Prevalence of malnutrition among settled pastoral Fulani children in Southwest Nigeria

<p>Abstract</p> <p>Background</p> <p>There is a dearth of information on the health of pastoral Fulani children living in southwestern Nigeria. These are fully settled pastoralists whose economy are centred on cattle and farming. In other to monitor and plan appropriate nutritional intervention for their children, a cross-sectional study was carried out to determine the prevalence of malnutrition of pastoral Fulani children.</p> <p>Findings</p> <p>Fulani's children aged 6 months to 15 years, living in 61 settlements in Kwara, Ogun and Oyo States in Southwestern Nigeria participated in the study. Heights and weights of 164 girls and 167 boys were measured. Their anthropometric indices, height-for-age (HA), weight-for-height (WH), and weight-for-age (WA) Z-scores determined. The prevalence of stunting (HAZ < -2), wasting (WHZ < -2) and underweight (WAZ < -2) was 38.7%, 13.6%, and 38.7%, respectively when compared to the reference NCHS/WHO standard used for defining stunting, wasting and underweight. Boys were more malnourished than the girls were, but this was not significant (stunting: χ²= 0.36; df = 1; P = 0.54); (underweight: χ²= 1.10; df = 1; P = 0.29); and (wasting: χ²= 0.00; df = 1; P = 0.98) The mean of Z-scores of Height-for-age, Weight-for-age and Weight-for-height in children were -1.502, -1.634 and -0.931 respectively. The SD was 1.52, 1.09 and 1.20 respectively. Using WHO Malnutrition Classification systems, 38.7% of the children were found to be malnourished.</p> <p>Conclusion</p> <p>These results indicate high prevalence of malnutrition among settled pastoral Fulani children, possibly due to changes in food habits and lifestyle occasion by the transition from nomadic to sedentary living. We suggest the inclusion of Fulani's settlements in nutritional intervention for these areas.</p

Preliminary study on temporal variations in biting activity of Simulium damnosum s.l. in Abeokuta North LGA, Ogun State Nigeria

<p>Abstract</p> <p>Background</p> <p><it>Simulum damnosum </it>Theobald <it>sensu lato </it>(<it>s.l</it>.) is the vector of the parasitic filarial worm <it>Onchocerca volvulus </it>Leuckart which causes onchocerciasis. In order to understand the vector population dynamics, a preliminary 12 months entomological evaluation was carried out at Abeokuta, the Southwest Zone of Nigeria, an onchocerciasis endemic area, where vector control has not been previously initiated. <it>S.damnosum s.l</it>. flies were caught on human attractants between 700 to1800 hours each day, for 4 days each month, from August 2007 to July 2008. The flies caught were classified as either forest-dwelling or savanna-dwelling groups based on the colour of certain morphological characters. Climatic data such as rainfall, humidity and temperature were also collected monthly during the period of survey.</p> <p>Results</p> <p>A total of 1,139 flies were caught, 596 (52.33%) were forest-dwelling group while 543 (47.67%) were savanna-dwelling group of <it>S. damnosum s.l</it>. The highest percentage of forest-dwelling group was caught in the month of August 2007 (78.06%) and the least percentage of forest-dwelling groups was caught in November 2007 (8.14%). The highest percentage of savannah-dwelling group was caught in the month of November 2007 (91.86%) and the least percentage of savannah-dwelling group was caught in August 2007 (21.94%). There was no significant difference between the population of forest and savannah-dwelling groups of the fly when the means of the fly population were compared (<it>P </it>= 0.830). Spearman correlation analysis showed a significant relationship between monthly fly population with monthly average rainfall (<it>r </it>= 0.550, n = 12, <it>P </it>= 0.033), but no significant relationship with monthly average temperature (<it>r </it>= 0.291, <it>n </it>= 12, <it>P </it>= 0.179). There was also a significant relationship between monthly fly population and monthly average relative humidity (<it>r </it>= 0.783, <it>n </it>= 12 <it>P </it>= 0.001). There was no significant correlation between the population of forest-dwelling group of <it>S. damnosum s.l</it>. and monthly average rainfall (<it>r </it>= 0.466, <it>n </it>= 12, <it>P </it>= 0.064) and monthly average temperature (<it>r </it>= 0.375, n = 12, <it>P </it>= 0.115) but there was significant correlation with monthly average relative humidity (<it>r </it>= 0.69, <it>n </it>= 12, <it>P </it>= 0.006). There was significant correlation between savannah-dwelling group and monthly average rainfall (<it>r </it>= 0.547, <it>n </it>= 12, <it>P </it>= 0.033), and monthly average relative humidity (<it>r </it>= 0.504, <it>n </it>= 12, <it>P </it>= 0.047) but there was no significant correlation with monthly average temperature (<it>r </it>= 0.142, <it>n </it>= 12, <it>P </it>= 0.329)</p> <p>Conclusion</p> <p>The results from this study showed that both the forest and the savannah dwelling groups of <it>S. damnosum s.l</it>. were caught biting in the study area. This could have implications on the transmission and epidemiology of human onchocerciasis if not monitored.</p

Urinary schistosomiasis among preschool children in a rural community near Abeokuta, Nigeria

<p>Abstract</p> <p>Background</p> <p>The control of schistosomiasis in Nigeria is mainly by mass treatment with praziquantel through the school system, with an absence of any provision for pre-school children. We therefore determined the prevalence and intensity of urinary schistosomiasis in pre-school children between the ages of 1-6 years in Ilewo-Orile a rural and endemic community, near Abeokuta, Nigeria as part of providing information on the neglected tropical diseases among this age group. Two urine samples were collected from each pre-school child. The samples were tested for microhaematuria using reagent strips and then processed and examined with a microscope for <it>Schistosoma haematobium </it>ova.</p> <p>Results</p> <p>Of the 167 children examined 97 (58.1%) had infection, with no significant difference (P = 0.809) in infection rates between boys (57.1%) and girls (59.2%). Both prevalence and intensity of infection did not increase significantly with age (P = 0.732). The overall geometric mean egg count was 1.17 eggs/10 ml urine. There was no significant association (<it>P </it>= 0.387) between intensity in boys (1.16 eggs/10 ml urine) and girls (1.19 eggs/10 ml urine). 47.4% of the children had microhaematuria which did not increase significantly with age (P = 0.526). Focus group discussions with guardians and caregivers revealed that infection of pre-school children early in life was due to exposures through bathing in the stream by their mothers, while the older children would visit the stream for washing, fetching of water, bathing and swimming.</p> <p>Conclusion</p> <p>Community participatory health education is needed in this community as a first step in reducing infection and transmission of the disease, while the rehabilitation and repair of the existing water borehole system in the community should be effected. The results of this study have shown that pre-school children also harbour infection and are a source of transmission of schistosomiasis in endemic communities. Planning and provision for their treatment should be considered in control programmes.</p

Biting behaviour of Simulium damnosum complex and Onchocerca volvulus infection along the Osun River, Southwest Nigeria

<p>Abstract</p> <p>Background</p> <p>Studies on biting behaviours and infectivity status of insect vectors are pre-requisites in understanding the epidemiology of the vector- borne diseases and planning effective control measures. A longitudinal study was carried out to investigate the transmission index of <it>Simulium damnosum </it>complex species along Osun River, South Western Nigeria. Adult flies were collected on human attractants from 07:00 to 18:00 hours for two consecutive days from February 2008 to June 2009 at three communities: Osun Eleja, Osun Ogbere and Osun Budepo. The infectivity rate was determined by dissection and Polymerase Chain Reaction amplification (PCR) of 0-150 genes of <it>Onchocerca </it>parasite using the pool screening technique.</p> <p>Results</p> <p>The results indicated that the majority of the flies collected at the three sampling points were nulliparous as they accounted for 53.90%, 57.86% and 59.58% of the flies dissected at Osun Budepo, Osun Ogbere and Osun Eleja, respectively. The parous rate was higher during the dry season than the wet season but the difference was not statistically significant (<it>p </it>< 0.05). The biting activity of the parous flies showed two peaks at Osun Budepo and three peaks at Osun Eleja and Osun Ogbere. Of the 1,472 flies dissected and 1,235 flies screened by molecular method, none was infected with <it>Onchocerca </it>parasite at the three sampling points however the annual biting rates at the three communities were higher than 1,000 considered as tolerable value for a person living in an onchocerciasis zone by Word Health Organization.</p> <p>Conclusion</p> <p>The study has provided the baseline data for further study on onchocerciasis transmission dynamics and the need to intercept man- simuliid vector contact at the study area.</p

Persistence of onchocerciasis in villages in Enugu and Ogun states in Nigeria following many rounds of mass distribution of ivermectin

BACKGROUND: Onchocerciasis is endemic in most local government areas (LGAs) in Enugu and Ogun states. Most meso- and hyper-endemic LGAs have received many rounds of ivermectin mass drug administration (MDA). This study aimed to determine the current prevalence of onchocerciasis in villages in Enugu and Ogun states that were formerly highly endemic and to assess progress toward elimination of the infection in areas believed to be at high risk for persistence. METHODS: Cross-sectional community surveys were conducted 8 to 12 months after the last round of MDA in 16 villages (6 in Enugu state and 10 in Ogun state) in individuals aged ≥ 18 years. Study participants were examined for the presence of palpable subcutaneous nodules. Skin snips from the posterior iliac crests were used to assess microfiladermia (Mf) prevalence and density. RESULTS: 643 subjects were palpated for nodules and 627 individuals (225 in Enugu state; 402 in Ogun state) provided skin snips. Nodule prevalence in the study villages ranged from 42 to 66.7% in Enugu state and from 0 to 25.0% in Ogun state. Mf prevalence in the Enugu and Ogun study villages ranged from 32 to 51.1% and 0 to 28.6%, respectively. Geometric mean skin Mf density in surveyed Enugu state villages ranged between 1 and 3.1 Mf/mg; these values were \u3c 1 Mf/mg in all but one community in Ogun state villages. CONCLUSION: Results from this study show that onchocerciasis persists in adults in many villages in Enugu and Ogun states despite many prior rounds of ivermectin MDA. Prevalence was higher in villages surveyed in Enugu than in Ogun. Low Mf densities suggest the MDA program is working well to reduce disease, but more time will be required to reach the elimination goal

Geographical information system and predictive risk maps of urinary schistosomiasis in Ogun State, Nigeria

<p>Abstract</p> <p>Background</p> <p>The control of urinary schistosomiasis in Ogun State, Nigeria remains inert due to lack of reliable data on the geographical distribution of the disease and the population at risk. To help in developing a control programme, delineating areas of risk, geographical information system and remotely sensed environmental images were used to developed predictive risk maps of the probability of occurrence of the disease and quantify the risk for infection in Ogun State, Nigeria.</p> <p>Methods</p> <p>Infection data used were derived from carefully validated morbidity questionnaires among primary school children in 2001–2002, in which school children were asked among other questions if they have experienced "blood in urine" or urinary schistosomiasis. The infection data from 1,092 schools together with remotely sensed environmental data such as rainfall, vegetation, temperature, soil-types, altitude and land cover were analysis using binary logistic regression models to identify environmental features that influence the spatial distribution of the disease. The final regression equations were then used in Arc View 3.2a GIS software to generate predictive risk maps of the distribution of the disease and population at risk in the state.</p> <p>Results</p> <p>Logistic regression analysis shows that the only significant environmental variable in predicting the presence and absence of urinary schistosomiasis in any area of the State was Land Surface Temperature (LST) (B = 0.308, p = 0.013). While LST (B = -0.478, p = 0.035), rainfall (B = -0.006, p = 0.0005), ferric luvisols (B = 0.539, p = 0.274), dystric nitosols (B = 0.133, p = 0.769) and pellic vertisols (B = 1.386, p = 0.008) soils types were the final variables in the model for predicting the probability of an area having an infection prevalence equivalent to or more than 50%. The two predictive risk maps suggest that urinary schistosomiasis is widely distributed and occurring in all the Local Government Areas (LGAs) in State. The high-risk areas (≥ 50% prevalence) however, are confined to scatter foci in the north western part of the State. The model also estimated that 98.99% of schools aged children (5–14 years) are living in areas suitable for urinary schistosomiasis transmission and are at risk of infection.</p> <p>Conclusion</p> <p>The risk maps developed will hopefully be useful to the state health officials, by providing them with detailed distribution of urinary schistosomiasis, help to delineate areas for intervention, assesses population at risk thereby helping in optimizing scarce resources.</p

Toward an Open-Access Global Database for Mapping, Control, and Surveillance of Neglected Tropical Diseases

Abstract Background: After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs

A quality improvement approach in co-developing a primary healthcare package for raising awareness and managing female genital schistosomiasis in Nigeria and Liberia

Background: Girls and women living in endemic areas for urogenital schistosomiasis may have lifelong vulnerability to female genital schistosomiasis (FGS). For &amp;gt;2 decades, the importance of FGS has been increasing in sub-Saharan Africa, but without established policies for case detection and treatment. This research aimed to understand the level of FGS knowledge of frontline health workers and health professionals working in endemic areas and to identify health system needs for the effective management of FGS cases and prevention of further complications due to ongoing infections. Methods: Workshops were conducted with health workers and stakeholders using participatory methods. These workshops were part of a quality improvement approach to develop the intervention. Results: Health workers’ and system stakeholders’ knowledge regarding FGS was low. Participants identified key steps to be taken to improve the diagnosis and treatment of FGS in schistosomiasis-endemic settings, which focused mainly on awareness creation, supply of praziquantel, development of FGS syndromic management and mass administration of praziquantel to all eligible ages. The FGS intervention component varies across countries and depends on the health system structure, existing facilities, services provided and the cadre of personnel available. Conclusion: Our study found that co-developing a new service for FGS that responds to contextual variations is feasible, promotes ownership and embeds learning across health sectors, including healthcare providers, NTD policymakers and implementers, health professionals and community health workers

Mixed-methods evaluation of integrating female genital schistosomiasis management within primary healthcare: a pilot intervention in Ogun State, Nigeria

Background: Detection and management of female genital schistosomiasis (FGS) within primary healthcare is crucial for achieving schistosomiasis elimination, however, current technical strategies are not feasible in many settings. In Nigeria, there are currently no established standard operating procedures to support front-line health workers. This article presents an evaluation of piloting an FGS care package in two LGAs of Ogun State, Nigeria. Methods: We used quantitative and qualitative analysis, including 46 interviews with patients, health workers and the quality improvement team; observations of training, learning sessions and supervision across 23 heath facilities; and records of patients detected and managed. Results: Of 79 women and girls who were screened, 66 were treated and followed up. Health workers assimilated knowledge of FGS and effectively diagnosed and managed patients, demonstrating the feasibility of using symptomatic screening and treatment tools to diagnose and care for women or girls with suspected FGS. Challenges included establishing a referral pathway to tertiary care for patients with complications, insecurity, gender norms that limited uptake and sensitization, the limited capacity of the workforce, conflicting priorities and praziquantel acquisition. Conclusions: Simple tools can be used in primary healthcare settings to detect and manage women and girls with FGS. Contextual challenges must be addressed. Sustainability will require political and financial commitments

Toward an Open-Access Global Database for Mapping, Control, and Surveillance of Neglected Tropical Diseases

There is growing interest in the scientific community, health ministries, and other organizations to control and eventually eliminate neglected tropical diseases (NTDs). Control efforts require reliable maps of NTD distribution estimated from appropriate models and survey data on the number of infected people among those examined at a given location. This kind of data is often available in the literature as part of epidemiological studies. However, an open-access database compiling location-specific survey data does not yet exist. We address this problem through a systematic literature review, along with contacting ministries of health, and research institutions to obtain disease data, including details on diagnostic techniques, demographic characteristics of the surveyed individuals, and geographical coordinates. All data were entered into a database which is freely accessible via the Internet (http://www.gntd.org). In contrast to similar efforts of the Global Atlas of Helminth Infections (GAHI) project, the survey data are not only displayed in form of maps but all information can be browsed, based on different search criteria, and downloaded as Excel files for further analyses. At the beginning of 2011, the database included over 12,000 survey locations for schistosomiasis across Africa, and it is continuously updated to cover other NTDs globally