Biomedical subjects

G C Ejezie

Publications and source records attributed to G C Ejezie.

At least 19 recordsLinked to original sources

PubMed2005

Enterobiasis and its relationship with anal itching and enuresis among school-age children in Calabar, Nigeria.

The prevalence of enterobiasis and its relationship with anal itching and enuresis were investigated among 799, randomly selected children aged 5-14 years, who lived, either in an area of high population density or one with a much lower population density, in Calabar, Nigeria. The eggs of Enterobius vermicularis were found in anal swabs (collected with transparent adhesive tape) from 60 (7.5%) of the subjects tested, with the prevalence of infection appearing markedly higher in the 403 children from the area with a high population density than in the 396 from the less densely populated area (11.7% v. 3.3%; P < 0.05). Questionnaire-based interviews were used to determine which of the children suffered from anal itching, enuresis or both. Compared with the egg-negative subjects, the 60 children who were egg-positive for Enterobius were found to be much more likely to be suffering from anal itching (78.3% v. 28.3%; P < 0.05) or enuresis (53.3% v. 36.4%; P < 0.05). Enterobiasis is therefore not a problem that is restricted to the temperate regions of the world, and may be a cause of enuresis or at least a contributory factor in the development of this complaint.

Adolescent↗

PubMed2004

Efficacy of artesunate in the treatment of urinary schistosomiasis, in an endemic community in Nigeria.

The efficacy and tolerability of oral artesunate for the treatment of urinary schistosomiasis was assessed among schoolchildren aged 5-18 years in Adim community, Nigeria. Overall, 500 children, randomly selected from those attending the Presbyterian primary school, were each invited to provide two consecutive urine samples. Using standard parasitological procedures, Schistosoma haematobium ova were found in the samples from 145 (29.0%) of the subjects. Most (87) of the infected subjects were then treated orally with artesunate, using two doses, each of 6 mg/kg, given 2 weeks apart. When the treated children were re-examined 4 weeks after the second dose of artesunate, 61 (70.1%) appeared egg-negative and were therefore considered cured. Post-treatment, the geometric mean egg count (GMEC) for the treated subjects who were not cured was significantly lower than the pre-treatment GMEC for all the treated subjects, with log10[(eggs/10 ml urine) + 1] values of 0.9 v. 1.75 (t = 4.45; P < 0.05). The cure 'rate' for the subjects aged > or = 10 years was slightly higher than that among the younger subjects. It was lowest for the heavier subjects (70% for those weighing 41-50 kg) and highest (79%) for the subjects who weighed 31-40 kg. The artesunate was well tolerated. This observation of a therapeutic effect of artesunate against S. haematobium in Nigeria confirms recent observations from Senegal. In the Adim community at least, it would be more cost-effective to treat urinary schistosomiasis with artesunate than with praziquantel. The wide-spread use of artesunate against schistosomiasis has to be considered carefully, however, if it is not to compromise the efficacy of the drug as an antimalarial, by increasing the risk of resistance developing in local Plasmodium.

Adolescent↗

PubMed1999

Modification of behaviour and attitude in the control of schistosomiasis. 1. Observations on water-contact patterns and perception of infection.

Observations on the water-contact patterns of 2136 residents of Admin community in Nigeria were conducted at four streams between February 1993 and January 1994. Urine samples collected from those observed were used to estimate the prevalence and intensity of Schistosoma haematobium infection. A questionnaire was also completed for each of the subjects, to test their perception of urinary schistosomiasis and its transmission. Infection was detected in 1076 (50.4%) of the subjects, with peak prevalence among those aged 10-14 years. Intensity of infection was more closely correlated with the number of water contacts (r = 0.97) than with the total duration of the exposure (r = 0.77), emphasising the importance of specific/multiple activities, and of the surface area of the body submerged, in transmission. One stream (Culvet) was identified as the main transmission point, with bathing/swimming and fishing as the main activities predisposing people to infection. The awareness of urinary schistosomiasis and its symptom (blood in urine) were high but specific knowledge about the parasite, its vector and the interaction between the parasite and vector in the parasite's life-cycle were extremely low. Activities that require behaviour and attitude modification have been identified and encouraged as components in the control of schistosome-attributable morbidity (in the absence of pipe-borne water).

Adolescent↗

PubMed1995

Urinary symptoms and blood pressure of children with Schistosoma haematobium infection in south-eastern Nigeria.

The urinary symptoms and blood pressures of 510 children (aged 5-15 years) with Schistosoma haematobium infection in Ijiman community, Cross River State of Nigeria, were studied in 1992. The prevalence rate of infection was 44%, a majority of the children presenting with light infection. Significant symptoms were visible haematuria, dysuria, suprapubic pain and strangury. The sensitivity and specificity of these symptoms were too low for them to be recommended as distinct clinical diagnostic criteria. The impact of the disease could not be demonstrated on blood pressures of the children. Nevertheless, urgent control measures with emphasis on the provision of ventilated improved pit toilets and potable water are strongly recommended for the control of the disease as persistent infection is known to mask manifestation of severe complications till an older age.

Adolescent↗

PubMed1995

The status and consequences of Mansonella perstans infection in Calabar, Nigeria.

Two aetiological studies on filariasis were conducted from January to June, 1993. In the first study, 690 blood samples clinically diagnosed of filariasis were examined. In the other, 150 blood samples and 150 skin snips collected from the same group of eye clinic Patients clinically diagnosed of filariasis were investigated. Of the 690 subjects, 108 (15.64%) had filariasis with M. perstans and Loa loa accounting for 98.15 and 1.85% of positive cases respectively. Among the eye clinic patients, 16% had M. perstans while O. volvulus was seen in 4% of patients. There was no concurrent infection with these two agents. A statistically significant association existed in the frequency of M. perstans in the different ages treated (p > 0.01) while non existed by sex (p > 0.01). The possible involvement of M. perstans in ocular filariasis and its treatment are discussed.

Adolescent↗

PubMed1994

Effect of Schistosoma haematobium infection on the physical growth and school performance of Nigerian children.

A cross-sectional study of urinary schistosomiasis among 510 primary school children in Ijiman community in south eastern Nigeria was undertaken in May 1992. Schistosoma prevalence and intensity of infection including the impact of the disease on the physical growth and school performance of the subjects aged 5-15 years was assessed. Prevalence of Schistosoma haematobium was 44 pc with the rate rising progressively with age, with a peak prevalence at 10-15. The ova burden was of light intensity (1-49 ova/10 ml) in a majority (73 pc) of the cases. No significant impact of the disease could be demonstrated regarding anthropometric parameters, school attendance and academic performance among the infected children compared with the controls. The lack of discernable effect of S. haematobium infection on these parameters is similar to the general pattern in the west African sub region and is attributed to the generally light ova burden among these children. It is also suggested that differences in the strains of the parasite between regions may be important determinants of morbidity.

Absenteeism↗

PubMed1992

New trends in chloroquine efficacy in the treatment of malaria: significance of low (scanty) parasitaemia in an endemic area, with emerging chloroquine-resistant P. falciparum.

In a continuous malaria therapy surveillance, using in vivo (WHO) seven-day-test, extended to 14 days follow up, we evaluated the significance of low (scanty) parasitaemia, in an area with chloroquine resistance P. falciparum (CRPF), where self-medication is widely practised. We found that 30.9 pc of the patients screened had Plasmodium species, and 71.4 pc of these had low parasite counts of less than 500 parasites/mm3, whole blood. Eight pc of these were febrile and 41.7 pc of the parasite strains were not susceptible to chloroquine. Parasite strains from four of the patients were also resistant to other antimalarials. These patients gave psychosomatic symptoms, and were seen by a psychiatrist. We conclude that 41 pc of the patients with low parasite counts consist of patients with CRPF and/or multiple-drug resistant P. falciparum in this area. These do not only cause chronic anaemia, but also may be responsible for moderate psychosomatic symptoms in all ages.

Adult↗

PubMed1992

Malaria parasite density and body temperature in children under 10 years of age in Calabar, Nigeria.

1,188 children under 10 years of age who attended the children's Emergency Clinic were examined from January to December 1988. Their axillary temperatures were recorded and thick and thin blood smears made to determine the malaria prevalence rate and the parasite density. The results show a high prevalence rate (44.8%) for malaria and this was stable throughout the year. The number of subjects with parasite densities of 100,000/mm3 and over, increased progressively with increase in body temperature such that 74.9% of the parasitemic subjects had high grade temperatures of 38 degrees C and over, while only 11.8% had moderate temperatures of 37.5-37.9 degrees C. The ratio of parasitemic afebrile to parasitemic febrile patients was in the order of 1:6, suggesting that parasitaemia is usually accompanied by fever. There was a steady rise in temperature with parasite density up to 39.5 degrees C, when further increase in parasite density apparently caused no further rise in temperature, suggesting a self-protective efficient feed back mechanism.

Axilla↗

PubMed1992

ABO blood groups distribution in relation to hepatitis B surface antigen and the presence of lipoidophil antibodies.

Three hundred and thirty donors were screened for HBs Ag using direct passive haemagglutination and the presence of Lipoidophil antibodies as detected by VDRL test. Blood group O donors had the highest HBs Ag prevalence rate of 4.3% as against the 0% frequency for group AB donors. There were no significant association between ABO blood group distribution and the presence of HBs Ag (P greater than 0.05). 11 donors in all were positive for HBs Ag giving a total prevalence of 3.3%. The sera of 27 blood donors (8.2%) contained lipoidophil antibodies. The highest percentage of VDRL test positivity was in blood group B donors (22.7%) followed by group O (9.1%). None of the 6 group AB donors had a reactive sera. Test of significance showed that there was no association between ABO distribution and the presence of lipoidophil antibodies. In conclusion, it is stated that since none of the blood donors that was reactive to the VDRL reagin carried HBs Ag, hepatitis virus B unlike other viral infection, may not elicit the production of lipoidophil antibodies.

ABO Blood-Group System↗

PubMed1992

Human ecology and parasitic infections. 1. The effect of occupation on the prevalence of parasitic infections in Calabar, Nigeria.

One thousand six hundred people belonging to three different occupational groups were randomly selected. Blood, urine and stool specimens were collected from them and processed for the detection of any parasitic infections. The results show 28.5% infection rate with one or more species of intestinal parasites; 50.7% in the school children, 17.3% among the farmers, and 12% among the soldiers. Results of blood examination showed 5.3%, 8.0% and 2.0% infection rates for P. falciparum in the school pupils, farmers and soldiers respectively, while 31.3% of the three groups were infected with the microfilaria of Dipetalonema perstans, and Loa loa. These were found in 60.7% of the farmers and none at all in the other two groups. Urine examination yielded no positive cases of urinary schistosomiasis and only one case of Trichomonas vaginalis. These results reflect the endemicity of the respective parasites, the degree of their sanitary awareness and their exposure frequencies to the pathogens as a result of their daily activities.

Animals↗

PubMed1991

New trends in chloroquine efficacy in the treatment of malaria: chloroquine-resistant Plasmodium falciparum in Anambra and Benue States of Nigeria.

Increasing malaria treatment failures with chloroquine (C25) and reports of chloroquine resistant Plasmodium falciparum (CRPF) led to the field survey of two sites (Agbani and Jato-Aka) both in Primary Health Zone A, using WHO--in vivo seven-day test, modified to 14-day follow-up period. Of the 922 children studied, high transmission rates of 40 pc and 59.2 pc were found in Agbani and Jato-Aka respectively. Varying degrees of parasitologic failures (CRPF), 52 pc in Agbani and 60 pc in Jato-Aka were confirmed. However, chemotherapy with C25 significantly reduced the clinical symptoms of malaria infection, even in the CRPF-cases. The clinical success in the two study sites were 69 pc ad 94 pc respectively.

Child, Preschool↗

PubMed1991

Schistosomiasis in Cross River State, Nigeria: 1. Prevalence and intensity of infection in Adim, Akamkpa Local Government Area.

Mid-stream urine was randomly collected from 248 subjects in Adim. Blood and protein concentrations were determined semi-quantitatively using Combi-7 reagent strips. The urine samples were then processed and any ova of Schistosoma haematobium present were counted per 10 ml urine. Fresh stool samples were also randomly collected, processed and examined for S. masoni and other helminthic ova. The prevalence of S. haematobium in the area was 43.5% and this was found to be age-related but not sex-related. Mean egg count was 137.2 per 10 ml urine. Intense haematuria of 250 ery/microliters and proteinuria of 500 mg/dl accompanied the high egg counts. The stool examination showed no cases of Manson's schistosomiasis but polyparasitism with other intestinal helminths was common particularly among children under 10 years old. This is the first report of urinary schistosomiasis in this area and the high prevalence rate is consistent with the rice farming occupation of the natives of the area. The sensitive nature and the case of application of the reagent strips in determining heavy infections by measuring haematuria and proteinuria is once again confirmed.

Adolescent↗

PubMed1991

Problems of chloroquine-resistant P. falciparum in Nigeria: one antimalaria drugs' utilisation in metropolitan Calabar.

We studied the antimalarial drugs utilisation pattern in urban Calabar, with a view to determining what drugs people take when they have malaria attack and who diagnoses and prescribes the drugs. We used a standard questionnaire data sheet to record the results of the interview carried out by the authors. Malaria symptoms and the drugs consumed were diagnosed and prescribed respectively by self (54pc), qualified medical doctor (32pc) and others including paramedical staff (2pc). The rest (12pc) took traditional remedies. The antimalarial drugs (chloroquine, fansidar, camouqin) were chosen because of their efficacy/popularity (21pc), cheapness (43pc) and availability (34pc). Among those interviewed, only 21.2pc took the adequate curative dose of 25 mg/kg chloroquine for 3 days according to WHO recommendations. Majority of the consumers took their drugs orally, but some (17pc) had chloroquine injections, administered, in some cases, by ill-qualified patient medicine dealer. The results show that there is an association between the level of education and the pattern of remedy sought by the respondents (p less than 0.05). Self-medication was practised significantly more by those with formal education than by those without (p less than 0.05). The trend of consulting patent medicine dealers for prescription decreased with acquisition of more formal education. Conversely, significantly more of the respondents with higher education consulted qualified medical doctors or paramedical staff (P less than 0.05). Two aspects of drug abuse observed here, i.e. the utilisation of sub-curative doses of chloroquine and monotherapy are believed to be two of the factors that lead to the several chloroquine treatment failures which have been recently reported in Calabar, and other areas of Nigeria.

Adult↗

PubMed1990

Malaria and its treatment in rural villages of Aboh Mbaise, Imo State, Nigeria.

We examined the malaria situation among 489 children under 5 years of age in the rural villages of Aboh Mbaise, Nigeria, using a combination of a standard questionnaire technique and laboratory diagnosis to confirm clinical observations. The results show a high prevalence rate of 52.8% for Plasmodium falciparum in this area. The geometric mean parasite density (GMPD) was 19,361.4/mm3. The proportion of children with fever and/or parasitaemia was not related to age, although the numbers in the febrile group appeared to increase with age. Using 37.5 degrees C as the threshold for fever, 48.7% of the heavily infected group (more than 1000/mm3) were afebrile while 51.3% were febrile. High grade temperatures above 38 degrees C were associated with high parasitaemia above 10,000 parasites/mm3. Of the 911 children who died in the area within the last five years, 22.4% died of fever of unknown origin, 39.7% from malaria, 22.5% from convulsion, 10.5% from diarrhoea and 4.6% from cough. Chloroquine is the drug of choice for the treatment of malaria and there were many cases of drug abuse, and use of sub-curative doses prescribed by non-medically qualified staff.

Age Factors↗

PubMed1990

A retrospective study of malaria and malnutrition in the University of Calabar Teaching Hospital, Calabar, Nigeria.

Morbidity and mortality due to malaria and marasmic kwashiorkor were determined from hospital records in the University of Calabar Teaching Hospital over five years. Malaria was found to be a significant cause of morbidity but was responsible for only 3.5% of the deaths that occurred during the period. This represents 0.3% of all infant deaths and 2.0% of deaths in children aged 1-4 years. The percentage of malaria deaths, 4.4% (1983), 5.2% (1984), 3.0% (1985) and 1.9% (1986), respectively showed a downward trend but went up again to 2.8% (1987), probably due to the treatment failures ascribed to chloroquine in the area. Malnutrition on the other hand, resulted in 174 deaths as opposed to 42 deaths due to malaria in children under six years of age. More of these deaths due to malnutrition (40.8%) occurred in children aged 2-3 years, just as the case with malaria (33.3%). 20.7% of these deaths occurred in infants. These results suggest that the pride of place, as a number one killer, goes to malnutrition while malaria is a serious cause of morbidity.

Adolescent↗

PubMed1989

The schistosomiasis problem in Nigeria.

Schistosomiasis is endemic in Nigeria as revealed by several prevalence studies but the degree of endemicity is low. The proliferation of several irrigation projects all over the country has stabilized the infection in Northern Nigeria while in the West rapid urbanisation, supply of portable water and mass chemotherapy have combined to reduce the prevalence rates. Human infection is measured by the determination of incidence, prevalence and intensity of infection. Heavy infections can rapidly be detected by use of urinalysis reagent strips to measure haematuria and protein levels in urine. The prevalence of severe pathological forms of the disease is very low and schistosomiasis is not associated with bacteriuria or hypertension in Nigeria, although isolated cases of ectopic lesions of the genitalis and uterus have been reported. Nodular filling defects occur early during infection, while bladder calcification comes at a later stage. The severity of the disease is related to the intensity of infection. Clinical trials with metrifonate and niridazole among other drugs have been carried out, with varying results. A new drug, praziquantel has been assessed and found suitable for mass use. Three methods of control include adequate provision of safe water, selective or targeted mass chemotherapy and use of molluscicides to kill the snails. Each method has its advantages and drawbacks, but the therapeutic approach is cheap, effects quicker result and treats the infected patients.

Clinical Trials as Topic↗

PubMed1989

Haemoparasites of blood donors in Calabar.

The study of haemoparasites in our blood donors revealed the following parasite prevalences: microfilaria (mf) of Loa loa (1.3%); Dipetalonema perstans (15.6%); Loa loa and D. perstans (0.2%), Plasmodium falciparum (3.3%), Plasmodium malariae (1.0%) and a mixture of P. falciparum and P. malariae (0.2%). No trypanosomes were observed in the 480 blood samples screened. There were more cases of D. perstans infection in the 24-30 year age group, indicating their increased exposure frequencies. Matching of ABO blood group and mf infection rates shows that the O blood group has a higher prevalence rate with regard to D. perstans than Loa loa. The B blood group, however, had the highest cumulative % of mf infection (23.4%), but these values are consistent with the preponderance of the various blood groups in the study population. Commercial donors, most of whom come from the less affluent social classes, had higher prevalence rates of mf. It is recommended that blood be properly screened for mf before donation for transfusion. Recipients of infected blood should be followed up so that any consequent infection would be treated immediately.

Adolescent↗

PubMed1987

The stabilising factors of parasitic infections in Nigeria.

The pattern of parasitic infections in Nigeria is discussed taking into consideration the status quo, and factors of change which tend to maintain the present situation rather than improving upon it. These factors include rapid urbanisation and uncontrolled population movement, agricultural developments, socio-economic factors, disease and vector control operations and health care delivery system. This rather deplorable situation calls for increased awareness on the part of everybody such that cognisance is taken of the hazards and remedies of these factors of change in order not to jeopardise our laudable development programmes.

Agriculture↗