Evaluating the Efficacy of Topical Silver Nitrate and Intramuscular Antimonial Drugs in the Treatment of Cutaneous Leishmaniasis in Sokoto, Nigeria

Background: Cutaneous leishmaniasis (CL) is a disease of public health importance in Nigeria, with high prevalence in the Northwest and Northeastern part of the country. The side effects of antimonial drugs {stibogluconate (SSG) and meglumine antimoniate} in the treatment of CL have often resulted in poor drug adherence and default by patients and possible drug resistance. The increasing default to follow-up and the significant side effects associated with antimonial therapy necessitated the dire need of alternative therapeutic modalities. Thus, this study aimed at comparing the efficacy of topical silver nitrate with the antimonial drugs in the treatment of CL. Methods: A total of 95 patients with clinically diagnosed leishmaniasis and parasitologically proven CL participated in the study after their informed-consent had been obtained. The treatment selection was optional to the participants. Sixty (63.2%) patients received alternative therapy of topical silver nitrate as a single dose while 35(36.8%) patients received antimonial therapy for 21 days at 20mg/kg body weight. Results: On day 30 of treatment, 68 (86.1%) lesions among patients on topical silver nitrate healed completely as compared with only 5 (6.8%) among those on i.m. SSG. There was no improvement in 25 (34.2%) lesions among those on i.m. SSG compared with only 1 (1.2%) lesion among those on topical silver nitrate. Overall, there was a  statistically significant difference in the cure rate among patients on silver nitrate as compared with those on i.m. SSG on the 21st and 30th days of treatment.(p<0.05). Conclusion: Topical silver nitrate therapy is an effective and better drug treatment for CL among this studypopulation.Keywords: Cutaneous leishmaniasis, efficacy, Silver nitrate, Sodium Stibogluconate, Sokot

Antioxidant vitamin levels among preschool children with uncomplicated Plasmodium falciparum malaria in Sokoto, Nigeria

Festus I Aghedo,1 Resqua A Shehu,2 Rabiu A Umar,2 Mohammed N Jiya,3 Osaro Erhabor4 1Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; 2Department of Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria; 3Department of Paediatrics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria; 4Department of Haematology, Faculty of Medical Laboratory Science, Usmanu Danfodiyo University, Sokoto, Nigeria Objective: To assess antioxidant vitamin levels among preschool children with plasmodium malarial infection. Methods: We assessed antioxidant vitamin levels by using a standard procedure in 130 malaria-parasitized preschool children. Packed cell volume and parasite density were also evaluated. Forty healthy age- and gender-matched nonparasitized children were included as controls. Results: Plasmodium falciparum was the causative species in all subjects. The mean malaria parasitemia was 4529.45 ± 1237.5/µL. The mean antioxidant concentrations for vitamins A, C, and E among plasmodium-parasitized subjects were 33.15 ± 1.79 µg/dL, 0.51 ± 0.02 mg/dL, and 0.61 ± 0.02 mg/dL, respectively. The mean concentrations of vitamins A, C, and E among the non-malaria-parasitized controls were 69.72 ± 1.71 µg/dL, 1.25 ± 0.04 mg/dL, and 1.31 ± 0.04 mg/dL respectively. We observed that the mean antioxidant concentrations of vitamins A, C, and E were significantly lower among plasmodium-parasitized subjects compared with non-parasitized controls (P = 0.01). Malaria parasitemia correlated negatively with antioxidant concentrations and packed cell volume (r = -0.736 and -0.723, P = 0.001). We observed that the higher the level of parasitemia, the lower the antioxidant concentration. Conclusion: Our study has shown that the antioxidant levels in plasmodium-parasitized children in the North-West of Nigeria are low and that the more severe the malarial infection, the lower the antioxidant level and the packed cell volume. One key strategic intervention is the provision of early diagnosis and prompt effective treatment. We recommend that malaria-parasitized children, particularly those in the North-West of Nigeria, be placed routinely on antioxidant vitamins to manage the micronutrient deficiencies seen in these children. There is also the need for the promotion of insecticide-treated bed nets, intermittent preventive treatment, and effective case management of malarial illness among children. Keywords: vitamin A, vitamin C, vitamin E, P. falciparu