Malaria Control Practices and Treatment Seeking Patterns among Adults in North Central Nigeria

Background: Malaria is a major public health problem in Nigeria and the burden of disease is largely due to inadequate control and treatment efforts. This cross-sectional study was conducted in a socio-culturally heterogeneous adult population in Northcentral Nigeria to evaluate malaria control practices and treatment seeking patterns and further determine the sociodemographic determinants.Methodology: Two hundred (200) adult out-patients attending the Jos University Teaching Hospital, Nigeria from urban and rural areas were recruited in a cross-sectional study spanning August to December 2009. A structured questionnaire was used to obtain information from the participants about their socio-demographic characteristics, malaria control practices, history of malaria treatment and choice of treatment provider.Results: The mean age of the subjects was 36 ± 9 years and 58% of them were females. Majority of the subjects (67.5%) reported embarking on at least one malaria control measure. Environmental measures (62.5%) and use of window/door nets (43.2%) were the commonest control practices while only 14.5% reported sleeping under insecticide-treated bed nets (ITN). Female gender (p=0.04), high educational level (p<0.0001), urban residence (p=0.0003) and unemployment (p=0.04) favoured ITN use. There were a total of 403 self-reported malaria treatments in the preceding 12 months with 68% having ≥ 2 treatments. Patent medicine dealers (42.5%) were the most patronized treatment providers followed by doctors (33.5%) and nurses/community health extension workers (18.0%). Marital status (p=0.005), level of education (p<0.0001) and place of residence (p=0.0002) were the significant determinants of choice of treatment provider.Conclusion: Malaria control measures and treatment seeking patterns are far from satisfactory in North-central Nigeria and both have strong socio-demographic determinants. There is great need to equitably improve malaria control practices and optimize access to formal treatment facilities

Pattern of opportunistic infections in HIV Patients who fail first line antiretroviral therapy in Jos, Nigeria

Background: Opportunistic infections (OIs) are an important cause of morbidity and mortality in persons living with human immuno-deficiency virus (HIV) infection and may be an indication of failure of antiretroviral therapy (ART).Methods: This descriptive cross-sectional study was carried out at a large HIV clinic of the Jos University Teaching Hospital (JUTH), North-central Nigeria. Hundred patients were randomly selected from a sample frame of 320 patients on antiretroviral therapy of at least 6 months who failed ART.Results: Fifty-nine (59%) were females. The mean age of the patients was 41 ± 9 years. The median duration on ART was 7.5months IQR (6-17) and the median CD4 cell count was 139 3 cell/ml IQR (69-245). The prevalence of OIs was 26% with the following frequencies: oral/ vaginal candidiasis 39%, chronic diarrhoea 26%, dermatitis 23% and pulmonary tuberculosis 13%. Neither age, sex, ART default, hepatitis co-infection, baseline CD4 count, nor CD4 count at the time of virological failure was associated with OIs.Conclusion: Oral/vaginal candidiasis, diarrhoeal diseases, and tuberculosis are common opportunistic infections in HIV patients who fail first line antiretroviral therapy. No risk factor was associated with virological failure in this cohort of patients.Keywords: Opportunistic infections, HIV, antiretroviral therapy

Epidemiological and clinical description of Lassa fever in Jos, Nigeria

Background: The epidemiological, clinical and laboratory description, and treatment outcome of Lassa Fever (LF) in Jos, Nigeria. Methods: A retrospective study from January 2012 -February 2013. Data analyzed included patients' demographics and clinical features. Main laboratory variable of interest was LF polymerase chain reaction (PCR) test. Categorical variables were compared using Chi square test or Fisher's exact test. Continuous variableswere expressed as mean ± standard deviation or as median with range. Means were compared by student's t test or Mann-Whitney U test. P < 0.05 was considered significant. Results: Six (40%) had confirmed LF by PCR while nine(60%) had negative PCR results. Mean age (years) was 31.0 ± 10.2 for confirmed cases compared with 22.0 ± 17.9 for unconfirmed cases (p=0.45). Two (33.3%) males and four (66.7%) females were confirmed cases compared with 5 (71.4%) males and 4 (50%) females that were unconfirmed cases (p=0.38). Median, with range, duration from onset of symptoms to presentation at hospital was 8 (4-11) days in confirmed cases compared with 4 (1-7) days in unconfirmed cases (p=0.01). Select findings among confirmed cases were as follow: rural/sub-urban residence 6 (100%); p= 0.01, fever 6 (100%), hemorrhagic manifestations 5 (83.3%), cough 4 (66.7%), sore throat 2 (33.3%), proteinuria 2 (33.3%), retrosternal pain 1 (16.7%). None of those with confirmed LF received ribavirin within 6 days of illness and the case fatality ratio was 83.3%. Conclusion: LF is lethal and clinical diagnosis is unreliable. Laboratory testing should be made widely available to guide early diagnosis and treatment. Keywords: Clinical Features, Epidemiology, LaboratoryDescription, Lassa, Nigeria  High Med Res J 2013;13:3-