Epidemiologic review of Zika virus disease

Zika virus disease has resonated great concern globally. The World Health Organization declared it “a public health emergency of International concern” on 1st February, 2016. The recent outbreaks have become a major challenge due to a drift from its earlier known benign exanthematous spectrum to a causal link to microcephaly. Historically, the name Zika virus comes from the Zika Forest of Uganda. It was first identified in 1947 among Rhesus Macaque sub-population. Two genetically distinct isolates have been well characterized; the Asian and African strains. This virus is spread by bites of day-time-active Aedes mosquitoes; the Aedes aegypti and Aedes albopictus. Zika Virus appears to spread along a narrow equatorial belt of Africa to Asia through the Pacific Ocean to French Polynesia, New Caledonia (southwest Pacific Ocean), the Cook Islands (south Pacific), and Easter Island (a Chilean territory in Polynesia), and most recently to Mexico, Central America, the Caribbean, and South America, where today has assumed a pandemic proportion.Up to eighty percent of infections are asymptomatic. Symptomatic infections are characterized by a self-limiting febrile illness and maculopapular rash, arthralgia, conjunctivitis, back pain and mild headaches. Maternal Zika viral load is thought to be a significant risk factor to fetal infection leading to invasion of either trophoblasts or placental cells or both through maternal decidua. Zika viral RNA proteins and associated extensive selective tissue injuries have been demonstrated in the brains and spinal cords of abortuses. Diagnosis of Zika virus is essentially based on viral RNA detection from clinical specimens. Currently, licensed preventive medicines or vaccines are unavailable. With the wide spate of recent outbreaks and consequent neurologic morbidity and mortality, there is need for deployment of point-of-care equipment for screening of pregnant women in our environment. This is an ambitious call for advocacy by all relevant health care providers.Keywords: Zika Virus, disease outbreaks, microcephaly, Aedes mosquitoe

Sero-prevalenceof Plasmodium falciparum malaria in rural communities of Bassa, Plateau State, Nigeria

Background: Nigeria and Democratic Republic of Congo account for an estimated 40% of world malaria burden. Malaria parasite prevalence is one of the primary tools for estimating disease burden in a population.Aim: To estimate rural sero-prevalence of Plasmodium falciparum malaria.Method: This was a cross-sectional descriptive study of 564 children and adults; 312 (55.3%) and 252 (44.7%) from Kwall and Jengre communities respectively of Bassa Local Local Government Areas of Plateau Stateusing a multistage sampling technique between 1st and 4th May, 2017.Clinical evaluation, laboratory diagnosis and case management for malaria were carried out. Stata 14.1 software was used for data analysis. Results were presented in table and bar chart.Result: One hundred and five (34.6%), 289 (51.2%), and 80 (14.2%) were aged 0 – 5, 5 – 17 and 18 – 80 years respectively. Fever was the commonest presenting complaint in 34 (6%) while 472 (83.7%) had no symptoms. P. falciparum sero-prevalence rates were 24.2%, 41.4% and 34.3% among under-five children, 6 – 17 years and 18 – 80 years respectively.Conclusion. Plasmodium falciparum malaria transmission continues to occur with high sero- prevalence in rural communities of Bassa Local Government Areas of Plateau State. A slight decline was however, noted. Research on innovative models such as malaria vaccines, mosquito bionomics and environmental sanitation to compliment malaria therapeutics may need be employed in our rural communities so as to achieve the global goal for malaria eradication.Keywords: Malaria, sero-prevalence, Rapid diagnostic test, disease burde

Availability and distribution of phototherapy services and health care providers for neonatal jaundice in three local government areas in Jos, North - Central Nigeria

Background: Severe neonatal jaundice remains common in Nigeria. Phototherapy is the most commonly used inhospital treatment for neonatal hyperbilirubinaemia.Objectives: To describe the availability and distribution of phototherapy services as an essential neonatal service in hospitals in Jos, North-Central Nigeria.Methods: This was a crosssectional study of all secondary and tertiary level health facilities in Jos-North, Jos-South and Jos-East Local government Areas (LGAs) between January and March 2015.Results: There were 30 (90.9%) secondary and three (9.1%) tertiary health facilities. Twenty – eight (84.8%) were privately owned. Fourteen (42.4%) of the 33 hospitals provided phototherapy services, of which 11 (78.6%) were private. Phototherapy services were available in all the tertiary facilities and in only 11 (36.7%) of the secondary level health facilities. Most (10; 71.4%) of the hospitals with phototherapy were located in Jos-North LGA. There were 38 phototherapy units in all the 14 hospitals that offered phototherapy, consisting of 8 (21.1%) light emitting diodes (LED) and 30(78.9%) conventional units of which 25(83.3%) were locally fabricated. In all the hospitals that provided phototherapy, jaundiced neonates were managed by physicians of whom only 12% were fulltime paediatricians. All hospitals that offered phototherapy had laboratory facilities to assay bilirubin.Conclusions: Phototherapy services in Jos, Nigeria are inadequate and are concentrated in the urban private sector. An increase in phototherapy services especially in secondary public facilities is needed.Keywords: Health Care Provider, Hyperbilirubinaemia, Jos, Neonatal Jaundice, Nigeria, Phototherap