The Attitude of Patients towards the Treatment of Malaria in Edo State, Nigeria

Failure of antimalarials in communities is to some extent attributed to the attitude of patients and health providers towards the management of malaria. In this study, the information on the therapy used prior to hospital visit was obtained using a well questionnaire and diagnosis of malaria parasitaemia in patients was carried out using standard parasitological techniques. Out of the 231 subjects, 187 (80.9%) subjects self-administered antimalarials prior to their visit to the hospital. Fifty seven (30.4%) self- administered herbal therapy while 130 (69.5%) did with chloroquine, sulphadoxine/pyrimethamine (SP) combination, and artemether medications, 41 (31.5%) of which adhered to the prescribed dosage. The prevalence of Plasmodium parasitaemia was significantly higher in patients who self administered herbal therapy than in those who did with conventional antimalarials at the recommended dosages (P < 0.05). On the other hand, significant higher prevalence of Plasmodium parasitaemia was obtained in subjects who self-administered chloroquine therapy than those who did with other drugs. The study revealed that uncontrolled use of herbal medications and self-prescribed medications are common practices in rural Nigeria.Keywords: Malaria, antimalarial drugs, self medication, herbal therapyEast and Central African Journal of Pharmaceutical Sciences Vol. 14 (2011) 95-9

Age and Sex Distribution of Intestinal Parasitic Infection Among HIV Infected Subjects in Abeokuta, Nigeria

Intestinal parasitic infection has been a major source of disease in tropical countries especially among HIV patients. The distribution of intestinal parasite among two hundred and fifteen (215) subjects with mean age of 32 years, comprising of 35 HIV-seropositive and 180 HIV seronegative patients was carried out using microscopic method to examine their stool specimens for presence of trophozoites, ova, cysts, larvae and oocysts of intestinal parasites. Overall parasitic infection rate was 28.4%. Infection rate among HIV seropositve subjects (42.9%) was statistically higher than that among HIV seronegative subjects (25.6%) (P<0.05). Although helminths infection rate (31.4%) was higher than that of protozoa (20%) among HIV-seropositive subject, the difference was not statistically significant (P>0.05). There was no statistically significant difference in the parasitic infection between HIV-seropositive males and females and among the various age groups (P>0.05). Adequate treatment, proper health education and good hygiene will help in reducing intestinal parasitic infectio

Candida albicans in Urinary Tract or in Seminal Sac

A case of urinary tract infection due to Candida albicans and responding to fluconazole is presente

Perfil de citoquina relacionado con la edad en la infección no complicada de malaria

Objective: Malaria infection is severe in children who are believed to be more at risk because of their relative poor immunity against the disease. Some cytokine levels (IFN-γ, IL-2, IL-4, and IL-10) of children, adolescents, and adults were assessed in this study. Methods: Cytokine levels were assayed by using Enzyme Linked Immunosorbent Assay (ELISA). Malaria diagnosis and blood parameters were carried out by using standard parasitological and haematological techniques. Results: The mean cytokine levels were significantly elevated in children, adolescent, and adult subjects when compared to their respective healthy controls (p<0.05). Also, mean IFN-γ and IL-2 levels were significantly higher in children than in adults (IFN-γ: 57.31±77.79 pg/ml vs. 20.37± 2.95 pg/ml, and IL-2: 108.75±63.53 pg/ml vs. 66.09±45.34 pg/ml) (p<0.05) and adolescents (IFN-γ: 20.37± 2.95 pg/ml and IL-2: 66.09±45.34 pg/ml) respectively. Furthermore, mean IL-10 level was significantly lower in children (7.39±15.08 pg/ml) than mean level in adults (22.73±13.89 pg/ml). The mean haematological parameters revealed significant increase in total white blood cell, CD4, and CD8 count and significant decrease in the hematocrit of children in relation to adolescent and adult subjects (p<0.05). However, mean monocyte count was significantly higher in subjects than in their respective healthy controls (p<0.05). Conclusion: Findings in this study revealed better Th1 driven immune response in children than in adolescents and adults. Objetivo: La infección por malaria es grave en los niños debido a su relativa baja inmunidad contra la enfermedad. Se evaluaron en este estudio algunos niveles de citoquinas (IFN-γ, IL-2, IL-4 e IL-10) en niños, adolescentes y adultos. Métodos: Se analizaron los niveles de citocinas mediante ensayo inmunoabsorbente ligado a enzimas (ELISA). El diagnóstico de malaria y sanguíneas se llevó a cabo utilizando las técnicas parasitológicas y hematológicas. Resultados: Los niveles de citoquinas eran significativamente elevados en los niños, adolescentes y adultos en comparación con sus respectivos controles sanos (p<0.05). Además, la media de IFN-γ y los niveles de IL-2 fueron significativamente mayores en niños que en adultos (IFN-γ: 57.31 ± 77.79 pg/ml vs. 20.37 ± 2.95 pg/ml e IL-2: 108.75 ± 63.53 pg/ml vs. 66.09 ± 45.34 pg/ml) (p<0,05) y adolescentes (IFN-γ: 20.37 ± 2.95 pg/ml e IL-2: 66.09 ± 45.34 pg/ml). Por otra parte, la media de IL-10 fue significativamente menor en los niños (7.39 ± 15.08 pg/ml) que en nivel medio en los adultos (22.73 ± 13.89 pg/ml). La media de los parámetros hematológicos reveló un aumento significativo en la celda total de color blanco, CD4, CD8 y disminución significativa en el hematocrito de los niños en relación con los adolescentes y los adultos (p<0.05). No obstante, el número promedio de monocitos fue significativamente mayor en los sujetos que en sus respectivos controles sanos (p<0.05). Conclusión: Los hallazgos en este estudio revelaron una mejor respuesta inmune Th1 en niños que en adolescentes y adultos

EFFECT OF ALLIUM CEPA AND ALLIUM SATIVUM ON SOME IMMUNOLOGICAL CELLS IN RATS.

Extracts of some spices have been reported to play a contributory role in enhancing immune function. We evaluated and compared the effect(s) of single and combined oral administration of fresh aqueous onion (Allium cepa) and garlic (Allium sativum) extracts at different concentrations on some immunological determinants in rats. CD4 cells of the rats were estimated using Partec flow cytometric technique, while total and differential white blood cell (WBC) counts were estimated using the Sysmsex® automated haematology analyzing technique. Our findings revealed that, CD4 and total WBC counts were significantly increased (P≤0.05) in a dose-dependent manner in both onion (250mg/Kg/d: 349±11cell/ul and 2.75±0.15X103cell/l; 500mg/Kg/d: 389±10cells/μl and 3.05±0.05 X103cell/l; 750mg/Kg/d: 600±11cell/μl and 3.25±0.05X103cells/l) and garlic (250mg/Kg/d: 410±10cell/ul and 2.85±0.15X103cell/l; 500mg/Kg/d: 494±32cells/μl and 3.30±0.10 X103cell/l; 750mg/Kg/d: 684±11cell/μl and 3.55±0.05X103cells/l) treated rats when compared to the zero control (200±11cells/μl and 1.55±0.05X103cells/l, respectively). Extract of garlic at 750mg/Kg/d had significantly increased the CD4 cells and total white cell count when compared to other concentrations (P≤0.05). However, no significant effect was observed on these parameters when extracts were combined (250mg/Kg/d: 252±21cell/μl and 1.80±0.10X103cells/l; 500mg/Kg/d: 315±21cells/ul and 2.10±0.10X103cells/l; 750mg/Kg/d: 368±10cells/μl and 2.35±0.05X103cells/l, respectively), the differential WBC count showed a significant increase in the proportion of cell types (lymphocytes, neutophils and monocytes) (P≤0.05). The results from this study revealed the immune boosting capabilities of Allium cepa and Allium sativum, but underscored their synergistic activities

ANTIMICROBIAL POTENTIALS OF SILVER COLLOIDAL (NANORODS) ON CLINICAL ISOLATES IN BAYELSA STATE, NIGERIA

Antimicrobial resistance in developing countries has long been an issue of major concern. Nanotechnology has become an eye opener for the intervention on multiple drug resistance organisms. In this study we investigated the antimicrobial potentials of Silver Nitrate (nanorods) solution used in managing infectious diseases, the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of the product against microbial isolates were determined using standard microbiological techniques. The mean MIC and MBC of silver nitrate solution on fungi (0.16 μg/ml and 0.29 μg/ml respectively) was significantly lower than that of Gram positive organisms (2.35μg/ml and 2.62μg/ml) and Gram negative organisms (2.05 μg/ml and 2.10 μg/ml). Of all the Gram positive organisms, Staphylococcus spp recorded the lowest mean MICand MBC while in the Gram negative organisms group, E. coli isolates showed the lowest mean MIC and MBC of the silver nitrate solution, though not significantly different from the other isolates. In conclusion, results from this study revealed that Silver Nitrate(nanorods) may have be broad spectrum in activity, but with higher antifungal potentials

MICROBIAL BURDEN OF SOME HERBAL ANTIMALARIALS MARKETED AT ELELE, RIVERS STATE

Herbal antimalarials still remain an alternative to our traditional communities who can not afford orthodox antimalarials. This study was aimed at investigating the microbial quality of six herbal antimalarials using standard microbiological methods. Of the six preparations analyzed, “schnapps”, palm wine and water were the media of preparation; the water base preparations recorded higher microbial load. The mean microbial load was 159.5x105 cfu/ml and 217.4x102cfu/ml in water and alcohol base preparations respectively. The microbial profile of the preparations showed that the schnapps base preparations were predominantly contaminated with Bacillus sp (Aerobic spore bearers) and Mucor spp. The palm wine preparation harboured Bacillus sp, yeasts and Mucor spp while the water base preparations had several isolates such as Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli 0157H7, Proteus mirabilis, Enterococcus feacalis, Serratia marcensces, Staph. aureus, Bacillus spp and Mucor spp. Conclusively, this study underlines the public health importance of these preparations given the high burden of such human pathogen as Ecoli O157H7, Ps aeruginosa, Stahp aureus, etc. in the preparations

Chloroquine prophylaxis associated with high prevalence of Plasmodium falciparum Pfcrt K76T mutation in people with sickle-cell disease in Benin City, Nigeria

Background & objectives: High mortality and morbidity in sickle-cell disease has been associated with malaria infection especially in countries where chloroquine is used. Chloroquine resistance has been associated with the emergence of Pfcrt mutant genes. This study aimed at comparing the prevalence rate of Pfcrt T76 mutation in Plasmodium falciparum isolates from infected individuals with sickle-cell disease and sickle-cell trait. This study was carried out in Benin City between the months of April and June 2006. This period is marked with high transmission rate of malaria. Methods: The genotype of the subjects was screened using haemoglobin electrophoresis system and the P. falciparum. Pfcrt genotyping was carried out using PCR–restriction fragment length polymorphism (RFLP).Results: Four hundred and twenty-four subjects comprising of 207 haemoglobin AA, 136 haemoglobin AS and 81 haemoglobin SS typed individuals were enrolled for this study. No significant difference existed in the prevalence rate of malaria in the three groups (p >0.05). However, the prevalence rate of Pfcrt K76T mutant gene was higher in the haemoglobin SS genotyped individuals than the haemoglobin AA and AS subjects (p<0.05).Interpretation & conclusion: An uncontrolled use of chloroquine has been incriminated as the major cause of chloroquine resistance in Nigeria. Therefore, rapid intervention measures are needed as a matter of urgency to curb the up rise in the prevalence of the chloroquine resistant genes in our environment

A comparative study on the susceptibility of male and female albino mice to Trypanosoma brucei brucei

Background & objectives: Trypanosomiasis has remained a major set-back in the development oflivestock farming in tropical Africa. Thus the need for ascertaining the trypanotolerant levels ofdomestic animal breeds and possible improvement on them cannot be over-emphasised.Methods: Level of trypanotolerance in animals was compared between sexes using albino mice infectedwith a Nigerian strain of Trypanosoma brucei brucei at a 50% mouse lethal dose (MLD50).Results: The male mice showed unrestrained parasite growth with a prepatent period (PP) of two daysand a mean survival period (MSP) of six days corresponding to a gradual decrease in packed cellvolume (PCV), body weight, diet response and white blood cells (WBC) count to the time of death.Their female counterparts showed a PP of three days and MSP of ten days with a similar PCV gradientbut a refractory WBC count. There was no significant difference in the differential leucocytes countin both sexes. However, the eosinophils count was significantly higher in the infected animals. It wasfound that female albino mice exercised more parasite restraint than their male counterparts.Interpretation & conclusion: The result suggests that the female animals may be more trypanotoleranthence may be more useful in protein production in trypanosomiasis endemic areas. However, furtherresearch using large domestic breeds like goats and sheep may be required to confirm the hypothesis

The role of coinfections in HIV epidemic trajectory and positive prevention: a systematic review and meta-analysis.

OBJECTIVES: Recurrent or persistent coinfections may increase HIV viral load and, consequently, risk of HIV transmission, thus increasing HIV incidence. We evaluated the association between malaria, herpes simplex virus type 2 (HSV-2) and tuberculosis (TB) coinfections and their treatment on HIV viral load. DESIGN: Systematic review and meta-analysis of the association of malaria, HSV-2 and TB coinfections and their treatment with HIV viral load. METHODS: PubMed and Embase databases were searched to 10 February 2010 for studies in adults that reported HIV plasma and/or genital viral load by coinfection status or treatment. Meta-analyses were conducted using random-effects models. RESULTS: Forty-five eligible articles were identified (six malaria, 20 HSV-2 and 19 TB). There was strong evidence of increased HIV viral load with acute malaria [0.67 log(10) copies/ml, 95% confidence interval (CI) 0.15-1.19] and decreased viral load following treatment (-0.37 log(10) copies/ml, 95% CI -0.70 to -0.04). Similarly, HSV-2 infection was associated with increased HIV viral load (0.18 log(10) copies/ml, 95% CI 0.01-0.34), which decreased with HSV suppressive therapy (-0.28 log(10) copies/ml, 95% CI -0.36 to -0.19). Active TB was associated with increased HIV viral load (0.40 log(10) copies/ml, 95% CI 0.13-0.67), but there was no association between TB treatment and viral load reduction (log(10) copies/ml -0.02, 95% CI -0.19 to 0.15). CONCLUSION: Coinfections may increase HIV viral load in populations where they are prevalent, thereby facilitating HIV transmission. These effects may be reversed with treatment. However, to limit HIV trajectory and optimize positive prevention for HIV-infected individuals pre-antiretroviral therapy, we must better understand the mechanisms responsible for augmented viral load and the magnitude of viral load reduction required, and retune treatment regimens accordingly