Malaria prevention practices and delivery outcome: a cross sectional study of pregnant women attending a tertiary hospital in northeastern Nigeria.

BACKGROUND: Malaria in pregnancy remains a public health problem in Nigeria. It causes maternal anaemia and adversely affects birth outcome leading to low birth weight, abortions and still births. Nigeria has made great strides in addressing the prevention and control of malaria in pregnancy. However, recent demographic survey shows wide disparities in malaria control activities across the geopolitical zones. This situation has been compounded by the political unrest and population displacement especially in the Northeastern zone leaving a significant proportion of pregnant women at risk of diseases, including malaria. The use of malaria preventive measures during pregnancy and the risk of malaria parasitaemia, anaemia and low birth weight babies were assessed among parturient women in an insurgent area. METHODS: A cross-sectional survey was conducted among 184 parturient women at Federal Medical Centre, Nguru in Yobe state, between July and November 2014. Information on demographics, antenatal care and prevention practices was collected using an interviewer-administered questionnaire. Maternal peripheral and the cord blood samples were screened for malaria parasitaemia by microscopy of Giemsa-stained blood films. The presence of anaemia was also determined by microhaemocrit method using the peripheral blood samples. Data was analysed using descriptive and analytical statistics. RESULTS: Prevalence of malaria parasitaemia, anaemia and low birth weight babies was 40.0, 41.0 and 37.0 %, respectively, and mothers aged younger than 25 years were mostly affected. Eighty (43.0 %) of the women received up to two doses of sulfadoxine-pyrimethamine for intermittent preventive treatment (IPTp-SP) during pregnancy and most, 63 (83.0 %) of those tested malaria positive received less than these. Presence of malaria infection at antenatal clinic enrollment (OR: 6.6; 95 % CI: 3.4-13.0), non-adherence to direct observation therapy for administration of IPTp-SP (OR: 4.6; 95 % CI: 2.2-9.5) and receiving

Asymptomatic Plasmodium falciparum parasitaemia among pregnant women: a health facility based survey in Nassarawa-Eggon, Nigeria.

BACKGROUND: Asymptomatic malaria parasitaemia remains an effective transmission pool for malaria during pregnancy, which can result in placenta parasitaemia and adverse pregnancy outcomes. This study examined asymptomatic malaria parasitaemia among pregnant women in the antenatal clinic in General Hospital, Nassarawa-Eggon, Nasarawa State, Nigeria. MATERIALS AND METHODS: A cross-sectional hospital based survey was carried out among 242 apparently healthy pregnant women presenting for booking in an antenatal clinic between June and August 2014. An interviewer-administered semi-structured questionnaire was used to obtain information on socio-demographic data and possible risk factors for asymptomatic malaria parasitaemia. These women should not have taken antimalarial medicines two weeks prior to the interview. Microscopy was used to identify malaria parasites and haemoglobin levels were estimated. Data was analysed using Epi Info 3.5.3. Descriptive statistics such as means, standard deviations, proportions, and range were used to summarise the data and the Chi square test was used to test association between categorical explanatory variables and outcome variables. RESULTS: Mean age (± SD) was 25.5 ± 5.5 years, 118 (48.8%) of the women were in the 25-34 years age group, while 153 (63.2%) were multigravidae. Asymptomatic Plasmodium falciparum infection was found in 55 women (22.7%; 95% CI: 18.0-28.7%) Among these, 36 (65.5%) were anaemic [OR: 2.0, CI: 1.1-3.8]. Long lasting insecticidal net (LLIN) was not used by 17 (30.9%) of the respondents. Younger age group (below 25 years) [AOR: 2.4, CI: 1.2-4.9] and non-usage of LLIN [AOR: 2.4, CI: 1.1-5.1] were significant predictors of asymptomatic malaria parasitaemia. CONCLUSION: Asymptomatic malaria parasitaemia is a health challenge among pregnant women, especially in the younger age group and can predispose them to maternal anaemia. The supply and appropriate use of LLIN should be intensified.

Microbiological assessment of well waters in Samaru, Zaria, Kaduna, State, Nigeria.

BACKGROUND: Majority of the human population in semi-urban and urban areas in Nigeria are heavily reliant on well water as the main source of water supply for drinking and domestic use due to inadequate provision of potable pipe borne water. These groundwater sources can easily be fecally contaminated and thus, increase the incidence and outbreaks of preventable waterborne diseases. This study was carried out to determine the bacteriological quality of some well waters in Samaru, Z. MATERIALS AND METHODS: Samaru, Zaria located in Northern Nigeria, is a semi-urban university satellite town blessed with abundant ground and surface water. Five sampling sites were randomly selected for this study. A total of 10 samples: Two from each of the sites were collected fortnightly for 1 month (May-June, 2013). Samples were analyzed using presumptive multiple tube fermentation and confirmatory tests for total and fecal coliforms. The well water samples were also cultured for Salmonella, Shigella, and Vibrio chole. RESULTS: The total coliform count for all the samples analyzed was >180+/100 ml. All the well water samples from the study locations were contaminated with one or more bacterial pathogens, Escherichia coli 20%, Klebsiella pneumoniae 100% and Proteus mirabilis 40%. Salmonella, Shigella, or V. cholerae were not isolated from any of the well water samples. CONCLUSIONS: The results from this study showed contamination of all the wells studied with fecal coliforms thus, indicating the possible presence of other enteric pathogens and a potential source for waterborne disease outbreaks. Well water in Samaru is not safe for drinking without additional treatment like disinfection or boiling. Periodic testing and constant monitoring of well waters should also be done to meet up with the World Health Organization Standards in the provision of safe, clean drinking water .