Maggot debridement therapy and complementary wound care: a case series from Nigeria.

OBJECTIVE: Maggot debridement therapy (MDT) is an emerging procedure involving the application of sterile maggots of the Dipteran species (commonly Lucilia sericata) to effect debridement, disinfection and promote healing in wounds not responding to antimicrobial therapy. Data on MDT in sub-Saharan Africa (including Nigeria) are scarce. This study aimed to use medicinal grade maggots as a complementary method to debride hard-to-heal necrotic ulcers and thereby promote wound healing. METHOD: In this descriptive study, we reported on the first group of patients who had MDT at Aminu Kano Teaching Hospital (AKTH), a tertiary hospital in northern Nigeria. The first instar larvae of Lucilia sericata were applied using the confinement (free-range) maggot therapy dressing method under aseptic conditions. RESULTS: Diabetic foot ulcer (DFU) grade III-IV constituted more than half of the wounds (53.3%), followed by necrotising fasciitis (30%), and post-traumatic wound infection (10%). Others (6.7%, included pyomyositis, surgical site infection and post traumatic wound infection). The median surface area of the wounds was 56cm2. Of the 30 patients, half (50%) had two MDT cycles with a median time of four days. Of the wounds, 22 (73%) were completely debrided using maggots alone while eight (27%) achieved complete debridement together with surgical debridement. Wound culture pre-MDT yielded bacterial growth for all the patients and Staphylococcus aureus was the predominant isolate in 17 wounds (56.7%) while Pseudomonas aeruginosa and Streptococcus pyogenes were predominant in five wounds (16.7%) each. Only four (13.3%) wound cultures yielded bacterial growth after MDT, all Staphylococcus aureus. CONCLUSION: A good prognosis was achieved post-MDT for various wounds. MDT effectively debrides and significantly disinfects wounds involving different anatomical sites, thus enhancing wound healing and recovery. MDT is recommended in such wounds.

Urinary schistosomiasis in the Danjarima community in Kano, Nigeria.

BACKGROUND: Studies in northern Nigeria have suggested a linear relationship between urinary schistosomiasis and individual water-related activities. Knowledge of the perceptions of the local populace about schistosomoasis and of gender and cultural restrictions could be beneficial to control programmes. We studied the prevalence of urinary schistosomoasis and the socio-demographic factors associated with the disease in Danjarima community of Kano, northern Nigeria. METHODOLOGY: A cross-sectional survey involving 890 subjects was conducted in the community. Urine samples were collected and examined for ova of Schistosoma haematobium using sedimentation technique. A semi-structured questionnaire was administered to the subjects in order to determine their knowledge and perceptions about urinary schistosomiasis in relation to their cultures. RESULTS: Eggs of S. haematobium were demonstrated in 370 (41.6%) of the urine sampled examined. The highest prevalence rate of 54.4% infection with S. haematobium was recorded in Zaura sub-village while the lowest rate of 6.4% was observed in Sabon-Fegi. More males (55.9%) were infected than females (3.7%) and the difference between the infection rate in males and females was statistically significant (P