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Ayede AI, Bello FA, Kehinde AO. A community-based surveillance of gastrointestinal helminthiasis among pregnant women in Ibadan, South West Nigeria. Niger J Clin Pract 2018; 21:1368-1373. [PMID: 30297573 DOI: 10.4103/njcp.njcp_196_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background : Intestinal helminthiasis is a major public health problem in Africa. Helminthic infection in pregnant women causes loss of appetite, poor nutrient absorption, gastrointestinal impairment, iron deficiency, and iron deficiency anemia resulting in low birth weights and preterm births. The main aim of this study is to assess the prevalence of helminthic infections in pregnant women in rural and peri-urban communities of Ibadan. Materials and Methods : A cross-sectional descriptive study was carried out at the antenatal clinics of 12 selected primary health centers and mission homes in Ibadan, Nigeria. Open- and closed-answer questionnaires were administered to 604 consenting pregnant women, who provided fresh stool samples for microscopy. Helminthic quantification was carried out by the Kato-Katz technique. Proportions were compared using Chi-squared with IBM® SPSS® Statistics 21 for analysis. Statistical significance was set at P < 0.05. Results : Eighty-nine stool samples (14.7%) were positive for helminthiasis. Most had roundworms (13.6%); 13 (2.2%) had hookworms. The mean arithmetic eggs per gram of feces were 2,124 and 248, respectively. No participant had a heavy intensity infection; nearly all were of low intensity. Participants (P = 0.005) and their husbands (P = 0.005) who had higher education were less likely to have helminthiasis. Conclusion These communities are classified as Category III, having a low prevalence and low intensity infection. Therefore, prophylactic anti-helminthic treatment in pregnancy is not recommended. The inverse relationship with education may be a function of better living conditions. Better hygiene should be advocated.
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Affiliation(s)
- A I Ayede
- Department of Paediatrics, Obstetrics and Gynaecology and Medical Microbiology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - F A Bello
- Department of Paediatrics, Obstetrics and Gynaecology and Medical Microbiology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - A O Kehinde
- Department of Paediatrics, Obstetrics and Gynaecology and Medical Microbiology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
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Ayinmode AB, Oliveira BCM, Obebe OO, Dada-Adgebola HO, Ayede AI, Widmer G. Genotypic Characterization of Cryptosporidium Species in Humans and Peri-Domestic Animals in Ekiti and Oyo States, Nigeria. J Parasitol 2018; 104:639-644. [PMID: 30207199 DOI: 10.1645/17-74] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Cryptosporidiosis is one of the leading causes of diarrhea in humans and several other vertebrate species. Because surveys of Cryptosporidium genotypes from animals and humans living in the same region are rare, our understanding of the importance of zoonotic transmission in the epidemiology of cryptosporidiosis remains superficial. PCR was used to amplify a portion of the Cryptosporidium 18S small subunit ribosomal RNA gene from fecal DNA from humans and livestock living in Ekiti and Oyo states, Nigeria. PCR-positive samples were further analyzed using PCR targeting the heat-shock protein HSP-70, the actin, and the sporozoite glycoprotein gene gp60. A questionnaire was used to collect demographic information. Sixteen of 187 samples collected were Cryptosporidium 18S PCR positive. Of these, 5 samples originating from HIV-positive patients, 5 from otherwise healthy children, 2 from chickens, 3 from goats, and 1 from a dog were positive for at least 1 marker. Sequencing of the 18S rRNA amplicons revealed the presence of Cryptosporidium parvum in 2 HIV positive patients and in a child; the actin sequence confirmed the presence of this species. Two samples of HIV-positive patients amplified Cryptosporidium hominis 18S rRNA, one of them confirmed by the HSP-70, actin, and gp60 sequences. Cryptosporidium meleagridis was found in another HIV patient, while C. hominis was detected in 3 children (of which 2 were confirmed by gp60). Cryptosporidium muris was found in 1 child. In birds, we found C. meleagridis and, significantly, C. parvum, whereas we detected C. parvum and C. muris in 1 goat each. The only dog sampled was positive for Cryptosporidium canis. We conclude that, in the environment we surveyed, humans and animals are a potential part of the same transmission cycle. Measures to prevent zoonotic transmission should therefore be considered to reduce the prevalence of cryptosporidiosis.
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Affiliation(s)
- A B Ayinmode
- 1 Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Ibadan, Nigeria 200284.,2 Centre for Control and Prevention of Zoonoses, University of Ibadan, Nigeria 200284.,* These authors contributed equally to this work
| | - B C M Oliveira
- 3 Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536.,4 Universidade Estadual Paulista (UNESP), Faculdade de Medicina Veterinária, Araçatuba, 16050-680 Brazil.,* These authors contributed equally to this work
| | - O O Obebe
- 1 Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Ibadan, Nigeria 200284
| | - H O Dada-Adgebola
- 5 Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria 200212
| | - A I Ayede
- 6 Department of Paediatrics, University College Hospital, Ibadan, Nigeria, 200212
| | - G Widmer
- 3 Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536
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Sowunmi A, Ayede AI, Falade AG, Ndikum VN, Sowunmi CO, Adedeji AA, Falade CO, Happi TC, Oduola AMJ. Randomized comparison of chloroquine and amodiaquine in the treatment of acute, uncomplicated, Plasmodium falciparum malaria in children. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.2001.11813670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Graham HR, Ayede AI, Bakare AA, Oyewole OB, Peel D, Falade AG, Duke T. Oxygen for children and newborns in non-tertiary hospitals in South-west Nigeria: A needs assessment. Afr J Med Med Sci 2016; 45:31-49. [PMID: 28686826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Oxygen is important for the treatment of hypoxaemia associated with pneumonia, malaria, and other medical, obstetric, and surgical conditions. Access to oxygen therapy is limited in many of the high mortality settings where it would be of most benefit. METHODS A needs assessment of 12 non-tertiary hospitals in south-west Nigeria, assessing structural, technical and clinical barriers to the provision of safe and effective oxygen therapy. RESULTS Oxygen supply was reported to be a major challenge by hospital directors. All hospitals had some access to oxygen cylinders, which were expensive and frequently ran out. Nine (75%) hospitals used oxygen concentrators, which were limited by inadequate power supply and lack of maintenance capacity. Appropriate oxygen delivery and monitoring devices (nasal prongs, catheters, pulse oximeters) were poorly available, and no hospitals had clinical guidelines pertaining to the use of -oxygen for children. Oxygen was expensive to patients (median US$20/day) and to hospitals. Estimated oxygen demand is reported using both a constant mean-based estimate and adjustment for seasonal and other variability. CONCLUSIONS Making oxygen available to sick children and neonates in Nigerian hospitals will require: improving detection of hypoxaemia through routine use of pulse oximetry; improving access to oxygen through equipment, training, and maintenance structures; and commitment to building hospital and state structures that can sustain and expand oxygen initiatives.
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Abstract
Preterm deaths are responsible for the highest number of neonatal
mortality in Nigeria. Preterm nutrition contributes significantly to overall
outcome particularly as it relates to neurodevelopment. Recently, new
guidelines for enteral feedings in premature infants were issued by the
American Academy of Paediatrics and European Society of Pediatric
Gastroenterology, Hepatology and Nutrition Committee on Nutrition.
Nevertheless, in clinical practice it is often difficult to attain suggested
intakes at all times. The situation is worse in Nigeria where there are no
specific national guidelines and recommendations derived from local
data targeting Preterms. There is a high possibility of significant
potential cumulative nutritional deficits occurring in Nigerian preterms.
The inevitable suboptimal intake contributes significantly to the
incidence of neonatal diseases and outcome. This review describes
practical ways of optimizing nutritional intake in these vulnerable
neonates with reference to Nigerian situation. Understanding the preterm
gut, initiation of parenteral nutrition, need for minimal enteral feeds,
ensuring adequate macro and micronutrients intake and need for follow
up are discussed. There are limitations to the practice of the
recommended preterm nutrition in Nigerian settings, nevertheless the
interventions like early commencement of minimal enteral feeds and
preference for human breast milk should be practiced optimally. Hence,
all health professionals should acknowledge that preterm nutrition may
be an emergency and need to improve their knowledge on when and
how to achieve optimal feeds in them. There is a dare need through
both clinical practice as well as research, to reduce nutritional deficits
in these vulnerable infants.
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Affiliation(s)
- A I Ayede
- Department of Paediatrics, University College Hospital, Ibadan
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Ayede AI, Agunloye AM, Gram L, Omokhodion SI. Normal Ultrasonographic Dimensions of the Liver in Neonates in South-West Nigeria. West Afr J Med 2014; 33:183-188. [PMID: 26070822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Ultrasound (US) is first choice of imaging in children suspected to have liver pathology because it is cheap, quick to perform with no radiation risks. Liver size may be increased or decreased in many pathological conditions and ultrasound is ideal since clinical evaluation by palpation and/or percussion can be unreliable or inaccurate. OBJECTIVE To our knowledge, no previous study has been done in an exclusively large neonatal population in Sub-Saharan Africa to establish reference values for the liver size. This study aims to determine by USS, the normal range of longitudinal dimensions for the liver in healthy neonates. METHODS A prospective cross-sectional study of 508 apparently healthy neonates. Routine clinical examination and liver ultrasound scans were performed before discharge or at the immunization clinic. Liver size was taken as the longitudinal dimension in the mid-clavicular line. Normograms with point-wise 95% reference ranges were constructed using a normal approximation. RESULTS Mean age was 9.67 ± 7.68 days and 51.4% were males. Ultrasound span of the liver ranged from 3.28-8.02 cm with a mean of 5.72 ± 0.88 cm. There was no evidence for sex difference in the liver size, p= 0.338. The liver size correlated most strongly with neonatal weight (r=0.55) and age (r=0.53) which were used in plotting the 95% reference ranges for the neonatal liver normogram. CONCLUSIONS This study of a large neonatal population has provided the normal range of US liver dimensions for neonates in the study area, using the age and weight in plotting the 95% reference ranges for the liver normogram.
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Affiliation(s)
- A I Ayede
- Department of Radiology, University College Hospital, Ibadan, Nigeria
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Fakunle GA, Ana GR, Ayede AI. Environmental risk factors for acute respiratory infections in hospitalized children under 5 years of age in Ibadan, Nigeria. Paediatr Int Child Health 2014; 34:120-4. [PMID: 24621237 DOI: 10.1179/2046905513y.0000000107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Acute respiratory infections (ARIs) are the fourth major cause of morbidity and mortality among children under 5 worldwide. However, information on the risk factors that could predispose children under 5 to ARIs is scanty in Nigeria. AIM To assess which environmental factors contribute to the acquisition of ARIs in children under 5 in Ibadan. METHODS A case-control study was undertaken. 220 children under 5 with ARI (cases) and 220 without ARI (controls) were selected consecutively from children visiting Oni Memorial Children's Hospital and University College Hospital, Ibadan. A pre-tested six-section questionnaire was administered to mothers to elicit information on factors that contribute to the acquisition of ARIs in children under 5. RESULTS Mean (SD) ages of cases and controls were 20·4 (14·7) and 20·3 (15·0) months, respectively. Mean (SD) household size of cases was 6·0 (1·5) compared with 4·0 (1·7) for the controls (P = 0·01). Children whose homes had more than two persons per room were found to have a 14-fold greater risk of ARI than children in houses with fewer than two persons per room. The use of a lantern at night (OR 4·1, 95% CI 2·4-6·9) and firewood for cooking (OR 9·3, 95% CI 3·6-24·1) were found to be independent risk factors for ARIs. CONCLUSION Cases were more exposed than controls to environmental risk factors for ARIs. Increased awareness of the importance of environmental factors with regard to prevention and control of ARI is therefore important.
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Falade AG, Ayede AI. Epidemiology, aetiology and management of childhood acute community-acquired pneumonia in developing countries--a review. Afr J Med Med Sci 2011; 40:293-308. [PMID: 22783679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Childhood acute community-acquired pneumonia is one of the leading causes of morbidity and mortality in developing countries. In children who have not received prior antibiotic therapy, the main bacterial causes of clinical pneumonia in developing countries are Streptococcus pneumoniae and Haemophilus influenzae type b (Hib), and the main viral cause is respiratory syncytial virus (RSV), but estimates of their relative importance vary in different settings. The only vaccines for the prevention of bacterial pneumonia (excluding vaccines for pertussis and measles) are Hib and pneumococcal conjugate vaccines (PCV). In children with human immunodeficiency virus (HIV) infection, bacterial infection remains a major cause of pneumonia mortality; however, Pneumocystis jirovecii and Mycobacterium tuberculosis are important causes of pneumonia in them. Studies of bacterial aetiology of acute pneumonia in severely malnourished children have implicated Klebsiella pneumoniae, Staphylococcus aureus, S. pneumoniae, Escherichia coli, and H. influenzae, with very few data on the role of respiratory viruses and tuberculosis. Studies of neonatal sepsis suggest that Gram-negative enteric organisms, particularly Klebsiella spp., and Gram-positive organisms, mainly pneumococcus, group b Streptococcus and S. aureus are causes of neonatal pneumonia. Many of the developing countries that ranked high in pneumonia mortality are preparing to introduce new pneumonia vaccines with support from Global Alliance for Vaccine and Immunization (GAVI Alliance), plan for the expansion of community-based case management and have ambitious plans for strengthening health systems. Assurance that these plans are implemented will require funding and continued public attention to pneumonia, which will help contribute to a substantial decline in childhood pneumonia deaths.
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Affiliation(s)
- A G Falade
- Department of Paediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.
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Abstract
Background and objectives: Methodology: Results: Conclusion:
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Affiliation(s)
- A I Ayede
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - T S Akingbola
- Department of Haematology, University College Hospital, Ibadan, Nigeria
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Otegbayo JA, Ayede AI, Ogunbiyi JO. Accuracy of clinical diagnosis of liver diseases at Ibadan. West Afr J Med 2011; 30:364-368. [PMID: 23408071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Liver diseases are a major cause of morbidity and mortality in Africa and rest of the world. The contribution of specific liver disease to overall mortality has not been well documented in Nigeria. OBJECTIVE To study aimed at determining the relative frequency of liver diseases seen at autopsy and the accuracy of ante-mortem clinical diagnosis of liver diseases relative to post-mortem findings at the University College Hospital (UCH), Ibadan. METHOD A retrospective study of autopsies performed at the Pathology Department of the UCH, Ibadan between January 1991 and December 2000. Information obtained from the autopsy records included age, sex, ante-mortem clinical diagnosis, and post-mortem diagnosis. The data were analysed for frequencies, means, proportions and sensitivity. RESULTS A total of 4,604 post-mortem examinations were performed over the 10-year-period with an annual average of 460.4. Of this, 3,408 (74.02%) were coroner's while 1,196 (25.98%) were routine. There were 75 autopsy diagnosis of liver disease accounting for 6.27% of the total routine autopsies and a frequency of 7.5 per annum. The liver cases at autopsy were made up of 53 (70.7%) males and 22 (29.3%) females with those in the age range 40 - 49 years accounting for about one quarter of all. There was positive correlation of the Clinical diagnoses with post-mortem diagnoses in 33 (44%) but discordance in 42 (56%) of cases. CONCLUSION The concordance between ante-mortem clinical diagnosis and post-mortem diagnosis of liver disease is rather low. There is a need to provide facilities for efficient diagnosis of liver diseases.
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Affiliation(s)
- J A Otegbayo
- Departments of Medicine,University College Hospital, Ibadan
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Sowunmi A, Ayede AI, Falade AG, Ndikum VN, Sowunmi CO, Adedeji AA, Falade CO, Happi TC, Oduola AM. Randomized comparison of chloroquine and amodiaquine in the treatment of acute, uncomplicated, Plasmodium falciparum malaria in children. Ann Trop Med Parasitol 2001; 95:549-58. [PMID: 11672461 DOI: 10.1080/00034980120092507] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The increasing resistance of Plasmodium falciparum to chloroquine (CQ) has created an urgent need for the evaluation of alternative, effective, safe, cheap, readily available and affordable antimalarial treatments. In the present study, the efficacy of amodiaquine (AQ) in the treatment of acute, symptomatic, uncomplicated, P. falciparum malaria was compared with that of CQ, each drug being given at 10 mg/kg per day for 3 days (days 0, 1 and 2). The 210 subjects (104 given AQ and 106 CQ) were Nigerian children aged 5 months-12 years. Fever-clearance times (FCT), parasite densities on days 1-4 and parasite-clearance times (PCT) were all significantly lower with AQ than with CQ. Mean (S.D.) PCT, for example, were 2.6 (0.8) days with AQ and 3.0 (1.0) days with CQ (P = 0.001). The cure rates obtained on days 14, 21 and 28 - 98.1% v. 79.3% (P =0.000), 97.1% v. 64.2% (P = 0.00001) and 95.2% v. 58.5% (P = 0.0000000) with AQ and CQ, respectively - were all also significantly higher with AQ. All but two of the 20 subjects who were considered CQ-treatment failures by day 14 (i.e. two RIII, two RII and 16 RI) responded to subsequent treatment with AQ, with PCT (but not FCT) significantly shorter than during their initial treatment with CQ. In siblings in whom there was clustering of infections, the cure rates were 100% with AQ (N =12) and 63.6% with CQ (N = 11; P = 0.03). Adverse reactions to CQ and AQ were similar and tolerable: pruritus in 10 and 11 children in the AQ and CQ groups, respectively, and gastro-intestinal disturbances which occurred in three children from each group. Haematological parameters were not adversely affected by either drug. At least in the setting of the present study, AQ appears more effective than CQ, effective against CQ-resistant infections, and well tolerated by children with acute, uncomplicated, P. falciparum malaria. It may therefore be useful as an alternative to CQ in areas of CQ resistance.
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Affiliation(s)
- A Sowunmi
- Department of Pharmacology and Therapuetics and Postgraduate Institute for Medical Research and Training, University College Hospital, Ibadan, Nigeria.
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