MALARIA IN CHILDREN IN ILORIN, NIGERIA

Objectives: To determine the prevalence of paediatric malaria admissions in an area of stablemalaria transmission and to ascertain the relative contributions of different forms of severemalaria to morbidity and mortality.Design: A descriptive restrospective study.Setting: Olanrewaju hospital, a general practice health facility in a malaria holoendemic cityin Nigeria.Subjects and rnethods: Case files of paediatric (age <15years) admissions between 1/1/98 and31/12/98 with a diagnosis of acute malaria were retrieved and relevant information includingdemographic data, clinical signs, laboratory records, treatments received and diagnosis ondischarge were extracted. Grouped age-associated prevalence rates were calculated;characteristics of different groups were compared using standard statistical methods.Results: Children with Falciparum malaria accounted for 95 (18%) of the 526 medicaladmissions. The proportion of children admitted with severe malaria was significantlyhigher among the under-fives compared to those over five years (p< 0.001; RR=S.36,95 %CI of 2.58 to 11.2). Thirty two (33.7%) children had severe malaria. Fifteen (15.8%) hadconvulsions without coma, 13 (13.68%) had malaria-associated anaemia and four (4.2%)were diagnosed as having had cerebral malaria. Seizures were significantly more frequentin the under-fives (p=0.001, RR=6.0; 95 % CI of 1.8 to 19.6). There was a significant negativecorrelation between age and severe anaemialblood transfusions (p=0.002). Cerebral malariacarried the greatest risk of fatality (CFR=25%; RR=7,95% CI of 1.5 to 91).Conclusion: High prevalence of paediatric malaria admissions in this study underscores themorbidity burden in Nigerian children, especially in under-fives in whom the severe formsare more common. A high incidence of anaemia requiring blood transfusions furtherincreases the risk of paediatric HIV infectionin Nigeria where organised control programmesare rudimentary

Open comparative efficacy of some artemisinin-based combinations for treatment of acute uncomplicated plasmodium falciparum malaria in Ilorin Nigeria

Widespread resistance of Plasmodium falciparum to chloroquine and sulfadoxinepyrimethamine has prompted the federal government of Nigeria, in line with WHO recommendations to adopt artemisinin-based combinations as first-line treatment of acute uncomplicated Plasmodium falciparum malaria. We evaluated 3 artemisinin-based combinations available in the Nigerian market to determine their efficacy and tolerability. Adequate clinical and parasitological response (ACPR) was comparable between artemetherlumefantrine (A-L) and artesunate-amodiaquine (AS-AQ) groups (92.8% v 91.2%, p = 0.79), both combinations being significantly more efficacious than artesunate-sulfadoxinepyrimethamine (AS-SP) group (A-L v AS-SP 92.8% v 69%; p = 0.005); (AS-AQ v AS-SP 91.2% v 69%; p = 0.018). Drug-related adverse events were significantly higher among the AS-AQ group compared to other treatment combinations (p = 0.004). We conclude that A-L and ASAQ have high comparative cure rates among patients evaluated in ilorin, Nigeria. Tolerability concern should play an important consideration when prescribing AS-AQ especially among adult patients

Clinical Presentations and Characteristics of Confirmed Covid-19 Patients over a 1-Year Period in a Private Health Facility in Ilorin, North-Central Nigeria

The first case of COVID-19 in Nigeria was confirmed on February 27, 2020.  Since then, many studies from government designated isolation centers have described the characteristics of patients with Covid-19. Even though COVID-19 testing and management are exclusively carried out at the NCDC-approved centers, majority of patients are referred from primary care facilities, both public and private owned. To our knowledge, there has been no studies regarding Covid-19 disease among the patients served by these centers. Our aim is to describe the clinical characteristics and outcome of COVID-19 cases seen at Olanrewaju Hospital, Ilorin, North Central Nigeria. This is a descriptive retrospective study of patients with confirmed COVID-19 seen over a one-year period. Records of all patients that tested positive using the real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) were retrieved to extract relevant information. Data was analyzed using Epi Info 7.48 patients were analyzed. The mean age (standard deviation) was 50.0 years (17.89). Male sex predominates (58.3% vs 41.7%). Majority of patients were symptomatic (93.7%). Fever was most common presentation (75.6%). Shortness of breath was experienced by 11 patients (24.4%). Co-morbidities were found among 75% of the patients with hypertension being the commonest (45.9%). There were 6 deaths (12.5%), 5 of which occurred in the older age patients. Case fatality rate was significantly higher during the first wave than during the second wave 40% vs 5.6%, p < 0.05. The male gender, co-morbidities and older age groups are particularly prone to severe covid-19 infection with poorer outcome