Comparison of Rapid Diagnostic Tests and Microscopy for Malaria

Presumptive treatment of malaria results in significant overuse of antimalarials. This study compared the diagnostic accuracy of Histidine Rich Protein II and plasmodium lactate dehydrogenase (pLDH)-based Rapid Kits( RDTs)and using expert microscopy as the gold standard for the detection of falciparum and non-falciparum in 200 individuals suffering from fever episodes over a period 8months in a malaria-endemic area in Osogbo, Osun State. 99(44.5%) of these patients were microscopically parasitaemic with three Plasmodium species identified expect P.ovale. 25 (12.5%) of the study population had temperature < 37.50C at the time of presentation in the clinic among which 16 (64% ) were parasitaemic. Furthermore, 148 (74%) of the study population had fever episode of which 65(44%) were positive for malaria. The sensitivity and specificity of pLDH (Pf) were 84.7% and  78.3% respectively and HRP-2 were 72.7% and 90.9% respectively. Both had high detection (94.7%) at parasite density ≥ 10,000 parasite/`l of blood. Microscopy still remains the ‘Gold Standard’ since both are not 95% sensitive and cannot determine parasites quantification.Keywords: Plasmodium, Microscopy, Rapid Kits, Osogbo, Nigeria, LAUTECH Le traitement présomptif de paludisme résulte de l’usage abusif considérable des antipaludiques. Cette étude a pour but de comparer l’efficacité de diagnostic de l'histidine RichProtein II et de test de diagnostic rapide (TDR) à base de kits plasmodium lactate déshydrogénase (pLDH) et en utilisant la microscopie experte comme «gold standard» pour la détection de P. falciparum et non-falciparum chez 200 personnes souffrant d'épisodes de fièvre sur une période de huit mois dans une région où le paludisme est endémique dans Osogbo, l'Etat d'Osun. 99 (44,5%) de ces patients étaient parasitémiques à la microscopie à trois espèces de Plasmodiumidentifiées différentes de P. ovaleattendu. 25 (12,5%) de la population étudiée avait une température <37,5°C au moment de leur arrivée à la clinique parmi lesquels, 16 (64%) étaient parasitémiques. En outre, 148 (74%) de la population d’étude avait un épisode de fièvre dont 65 (44%) étaient positifs pour le paludisme. La sensibilité et la spécificité de pLDH (Pf) étaient respectivement de 84,7% et 78,3% et celles de HRP-2 étaient respectivement de 72,7% et 90,9%. Tous les deux tests avaient une bonne détection (94,7%) à densité parasitaire ≥ 10000 parasite/ul de sang. La microscopie reste le «Gold Standard» puisque les deux autres tests ne sont pas sensibles à 95% et ne peut pas déterminer la quantité parasitaire.Mots clés: Plasmodium, microscopie, kits de test rapide, Osogbo, Nigeria, LAUTECHArticle in English

Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting among Healthcare Workers in a Tertiary Centre in Northern Nigeria

Purpose: To determine the knowledge, attitude and practice of ADR monitoring and reporting among healthcare workers in a teaching hospital in Kano, Nigeria Methods: The study was cross-sectional and questionnaire-based involving mainly medical doctors, nurses and pharmacists working in different departments of the Aminu Kano Teaching Hospital hospital. A total of 110 questionnaires were distributed to the respondents (60 doctors, 40 nurses, 10 pharmacists). The completion of the questionnaire by respondents was taken as their consent toparticipate in the study. Results: Only 65 respondents filled and returned the questionnaire within the stipulated time frame giving a response rate of about 59.1 %. The standard yellow reporting form for adverse drug reactions was only known to 35.9 % of the participating health care workers. Only 42.7 % of the respondents had ever reported an adverse drug reaction and the report was verbal in over 75 % of cases. Ignorance of the rules and procedures of reporting, lack of knowledge of the forms for reporting and which ADRs to report were some of the factors responsible for non-reporting of adverse drug reactions among respondents in the study Conclusion: Adverse drug reaction reporting using the yellow card reporting scheme is low among health care workers (doctors, nurses and pharmacists) in Kano, Nigeria. There is a need for regular training and re-enforcement of guidelines for ADR reporting among health care personnel. The inclusion of nurses in pharmacovigilance will go a long way in improving reporting of ADRs.Keywords: Adverse drug reactions; Knowledge, attitude and practice; Health care workers; Yellow card reporting schem

Evaluation of renal volume by ultrasonography in patients with essential hypertension in Ile-Ife, south western Nigeria

Background and aims: To determine renal volume in adult patients with essential hypertension and correlate it with age, sex, body mass index (BMI), body surface area (BSA) and duration of hypertension. Patients and methods: A total of 150 patients (75 males, 75 females) with essential hypertension and normal renal status were evaluated sonographically in this prospective study. Fifty healthy individuals (25 males, 25 females) without hypertension were also evaluated as control. Renal volume was then calculated from the kidney’s length, width and anterio-posterior diameter using the formula L*W*AP*0.523. Results: The range of renal volume obtained was 51.65-205.02 cm3, with a mean of 114.06±29.78 cm3 for the left kidney and 47.37-177.50 cm3 with a mean of 106.14±25.42 cm3 for the right kidney. The mean volumes of the right and left kidneys in males (112.98±25.56 cm3 and 123.11±32.49 cm3, respectively), were significantly higher than in females (99.31±23.07 cm3 and 105.01±23.77 cm3, respectively). Renal volume correlated significantly with BSA and BMI, but decreased with age. The renal volume showed no correlation with duration of hypertension. Conclusion: Renal volume is higher in the left than the right kidney in hypertensive patients of both sexes and female hypertensive patients have smaller kidney size compared to males. The study also shows that volume of both kidneys decreases with age and positive correlation between renal volume, BSA and BMI. However, there is no correlation between renal size and duration of hypertension.Keywords: essential hypertension; renal volume; ultrasonograph

Review of fine needle aspiration cytology in the management of goitres in Ibadan, Nigeria

No Abstract

SORGHUM BICOLOR EXTRACT: A SUITABLE COUNTER STAIN IN HIBISCUS EXTRACT NUCLEAR STAINING OF LIVER AND KIDNEY

ABSTRACT Aim: To investigate the suitability of alcoholic extract of Sorghum bicolor stalk as a counter stain for Hibiscus extract stained nuclei. Method: Formalin fixed kidney and liver biopsies were processed by the paraffin wax technique, sectioned, stained with Hibiscus extract solution and counterstained with 10% alcoholic extract of Sorghum bicolor stalk. Parallel sections were stained with H&E as control. Results: Results show distinct dark -violet nuclear staining with light-brown staining of collagen and other components. Conclusion: Sorghum bicolor stalk alcoholic extract could be a useful substitute to eosin in histology for the demonstration of collagen and other cytoplasmic components especially when H. sabdariffa is used as the nuclear stain

Translation and psychometric evaluation of the Yoruba version of the STarT Back tool among persons with longterm non-specific low-back pain

Background. Translating questionnaires into local languages is essential as it aids easy accessibility and understanding of such questionnaires by patients and their health caregivers. The STarT Back Tool (SBT), validated tool used to classify subgroups of persons with Low-Back Pain, has few translated versions. We translated the STarT Back Tool into the Yoruba language and established its psychometric properties among patients with long-term non-specific Low-Back Pain. Methods. Following the Lenz protocol, the SBT was successfully cross-culturally adapted into the Yoruba language. One hundred consenting patients (mean age = 57.0±11.43 years, 55% females) took part in the validation phase, while 53 of them participated in the test-retest phase. Psychometric indices of the Y-SBT assessed showed internal consistency, intraclass correlation coefficient (ICC), ceiling and floor effects and divergent validity. Results. The sub and total Cronbach’s α score for Y-SBT was 0.704 and 0.857, respectively. The test-retest reliability of the sub and total scores of the Y-SBT yielded an ICC of 0.82 (95% CI: 0.74 - 0.87) and 0.89 (95% CI: 0.84 - 0.93), respectively. The divergent validity for sub and total-scores of the Y-SBT based on Quadruple Visual Analogue Scale score for on-going pain was r = 0.374 (p = 0.001) and r = 0.432 (p = 0.001), respectively. The Y-SBT had no ceiling or floor effects. Conclusion. The Y-SBT have acceptable psychometric properties. It is recommended for use among Yorub speaking patients with LB

Reference values of haematological parameters of healthy adults in the north central zone of Nigeria

Background: Haematological parameters differ from one population to another due to several factors. To determine the clinical implication of the blood parameters of an individual in the state of health or disease, we need to have the knowledge of the normal reference range for that locality.Objectives: To determine the reference values of haematological parameters of apparently healthy adults in Ilorin.Design: A descriptive cross sectional study.Setting: Ilorin, North Central zone of NigeriaSubjects: Nine hundred and ten (443 males and 467 females) randomly selected normal, HIV negative individuals aged 18-65 yearsResults: The red blood cell count, Haemoglobin concentration, PCV and MCHC were significantly higher among males than females while the platelet count, total WBC count and absolute neutrophil count were significantly higher in females than in males. There was however no significant gender difference in the values of MCV, MCH and absolute lymphocyte count. The normal reference values obtained in this study were notably different from those that are used currently in the hospital.Conclusion: The normal reference value obtained in this study was notable different from those that are currently used in the hospital. These findings will have clinical implications regarding the adjustment of our current reference values and definitely add value to the management of patients in this part of the country

Self-medication with antibiotics for the treatment of menstrual symptoms in southwest Nigeria: a cross-sectional study

Background: Self-medication with antibiotics is an important factor contributing to the development of bacterial antibiotic resistance. The purpose of this study was to evaluate the prevalence of self-medication with antibiotics for the treatment of menstrual symptoms among university women in Southwest Nigeria. Methods: A cross-sectional survey was administered to female undergraduate and graduate students (n = 706) at four universities in Southwest Nigeria in 2008. The universities were selected by convenience and the study samples within each university were randomly selected cluster samples. The survey was self-administered and included questions pertaining to menstrual symptoms, analgesic and antibiotic use patterns, and demographics. Data were analyzed using descriptive statistics and logistic regression. Results: The response rate was 95.4%. Eighty-six percent (95% CI: 83-88%) of participants experienced menstrual symptoms, and 39% (95% CI: 36-43%) reported using analgesics to treat them. Overall, 24% (95% CI: 21-27%) of participants reported self-medicated use of antibiotics to treat the following menstrual symptoms: cramps, bloating, heavy bleeding, headaches, pimples/acne, moodiness, tender breasts, backache, joint and muscle pain. Factors associated with this usage were: lower levels of education (Odds Ratio (OR): 2.8, 95% CI: 1.1-7.1, p-value: 0.03); nonscience major (OR: 1.58, 95% CI: 1.03-2.50, p-value: 0.04); usage of analgesics (OR: 3.17, 95% CI: 2.07-4.86, p-value: <0.001); and mild to extreme heavy bleeding (OR: 1.64, 95% CI: 1.01-2.67, p-value: 0.05) and pimples/acne (OR: 1.57, 95% CI: 0.98-2.54, p-value: 0.06). Ampicillin, tetracycline, ciprofloxacin and metronidazole were used to treat the most symptoms. Doctors or nurses (6%, 95% CI: 4-7%), friends (6%, 95% CI: 4-7%) and family members (7%, 95% CI: 5-8%) were most likely to recommend the use of antibiotics for menstrual symptoms, while these drugs were most often obtained from local chemists or pharmacists (10.2%, 95% CI: 8-12%). Conclusions: This is the first formal study to report that approximately 1 out of 4 university women surveyed in Southwest Nigeria self-medicate with antibiotics to treat menstrual symptoms. This practice could provide monthly, low-dose exposures to antibiotics among users. Further studies are necessary to evaluate the impacts of selfmedication on student health