Prevalence and Pattern of Malaria Parasitaemia among Under-Five Febrile Children Attending Paediatric Out-Patient Clinic at University of Maiduguri Teaching Hospital, Maiduguri

Background: Malaria has remained a major public health problem in Nigeria with the under-five aged children and pregnant women being the most affected. The local epidemiological profile of the disease is dynamic owing to the continuous variation in the various determinants and hence the need for periodic re-evaluation. We aim to determine the prevalence of malaria parasitaemia among the under -five aged children and the effect of various determinants.Material and Method: In this cross-sectional study, 433 outpatients aged below 5 years with fever or history of fever in the previous 72 hours were enrolled. Relevant information was obtained and recorded using a questionnaire. Thick and thin films were prepared from a finger or heel prick for each of the patients and subjected to microscopy.Result: The prevalence of malaria parasitaemia was 27.7%. Age, sex, nutritional status, socioeconomic class, temperature at presentation as well as ownership of insecticide treated nets had no significant effect on the prevalence of malaria (p>0.05). Only P. falciparum was seen in all the positive slides. The parasite density was generally low with 48.3% having parasite densities below 100/μl and only 7.5% had parasite density of ≥1000/μl. Parasite density increased significantly with increasing age (p=0041). Nutritional status as well as other studied factors had no significant effect on parasite density (p>0.05).Conclusion and Recommendation: Prevalence of malaria infection was high in the population studied. It is characterized by low density parasitaemia and hence the need to interpret negative results with caution. Age, gender, socio-economic and nutritional status, temperature at presentation as well as ownership of ITN had no significant effect on prevalence of malaria parasitaemia. There is need to strengthen and scale up various malaria control programs while ensuring proper implementations of programs and activities through effective monitoring and evaluation.Keywords: Prevalence, Pattern, Malaria, Parasitaemia, Under-five Febrile Children, Outpatient Clini

Phytochemical and antimicrobial study on the leaf extracts of Erythrophleum africanum (Caesalpiniaceae)

The leaf of Erythrophleum africanum was exhaustively extracted with ethanol using cold maceration techniques. This was subsequently partitioned with petroleum ether, chloroform, ethylacetate and nbutanol. The agar diffusion method was used to determine the antimicrobial activity against the following micro-organisms eithicillin resistant Staphylococus, Staphylococcus aureaus, Streptococcus feacalis, Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi, Proteus vulgaris, Candida albicans, Candida krusei and Candida tropicalis. Minimum Inhibitory Concentration (MIC), minimum bactericidal concentration (MBC) and minimum fungicidal concentration (MFC) were determined. The in vitro antimicrobial screening revealed that the extracts exhibited diverse activities against different microbes with zones of inhibition ranging from 12 to 36 mm, MIC ranging from 3.25 to 60 mg/ml and MBC/MFC of 3.25 to 60 mg/ml for sensitive organisms at the tested concentrations. The activities observed could be attributed to the presence of terpenoids, saponins, flavonoids, alkaloids and tannins. The results justify the ethnomedicinal use of this plant in the treatment of sores, boils, wounds, dysentery, diarrhea and sexually transmitted infections.Keywords: Erythrophleum africanum, phytochemistry, antimicrobial activityAfrican Journal of Biotechnology, Vol. 13(4), pp. 598-603, 22 January, 201

Competency-based Learning: The effectiveness of targeted resident education and clinical auditing feedback on completed death certificate accuracy rates

Background: Death certification is an integral part of physician practice, yet common errors are being encountered from this vital source of health information. Most medical training programs lack formal curricula for this important skill. Accurate information from DC will help in improve our mortality data which can be use public health purposesObjectives: This study evaluated the effect of a multifaceted educational intervention on accuracy of completing death certification in a tertiary-based paediatric residency programMethod: A pre-post intervention and control cohort study over 12- month period to assess the effect of our multifaceted intervention accuracy rate of completed DC was conducted. The intervention consisted of a 3-part program (distribution of educational material, presentation by a skilled instructor, skills workshop, and clinical mortality/auditing feedback sessions). Primary outcome was the difference in scores preand post-intervention and also the rate of accuracy on the MAHI death certificate scoring system.Results: The mean score before the intervention was 6.8±2.7 and 7.1±2.3 in both the intervention and control cohorts respectively. The mean score after the intervention was 16.3±2.5 and 7.3±2.8 in both the intervention and control cohorts respectively indicating an increase in scores. The mean difference in pre- and post-tutorial scores was significant (t=20.39, p=0.0001).Conclusions: We found that using a multifaceted educational intervention to train junior physicians on how to correctly complete a DC was effective in a residency-based pediatric programKeywords: Death certificate, medical education, multifaceted training, heath information, Nigeria

Epidemiological Interactions between Urogenital and Intestinal Human Schistosomiasis in the Context of Praziquantel Treatment across Three West African Countries

© 2015 Knowles et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The attached file is the published version of the article

Study of variations in the broncho-arterial pedicles of the upper right lung lobe

Bronchial distribution and functional arterial vascularization of the upper lobe of the right lung are subject to many anatomical variations. The control of  these variations is essential for endoscopic and agiographic examinations. It also offers a better guarantee for safe and controlled surgery. In this  preliminary work, the exploitation of 15 heart-lung blocks treated by the injection corrosion method allowed us to study the general arrangement of the  broncho-arteries of the right upper lung lobe and their anatomical variations in the Senegalese population. Our results were as follows: the right upper  lobar bronchus was born on average at 1.25 cm from the tracheal bifurcation, with an average length of 1.13 cm. It ended with trifurcation into apical  (B1), dorsal (B2) and ventral (B3) segmental bronchi in 10 cases (66.66%); in 3 cases (20%), it ended with bifurcation into the dorsal segmental bronchus  and the apico-ventral trunk (B1+B3) (1 case), the apico-dorsal trunk (B1+B2) and the ventral segmental bronchus (B3), finally, in ventral and dorsal  segmentary bronchi giving each one an apical branch (1 case); in a last case, it ended by quadrifurcation, giving an external parabronche. The right upper  lobe was vascularized by 1 to 4 arteries, with eight modes of vascularization. It received more frequently two arteries. The anterior mediastinal  artery was the most common (100%). These results allowed us to discuss anatomical variations in the bronchial tree of the right upper lung lobe and the  pulmonary arterial distribution in that lobe. These variations must be taken into account during endoscopic examinations of imaging and surgery of  pulmonary excision, under penalty of accidents.&nbsp

Ash deposition propensity of coals/blends combustion in boilers: a modelling analysis based on multi-slagging routes

A method that is based on the initial slagging routes and the sintered/slagging route has been developed and used for predicting the ash deposition propensities of coal combustion in utility boilers supported by the data collected from power stations. Two types of initial slagging routes are considered, namely (i) pyrite-induced initial slagging on the furnace wall, and (ii) fouling caused by the alkaline/alkali components condensation in the convection section. In addition, the sintered/slagging route is considered by the liquids temperature, which represents the melting potential of the main ash composition and is calculated using the chemical equilibrium methods. The partial least square regression (PLSR) technique, coupled with a cross validation method, is employed to obtain the correlation for the ash deposition indice. The method has been successfully applied to coals/blends combustion in boilers, ranging from low rank coals to bituminous coal. The results obtained show that the developed indice yields a higher success rate in classifying the overall slagging/fouling potential in boilers than some of the typical slagging indices. In addition, only using the SiO2/Al2O3 ratio to predict the melting behaviors and slagging potential is inaccurate since the effect of the SiO2/Al2O3 ratio is dictated by both the original ash composition and the way in which the SiO2/Al2O3 ratio is changed. Finally, the influence of the acid components (SiO2 and Al2O3) on the ash deposition prediction is investigated for guiding the mineral additives. It is noticed that the predicted ash deposition potentials of the three easy slagging coals investigated decrease more rapidly by adding Al2O3 than by adding SiO2

Highly Accurate Diagnosis of Pleural Tuberculosis by Immunological Analysis of the Pleural Effusion

Pleural TB is notoriously difficult to diagnose due to its paucibacillary nature yet it is the most common cause of pleural effusions in TB endemic countries such as The Gambia. We identified both cellular and soluble biomarkers in the pleural fluid that allowed highly accurate diagnosis of pleural TB compared to peripheral blood markers. Multi-plex cytokine analysis on unstimulated pleural fluid showed that IP-10 resulted in a positive likelihood ratio (LR) of 9.6 versus 2.8 for IFN-γ; a combination of IP-10, IL-6 and IL-10 resulted in an AUC of 0.96 and positive LR of 10. A striking finding was the significantly higher proportion of PPD-specific IFN-γ+TNF-α+ cell population (PPD-IGTA) in the pleural fluid compared to peripheral blood of TB subjects. Presence of this pleural PPD-IGTA population resulted in 95% correct classification of pleural TB disease with a sensitivity of 95% and specificity of 100%. These data suggest that analysis of the site of infection provides superior diagnostic accuracy compared to peripheral blood for pleural TB, likely due to the sequestration of effector cells at this acute stage of disease

Interactions between Schistosoma haematobium group species and their Bulinus spp. intermediate hosts along the Niger River Valley

Background Urogenital schistosomiasis, caused by infection with Schistosoma haematobium, is endemic in Niger but complicated by the presence of Schistosoma bovis, Schistosoma curassoni and S. haematobium group hybrids along with various Bulinus snail intermediate host species. Establishing the schistosomes and snails involved in transmission aids disease surveillance whilst providing insights into snail-schistosome interactions/compatibilities and biology. Methods Infected Bulinus spp. were collected from 16 villages north and south of the Niamey region, Niger, between 2011 and 2015. From each Bulinus spp., 20–52 cercariae shed were analysed using microsatellite markers and a subset identified using the mitochondrial (mt) cox1 and nuclear ITS1 + 2 and 18S DNA regions. Infected Bulinus spp. were identified using both morphological and molecular analysis (partial mt cox1 region). Results A total of 87 infected Bulinus from 24 sites were found, 29 were molecularly confirmed as B. truncatus, three as B. forskalii and four as B. globosus. The remaining samples were morphologically identified as B. truncatus (n = 49) and B. forskalii (n = 2). The microsatellite analysis of 1124 cercariae revealed 186 cercarial multilocus genotypes (MLGs). Identical cercarial genotypes were frequently (60%) identified from the same snail (clonal populations from a single miracidia); however, several (40%) of the snails had cercariae of different genotypes (2–10 MLG’s) indicating multiple miracidial infections. Fifty-seven of the B. truncatus and all of the B. forskalii and B. globosus were shedding the Bovid schistosome S. bovis. The other B. truncatus were shedding the human schistosomes, S. haematobium (n = 6) and the S. haematobium group hybrids (n = 13). Two B. truncatus had co-infections with S. haematobium and S. haematobium group hybrids whilst no co-infections with S. bovis were observed. Conclusions This study has advanced our understanding of human and bovid schistosomiasis transmission in the Niger River Valley region. Human Schistosoma species/forms (S. haematobium and S. haematobium hybrids) were found transmitted only in five villages whereas those causing veterinary schistosomiasis (S. bovis), were found in most villages. Bulinus truncatus was most abundant, transmitting all Schistosoma species, while the less abundant B. forskalii and B. globosus, only transmitted S. bovis. Our data suggest that species-specific biological traits may exist in relation to co-infections, snail-schistosome compatibility and intramolluscan schistosome development

A Research Agenda for Helminth Diseases of Humans: Intervention for Control and Elimination

Recognising the burden helminth infections impose on human populations, and particularly the poor, major intervention programmes have been launched to control onchocerciasis, lymphatic filariasis, soil-transmitted helminthiases, schistosomiasis, and cysticercosis. The Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), was given the mandate to review helminthiases research and identify research priorities and gaps. A summary of current helminth control initiatives is presented and available tools are described. Most of these programmes are highly dependent on mass drug administration (MDA) of anthelmintic drugs (donated or available at low cost) and require annual or biannual treatment of large numbers of at-risk populations, over prolonged periods of time. The continuation of prolonged MDA with a limited number of anthelmintics greatly increases the probability that drug resistance will develop, which would raise serious problems for continuation of control and the achievement of elimination. Most initiatives have focussed on a single type of helminth infection, but recognition of co-endemicity and polyparasitism is leading to more integration of control. An understanding of the implications of control integration for implementation, treatment coverage, combination of pharmaceuticals, and monitoring is needed. To achieve the goals of morbidity reduction or elimination of infection, novel tools need to be developed, including more efficacious drugs, vaccines, and/or antivectorial agents, new diagnostics for infection and assessment of drug efficacy, and markers for possible anthelmintic resistance. In addition, there is a need for the development of new formulations of some existing anthelmintics (e.g., paediatric formulations). To achieve ultimate elimination of helminth parasites, treatments for the above mentioned helminthiases, and for taeniasis and food-borne trematodiases, will need to be integrated with monitoring, education, sanitation, access to health services, and where appropriate, vector control or reduction of the parasite reservoir in alternative hosts. Based on an analysis of current knowledge gaps and identification of priorities, a research and development agenda for intervention tools considered necessary for control and elimination of human helminthiases is presented, and the challenges to be confronted are discussed

Utility of Repeated Praziquantel Dosing in the Treatment of Schistosomiasis in High-Risk Communities in Africa: A Systematic Review

Infection by Schistosoma worms causes serious disease among people who live in areas of Africa, South America, and Asia where these parasites are regularly transmitted. Although yearly treatment with the drug praziquantel is fairly effective in reducing or eliminating active infection, it does not cure everyone, and reinfection remains a continuing problem in high-risk communities. Studies have suggested that a repeat dose of praziquantel, given 2 to 8 weeks after the first dose, can improve cure rates and reduce remaining intensity of infections in population-based programs. Our systematic review of published research found that, on average, in Africa, such repeated dosing appears to offer particular advantages in the treatment of S. mansoni, the cause of intestinal schistosomiasis, but there was less consistent improvement after double-dosing for S. haematobium, the cause of urogenital schistosomiasis. Based on this evidence, we used a calibrated life-path model to predict the costs and benefits of a single-dose vs. a double-dose strategy in a typical high-risk community. Our projections suggest cost-effective incremental benefits from double dosing in terms of i) limiting a person's total years spent infected and ii) limiting the number of years they spend with heavy infection, with consequent improvements in quality of life