Tropical Parasitic Diseases andWomen

Tropical parasitic diseases constitute the greatest threat to the health and socio – economic status of women as a gender and social group. There are some gender specific ways in which parasitic diseasesaffect women in contrast to men due to differences in exposure, occupational risk, sociocultural behavior, gender roles and practices. These parasitic diseases confer some social stigma, which affects the healthseeking behavior of women. Women are therefore important in the control of these parasitic diseases and they are key agents of change, if they are included in community control programs. Women need moreattention in endemic areas as a group that had been neglected. This deprived and excluded group have got vital role to play, as discussed in this revie

Social Aspects of Malaria among Students in Two Tertiary Institutions in Lagos, Nigeria

Studies were carried out on the social aspects of malaria among 600 students. Three hundred students (150 male, 150 females) were randomly selected from two tertiary institutions in Lagos, Nigeria. These schools are Lagos State University (LASU) and AOCOED (Adeniran Ogunsanya College of Education). A structured questionnaire elicited relevant information on knowledge, perception and social aspects of malaria. Students aged 21-23, from faculty of arts and in their second year participated mostly in the study with no significant difference between the two schools. In LASU, 223(74.3%) and 211(70.3%) in AOCOED knew the cause of malaria (P>0.05). In LASU, 282(94%) and 192(64%) in AOCOED believed that malaria could be prevented (P<0.05). In LASU, 283(96%) and 283(94.3%) in AOCOED believed malaria could be treated (P>0.05). 109 (36.3%) respondents in LASU and 112(37.3%) in AOCOED thought that malaria was contagious (P>0.05). Fever was the most recognised symptom of malaria in both schools and self-medication was more popular in AOCOED. In LASU, 284(94.6%) and AOCOED, 273(91%) had malaria in the past one year (P>0.05). 146(48.7%) of the students who participated in LASU and 206(68.6%) in AOCOED had been admitted for malaria within the past one year (P<0.05). Class absenteeism and low academic performance were significantly higher in AOCOED than LASU. However, our results suggested that the LASU students were more informed about malaria than the AOCOED students because their knowledge and perception was better. The students, despite their academic backgrounds need intensified health education on malaria incorporated into their schools’ curriculum.Keywords: Academic performance, Knowledge and perception, Malaria, Socioeconomic status, Student

Transmission dynamics of malaria in Nigeria.

Background: Two of the problems of malaria parasite vector control in Nigeria are the diversity of Anopheline vectors and large size of the country. Anopheline distribution and transmission dynamics of malaria were therefore compared between four ecotypes in Nigeria during the rainy season. Methods: Polymerase chain reaction (PCR) was used in molecular identification after morphological identification microscopically. Enzyme linked immunorsorbent assay (ELISA) was used for the blood meal analysis and sporozoite detection. Results: Five species were identified out of 16,410 anophelines collected. An. gambiae s.s made up approximately 29.2%-36.6% of the population in each zone. All five species acted as vectors for P. falciparum. An. gambiae s.s had the highest sporozoite rate. The most infected mosquitoes were found in the rain forest. More blood meals were taken from bovids, except the savannah forest, where 73.3%were on humans and Human Blood index (HBI) was 57.3%. The Entomological inoculation rate (EIR) was a mean of 13.6 ib/p but was highest in the rainforest zone. Conclusions and limitations: This study demonstrates the complex distribution of anophelines and theconsiderable variations in the intensity of malaria transmission in Nigeria. We highlight the need to consider diverse epidemiological situations when planning countrywide control programmes

Utilization of insecticide treated nets during pregnancy among postpartum women in Ibadan, Nigeria: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Pregnant women are susceptible to symptomatic malaria due to invasion of the placenta by plasmodium. Malaria increases the risk of adverse pregnancy outcomes for mothers, the foetuses and newborns. The effective use of Insecticide Treated Nets (ITNs) would be of benefit to these vulnerable women. Previous studies have focused on prenatal-women but this study sought to explore the actual trend of utilization of the proven strategy across all the pregnancy stages among postpartum women in Ibadan.</p> <p>Methods</p> <p>This cross-sectional survey utilized a validated structured questionnaire for data collection. A calculated sample of 335 postpartum women was proportionately recruited from three fee-paying facilities within Ibadan, Nigeria using a simple random sampling technique. These hospitals have high client flow for maternity cases and are known for provision of care under traditional ANC model. The data collected were analyzed using descriptive and inferential statistics by means of Statistical Package of Social Sciences (SPSS) version 15. The level of significance was set at = 0.05.</p> <p>Results</p> <p>The women's age ranged between 18 and 47 years, mean age was 29.4 ± 0.8 years. Various irregularities marked the traditional model of ANC provided at the settings and no exposure to preconception care. Also, 276 (82.4%) had heard of ITNs. Antenatal clinics formed the major source of information. Low utilization and compliance rates were observed. One hundred and twenty-seven (37.9%) of the women had high knowledge of Malaria in Pregnancy (MIP) but only 70 (20.9%) demonstrated positive attitude towards the use of ITNs. Participants' educational status, family types, employment and residential areas significantly influenced ITNs utilization.</p> <p>Conclusions</p> <p>The women knew and learned about ITNs from ANC visits. Majority of the women did not own ITNs because of lack of access to free distribution. The existing traditional model of ANC was marked by irregularities and none of the women was exposed to preconception care. In addition, negative attitude in spite of increased knowledge of MIP was observed among the women. Therefore, evaluation of free distribution of ITNs is recommended. Integration of focused ANC and preconception care are advocated to promote early access to health information.</p

Low coverage of intermittent preventive treatment for malaria in pregnancy in Nigeria: demand-side influences

BACKGROUND: Nigeria instituted intermittent preventive treatment for malaria (IPTp) using sulphadoxine-pyrimethamine (SP) for pregnant women in 2001, but coverage remains low. This study examined the influence of demand side factors on IPTp coverage. METHODS: Data were collected using a household survey from 1307 women who were delivered of a live baby within the one-year period preceding the study and through an exit poll from 146 women attending antenatal clinics (ANC). Data analysis examined coverage based on the national and WHO guidelines for IPTp delivery which differ with regards to use of IPTp in the last month of pregnancy. Focus group discussions (FGDs) were undertaken to further explain demand side constraints to coverage. RESULTS: From the household survey, 96.1% of respondents attended ANC, with most having five or more visits. Overall IPTp coverage for the first and second doses was 13.7% and 7.3% respectively. The coverage was higher in the urban areas compared to rural areas (p < 0.01). Amongst women who could have received IPTp based on the timing of their attendance, only 14.1% and 14.3% were offered the first dose based on national and WHO guidelines, while 7.7% and 7.5% were offered the second dose respectively giving significant missed opportunities. Amongst ANC attendees offered first and second doses, 98.9% and 96.9% respectively took the medicine. Only 13.6% and 21.5% of these clients reported taking the drug under direct observation. The low level of coverage was confirmed by exit survey data, which found coverage of 11.6% and 3.0% for the first and second doses. The FGDs revealed that women do not have many concerns about side effects, but they take drugs providers give them because they believe such drugs must be safe. CONCLUSION: This study found low coverage of IPTp and high levels of missed opportunities supporting findings that high ANC attendance does not guarantee high IPTp coverage. Demand side factors such as ANC attendance, appropriate timing of attendance, and perceptions about side effects were not constraining factors to increased coverage, raising the need to examine supply side factors

Knowledge and utilization of intermittent preventive treatment for malaria among pregnant women attending antenatal clinics in primary health care centers in rural southwest, Nigeria: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Intermittent preventive treatment for prevention of malaria in pregnancy (IPTp) is a key component of malaria control strategy in Nigeria and sulfadoxine-pyrimethamine (SP) is the drug of choice. Despite the evidence of the effectiveness of IPTp strategy using SP in reducing the adverse effects of malaria during pregnancy the uptake and coverage in Nigeria is low. This study set out to assess the use of IPTp among pregnant women attending primary health centres in the rural area and determine factors that influence the uptake.</p> <p>Methods</p> <p>A cross-sectional study was carried out between July and August 2007 among 209 pregnant women selected by systematic random sampling from antenatal care attendees at primary health care in a rural Local Government Area of Ekiti State, Nigeria. Information on knowledge of IPT, delivery, adherence and acceptability was obtained using an interviewer administered questionnaire. Descriptive statistics such as means, range, proportions were used. Chi-square test was used to examine association between categorical variables. All analyses were performed at 5% level of significance.</p> <p>Results</p> <p>One hundred and nine of 209 (52.2%) respondents have heard about IPTp but only 26 (23.9%) were able to define it. Fifty seven (27.3%) reported to have received at least one dose of IPTp during the index pregnancy and all were among those who have heard of IPTp (52.3%). Twenty one of the 57 (36.8%) took the SP in the clinic. Only three of the twenty-one (14.3%) were supervised by a health worker. Twenty two of the 36 women (61.1%) who did not take their drugs in the clinic would have liked to do so if allowed to bring their own drinking cups. Almost half (43.9%) of those who had used IPTp during the index pregnancy expressed concern about possible adverse effect of SP on their pregnancies. Periodic shortages of SP in the clinics were also reported.</p> <p>Conclusion</p> <p>In this study, IPTp use among pregnant women was very low and there was poor adherence to the Directly Observed Therapy (DOT) scheme. Concerted effort should be made to increase awareness of IPTp among the public especially women of child bearing age. Health workers should also be trained and monitored to ensure adherence.</p

Multi-dimensional knowledge of malaria among Nigerian caregivers: implications for insecticide-treated net use by children

Abstract Background Poor malaria knowledge can negatively impact malaria control programmes. This study evaluates knowledge distribution in the domains of causation, transmission, vulnerability, symptoms, and treatment of malaria. It assesses the association between a caregiver’s knowledge about malaria and ownership and use of insecticide-treated nets (ITNs) by children. Methods Some 1939 caregivers of young children were recruited through a school-based survey in two Nigerian states. A 20-item, multi-dimensional survey instrument was developed and used to rank each caregiver’s knowledge in five dimensions (cause, transmission, vulnerability, symptoms, treatment of malaria). Scores for each domain were used to create an aggregate knowledge score for each caregiver. The outcome measures were ITN ownership, and ITN use the night and week before the study. Regression models were used to evaluate the relationship between caregiver’s knowledge (individual domains and aggregate score) and ownership and use of ITN after controlling for likely confounders. Results The main predictor of ITN use was ITN ownership (r = 0.653; p < 0.001); however, ownership only explains 43 % of variance in net use. Total knowledge index for the study population was significantly associated with both ITN ownership (r = 0.122; p = 0.001) and use (r = 0.095; p = 0.014). The spectrum of caregiver’s knowledge of malaria and its causes captured in the various domains was, however, found to be poor. Fifty percent of the respondents knew that malaria is transmitted by female mosquitoes and 65 % still believe that too much exposure to the sun is a risk factor for malaria. Knowledge of populations most vulnerable to malaria (83 %) and knowledge of malaria transmission (32 %) were the domains with the highest and lowest average correct answers. Conclusions There is a need to improve ITN coverage in Nigeria as ITN ownership was associated with ITN use. Additionally, treating knowledge as a multi-dimensional phenomenon revealed that a lot of misperceptions about malaria still exist. Distribution of ITNs through the public/private sector may need to be augmented with tailored behavioural change communication to dispel myths and improve the multi-dimensional knowledge of malaria in the local population.http://deepblue.lib.umich.edu/bitstream/2027.42/134666/1/12936_2016_Article_1557.pd

Preliminary investigations on malaria in sickle cell patients among pregnant women and infants in Lagos, Nigeria

Sickle cell patients are a special risk-group that deserves special attention in our endeavour to roll back malaria, especially among the right risk-group. Special attention should be directed at sicklers who are already anaemic. Moreso, malaria is one of the causes of anaemia in the tropics. The gravity of these dual problems prompted this study. Studies were carried out on the status of malaria among 18 pregnant women (sicklers) and 20 infacts (sicklers). They were selected after genotype testing from 480 pregnant women and 600 infants randomly selected in two hospitals in Lagos State. Blood were obtained puncture and finger-pricking, buffered giemsa stains were used on thick blood films. The blood films revealed genotype, parasite density, parasite species and stages, haematocrit value and haemoglobin rate. Spleen examination was carried out. The result of the study confirmed that trophozoites of Plasmodium falciparium formed a greater percentage of the blood parasite stages in pregnant women (60%) and children (48%). Overall, P.falciparium constituted 9% of the parasite density. Haemoglobin rate of 6.0-13.1mg was recorded. Severe splenomegaly (60%), was observed among the children. The result of these findings elicits the precarious state posed to this vulnerable special risk-group, whose situation is further compounded by the anaemic state. They therefore need urgent special attention as we roll back malaria. Nigerian Journal of Parasitology Vol. 25, 2004: 81-8