Awareness, perceptions and intent to comply with the prospective malaria vaccine in parts of South Eastern Nigeria.

BACKGROUND: There are potentials of a malaria vaccine being developed sooner than expected. While focus is more on the development of a vaccine, less attention has been paid on the extent to which such vaccines could be well accepted and the readiness among caregivers to comply with its use in order to achieve the effectiveness of the vaccine in the malaria endemic areas. Compliance rates are influenced by the level of awareness, as well as the perception of the population. This cross-sectional study was aimed at assessing the awareness, perceptions and intent to comply with the prospective malaria vaccine by caregivers in Owerri West, South Eastern Nigeria. METHODS: Structured pretested questionnaires were used to collect data from 500 randomly selected consenting care givers (mostly mothers). Items used to assess the intent to comply with the vaccine include willingness to accept and use the vaccine, and allow children to be vaccinated. RESULTS: The study found that awareness of malaria as a public health problem was high (89.8%), but awareness about a prospective malaria vaccine was not high (48.2%). Up to 88.2% of respondents showed positive perception towards the vaccine, of which 65.2% had strong positive perception. The study found high level of intent to comply with the prospective malaria vaccine among the study group (95.6% positive). Significant association was established between caregivers perception and intent to comply with the prospective malaria vaccine (χ2 = 144.52; p < 0.0001). CONCLUSIONS: While malaria vaccine adoption is likely to be a welcome development in South Eastern Nigeria, proper consideration should be given to factors that are likely to influence people's perceptions about vaccines in the plans/process of malaria vaccine development and vaccination programmes.

Detection and characterization of micro-organisms linked to unsealed drugs sold in Ihiagwa community, Owerri, Imo State, Nigeria.

The contamination of pharmaceutical products by micro-organisms poses a significant risk to public health. This study was conducted to detect and characterize micro-organisms associated with unsealed drugs sold in Ihiagwa community in Owerri, Imo State, Nigeria. A variety of microbiological techniques were employed to analyse samples from unsealed drug containers. The identification process involved morphological, biochemical and sugar utilization methods, aiding in the accurate determination of microbial species. Microbial contamination was observed in 42 (84 %) out of 50 samples, with contaminants including bacteria and fungi. The range of contamination is between 1.2±0.01×103 and 2.3±0.02×103 c.f.u. ml-1 for viable count, 0.1±0.02×102 and 0.3±0.01×102 c.f.u. g-1 for coliform count and 0.2±0.01×101 and 0.5±0.01×101 c.f.u. g-1 for fungi count. The identified microbes were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans and Aspergillus niger. The most common bacterial isolate was S. aureus (51.8 %), while C. albicans (73.3 %) was the most prevalent fungus. Among the pharmacies and healthcare facilities examined, the Uchems pharmacy had the highest proportion of bacterial isolates (37 %), followed by the Stepwise pharmacy (22.2 %), while the lowest proportion was found at the Roseline Health Clinic (7.4 %). The identification of potentially harmful micro-organisms in these unsealed drug container samples emphasizes the importance of stringent quality control measures and improved handling, storage and packaging practices to ensure product safety and efficacy, especially among pharmacetical dealers.

Malaria care-seeking behaviour among HIV-infected patients receiving antiretroviral treatment in South-Eastern Nigeria: A cross-sectional study.

This study assesses malaria prevention and treatment behaviour among people living with HIV/AIDS (PLWHA) in Owerri, South Eastern Nigeria. Although Nigeria bears one of the world's largest burdens of both malaria and HIV, there is almost no research studying how co-infected patients manage their care. We systematically sampled 398 PLWHA receiving care at Imo State Specialist Hospital and the Federal Medical Centre in Owerri to complete a structured, pre-tested questionnaire on malaria care-seeking behaviour. Descriptive statistics were reported and chi-square tests and multivariate logistic regressions were also used. The majority of HIV-infected patients (78.9%) reported having had an episode of suspected malaria quarterly or more often. There was a large variation in care-seeking patterns: on suspicion of malaria, 29.1% of participants engaged in self-medication; 39.2% went to drug shops, and only 22.6% visited HIV/AIDS care centres. Almost 40% waited more than 24 hours before initiating treatment. Most (60.3%), reported taking recommended artemisinin-based combination treatments (ACT) but a significant minority took only paracetamol (25.6%) or herbal remedies (3.5%). Most (80%) finished their chosen course of treatment; and completion of treatment was significantly associated with the frequency of suspected malaria occurrence (p = 0.03). Most (62.8%) did not take anti-malaria medication while taking antiretroviral treatment (ART) and almost all (87.6%) reported taking an ACT regimen that could potentially interact with Nigeria's first-line ART regimen. Our findings suggest the need to pay more attention to malaria prevention and control as a crucial element in HIV/AIDS management in this part of Nigeria and other areas where malaria and HIV/AIDS are co-endemic. Also, more research on ART-ACT interactions, better outreach to community-level drug shops and other private sector stakeholders, and clearer guidelines for clinicians and patients on preventing and managing co-infection may be needed. This will require improved collaboration between programmes for both diseases.

Exploring the antimalarial potential of whole Cymbopogon citratus plant therapy.

ETHNOPHARMACOLOGICAL RELEVANCE: Cymbopogon citratus (lemon grass) has been used in traditional medicine as an herbal infusion to treat fever and malaria. Generally, whole plant extracts possess higher biological activity than purified compounds. However, the antimalarial activity of the whole C. citratus plant has not been experimentally tested. AIM OF THE STUDY: To evaluate the antimalarial activity of an herbal infusion and the whole Cymbopogon citratus plant in two experimental models of malaria. MATERIAL AND METHODS: The plant was dried for 10 days at room temperature and was then milled and passed through brass sieves to obtain a powder, which was administered to CBA/Ca mice with a patent Plasmodium chabaudi AS or P. berghei ANKA infection. We analysed the effects of two different doses (1600 and 3200mg/kg) compared with those of the herbal infusion and chloroquine, used as a positive control. We also assessed the prophylactic antimalarial activities of the whole C. citratus plant and the combination of the whole plant and chloroquine. RESULTS: The C. citratus whole plant exhibited prolonged antimalarial activity against both P. chabaudi AS and P. berghei ANKA. The low dose of the whole C. citratus plant displayed higher antimalarial activity than the high dose against P. berghei ANKA. As a prophylactic treatment, the whole plant exhibited higher antimalarial activity than either the herbal infusion or chloroquine. In addition, the combination of the whole C. citratus plant and chloroquine displayed higher activity than chloroquine alone against P. berghei ANKA patent infection. CONCLUSIONS: We demonstrated the antimalarial activity of the whole C. citratus plant in two experimental models. The whole C. citratus plant elicited higher anti-malarial activity than the herbal infusion or chloroquine when used as a prophylactic treatment. The antimalarial activity of the whole C. citratus plant supports continued efforts towards developing whole plant therapies for the management of malaria and other infectious diseases prevalent in resource-poor communities.

Malaria transmission and morbidity patterns in holoendemic areas of Imo River Basin of Nigeria.

BACKGROUND: This study determines the relationship between malaria transmission intensity and morbidity in holoendemic areas of Imo River Basin, Nigeria. RESULTS: Standard entomological and parasitological techniques were used to determine transmission intensity and parasite rates respectively while sociocultural methods and review of hospital records were used to determine morbidity patterns. The average transmission rate was 16.1 infective bites per person per night (ib/p/n). The average malaria specific morbidity rate for the study area was 30.2%. These parameters showed no significant differences among the communities studied (P > 0.05). Transmission intensity and morbidity rate had a linear relationship such that high transmission intensity corresponded with high morbidity rate and vice versa. CONCLUSIONS: This therefore puts to rest discrepancies about the relationship between malaria transmission and morbidity in the study area and calls for serious scaling up of the insecticide treated nets strategy especially in high transmission areas and seasons. Concerted efforts should also be made towards production of transmission blocking vaccines.