Spatial distribution of urinary schistosomiasis in Cross River State, Nigeria using geographical information system and school based questionnaire.

Urinary schistosomiasis is a serious disease in Cross River State, Nigeria. Dearth of information on its distribution has hampered the implementation of focused control of the disease. The availability of a rapid method for mapping the disease necessitated this research to provide data for control of Urinary schistosomiasis in Cross River State, Nigeria. The study used a rapid validated school-based questionnaire method in mapping schistosomiasis. Geographical information system (GIS) software tools were used to produce a spatial map for prevalence of infection and areas at risk for urinary schistosomiasis in Cross River State. Data analysis with SPSS package revealed that 9,993 (10.2%) female and 10,328 (10.0%) male pupils in 218 schools passed blood in urine in one month out of 199,794 pupils interviewed. There was no statistically significant difference in the prevalence between male and female pupils with infection (p < 0.005). The prevalence of urinary schistosomiasis using questionnaire method correlated positively with the filtration method used in determining the egg output (r = 0.71, p < 0.001). Endemic schools were distributed in thirteen Local Government Areas of Cross River State, Nigeria. Yala and Yakurr LGAs had the highest number of schools that reported schistosomiasis with 39 (59%) and 13 (59%), respectively. Odukpani LGA had the lowest prevalence of 1 (0.2%). The overall results showed a mean urinary schistosomiasis prevalence of 10.2% for Cross River State, Nigeria. The findings of this study would guide Government and other relevant agencies in the implementation of control strategies for the treatment of urinary schistosomiasis in Cross River State, Nigeria.

African programme for Onchoceriasis control: ophthalmological findings in Bushenyi, Uganda.

BACKGROUND: The overall prevalence of blindness from Onchoceriasis in Bushenyi is relatively low, most of which is to be found in the elderly. Onchoceriasis is a major health problem in Africa. The Community-Directed treatment with invermectin is a control strategy to address the problem, but baseline data are generally lacking in several countries. OBJECTIVE: To describe baseline ophthalmological data in order to assess the impact of Community-Directed with Ivermectin (CDTI) in Uganda. METHODS: The study site was in Bushenyi, Western Uganda. In a cross-sectional study, 367 persons aged 10 years or older from seven selected villages received eye examination using a standardised protocol and Wu-Jones Motion Sensitivity Testing (MSST). Besides MSST, other information sought included visual acuity, slit lamp examination, testicular opacities and intraocular presence. RESULTS: Of the 367 subjects, 219(57.2%) were males. Subjects less than 25 years of age were 104(28.3). The prevalence of blindness were 1.9% while 4.1% was visually impaired by acuity criteria alone. A further 9.1% had moderate visual field loss while 2.8% had severe field loss. There was no case of anterior chamber microfilaria but dead microfilariae were seen in two cases. Punctate keratitis was present in 1.8% with sclerosing keratitis was twice as common at 3.8%. Optic atrophy was also relatively common at 12.4%, while chorioretinitis was present in 3.3%. CONCLUSION: There was an apparent paucity of acute onchocerciasis-related lesions but a significant presence of irreversible onchocerciasis-related lesions. The most significant problem requiring intervention would appear to be cataract.

The African Programme for Onchocerciasis Control: impact on onchocercal skin disease.

OBJECTIVES: To assess the long-term impact of the African Programme for Onchocerciasis Control on itching and onchocercal skin disease (OSD). METHODS: Seven study sites in Cameroon, Sudan, Nigeria and Uganda participated. Two cross-sectional surveys were conducted of communities meso- and hyper-endemic for onchocerciasis before and after 5 or 6 years of community-directed treatment with ivermectin (CDTI). Individuals were asked about any general health symptoms including itching and underwent full cutaneous examinations. Onchocercal skin lesions were documented according to a standard classification. RESULTS: Five thousand one hundred and ninety three people were examined in phase I and 5,180 people in phase II. The presence of onchocercal nodules was a strongly significant (P < 0·001) risk factor for all forms of onchocercal skin disease: APOD (OR 1·66); CPOD (OR 2·84); LOD (OR 2·68); reactive skin lesions (OR 2·38) and depigmentation (OR 3·36). The effect of community-directed treatment with ivermectin was profound. At phase II, there were significant (P < 0·001) reductions in the odds of itching (OR 0·32), APOD (OR 0·28); CPOD (OR 0·34); reactive skin lesions (OR 0·33); depigmentation (OR 0·31) and nodules (OR 0·37). Reduction in the odds of LOD was also significant (OR 0.54, P < 0.03). CONCLUSIONS: This first multi-country report of the long-term impact of CDTI reveals a substantial reduction in itching and OSD. APOC operations are having a major effect in improving skin health in poor rural populations in Africa.

Prevalences of loiasis in Ondo state, Nigeria, as evaluated by the rapid assessment procedure for loiasis (RAPLOA).

The rapid assessment procedure for loiasis (RAPLOA) was used to assess the prevalences of loiasis among 4800 subjects in 60 villages in Ondo state, south-western Nigeria. Coverages for community-directed treatment with ivermectin (CDTI) were assessed in the same communities, which were located in the Owo, Akure North, Ifedore, Akure South, Ondo East and Ondo West local government areas (LGA). In addition, fingerprick blood samples were collected from 80 individuals in each of six villages (i.e. one village in each LGA investigated) and checked for Loa loa microfilaraemia. Microfilaraemias were only detected in three of the villages where blood samples were collected and then only at low prevalences (1.25%-5.0%) and intensities (267-1600 microfilariae/ml). No serious adverse events were or ever had been related to the CDTI but mild or moderate adverse reactions were quite common, especially in Akure North (55.0%) and Owo (40.2%). A female subject was more likely to report an history of eye worm than a male subject (20.3%-35.7% v. 20.8%-26.5%, according to LGA). Although the subjects aged 41-50 years formed the age-group most likely to report an history of eye worm (32.7%), the highest CDTI coverage was recorded in the subjects aged 61-70 years (54.7%). The results indicated that CDTI had helped to reduce the prevalence and intensity of Loa microfilaraemia and that ivermectin can continue to be used for mass administrations in Ondo state with little risk of serious adverse events.

Community participation in the eradication of guinea worm disease.

As Guinea worm eradication programmes have got under way in endemic countries over the last decade, there has been a shift towards more participatory methods. The approach to surveillance has changed from periodic cross-sectional surveys to monthly village-based reporting of cases by a volunteer village health worker. At the same time, the emphasis regarding control interventions has moved from the provision of safe water supplies to health education. The new approach has proved very effective. The village health volunteers who carry out both surveillance and health education seem to be motivated largely by the social status of their role; still more commitment will be required of them in the final stages of eradication. It is to be hoped that the networks of village health workers established for Guinea worm eradication will find a useful role in health promotion after the worms have gone.

Mobilization strategy for guinea worm eradication in Nigeria.

The transformation of dracunculiasis from an obscure and neglected rural disease to the highly visible target of a national eradication campaign in Nigeria is described in this report. This process progressed through four overlapping stages: documentation of the extent and nature of the disease as a national problem, demonstration in Nigeria that dracunculiasis could be effectively prevented by targeted provision and use of protected rural water supplies, mobilization for community participation in, and political support of, the eradication effort, and implementation of interventions nationwide. The conduct of the first national village-by-village search for cases and documentation of the adverse socioeconomic impact of the disease (e.g., on rice production) in Nigeria were the key elements used to solicit greater attention to the problem and mobilize support for its eradication. The critical role of the mass media in this effort and other benefits of this mobilization strategy are also highlighted.

Schistosomiasis in Cross River State, Nigeria: 1. Prevalence and intensity of infection in Adim, Akamkpa Local Government Area.

Mid-stream urine was randomly collected from 248 subjects in Adim. Blood and protein concentrations were determined semi-quantitatively using Combi-7 reagent strips. The urine samples were then processed and any ova of Schistosoma haematobium present were counted per 10 ml urine. Fresh stool samples were also randomly collected, processed and examined for S. masoni and other helminthic ova. The prevalence of S. haematobium in the area was 43.5% and this was found to be age-related but not sex-related. Mean egg count was 137.2 per 10 ml urine. Intense haematuria of 250 ery/microliters and proteinuria of 500 mg/dl accompanied the high egg counts. The stool examination showed no cases of Manson's schistosomiasis but polyparasitism with other intestinal helminths was common particularly among children under 10 years old. This is the first report of urinary schistosomiasis in this area and the high prevalence rate is consistent with the rice farming occupation of the natives of the area. The sensitive nature and the case of application of the reagent strips in determining heavy infections by measuring haematuria and proteinuria is once again confirmed.

Community participation in the control of onchocerciasis in Cross River State, Nigeria.

Human onchocerciasis is reported to occur in all States of the Federal Republic of Nigeria with serious medical, social and economic impact on affected communities. Attempted control schemes have failed because of reinvasion caused by limited area coverage, short duration of the scheme and non-involvement of the affected communities. As the Nigeria National Onchocerciasis Control Programme (NOCP) takes off with baseline data collection, it is essential to point out the need for community participation in the programme. Information obtained from group interviews in 8 villages in Akamkpa Local Government Area of Cross River State, Nigeria, reveal that ignorance of the cause of onchocerciasis. Location of villages and farms near fast flowing waters and outdoor working habits, have resulted in continued endemicity of the disease in the affected poor farming communities. For successful control of the disease, the communities should be involved in all stages of the control programme. During the preparatory stage, control officials should carry out intensive health education; encourage, and assist in, formation of village health committees (VHC) and selection of village based workers (VBW); and work with the VHC and VBW in developing skeletal control plans and deciding on input from community. During screening for prevalence, communities will, if adequately mobilized, accommodate field workers, act as field guides and interpreters and cooperate despite conflicting religions and traditional beliefs and practices. Before chemical treatment of breeding sites of Simulium, permission will be required from the communities, members of which will, if trained, take part in the exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence and geographical distribution of dracunculiasis (guineaworm disease) in Cross River State, Nigeria.

A cross-sectional survey conducted in 1986 revealed the occurrence of guineaworm disease in a total of 70 villages in 3 out of the 17 local government areas (L.G.A.) of the State with an average prevalence rate of 56.9%. All villages affected, 39 in Ogoja L.G.A., 23 in Obubra L.G.A. and 8 in Ikom L.G.A., were located in the North Western part of the state. In all areas affected, there were no sources of safe drinking water and 95% of the people obtained their drinking water from ponds and wells with only a negligible number treating the water before drinking. Evidence of spill-over was found in the villages of Ofat and Mkpani (Obubra L.G.A.) which had no cases of guineaworm disease prior to 1986 and 1980 respectively. Observations in this study indicate that there is a gradual spread of the disease eastwards and southwards.

Observations on the food habits of some African rodents.

Food habits of four common species of African rodents: the giant rat (Cricetomys gambianus), the black house rat (Rattus rattus), the multimammate rat (Mastomys natalensis) and the pygmy mouse (Mus minutoides) were studied on the basis of stomach content analysis, habitat sampling and experimental trials with caged animals. Vegetable items (especially grass, grains and tubers) formed the bulk of the food of all the species. Oil-palm nuts and kernels were also common in the guts of C. gambianus and M. natalensis. Animal food components of all the rodent species comprised mainly insects (especially ants, crickets etc.). Vertebrate flesh and scales were also well represented in the guts of C. gambianus. Domestic and miscellaneous food items were recorded from R. rattus, most of which were trapped in human and animal shelters. Inorganic gut contents, primarily sand grains, were found in sizeable quantities in more than 70% of the rodents examined. Results of experimental feeding trials with caged rodents showed close correlation with those recorded from field samples, especially in terms of food choices and the relative quantities consumed. The ecological and practical implications of these observations are discussed in the light of the importance of the rodents as agricultural and domestic pests.