Knowledge, perception and acceptability of microbicides among healthcare workers in Lagos, Nigeria.
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Adult↗
Biomedical subjects
N N Odunukwe
Publications and source records attributed to N N Odunukwe.
Knowledge and practices of traditional birth attendants in prenatal services in Lagos State, Nigeria.
A questionnaire-based study was conducted on 189 Traditional Birth Attendants (TBAs) on their knowledge and practices in prenatal services. Only 86 (45.5%) of them associated cessation of menstrual period with pregnancy while others use mystic power 46 (24.3%), early morning sickness, pallor of conjunctiva and reaction to herbs 56 (29.6%) to detect pregnancy. Fundal height n=76 (40.2%), palpation n=82 (43.4%), special soaps and soups n=52 (27.5%) and special devices n=8 (4.2%) are used to determine stages of pregnancy. Foetal health status is determined by regular foetal movements n=95 (50.3%), mystic power n=15 (8%), soap n=2 (1.1%), special concoction 9 (4.8%), health status of mother n=67 (35.4%) and foetal heart beat n=24 (12.7%). Ninety seven (51.3%) of them used herbal treatment, 77 (40.7%) used incantations, 189 (100%) used special soaps as their main methods of delivery, while only 18 (9.5%) of respondents refer difficult cases to hospitals. Instruments used for separating cord were blade 123 (65.1%) and scissors 40 (21.1%). Symptoms recognized by the TBAs as signs of complications in pregnancy were dizziness, swollen feet, pallor, tiredness, absent foetal movement, loss of appetite, heaviness, pain in back/stomach/side, weight loss, vomiting, bleeding, fever/malaria, head ache, bad dream, premature or delayed labour. Although some of them recognized some danger signs in pregnancy and labour, only very few would refer difficult cases for emergency obstetric interventions. Clear protocols for management and referral, which are necessary for improved maternal survival, should be provided through regular training of the TBAs.
Clinical Competence↗
Aetiological agents of vaginitis in Nigerian women.
This study focuses on the identification of aetiological agents of vaginitis in Nigerian women. Study subjects are drawn from patients presenting with lower abdominal pain, vaginal discharge and itching at the gynaecology clinic of Lagos University Teaching Hospital and at the Clinical Centre of the Nigerian Institute of Medical Research, Yaba, Lagos, between January 2001 and July 2002. A total of 250 patients gave informed consent to participate in the study. The patients also had pre- and post-test human immunodeficiency virus (HIV) counselling. Each patient completed a questionnaire in order to provide biographical data, past clinical history and socio-economic background information. A cervical swab (CS) and a high-vaginal swab (HVS) were obtained from each patient. Swab samples were examined for pH and under light microscopy by Gram's stain and as wet preparations in 10% potassium hydroxide. Subsequently, samples were cultured on appropriate media at optimal conditions and a drug sensitivity profile for all isolates was determined by standard methods. Blood samples were screened and confirmed for HIV antibodies. Bacterial, fungal and parasitic pathogens were identified or isolated in samples from 241 (96.4%) of the women. Bacterial agents (Neisseria, Streptococcus and Staphylococcus species) were predominant in 128 (51.2%) patients, followed by fungi in 108 (43.2%) and parasites (Trichomonas vaginalis) in five (2.0%). Sensitivity to ciprofloxacin was seen in 40% of Staphylococcus species and in 90% of Neisseria species. Positive HIV serology was seen in 25 (10%) of the 250 women studied, 20 (80%) of which had concurrent microbial infections. Overall, a broad spectrum of microbial agents were shown to be responsible for vaginitis in the group of patients studied.
Adolescent↗
Diagnostic methods for typhoid fever in Nigeria.
In this study, 65 patients are screened for Salmonella typhi by conventional culture and the Widal test. In addition, the patients undergo full blood count are screened for malaria parasites. Of the 65 patients, 50 report febrile conditions, while the remaining 15 are used as a control population. In the febrile group, 13 (26%) were positive for S. typhi, while in the control group only one (7%) was positive for S. typhi. Overall, 36 (64.3%) patients had malaria parasites. Patients with a higher O antibody titre (> or = 1 in 80) by Widal test were found to have consumed both tap water and pure water. More females (10/14; mean age: 33) had typhoid fever as a result of S. typhi infection, the majority of which were isolated from stool samples (57%). Nine of the isolates were also positive for malaria parasites, seven of which were in the trophozoite stage. Plasmodium falciparum was the predominant parasite (78%), the remainder being P. malariae. The majority of patients (12/14) with typhoid fever had normal PCV values. In conclusion, it is recommended that tests for the diagnosis of typhoid fever in Nigeria should include malaria parasites, S. typhi culture from faecal samples, and the Widal test.
Adult↗
Current clinical presentation of malaria in Enugu, Nigeria.
This study examined the malaria situation in a malarial endemic area of Nigeria. Structured questionnaire was applied to 300 doctors practising in Enugu urban, Nigeria and confirmation of the clinical diagnosis by laboratory technique was done using 468 patients. The result shows a high prevalence of Plasmodium falciparum infection (96.4% in children, 87.0% in adults). Malaria positivity rate was 51.9% in children and 42.8% in adults. Fever, vomiting and anorexia were the commonest malaria symptoms in children, while headache, fever, chills and rigors were the commonest malaria symptoms in adults. The diagnostic practice of the doctors was clinical. Fever, vomiting and cough were found to be more associated with malaria parasitaemia in children, while in adults fever was found to be more associated with malaria parasitaemia. Chloroquine and sulphadoxine-pyrimethamine were the commonest drugs used for treating uncomplicated malaria, while quinine was the commonest drug used for treating severe malaria.
Adult↗
Serum ferritin and other haematological measurements in apparently healthy adults with malaria parasitaemia in Lagos, Nigeria.
We studied 300 apparently healthy residents of Lagos aged 16-57 years. Their mean ferritin levels were 99.6 +/- 50.5 microg/l (men aged 20-57) and 66.5 +/- 44 microg/l (women aged 20-53) in aparasitaemic individuals. In parasitaemic subjects, mean ferritin levels were 133.1 +/- 48.3 microg/l (men aged 20-56) and 114.8 +/- 51.1 microg/l (women aged 16-50). Mean haematocrit values for aparasitaemic males were 45.7 +/- 5.6% and 37.9 +/- 5% for females, while mean haemoglobin levels were 153.2 +/- 1.5 microg/l and 124 +/- 3 microg/l, respectively. The mean values for MCV (mean corpuscular volume), MCH (mean corpuscular haemoglobin), MCHC (mean corpuscular haemoglobin concentration) were 101.7 +/- 8fl, 30.6 +/- 2.2 pg, 335 +/- 0.4 g/l and 99.8 +/- 10.1fl, 29.1 +/- 6.5 pg, 335 +/- 6 g/l. Serum iron levels were 34.2 +/- 5 micromol/l and 29.5 +/- 77 micromol/l. All haematological parameters measured were similar in both malaria parasitaemia positive and negative subjects, except ferritin level which was significantly higher in parasitaemic individuals (P < 0.05). Ferritin concentration and malaria density (r = 0.76 in males, r = 0.74 in females, P < 0.05) were positively correlated. Ferritin levels of subjects infected with Plasmodium falciparum were significantly higher than of those infected with P. malariae (P < 0.05). Hence ferritin estimation without examination for malaria parasitaemia in a malaria-endemic region such as Nigeria is not reliable. Asymptomatic malaria parasitaemia increases the ferritin level. Considering the mean ferritin level we found in normal subjects on a balanced diet, routine iron supplementation may not be necessary in the treatment of malaria-induced anaemia in Nigeria.
Adolescent↗
Tuberculosis masquerading as 'constant malaria'.
Four hundred adults aged 20-60 years, (200 females and 200 males) were studied. All the subjects were residing in the urban areas of Lagos, Nigeria. Thirteen percent claimed they were having "constant malaria" (> 8 times per year), 5% (20) claimed to have cough mostly during the cold period, 2.5% (10) produced mucoid sputum, 2.5% unproductive cough, 13% were AFB smear positive, 1.5% had positive chest X-ray for pulmonary Tuberculosis (PTB), 1.5% were HIV positive and 50% were mantoux positive (> 10 mm induration). All who complained of "constant malaria" were AFB positive. Malaria parasite density was lower in those who complained of "constant malaria" than those who did not complain (P = 0.003). The complaint of frequent malaria attack decreased after Antituberculosis therapy for 6 months. This study revealed that in a malaria and tuberculosis endemic region, early stage of tuberculosis can masquerade as "constant malaria". Therefore any such complaint should be fully investigated.
Adult↗
Serum ferritin and other haematological measurements in apparently healthy children with malaria parasitaemia in Lagos, Nigeria.
One hundred apparently normal nursery and primary school children aged between 2 to 12 years from private schools, in Lagos Nigeria were studied. From this study the mean ferritin levels for children aged 2-5 years, and 6-12 years were 112 +/- 48 micrograms/l, and 119 +/- 38 micrograms/l respectively. Mean haematocrit values were 37.6 +/- 2.2%, and 37.5 +/- 2.6%, while mean haemoglobin levels were 126 +/- 9 g/l 127 +/- 7.9 g/l (2-5 years and 6-12 years respectively). The mean values for MCV, MCH, MCHC were 92 +/- 8.6 fl, 27.6 +/- 3.0 pg, 338.0 +/- 15.0 g/l and 93.5 +/- 9.0 fl, 28.7 +/- 2.5 pg, 332.0 +/- 17.0 g/l (2-5 years and 6-12 years respectively). All haematological parameters measured were similar in both malaria parasitaemia positive and negative subjects, except ferritin level which was significantly higher in subjects with malaria parasitaemia (p < 0.05). There was positive correlation between ferritin concentration and malaria density (r = 0.85, p < 0.05). From the above findings, it would be concluded that, ferritin estimation without examination for malaria parasitaemia in a malarious region like Nigeria is not reliable. It is also concluded that with the high mean ferritin level obtained in this study for normal children on balanced diet, routine iron supplementation may not be necessary for this group of children in Nigeria.
Child↗
HIV association with conventional STDS (sexual transmitted diseases) in Lagos State, Nigeria.
The study examined a possible association between HIV infection and conventional sexually transmitted diseases (STDS) in a population of 700 patients seen in some hospitals and clinics in Lagos State between November 1997 and December 1999. The patients were drawn mainly from LUTH and Jolad hospitals in Lagos State. In these hospitals, patients who presented with symptoms of STDS were screened clinically and microbiologically for agents of STDS and HIV antibodies. Screening was carried out using conventional methods. A total of 150 (21.5%) were found positive for various STDS while 550 (78.5%) were negative Also, 109 (15.8%) were sero-positive for HIV while 591 (84.4%) were sero-negative. The frequency of STDS diagnosed were, Treponema pallidum, 38(25.3%), Neisseria gonorrhoea 3(2.0%), Chlamydia trachomatis 26(17.3), Hepatitis B virus 60(40.0%) Staphylococcus aureaus, 20 (13.3%) and Candida albicans 3(2.0%). Data showed that Syphillis was the most prevalent STDS diagnosed while Calbicans and N. gonorrhoea are the least. Amongst the 150 (21.5%) patients positive with STDS, 82(54.65%) were found to be positive for HIV antibodies. The remaining 68(45.3%) patients were negative for HIV. The difference in sero-prevalence on the true group of patients rates was significant. The higher rate in the STDS patients strongly suggest some association between HIV infections andSTDS amongst the patients studied p = 0.05. It was also recorded that HIV-1 infection is four times more prevalent than HIV-2 in these patients.
AIDS-Related Opportunistic Infections↗