ISSN 2347-954X (Print) Awareness, Ownership and Utilization of Insecticide Treated Nets among Households in a Rural Community in Southern Nigeria

Abstract: The use of Insecticidal Treated Nets (ITNs) is a key strategy for achieving a reduction in the malaria burden in Nigeria and other malaria endemic countries. This study was conducted to assess the awareness, ownership and utilization of ITNs in a rural community in southern Nigeria. It was a cross-sectional descriptive study. The instrument of data collection was an interviewer administered semi-structured questionnaire. Respondents were selected through multistage sampling method. Data was analyzed using SPSS version 18. A total of 269 respondents, each representing a household participated in the study. One hundred and twenty three, (45.7%) respondents were aged 21-30 years; 213 (79.2%) had at least secondary level of education and 253 (94%) were aware of ITNs. The main sources of information were radio/television, 139 (51.5%) and hospital 60 (22.3%). One hundred and twenty six (49.8%) owned ITNs out of which 90 (71.4%) obtained it from the health facility. Up to 46 (36.5%) had more than one, while 127(50.2%) did not own any. A total of 95(75.4%) of those who owned ITNs used them with 41 (43.2%) using them regularly. Pregnant women in only 17(33.3%) out of 51 households used ITN. Also, under five children in only 44 (37.6%) out of 117 households used ITNs. Though awareness of ITN was high, ownership and utilization were comparatively low. Efforts should be made by relevant stakeholders to increase ownership and usage of ITNs in order to reduce morbidity and mortality from malaria especially among pregnant women and under-five children in this community

Comparative assessment of the clinical performance of chloroquine and sulphadoxine/pyrimethamine in the treatment of Plasmodium falciparum infection in Plateau State: an open randomised study of 109 children with acute uncomplicated malaria

Background: Malaria remains one of the most common threats to child survival in Nigeria. Chloroquine (CQ) is the first line drug of choice against uncomplicated malaria. In view of reports indicating an increasing resistance of P. falciparum to CQ, a regular surveillance of malaria therapy requires constant evaluation of its efficacy and that of suitable alternatives.Objective: To compare the current efficacy of CQ with that of sulphadoxine/pyrimethamine (SP) in the treatment of P falciparum infection in Plateau State.Patients and Methods: Using a 14-day protocol, an open randomized study of the efficacy of CQ and SP in the treatment of uncomplicated P. falciparum infection was conducted in 109 febrile children under five years of age in the Barkin Ladi Local Government Area of Plateau State. Adequate clinical response (ACR), adequate clinical and parasitological response (ACPR) and clinical efficacy (CE) were assessed in the two treatment groups.Results: Out of the 708 children screened for P. falciparum parasitaemia, 378 (53.4 percent) tested positive. One hundred and nine of the 115 children who qualified for enrollment, completed the study. Fifty-four and 55 children received CQ and SP, respectively. The mean (SD) duration of illness before presentation at the hospital was 1.5 (0.71) days. The means of age, temperature, packed cell volume and parasite counts on admission to the study were similar in the two treatment groups. Thirty-nine (75 percent) of the 52 children who received CQ, and in respect of whom the data was complete, attained clinical cure compared to 52 (94.5 percent) of 55 children on SP (p= 0.013). Twenty-seven (51.9 percent) of 52 children treated with CQ versus 48 (87.3 percent) of 55 children on SP achieved adequate clinical and parasitological cure (p=0.00010). Thirty (57.7 percent) of 52 children on CQ versus 48 (87.3 percent) of 55 children who received SP were clinically cured (p = 0.0012). Failure to achieve fever clearance by day 14 was noted in eight (16.7 percent) of 48 children on CQ against four (7.3 percent) of 55 children on SP. Conclusion: Although both drugs fell short of a hundred percent cure rate, CQ performed less creditably than SP in the treatment of uncomplicated malaria. There appears to be an urgent need to seek other effective alternative first-line anti-malarial drugs in the country. Nigerian Journal of Paediatrics Vol. 31(3) 2004: 87-9

Effects of pyrimethamine-sulphadoxine, chloroquine plus chlorpheniramine, and amodiaquine plus pyrimethamine-sulphadoxine on gametocytes during and after treatment of acute, uncomplicated malaria in children

The effects of pyrimethamine-sulphadoxine (PS), chloroquine plus chlorpheniramine, a H1 receptor antagonist that reverses chloroquine resistance in Plasmodium falciparum in vitro and in vivo (CQCP), and amodiaquine plus pyrimethamine-sulphadoxine (AQPS) on gametocyte production were evaluated in 157 children with acute, symptomatic, uncomplicated falciparum malaria who were treated with these drugs. PS was significantly less effective than CQCP or AQPS at clearing asexual parasitaemia or other symptoms of malaria. Gametocyte carriage on days 3, 7, and 14 were significantly higher in those treated with PS. The ratio of the density (per µl blood) of peripheral young gametocyte (PYG), that is, < stage III to peripheral mature gametocyte (PMG), that is, stage IV and V, an index of continuing generation of gametocytes, rose to 1 by day 7 of treatment in those treated with PS, but remained consistently below 1 in the other treatment groups. PYG-PMG density ratio increased significantly from day 0-14 in those treated with PS and CQCP (chi2 = 76, P = 0.000001 and chi2 = 42.2, P = 0.00001, respectively) but decreased significantly in those treated with AQPS (chi2 = 53.2, P = 0.000001). Both PS-sensitive and -resistant infections generated PYG (18 of 29 vs 13 of 20, chi2 = 0.04, P = 0.93) but PYG was present only in those with resistant response to CQCP. Combination of PS with amodiaquine (AQ), that is, (AQPS) resulted in less production of PYG, but in this setting, PYG was not indicative of response to AQPS. These data indicate that PS enhanced production or release of young gametocytes when used alone, but generated less young gametocytes when used in combination with AQ. PYG may be used as an indicator of response to CQCP but not PS or PS-based combination drugs