , Germany
| | - Christian N Nguetse
- b Institute of Tropical Medicine , Eberhard Karls University of Tübingen , Tübingen , Germany.,c Department of Pediatrics , Stanford University School of Medicine , Stanford , CA , USA
| | - Samuel A Fayemiwo
- d Department of Medical Microbiology, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - Catherine O Falade
- e Department of Pharmacology & Therapeutics, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - Taiwo A Ojurongbe
- f Department of Mathematical and Physical Sciences , Osun State University , Osogbo , Nigeria
| | - Bolaji N Thomas
- g Department of Biomedical Sciences , Rochester Institute of Technology , Rochester NY , USA
| | - Christian G Meyer
- b Institute of Tropical Medicine , Eberhard Karls University of Tübingen , Tübingen , Germany.,h Duy Tan University , Da Nang , Vietnam
| | - Thirumalaisamy P Velavan
- b Institute of Tropical Medicine , Eberhard Karls University of Tübingen , Tübingen , Germany.,h Duy Tan University , Da Nang , Vietnam.,i Fondation Congolaise Pour la Recherche Medicale , Brazzaville , Republic of Congo
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Determinants of Malaria Prevention and Treatment Seeking Behaviours of Pregnant Undergraduates Resident in University Hostels, South-East Nigeria. J Pregnancy 2017; 2017:3653874. [PMID: 29333296 PMCID: PMC5733237 DOI: 10.1155/2017/3653874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 10/24/2017] [Accepted: 10/31/2017] [Indexed: 11/20/2022] Open
Abstract
This cross-sectional descriptive survey investigated determinants of malaria prevention and treatment seeking behaviours of pregnant undergraduates resident in university hostels, South-East Nigeria. Purposive sampling was used to enrol 121 accessible and consenting undergraduates with self-revealed and noticeable pregnancy residing in twenty-three female hostels of four university campuses in Enugu State, Nigeria. Structured interview guide developed based on reviewed literature and WHO-recommended malaria prevention and treatment measures was used to collect students' self-report data on malaria preventive health behaviours, sick role behaviours, and clinic use using mixed methods. The WHO-recommended malaria prevention measures were sparingly used. Some believed that pregnancy does not play any role in a woman's reaction to malaria infection. Only 41 (50.6%) visited a hospital for screening and treatment. Thirty-four (28.1%) used antimalaria medicine bought from chemist shop or over-the-counter medicines, while 33 (27.3%) used untreated net. The students were more likely to complete their antimalaria medicine when they were sick with malaria infection than for prevention (p = 0.0186). Knowledge, academic schedule, cultural influence on perception and decision-making, and accessibility of health facility were key determinants of the women's preventive and treatment seeking behaviours. Health education on malaria prevention and dangers of drug abuse should form part of orientation lectures for all freshmen. University health centres should be upgraded to provide basic antenatal care services.
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Olukoya O, Adebiyi O. MISSED OPPORTUNITIES FOR INTERMITTENT PREVENTIVE TREATMENT FOR MALARIA IN PREGNANCY IN NIGERIA: EVIDENCE FROM DEMOGRAPHIC AND HEALTH SURVEY IN NIGERIA 2013. Ann Ib Postgrad Med 2017; 15:88-95. [PMID: 29556162 PMCID: PMC5846180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Malaria is of global health concern particularly among pregnant women. Nigeria contributes largely to global burden but coverage of Intermittent Preventive Treatment of malaria in pregnancy using Sulphadoxine pyrimethamine remains low. This study was conducted to determine the national situation of missed opportunity for IPTp-SP and attempted to look at correlates and predictors. METHOD The study used secondary data analysis of the Nigeria Demographic Health Survey, 2013. Data on socio-demographics, ANC characteristics and IPTp-SP use during pregnancy among 6,910 women aged 15-49 years who delivered in the last two years with at least 4 ANC visits were analyzed. Missed opportunity for IPTp delivery was defined as an ANC visit where IPTp was not delivered as per the policy. Data was analyzed using SPSS version 21. Associations used Chi-square test and significant variables were fit into multi-variate logistic regression model. All analyses were performed at 5% level of significance. RESULTS National prevalence for missed opportunity for IPTp-SP was high (73.4%). Predictors of missed opportunity are being of poorer, middle and richer wealth index (OR=0.737, CI 0.566-0.960); (OR=0.659, CI 0.521-0.833); (OR=0.686, CI 0.550-0.857), residence in South East OR=0.549, CI (0.415-0.726) and in the North West (OR=0.176, CI 0.133-0.232). Other predictors are having a primary and secondary education and presenting for the first ANC visit in the second trimester OR=0.739, p=0.024, CI (0.569-0.961). CONCLUSION Missed opportunity for IPTp-SP was high. The need for stronger governmental commitment to upscale uptake of IPTp-SP by incorporating the knowledge of socio-economic, cultural and demographic barriers to accessing IPTp is paramount.
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Affiliation(s)
- O.O Olukoya
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - O.A. Adebiyi
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria,Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Antenatal Practices Ineffective at Prevention of Plasmodium falciparum Malaria during Pregnancy in a Sub-Saharan Africa Region, Nigeria. Trop Med Infect Dis 2017; 2:tropicalmed2020015. [PMID: 30270874 PMCID: PMC6082074 DOI: 10.3390/tropicalmed2020015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/08/2017] [Accepted: 06/09/2017] [Indexed: 11/17/2022] Open
Abstract
Pregnancy-associated malaria (PAM) is a major public health concern constituting a serious risk to the pregnant woman, her foetus, and newborn. Management of cases and prevention rely partly on effective and efficient antenatal services. This study examined the effectiveness of antenatal service provision in a major district hospital in sub-Saharan Africa at preventing PAM. A cross-sectional hospital based study design aided by questionnaire was used. Malaria diagnosis was by microscopy. Overall prevalence of PAM was 50.7% (38/75). Mean Plasmodium falciparum density was (112.89 ± standard error of mean, 22.90) × 10³/µL red blood cell (RBC). P. falciparum prevalence was not significantly dependent on gravidity, parity, trimester, age, and BMI status of the women (p > 0.05). Difference in P. falciparum density per µL RBC in primigravidae (268.13 ± 58.23) × 10³ vs. secundi- (92.14 ± 4.72) × 10³ vs. multigravidae (65.22 ± 20.17) × 10³; and in nulliparous (225.00 ± 48.25) × 103 vs. primiparous (26.25 ± 8.26) × 10³ vs. multiparous (67.50 ± 20.97) × 10³ was significant (p < 0.05). Majority of attendees were at 3rd trimester at time of first antenatal visit. Prevalence of malaria parasitaemia in the first-time (48.6%), and multiple-time (52.6%) antenatal attendees was not significantly different (χ² = 0.119, p = 0.730). The higher prevalence of malaria among bed net owners (69.6% vs. 42.9%, χ² = 2.575, p = 0.109, OR = 3.048 (95% CI 0.765⁻12.135)) and users (66.7% vs. 33.3%, χ² = 2.517, p = 0.113, OR = 4.000 (95% CI 0.693⁻23.089)) at multiple antenatal visits vs. first timers was not significant. None of the pregnant women examined used malaria preventive chemotherapy. Antenatal services at the hospital were not effective at preventing PAM. Holistic reviews reflecting recommendations made here can be adopted for effective service delivery.
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Evaluation of Renal Function in Pregnant Women with Malaria: A Case-Control Study in a Mesoendemic Area. Obstet Gynecol Int 2017; 2017:6030943. [PMID: 28367218 PMCID: PMC5359451 DOI: 10.1155/2017/6030943] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 02/03/2017] [Accepted: 02/22/2017] [Indexed: 11/18/2022] Open
Abstract
Background. Malaria is known to have devastating effects on mortality in tropical and subtropical regions with the effect being magnified in people with weakened immunity such as those in pregnancy. We assessed the effect of malaria on renal function of pregnant women receiving antenatal care in a mesoendemic area of Ghana. Methodology. A case-control study that enrolled a total of 100 pregnant women (50 with confirmed gestational malaria as cases and 50 without malaria as controls). Sociodemographic characteristics, obstetric history (obtained with a questionnaire), urea, creatinine, sodium, and potassium were analyzed using a chemistry automated analyzer. Results. Plasma urea and creatinine were significantly increased (P = 0.0003 and P < 0.0001, resp.) among cases compared to the controls. Also the levels of urea (P = 0.033), creatinine (P = 0.032), and parasitaemia (0.016) were significantly increased with increasing gestational age. Conclusion. Malaria has a significant impact on renal function (most importantly, urea and creatinine) and is also significantly associated with increasing gestational age among our study participants.
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Debo GW, Kassa DH. Prevalence of malaria and associated factors in Benna Tsemay district of pastoralist community, Southern Ethiopia. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2016; 2:16. [PMID: 28883960 PMCID: PMC5530935 DOI: 10.1186/s40794-016-0033-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 08/23/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Though the burden of malaria is declining, challenges in control continue globally, regionally and nationally as the transmission of malaria is dynamic and determinants differ by place and time, and across populations. The current level of knowledge on malaria prevalence and associated factors in specific communities, such as pastoralist communities of Ethiopia, is lacking. METHODS A community based cross-sectional survey was conducted among pastoralist communities from December 2011 to January 2012. Background information and peripheral blood samples were collected from 461 randomly selected study participants. Multivariate regression analysis was done to explore the risk factors associated to malaria. RESULT The prevalence of malaria among 461 examined study participants was 6.1 % (95 % CI = 4.2, 8.5). The infection rate with Plasmodium falciparum and Plasmodium vivax was 64.3 % (95 % CI = 45.5, 80.2) and 21.4 % (95 % CI = 19.8, 54.5), respectively, while mixed infection was 14.3 % (95 % CI = 4.7, 30.9). The infection rate was higher among lactating (22.2 %, 95 % CI =7.5, 45.3) and pregnant (17.6 %, 95 % CI = 4.7, 40.9) women compared with other community groups like infants (12 %). Mosquito net coverage of the study population was 90.1 % with an average of 1.8 per household. Traditional practices related to malaria prevention and treatment were not significantly associated with malaria infection (p > 0.05). Pregnancy (adjusted Odds Ratio [AOR]: 12.6, 95 % CI = 1.7, 94.7) and saving mosquito net for later use (AOR 9.6: 95 % CI = 2.2, 42.8) were independently associated with prevalent malaria infection. CONCLUSION In spite of high coverage of mosquito nets, prevalence of malaria in this pastoralist community was high, affecting pregnant and lactating women at a higher rate. Pregnancy and saving mosquito nets for later use were identified as the associated risk factors. Health education on prevalence of malaria and knowledge on risk factors might be able to change the health behavior in this pastoralist community which consequently can decrease the malaria morbidity and mortality. TRIAL REGISTRATION ISRCTN ISRCTN73824458, Registered 28 September 2014.
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Affiliation(s)
- Gidie Woju Debo
- UNICEF SNNPR Field Office, UNDP/UNV/UNICEF-Ethiopia, Hawassa, Ethiopia.,P.O.B. 12038, Addis Ababa, Ethiopia
| | - Dejene Hailu Kassa
- School of Public and Environment Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Mutagonda RF, Kamuhabwa AAR, Minzi OMS, Massawe SN, Maganda BA, Aklillu E. Malaria prevalence, severity and treatment outcome in relation to day 7 lumefantrine plasma concentration in pregnant women. Malar J 2016; 15:278. [PMID: 27177586 PMCID: PMC4866074 DOI: 10.1186/s12936-016-1327-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/04/2016] [Indexed: 12/28/2022] Open
Abstract
Background Day 7 plasma concentrations of lumefantrine (LF) can serve as a marker to predict malaria treatment outcome in different study populations. Two main cut-off points (175 and 280 ng/ml) are used to indicate plasma concentrations of LF, below which treatment failure is anticipated. However, there is limited data on the cumulative risk of recurrent parasitaemia (RP) in relation to day 7 LF plasma concentrations in pregnant women. This study describes the prevalence, severity, factors influencing treatment outcome of malaria in pregnancy and day 7 LF plasma concentration therapeutic cut-off points that predicts treatment outcome in pregnant women. Methods This was a one-arm prospective cohort study whereby 89 pregnant women with uncomplicated Plasmodium falciparum malaria receiving artemether-lumefantrine (ALu) participated in pharmacokinetics and pharmacodynamics study. Blood samples were collected on days 0, 2, 7, 14, 21 and 28 for malaria parasite quantification. LF plasma concentrations were determined on day 7. The primary outcome measure was an adequate clinical and parasitological response (ACPR) after treatment with ALu. Results The prevalence of malaria in pregnant women was 8.1 % (95 % CI 6.85–9.35) of whom 3.4 % (95 % CI 1.49–8.51) had severe malaria. The overall PCR-uncorrected treatment failure rate was 11.7 % (95 % CI 0.54–13.46 %). Low baseline hemoglobin (<10 g/dl) and day 7 LF concentration <600 ng/ml were significant predictors of RP. The median day 7 LF concentration was significantly lower in pregnant women with RP (270 ng/ml) than those with ACPR (705 ng/ml) (p = 0.016). The relative risk of RP was 4.8 folds higher (p = 0.034) when cut-off of <280 ng/ml was compared to ≥280 ng/ml and 7.8-folds higher (p = 0.022) when cut-off of <600 ng/ml was compared to ≥600 ng/ml. The cut-off value of 175 ng/ml was not associated with the risk of RP (p = 0.399). Conclusions Pregnant women with day 7 LF concentration <600 ng/ml are at high risk of RP than those with ≥600 ng/ml. To achieve effective therapeutic outcome, higher day 7 venous plasma LF concentration ≥600 ng/ml is required for pregnant patients than the previously suggested cut-off value of 175 or 280 ng/ml for non-pregnant adult patients.
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Affiliation(s)
- Ritah F Mutagonda
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. BOX 65013, Dar es Salaam, Tanzania.
| | - Appolinary A R Kamuhabwa
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. BOX 65013, Dar es Salaam, Tanzania
| | - Omary M S Minzi
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. BOX 65013, Dar es Salaam, Tanzania
| | - Siriel N Massawe
- Department of Obstetrics and Gynaecology, School of Medicine, Muhimbili University of Allied Sciences, P.O. BOX 65013, Dar es Salaam, Tanzania
| | - Betty A Maganda
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. BOX 65013, Dar es Salaam, Tanzania
| | - Eleni Aklillu
- Department of Laboratory of Medicine, Division of Clinical Pharmacology, Karolinska Institutet, 141 86, Stockholm, Sweden
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Assessment of Markers of Antimalarial Drug Resistance in Plasmodium falciparum Isolates from Pregnant Women in Lagos, Nigeria. PLoS One 2016; 11:e0146908. [PMID: 26808627 PMCID: PMC4726598 DOI: 10.1371/journal.pone.0146908] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 12/23/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The use of antimalarial drugs for prevention and treatment is a major strategy in the prevention of malaria in pregnancy. Although sulphadoxine-pyrimethamine (SP) is currently recommended for intermittent preventive treatment of malaria during pregnancy in Nigeria, previously used drugs for prophylaxis such as chloroquine (CQ) and pyrimethamine are accessible as they are purchased over the counter. This study describes the markers of absence or presence of resistance to quinoline (Pfcrt and Pfmdr 1) and type 1 antifolate antimalarial medicines (Pfdhfr). METHODS Plasmodium falciparum-positive dried blood spots from pregnant women attending antenatal clinics for the first time during current pregnancy were investigated for the presence of mutations at codons 72-76 of Plasmodium falciparum chloroquine resistance transporter (Pfcrt) gene by real time polymerase chain reaction (PCR) using haplotype-specific probes. PCR followed by sequence analysis was used to identify mutations at codons 86, 184, 1034, 1042 and 1246 of P. falciparum multi-drug resistance-1 (Pfmdr1) gene; and codons 16, 50, 51, 59, 108, 140 and 164 of Pfdhfr gene. RESULTS Two haplotypes of Pfcrt (n = 54) were observed: CVMNK 13(24.2%) and CVIET 41 (75.9%) of the samples. The SVMNT haplotype was absent in this population. The Pfmdr1 (n = 28) haplotypes were NYSND 15(53.6%), YYSND 5(17.9%), NFSND 6(21.4%) and YFSND 2(7.1%). The Pfdhfr (n = 15) were ACNCSVI 4(26.7%), and ACICNSVI 1(6.7%) and ACIRNVI 10 (66.7%). The rate of occurrence of Pfcrt 76T, Pfdhfr108N, Pfmdr186Y and 184F were 75.9%, 73.3%, 25% and 28.1% respectively. The Pfmdr1 86Y was associated with low parasitaemia (median = 71 parasites/μl, P = 0.024) while Pfcrt 76T was associated with young maternal age (mean 24.1 ± 4.5 years; P = 0.006). The median parasitaemia were similar (P>0.05) in wild and mutant strains of Pfcrt 76, Pfmdr1 184 and Pfdhfr 108. There was no association between gravidity or gestational age of the women and presence of mutations in the Pfcrt, Pfmdr1 or Pfdhfr genes (P>0.05). CONCLUSION Markers of resistance to chloroquine and pyrimethamine were high, whereas cycloguanil-resistance marker was not present in the studied population. The low level of mutations in the Pfmdr1gene indicates likely efficacy of amodiaquine against malaria in pregnancy.
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Fana SA, Bunza MDA, Anka SA, Imam AU, Nataala SU. Prevalence and risk factors associated with malaria infection among pregnant women in a semi-urban community of north-western Nigeria. Infect Dis Poverty 2015; 4:24. [PMID: 26269742 PMCID: PMC4534061 DOI: 10.1186/s40249-015-0054-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 04/13/2015] [Indexed: 11/20/2022] Open
Abstract
Background Malaria during pregnancy remains a serious public health problem, with substantial risks for the mother, her foetus and the newborn. The aim of this study was to determine the prevalence of malaria and possible risk factors for malaria infection among pregnant women in a semi-urban area in north-western Nigeria. Pregnant women are among the most susceptible to malaria infection. Knowledge of their malaria infection status is an important yardstick to measure the effectiveness of any malaria control programme. Methods We conducted a cross sectional study in the semi-urban area of Argungu, Kebbi State Nigeria. Two hundred and fifty five pregnant women were included in the study after informed verbal consent was obtained. For each participant, the socio-demographic profile, stage of pregnancy and attitude to the use of insecticide- treated nets (ITNs) were investigated using a questionnaire. Peripheral blood samples were collected and thick blood smears were prepared and stained with Giemsa stains to check for malaria parasitaemia. The associations between age, education level and use of ITNs with occurrence of malaria infection during pregnancy were analysed using the chi-square test. Results One hundred and six (41.6%) out of 255 pregnant women were infected with malaria parasites, with a mean parasite density of 800 parasitesμl−1. It was found that prevalence and parasite density decreased as age increased. The chi-square test indicated that a lack of education and non-usage of ITNs were significantly associated with malaria infection. Conclusion Malaria is still a major public health issue among pregnant women mainly due to illiteracy and non -compliance to using ITNs. Increasing awareness about malaria preventive measures and early attendance of antenatal care services will help to reduce malaria and, consequently, its associated morbidities and mortalities. Electronic supplementary material The online version of this article (doi:10.1186/s40249-015-0054-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sani Abdullahi Fana
- Department of Medical Microbiology, Faculty of Medical Laboratory Science, UsmanuDanfodiyo University, Sokoto, Nigeria
| | | | - Sule Aliyu Anka
- Department of Biological Sciences, UsmanuDanfodiyo University, Sokoto, Nigeria
| | - Asiya Umar Imam
- Department of Medical Microbiology, Faculty of Medical Laboratory Science, UsmanuDanfodiyo University, Sokoto, Nigeria
| | - Shehu Usman Nataala
- Department of Medical Microbiology, Faculty of Medical Laboratory Science, UsmanuDanfodiyo University, Sokoto, Nigeria
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Morenikeji OA, Atanda OS, Eleng IE, Salawu OT. Schistosoma haematobium and Plasmodium falciparum single and concomitant infections; any association with hematologic abnormalities? PEDIATRIC INFECTIOUS DISEASE 2014; 6:124-129. [DOI: 10.1016/j.pid.2014.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
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Amuta E, Houmsou R, Wama E, Ameh M. Malarial Infection among Antenatal and Maternity Clinics Attendees at the Federal Medical Centre, Makurdi, Benue State, Nigeria. Infect Dis Rep 2014; 6:5050. [PMID: 24757507 PMCID: PMC3987244 DOI: 10.4081/idr.2014.5050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 11/29/2013] [Accepted: 12/20/2013] [Indexed: 11/22/2022] Open
Abstract
This study assessed the level of malarial infection in relation to some epidemiological factors, gravidity and pregnancy period of antenatal clinic attendees of the Federal Medical Centre, Makurdi, Benue State, Nigeria. We also assessed malarial infection in placental blood in relation to gravidity of pregnant women at delivery in the maternity clinic of the same hospital. Thin and thick blood films were prepared for microscopic examination. A questionnaire was administered to each pregnant woman at the antenatal clinic to collect data on educational level, occupation, gravidity, pregnancy period, malaria preventive measures and malaria symptoms. Of the 163 pregnant women examined at the antenatal clinic, 68.3% (111/163) were infected with malaria. Pregnant women that are illiterates (χ(2) =15.44, P=0.100) and those that are farmers (χ(2) =9.20, P=0.270) had the highest infection rate with no significant difference respectively. Malarial infection was significantly higher in the multigravidae, 57.6% (34/59) (χ(2) =5.16, P=0.007) and non-significant in the pregnant women at their third trimester of pregnancy, 60.9% (53/89) (χ(2) =4.45, P=0.108). Placental malaria was significantly higher in the primigravidae among pregnant women at delivery (χ(2) =9.33, P=0.000). A significant difference (χ(2) =33.52, P=0.000) was observed between pregnant women that did not use any malaria preventive methods, 91.2% (31/34) and those that used single, 64.3% (65/101) and combined, 46.4% (13/28) methods of prevention. Malaria remains highly prevalent among antenatal clinics attendees in Makurdi, Nigeria. Combined method of prevention (insecticides treated nets and insecticide spray) yielded good results and its use is advocated in preventing malaria among the pregnant women.
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Affiliation(s)
- Elizabeth Amuta
- Department of Biological Sciences, University of Agriculture , Makurdi, Nigeria
| | - Robert Houmsou
- Departement of Biological Sciences, Taraba State University , Jalingo, Nigeria
| | - Emmanuel Wama
- Departement of Biological Sciences, Taraba State University , Jalingo, Nigeria
| | - Mary Ameh
- Department of Biological Sciences, Benue State University Makurdi , Nigeria
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El Ayadi A, Raifman S, Jega F, Butrick E, Ojo Y, Geller S, Miller S. Comorbidities and lack of blood transfusion may negatively affect maternal outcomes of women with obstetric hemorrhage treated with NASG. PLoS One 2013; 8:e70446. [PMID: 23950937 PMCID: PMC3738589 DOI: 10.1371/journal.pone.0070446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 06/18/2013] [Indexed: 11/18/2022] Open
Abstract
The Non-Pneumatic Anti-Shock Garment (NASG) is a first-aid device to reduce mortality from severe obstetric hemorrhage, the leading cause of maternal mortality globally. We sought to evaluate patient characteristics associated with mortality among a cohort of women treated with the NASG in Nigeria. Data on 1,149 women were collected from 50 facilities participating in the Pathfinder International Continuum of Care: Addressing Postpartum Hemorrhage project in Nigeria from 2007-2012. Characteristics were compared using the appropriate distributional tests, and we estimated multivariable logistic regression models to control for treatment received. There were 201 deaths (17.5%). Women who died were significantly more likely to have any co-morbidity (AOR 3.63, 95% CI: 2.41-5.48), ruptured uterus (AOR 2.79, 95% CI: 1.48-5.28), macerated stillbirth (AOR 2.96, 95% CI 1.60-5.48) and to have had 6 or more previous births, (AOR 1.53, 95% CI 1.11-2.12), after adjusting for treatment received. These results suggest certain maternal conditions, particularly the presence of another life-threatening co-morbidity or macerated stillbirth, conferred a higher risk of mortality from PPH. This underscores the need for multi-system assessment and a comprehensive approach to the treatment of women with pregnancy complications.
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Affiliation(s)
- Alison El Ayadi
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America.
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Sanyaolu AO, Fagbenro-Beyioku AF, Oyibo WA, Badaru OS, Onyeabor OS, Nnaemeka CI. Malaria and HIV co-infection and their effect on haemoglobin levels from three health-care institutions in Lagos, southwest Nigeria. Afr Health Sci 2013; 13:295-300. [PMID: 24235927 DOI: 10.4314/ahs.v13i2.14] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Malaria and human immunodeficiency virus (HIV) are two major infections with enormous public health consequence. Together, they are endemic in many developing countries with anaemia being the most frequent haematological consequence of the infections. OBJECTIVES To determine the prevalence of malaria and HIV co-infection as well as anaemia among selected patients from three health-care institutions in Lagos, Nigeria. METHODS A cross-sectional study of 1080 patients was carried out to determine the prevalence of malaria and HIV co-infection as well as anaemia. Blood sera from each of the patients were screened for malaria parasites, HIV-1 and HIV-2 using Giemsa stain, Cambridge Biotech Recombigen HIV-1/HIV-2 rapid device, respectively while haemoglobin estimation was performed using cyanmethemoglobin method. RESULTS Our data showed that the total number of malaria infected patients were significantly higher in HIV sero-positive patients 47.7% (31/65) when compared with their HIV sero-negative counterparts 25.8% (262/1015) P = 0.047. The result also revealed that 25.8% (8/31) of the patients co-infected with malaria and HIV had anaemia as compared to 11.1% (29/262) infected with malaria alone. Multivariable logistic regression analysis showed that patients with dual infection of malaria and HIV were twice likely to be anaemic than those infected with malaria alone [adjusted OR 2.4, 95% CI, 1.3 to 2.7, P = 0.014]. CONCLUSIONS Our data indicated a higher prevalence of malaria in HIV infected patients and also revealed that patients co-infected with malaria and HIV were more likely to be anaemic.
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Affiliation(s)
- A O Sanyaolu
- Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Idi-araba, PMB 12003 Lagos, Nigeria ; Central Public Health Laboratory of the Federal Ministry of Health, Yaba, Lagos, Nigeria ; Department of Medical Microbioloy and Immunology, St. James School of Medicine, Albert Lake Dr. The Quarter, P. O. Box 318, The Valley, Anguilla, BWI
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Efunshile M, Amoo AOJ, Akintunde GB, Ojelekan OD, König W, König B. Use and effects of malaria control measures in pregnancy in Lagos, Nigeria. THE KOREAN JOURNAL OF PARASITOLOGY 2012; 49:365-71. [PMID: 22355203 PMCID: PMC3279674 DOI: 10.3347/kjp.2011.49.4.365] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 08/10/2011] [Accepted: 08/10/2011] [Indexed: 11/23/2022]
Abstract
In Nigeria, malaria causes up to 11% of maternal mortality. Our main aim was to find out the most common mosquito control measures employed by the pregnant women in Lagos and their effects on malaria infection. The study was carried out over a period of 6 months during which trained interviewers administered questionnaires to 400 pregnant women. The prevalence of malaria was 8.4%. There was no significant association between the prevalence of malaria and age, level of education, or occupation of the participants. Pregnant women in the age range 26-30 had the mean parasite density (409.9 ± 196.80). Insecticide spray (32.8%), mosquito coil (27.5%), and insecticide-treated nets (ITN) (15.5%) were the major mosquito control measures employed by the participants while the prevalence of infection among them were 2.3%, 6.2%, and 3.2%, respectively (P<0.05). Only 18.3% of the women had taken more than one dose of intermittent preventive treatment (IPT), while another 11.8% had taken a single dose. The infection rate among them was 4.1% and 6.4%, respectively. Malaria prevalence was highest among those who had not received any dose of IPT (10%). This study showed that the use of ITN and IPT among the pregnant women were still unacceptably low. It also showed that the use of insecticide spray which was the most common malaria control measure adopted by the participants was effective despite the fact that it is not a National Malaria Control Policy. We recommend that a sustained integrated mosquito management and public education should be strengthened in Nigeria.
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Ojurongbe O, Tijani BD, Fawole AA, Adeyeba OA, Kun JF. Prevalence of Dihydrofolate reductase gene mutations in Plasmodium falciparum isolate from pregnant women in Nigeria. Infect Dis Rep 2011; 3:e16. [PMID: 24470913 PMCID: PMC3892595 DOI: 10.4081/idr.2011.e16] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 10/05/2011] [Accepted: 10/30/2011] [Indexed: 11/23/2022] Open
Abstract
We assessed the prevalence of Plasmodium falciparum and the frequency of the dhfr triple mutation that is associated with antifolate drug resistance among P. falciparum isolates obtained from pregnant women in Ilorin, Nigeria. The study included 179 women in the second and third trimester of pregnancy who have been exposed to intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine. Thick and thin blood films and PCR were used for malaria parasite detection. Blood group and hemoglobin concentration were also determined. Mutations in P. falciparum dhfr were analyzed by sequencing DNA obtained from blood spots on filter paper. Prevalence of P. falciparum in the population (PCR corrected) was 44.1% (79/179) with 66.7% and 33.3% in the second and third trimester, respectively. Primigravide (51.3%) were more infected than multigravide (48.7%) but the difference was not statistically significant. Women in blood group A had the highest P. falciparum malaria infection (30.8%). The mean hemoglobin concentration was lower among those infected with malaria parasite. Also, more women with the malaria parasite (38.4%) had anemia compare to those without (21.4%). The prevalence of the P. falciparum dhfr mutant alleles was 64.1%, 61.5%, 38.5%, and 12.8% for I51, R59, N108 and T108, respectively. None of the samples had the L164 mutation. The combined triple dhfr mutation (51 + 59 + 108) in the population was 17.9% (7 of 39). Also, the prevalence of the triple mutant alleles was not significantly associated to the number of doses of SP taken by the women. These findings highlight the need for a regular assessment of IPTp/SP efficacy, and evaluation of possible alternative drugs.
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Affiliation(s)
- Olusola Ojurongbe
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Nigeria; ; Institute of Tropical Medicine, University of Tuebingen, Germany
| | - Bukola D Tijani
- Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital
| | - Adegboyega A Fawole
- Department of Obstetrics and Gynecology, University of Ilorin Teaching Hospital, Nigeria
| | - Oluwaseyi A Adeyeba
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Nigeria
| | - Juergen F Kun
- Institute of Tropical Medicine, University of Tuebingen, Germany
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Roberts T, Gravett CA, Velu PP, Theodoratou E, Wagner TA, Zhang JSF, Campbell H, Rubens CE, Gravett MG, Rudan I. Epidemiology and aetiology of maternal parasitic infections in low- and middle-income countries. J Glob Health 2011. [PMID: 23198118 PMCID: PMC3484768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There have been very few systematic reviews looking at maternal infections in the developing world, even though cutting maternal mortality by three quarters is United Nation's Millennium Development Goal number five. This systematic review has two aims. The first is to present the prevalence of parasitic infections in the developing world over the last 30 years and the second is to evaluate the quality and distribution of research in this field. METHODS A systematic review of Medline, EMBASE and Global Health databases was undertaken using pre-determined search criteria. Three levels of quality criteria for exclusion of inadequate studies identified 115 out of initial 8580 titles. The data were extracted for 5 domains: worldwide pathogen prevalence, year of study, study setting, sample size and diagnostic test for each pathogen. RESULTS The initial search retrieved 8580 results. From these titles, 43 studies on malaria, 12 studies on helminths, 49 studies on Toxoplasma gondii, 7 studies on Chagas disease, 5 studies on Trichomonas, 1 leishmaniasis study and 1 study on trichinellosis were extracted for analysis. High prevalence of malaria was found in Gabon (up to 57%) India (55%), Cameroon (50%), Yemen (55%), Nigeria (up to 64%) and Ghana (54%). High prevalence of hookworm infections was found in Nepal at 78.8% and high values of Ascaris lumbricoides were found in Nepal, (56.2%), Kenya (52.3%) and Gabon (45.5%). High levels of Schistosoma mansoni were found in Zimbabwe (50%) and Tanzania (63.5%). The prevalence of active Toxoplasma gondii infection was found to be highest in India (27.7%). CONCLUSION This study highlights the large burden of maternal parasitic infections globally. It may serve as a useful starting point for health policy development and research prioritization in this area.
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Affiliation(s)
- Tom Roberts
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK,Joint first and joint senior authorship
| | - Courtney A. Gravett
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA,Joint first and joint senior authorship
| | - Prasad Palani Velu
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
| | - Evropi Theodoratou
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
| | - Thor A. Wagner
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Jian Shayne F. Zhang
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
| | - Harry Campbell
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK,Joint first and joint senior authorship
| | - Craig E. Rubens
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA,Department of Pediatrics, University of Washington, Seattle, Washington, USA,Joint first and joint senior authorship
| | - Michael G. Gravett
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA,Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA,Joint first and joint senior authorship
| | - Igor Rudan
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK,Joint first and joint senior authorship
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Agomo CO, Oyibo WA, Odukoya-Maije F. Parasitologic Assessment of Two-Dose and Monthly Intermittent Preventive Treatment of Malaria during Pregnancy with Sulphadoxine-Pyrimethamine (IPTP-SP) in Lagos, Nigeria. Malar Res Treat 2011; 2011:932895. [PMID: 22312575 PMCID: PMC3265291 DOI: 10.4061/2011/932895] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 08/10/2011] [Accepted: 08/30/2011] [Indexed: 11/20/2022] Open
Abstract
Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine (IPTP-SP) is a key strategy in the control of malaria in pregnancy. However, reports of increasing level of resistance to SP using nonpregnant populations have made it imperative for the continuous monitoring of the efficacy of SP in pregnant women. This study assessed using microscopy, monthly dosing and the standard two-dose regimen among 259 pregnant women attending antenatal clinics in Lagos, Nigeria that consented 122 in the two-dose arm (Arm A) and 137 in the monthly dose arm (Arm B). Baseline parasitaemia in the two groups was 5 (4.1%) and 3 (2.2%) in Arms A and B, respectively. Few of the women developed parasitaemia after the initial SP dose in Arms A 4 (3.3%) and B 2 (1.5%). However, none of the women had malaria infection after the second dose in both Arms. Although IPTP-SP is suggestive of protecting the women from malaria infection, there was no significant difference observed between the two dosing schemes.
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Affiliation(s)
- Chimere O. Agomo
- Tropical Diseases Laboratory, Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria
- Malaria Research Laboratory, Department of Biochemistry, Nigerian Institute of Medical Research, P.M.B 2013 Yaba, Lagos, Nigeria
| | - Wellington A. Oyibo
- Tropical Diseases Laboratory, Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Funke Odukoya-Maije
- Department of Obstetrics and Gynaecology, Ajeromi General Hospital, Ajegunle, Lagos, Nigeria
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Prevalence of congenital malaria in minna, north central Nigeria. J Trop Med 2011; 2012:274142. [PMID: 21876706 PMCID: PMC3157756 DOI: 10.1155/2012/274142] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 06/24/2011] [Accepted: 06/28/2011] [Indexed: 12/02/2022] Open
Abstract
The study was designed to determine the true prevalence of congenital, cord, and placental malaria in General Hospital Minna, North Central Nigeria. Peripheral blood smears of near-term pregnant women, as well as the placental, cord, and peripheral blood smears of their newborn babies, were examined for malaria parasites, using the Giemsa staining technique. Out of 152 pregnant women screened, 21 (13.82%) of them were infected with malaria parasites. Of the 152 new born babies, 4 (2.63%) showed positive peripheral parasitaemia. Placental parasitaemia was 7/152 (4.61%), while cord blood parasitaemia was 9/152 (5.92%). There were strong associations between peripheral and cord malaria parasitaemia and congenital malaria (P < 0.05). Plasmodium falciparum occurred in all, and none had mixed infection. The average birth weights of the babies delivered of nonmalarious pregnant women were higher than those delivered by malarious pregnant women, though not significant (P > 0.05). Malaria parasitaemia occurred more frequently in primigravidae than multigravidae.
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Ekanem EI, Agan TU, Efiok EE, Ekott MI, Okodi E. A study of anemia in women with asymptomatic malaria parasitaemia at their first antenatal care visit at the General Hospital, Ikot Ekpene, Akwa Ibom State, Nigeria. ASIAN PAC J TROP MED 2010. [DOI: 10.1016/s1995-7645(10)60137-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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