Abnormal findings on dipstick urinalysis of out-patients with malaria in Abakaliki, Nigeria.

BACKGROUND & OBJECTIVES: Malaria, one of the major health challenges of the tropics affecting about 500 million people, particularly the children and pregnant women have been associated with changes in urine compositions. The present study was undertaken to document the urinary abnormalities in malaria patients based on malaria species and the level of malaria parasitaemia. METHODS: Febrile patients (n = 365) with positive Giemsa - stained blood films for malaria recruited from Outpatient Department of Ebonyi State University Teaching Hospital, Abakaliki participated in the study. Patients were classified into two categories (+ and ++) based on parasite density. Apparently healthy individuals (n = 81), without malaria parasite on both thick and thin films of comparable age and gender acted as control group. Urine sample (10 ml) was collected from each participant and analysed using standard laboratory methods and techniques. RESULTS: Seventy - four (20.3%) of the patients had Plasmodium falciparum malaria. Although all the urine parameters were higher in the malarial patients in comparison to the control, only bilirubinuria and urobilinogenuria were statistically significant (p <0.05). Also, bilirubinuria, urobilinogenuria, haematuria and proteinuria were significantly (p < 0.05) higher in P. falciparum infection than in infections with other malaria species, but only in P. falciparum infection, bilirubinuria and urobilinogenuria were significantly (p < 0.05) higher at higher parasitaemia. CONCLUSION: Even though positive blood film for malaria parasite remains the gold standard for the diagnosis of malaria, urinary abnormalities, such as bilirubinuria, urobilinogenuria, proteinuria and haematuria may aid in identifying patients with severe malaria parasitaemia, especially the falciparum malaria.

Prevalence of low sperm count and abnormal semen parameters in male partners of women consulting at infertility clinic in Abakaliki, Nigeria.

In order to provide an insight to the prevalence of low sperm count and abnormal semen parameters in suspected subfertile/infertile men in our environment, semen samples collected from one hundred and seventy (170) men aged 21-50 years, whose wives were seen at a private fertility clinic in Abakaliki, Nigeria with diagnosis of primary and secondary infertility (78 and 92 respectively) were analysed in accordance with World Health Organization guidelines. Significantly high proportion (70%) of the study population had low sperm count (p < 0.05) with significantly high defective parameters (64%). Asthenozoospermia and teratozoospermia were the major abnormal parameters recorded. Higher prevalence of oligospermia was found in the civil servants and age-group 31-40 years (74% and 75% respectively). Using 10(5) cfu/ml as a significant level of bacteria growth, the prevalence of bacteria growth was found to be 56% of which 18% were from normospermic semen d 38% from oligospermic semen.

Urinary findings in young adults in Abakaliki, Nigeria.

OBJECTIVE: To determine the prevalence of urinary abnormalities in young adults living in Abakaliki, Southeastern Nigeria. METHOD: Two hundred and fifty (250) clean-catched mid-stream urine samples obtained between October 2005 and June 2006 from apparently healthy young adults, aged 18-25 years (mean = 19.7 +/- 4.1 years) resident in Abakaliki, comprising 151 (60.4%) females and 99 (39.6%) males were analysed using standard laboratory procedures and techniques. RESULTS: The prevalence of urinary abnormalities was found to be 20.7%. In addition to leucocyte esterase and pyuria, which were found in significantly more female samples than the males' (p < 0.05), there were generally more abnormalities in female urine samples than their male counterparts (p < 0.05). The major abnormalities recorded were pyuria (47.1%), bacteriuria (21.6%), proteinuria (14.0%) and haematuria (8.0%). CONCLUSION: The finding supports routine urine screening as an important disease surveillance approach in young adults Nigerians resident in Abakaliki metropolis.

Altered pharmacokinetics of halofantrine by an antacid, magnesium carbonate.

This study investigated the in vitro adsorption of halofantrine (Hf) by some antacids. Magnesium carbonate showed the highest adsorptive effect, the extent of adsorption being up to 83%. Only 4% of Hf adsorbed by the antacid could be eluted with 0.1 M HCl while no detectable elution occurred with water. Other antacids investigated were magnesium trisilicate and aluminium hydroxide and these had Hf-adsorption capacities of 23 and 43%, respectively. The effect of magnesium carbonate on the bioavailability of Hf was evaluated in seven healthy volunteers. The subjects were administered with 500 mg oral dose of Hf-HCl or the same dose of the drug in combination with 1 g of magnesium carbonate, in a crossover fashion. Blood samples were collected at predetermined time intervals and were analysed for Hf and its major metabolite, desbutylhalofantrine (Hfm), using high-performance liquid chromatography method. The results showed that magnesium carbonate significantly prolonged (P<0.05) the time to reach maximum plasma concentration (Tmax) of Hf. Also the maximum plasma concentrations (Cmax) of Hf and Hfm were significantly reduced (P<0.05). Furthermore, there was a reduction in the area under the curve (AUC) values of Hf and this was as high as 56% (range 1-56%). Results of this study suggest that it may not be advisable to concomitantly administer Hf with an antacid like magnesium carbonate.

Zinc and copper concentration in plasma of pregnant women in Nigeria.

The concentration of plasma zinc and copper were determined by atomic absorption spectrophotometry in 58 Nigerian women at various times in pregnancy and compared with those of 11 non-pregnant controls. The results showed 67.5% decrease in zinc and 100% increase in copper over non-pregnant levels at the end of pregnancy. The mean plasma zinc levels were appreciably lower and copper the same as published values for Caucasian women at similar periods in pregnancy. Furthermore, there was no correlation between plasma zinc and copper and neonatal birthweight. We conclude that (1) a significant proportion of pregnant women in Nigeria have biochemical hypozincemia; (2) this hypozincemia is not responsible for fetal growth retardation in this population and (3) there is at present no justification for giving routine zinc supplementation to pregnant women in Nigeria.

Plasma zinc and copper in pregnant Nigerian women at term and their newborn babies.

The concentration of copper and zinc was determined by atomic absorption spectrophotometry in 26 normal Nigerian women at term and their newborn babies. Cord zinc was significantly greater than maternal zinc. In contrast, cord copper was lower than maternal copper. There was only a weak correlation between cord copper and maternal copper but none between cord zinc and maternal zinc. There was no correlation between maternal and cord zinc and neonatal birthweight. However, an inverse correlation was found between maternal and cord copper and neonatal birthweight. These results indicate that: (1) zinc has no effect on fetal growth in Nigerian women but (2) copper may have a negative effect on fetal growth.

An evaluation of the WHO criteria for abnormal glucose tolerance test during pregnancy in Nigerian women.

A 75 g oral glucose tolerance test was performed in 127 normal Nigerian women between 24 and 28 weeks of pregnancy. The glucose response at fasting, 1, 2 and 3 h were studied. At 2 h, the glucose level at 2-SD and 4-SD above the mean were less than the criteria of abnormality recommended by the World Health Organisation: 6.5 mmol/l vs. 8 mmol/l for impaired glucose tolerance and 8.0 mmol/l vs. 11.0 mmol/l for gestational diabetes mellitus. The area under the glucose response curve correlated best with the glucose levels at 2 h during the OGTT (y = 4.3 + 1.8x, r = 0.862). The 75-g OGTT interpreted with the WHO criteria appear not to be appropriate for use in pregnant women in Nigeria.

Disposition of quinine in rats with induced renal failure.

Aetiologically different models of experimental acute renal failure were induced in rats by the administration of glycerol, mercuric chloride and gentamicin, respectively, to different groups. Quinine levels in plasma and urine of the rats with induced renal failure were determined and pharmacokinetic parameters (elimination t1/2, CLp, V, CLR AUC0-infinity) of the drug were derived and compared with values obtained from control rats following intraperitoneal administration of a 10 mg/kg body-weight dose of quinine. Results showed that each of the three compounds caused an up to 25-fold increase in the plasma levels of the drug and a marked decrease in the levels of the metabolite 3-hydroxyquinine. All the pharmacokinetic parameters determined for the rats with renal impairment were markedly different when compared to control. The high plasma quinine levels observed in the rats with renal failure could be largely due to the marked decrease in V and reduced metabolism. Also, in the rats with renal impairment, no correlation was observed between the increased plasma urea levels and plasma quinine levels or disposition of the drug. The results of the study suggest that quinine should be used with caution in patients with renal impairment. The plasma urea levels, as a measure of renal function, might not provide a suitable index for determining quinine dosage.