Effects of sulphadoxine-pyrimethamine on maternal, neonatal and placental malaria in Port Harcourt, Rivers State, Nigeria.

BACKGROUND & OBJECTIVES: The utilization of Intermittent Preventive Treatment (sulphadoxine-pyrimethamine) in pregnancy (IPTp-SP) for combating malaria has indicated control over adverse birth outcomes and has been recommended for use by pregnant women. The aim of this study was to determine the effectiveness of IPTp-SP on maternal, neonatal and placental malaria in Port Harcourt, Nigeria. METHODS: 316 samples of maternal peripheral blood (MPB), placental blood (PLB), neonatal cord blood (NCB) and placental tissue (PT) were collected each from consenting mothers. Blood samples were processed and stained by the Giemsa method. Placental tissues were processed and stained in haematoxylin. Examination of samples for malaria parasitaemia was carried out using standard parasitological methods. Demography of participants was collected through questionnaires and from ante natal care (ANC) records. RESULTS: Overall prevalence of 74 (23.42%) was recorded. Age-related prevalence indicated that ≤ 20 years, 9 (56.25%) had the highest prevalence followed by 21-30 years (23.48%), and ≥41 years (16.67%) (p <0.05). Malaria in MPB showed that SP-users had 26 (13.20%) while non-users had 48 (40.33%) (p <0.05). In NCB, SP-users recorded 20 (10.15%) while non-users had 13 (10.92) (p>0.05). The prevalence in PLB and PT revealed that SP-users had a lower prevalence in PLB, 31 (15.73%) and PT, 12 (6.09%) while non-users recorded a higher prevalence 48 (40.33%) in PLB and 21 (17.65%) in PT (P<0.05). INTERPRETATION & CONCLUSION: The utilization of IPTp-SP is seen to significantly reduce the occurrence of malaria in pregnancy, placental tissue and in neonates thereby helping in improving birth outcomes.

Effectiveness and compliance to the use of sulphadoxine-pyrimethamine as a prophylaxis for malaria among pregnant women in Port Harcourt, Rivers State, Nigeria.

Background: Malaria during pregnancy escalates the damaging consequence to the mother and neonate. The usage of intermittent preventive treatment of malaria (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended for averting the deleterious consequences of malaria in pregnancy. This study evaluated the effectiveness of, and compliance with the use of SP for malaria among pregnant women in Port Harcourt Rivers State, Nigeria. Method: A total of 300 samples of maternal peripheral blood (MPB), 84 neonatal cord blood (NCB) and 84 placental blood (PLB) were collected from consenting mothers. Malaria parasitaemia were analysed using standard parasitological methods, and bio-data of consenting mothers were collected through questionnaires and from ANC records. Results: Out of the samples examined for MPB, 59(19.7%) tested positive to malaria. Those with only primary education (57.1%) and women of age ≤ 20yrs (25%) had higher prevalence. Women who took SP had significantly lower prevalence (17.6%) than those that took other drugs (36.4%) (p < 0.05). Malaria prevalence was highest among women who had 3 months interval between each dose (39.1%), followed by those of 2months (23.7%) and those of 1 month (7.0%) (p < 0.05). The primigravidaes (22.8%) had an insignificantly higher prevalence than secundigravidae (19.4%) and multigravidae (15.9%). Also, 30.5% of women who registered in their third trimester of pregnancy had a significantly higher malaria parasitaemia than those who registered during their first 8.10%, or second trimesters, 19.4%. Of the 84 MPB-NCB-PLB pairedamples examined, 16.7%, 8.3% and 25% respectively were infected with malaria parasitaemia. On frequency of compliance, mothers who took SP once (37.5%) had a significantly higher MPB parasitaemia than those who took it twice (7.84%) and those of thrice (6.25%). Neonatal cord blood parasitaemia prevalence revealed that those that took SP once, that is, 25%, had a higher prevalence than others like those of twice (5.88%) and thrice (0%) respectively. Conclusion: The use and compliance of SP reduced the prevalence of malaria among pregnant women and their new-borns.

Populations of Eimeria tenella express resistance to commonly used anticoccidial drugs in southern Nigeria.

Coccidiosis is one of the most economically important diseases of poultry. This study determined the preponderance of chicken Eimeria in southern Nigeria and assessed the parasite's resistance to three anticoccidial drugs: Amprolium hydrochloride; Amprolium hydrochloride + Sulfaquinoxaline-Sodium; and Toltrazuril. Multiplex PCR amplification of the SCAR region was used to confirm Eimeria preponderance. Resistance was assessed following the inoculation of 2.32 × 105 infective oocysts into broilers. Data on weight gain, feed intake, feed conversion and fecal oocyst shed were recorded. At 7 days post inoculation 9 birds per treatment were sacrificed and assessed for macroscopic lesions in four intestinal regions. Percent optimum anticoccidial activity (POAA), Anticoccidial index (ACI) and Anticoccidial sensitivity test (AST) were used to access resistance. The preponderance of Eimeria spp. were E. tenella (77%), E. necatrix (55%), E. acervulina (44%) and E. mitis (11%), with multi-species infection occurring in 55% of samples assessed. Fecal oocyst shedding was low (P < 0.05) in the medicated groups. Lesions in the cecal region were present in all infected groups regardless of treatment and accounted for 27.8% of lesion scores by severity and 37.5% of lesion scores by frequency. Overall, lesion scores were less (P < 0.05) in birds of the medicated groups compared with the infected-unmedicated group. The high preponderance of E. tenella in the field, and the occurrence of cecal lesions - caused mainly by E. tenella- despite drug administration, indicate resistance in populations of this species in our isolate. Based-on the POAA, ACI and AST values, the Eimeria isolate showed reduced sensitivity to toltrazuril.