Nigeria's war on terror: fighting dracunculiasis, onchocerciasis, lymphatic filariasis, and schistosomiasis at the grassroots.

Africa's populous country, Nigeria, contains or contained more cases of dracunculiasis, onchocerciasis, lymphatic filariasis, and schistosomiasis than any other African nation and ranks or ranked first (dracunculiasis, onchocerciasis, schistosomiasis) or third (lymphatic filariasis) in the world for the same diseases. After beginning village-based interventions against dracunculiasis 20 years ago and confronting onchocerciasis a few years later, Nigeria has nearly eliminated dracunculiasis and has provided annual mass drug administration for onchocerciasis to over three quarters of that at-risk population for 7 years. With assistance from The Carter Center, Nigeria began treating lymphatic filariasis and schistosomiasis in two and three states, respectively, over the past decade, while conducting pioneering operational research as a basis for scaling up interventions against those diseases, for which much more remains to be done. This paper describes the status of Nigeria's struggles against these four neglected tropical diseases and discusses challenges and plans for the future.

Household possession, use and non-use of treated or untreated mosquito nets in two ecologically diverse regions of Nigeria--Niger Delta and Sahel Savannah.

BACKGROUND: Current use of treated mosquito nets for the prevention of malaria falls short of what is expected in sub-Saharan Africa (SSA), though research within the continent has indicated that the use of these commodities can reduce malaria morbidity by 50% and malaria mortality by 20%. Governments in sub-Sahara Africa are investing substantially in scaling-up treated mosquito net coverage for impact. However, certain significant factors still prevent the use of the treated mosquito nets, even among those who possess them. This survey examines household ownership as well as use and non-use of treated mosquito nets in Sahel Savannah and Niger Delta regions of Nigeria. METHODOLOGY: This survey employed cross-sectional survey to collect data from households on coverage and use of mosquito nets, whether treated or not. Fever episodes in previous two weeks among children under the age of five were also recorded. The study took place in August 1 - 14 2007, just five months after the March distribution of treated mosquito nets, coinciding with the second raining period of the year and a time of high malaria transmission during the wet season. EPI INFO version 2003 was used in data analysis. RESULTS: The survey covered 439 households with 2,521 persons including 739 under-fives, 585 women in reproductive age and 78 pregnant women in Niger Delta Region and Sahel Savannah Region. Of the 439 HHs, 232 had any mosquito nets. Significantly higher proportion of households in the Niger Delta Region had any treated or untreated mosquito nets than those in the Sahel Savannah Region. In the Niger Delta Region, the proportion of under-fives that had slept under treated nets the night before the survey exceeded those that slept under treated nets in the Sahel Savannah Region. Children under the age of five years in the Niger Delta Region were four times more likely to sleep under treated nets than those in the Sahel Savannah Region. CONCLUSION: This study found that despite the fact that treated nets were distributed widely across Nigeria, the use of this commodity was still very low in the Sahel Savannah region. Future campaigns should include more purposeful social and health education on the importance and advantages of the use of treated nets to save lives in the Sahel Savannah region of Nigeria.

Utilization of insecticide-treated nets by under-five children in Nigeria: assessing progress towards the Abuja targets.

BACKGROUND: The Abuja target of increasing the proportion of people sleeping under insecticide-treated nets (ITNs) to 60% by the year 2005, as one of the measures for malaria control in Africa, has generated an influx of resources for malaria control in several countries in the region. A national household survey conducted in 2005 by the Malaria Control Programme in Nigeria assessed the progress made with respect to ITN ownership and use among pregnant women and children under five years of age since 2000. The survey was the first nationally representative study of ITN use assessing progress towards the Abuja target amongst vulnerable groups. POPULATION AND METHOD: A cross-sectional survey of a sample of 7,200 households, selected by a multistage stratified sampling technique from 12 randomly selected states from the six geopolitical zones of the country. Data collection was done during the malarious rainy season (October 2005) using a modified WHO Malaria Indicator Survey structured questionnaire about household ownership and utilization of mosquito nets (treated or untreated) from household heads. RESULTS: Household ownership of any net was 23.9% (95% CI, 22.8%-25.1%) and 10.1% for ITNs (95% CI, 9.2%-10.9%). Education, wealth index, presence of an under-five child in the household, family size, residence, and region by residence were predictive of ownership of any net. The presence of an under-five child in the household, family size, education, presence of health facility in the community, gender of household head, region by residence and wealth index by education predicted ITN ownership. Utilization of any net by children under-five was 11.5% (95% CI, 10.4%-12.6%) and 1.7% (95% CI, 1.3%-2.2%) for ITN. Predictors of use of any net among under-five children were fever in the previous two weeks, presence of health facility in the community, caregiver's education, residence, and wealth index by caregiver's education; while religion, presence of health facility and wealth index by caregiver's education predicted the use of ITN among this group. CONCLUSION: This study demonstrated that the substantial increase in ITN utilization among children under five years of age in Nigeria is still far from the Abuja targets.