Emmanuel Chukwudirim Emukah

Publications

• 2.22

  Impact points

  Urine heme dipsticks are useful in monitoring the impact of Praziquantel treatment on Schistosoma haematobium in sentinel communities of Delta State, Nigeria.

  Emmanuel Emukah, Julie Gutman, John Eguagie, Emmanuel S Miri, Paul Yinkore, Ndudi Okocha, Victoria Jibunor, Obiageli Nebe, Augustine Ikenna Nwoye, Frank O Richards

  Acta tropica. 04/2012; 122(1):126-31.

  Nigeria is highly endemic for infection with Schistosoma haematobium, which most commonly manifests itself with blood in urine. To monitor the impact of annual mass drug administration (MDA) with Praziquantel for S. haematobium in Delta State, Nigeria, cross-sectional hematuria surveys of school chi... [more] Nigeria is highly endemic for infection with Schistosoma haematobium, which most commonly manifests itself with blood in urine. To monitor the impact of annual mass drug administration (MDA) with Praziquantel for S. haematobium in Delta State, Nigeria, cross-sectional hematuria surveys of school children were conducted in 8 sentinel villages (SVs) at baseline (n=240) and after two annual doses (n=402). We assessed the comparability of three assessments of hematuria (child's reported history, nurse visual diagnosis (NVD) and dipstick) to determine the need for mass treatment. Dipstick was considered to be the gold standard. Prior to treatment, history and NVD each identified only the 3 most highly prevalent SVs, and overall this represented just 37.5% of the 8 SVs in need of treatment. Following treatment, after dipstick prevalence decreased by 88.5% (p<0.001), and history and NVD identified only one of two villages still needing treatment. The study suggests that dipsticks should be the recommended method for launching and monitoring mass treatment for S. haematobium.
• 2.80

  Impact points

  Effects of annual mass treatment with ivermectin for onchocerciasis on the prevalence of intestinal helminths.

  Julie Gutman, Emmanuel Emukah, Njideka Okpala, Chinyere Okoro, Andrew Obasi, Emmanuel S Miri, Frank O Richards

  The American journal of tropical medicine and hygiene. 09/2010; 83(3):534-41.

  We evaluated the effect of annual ivermectin (IV) distribution for onchocerciasis on the prevalence of soil transmitted helminth (STH) infections in school-aged (SAC) and preschool-aged (PAC) children by comparing children in villages that had received treatment for 13 years to those from socioecono... [more] We evaluated the effect of annual ivermectin (IV) distribution for onchocerciasis on the prevalence of soil transmitted helminth (STH) infections in school-aged (SAC) and preschool-aged (PAC) children by comparing children in villages that had received treatment for 13 years to those from socioeconomically similar villages in untreated areas. We enrolled 1,031 SAC and 211 PAC for Kato Katz examinations. Treated areas had a lower prevalence of Ascaris (SAC: 3% versus 12%, P < 0.0001; PAC: 3% versus 10%, P < 0.051) and Trichuris (SAC: 6% versus 10%, P = 0.012; PAC: 1% versus 8%, P = 0.019), but not hookworm (SAC: 38% versus 42%, P = 0.20; PAC: 21% versus 27%, P = 0.30). The prevalence of Ascaris or Trichuris in treated areas was below the WHO threshold for mass antihelminthic treatment (MDA), but not for hookworm. We conclude that benzimidazole MDA in IV treatment areas is indicated to effectively control hookworm.
• 30.76

  Impact points

  Sustainability of ivermectin distribution programmes.

  Lindsay J Rakers, Emmanuel Emukah, Jude Onyenama, Grace Amah, Nnenna Ukairo, Uche Enyinnaya, Emmanuel Miri, Frank Richards

  Lancet. 10/2009; 374(9692):785-6.
• 2.80

  Impact points

  Nigeria's war on terror: fighting dracunculiasis, onchocerciasis, lymphatic filariasis, and schistosomiasis at the grassroots.

  Ngozi A Njepuome, Donald R Hopkins, Frank O Richards, Ifeoma N Anagbogu, Patricia Ogbu Pearce, Mustapha Muhammed Jibril, Chukwu Okoronkwo, Olayemi T Sofola, P Craig Withers, Ernesto Ruiz-Tiben, Emmanuel S Miri, Abel Eigege, Emmanuel C Emukah, Ben C Nwobi, Jonathan Y Jiya

  The American journal of tropical medicine and hygiene. 06/2009; 80(5):691-8.

  Africa's populous country, Nigeria, contains or contained more cases of dracunculiasis, onchocerciasis, lymphatic filariasis, and schistosomiasis than any other African nation and ranks or ranked first (dracunculiasis, onchocerciasis, schistosomiasis) or third (lymphatic filariasis) in the world... [more] Africa's populous country, Nigeria, contains or contained more cases of dracunculiasis, onchocerciasis, lymphatic filariasis, and schistosomiasis than any other African nation and ranks or ranked first (dracunculiasis, onchocerciasis, schistosomiasis) or third (lymphatic filariasis) in the world for the same diseases. After beginning village-based interventions against dracunculiasis 20 years ago and confronting onchocerciasis a few years later, Nigeria has nearly eliminated dracunculiasis and has provided annual mass drug administration for onchocerciasis to over three quarters of that at-risk population for 7 years. With assistance from The Carter Center, Nigeria began treating lymphatic filariasis and schistosomiasis in two and three states, respectively, over the past decade, while conducting pioneering operational research as a basis for scaling up interventions against those diseases, for which much more remains to be done. This paper describes the status of Nigeria's struggles against these four neglected tropical diseases and discusses challenges and plans for the future.
• 1.37

  Impact points

  Factors affecting the attrition of community-directed distributors of ivermectin, in an onchocerciasis-control programme in the Imo and Abia states of south-eastern Nigeria.

  E C Emukah, U Enyinnaya, N S Olaniran, E A Akpan, D R Hopkins, E S Miri, U Amazigo, C Okoronkwo, A Stanley, L Rakers, F O Richards, M N Katabarwa

  Annals of tropical medicine and parasitology. 01/2008; 102(1):45-51.

  In areas of Nigeria where onchocerciasis is endemic, community-directed distributors (CDD) distribute ivermectin annually, as part of the effort to control the disease. Unfortunately, it has been reported that at least 35% of the distributors who have been trained in Nigeria are unwilling to partici... [more] In areas of Nigeria where onchocerciasis is endemic, community-directed distributors (CDD) distribute ivermectin annually, as part of the effort to control the disease. Unfortunately, it has been reported that at least 35% of the distributors who have been trained in Nigeria are unwilling to participate further as CDD. The selection and training of new CDD, to replace those unwilling to continue, leads to annual expense that the national onchocerciasis-programme is finding difficult to meet, given other programme priorities and the limited resources. If the reported levels of attrition are true, they seriously threaten the sustainability of community-directed treatment with ivermectin (CDTI) in Nigeria. In 2002, interviews were held with 101 people who had been trained as CDD, including those who had stopped serving their communities, from 12 communities in south-eastern Nigeria that had high rates of CDD attrition. The results showed that, although the overall reported CDD attrition was 40.6%, the actual rate was only 10.9%. The CDD who had ceased participating in the annual rounds of ivermectin blamed a lack of incentives (65.9%), the demands of other employment (14.6%), the long distances involved in the house-to-house distribution (12.2%) or marital duties (7.3%). Analysis of the data obtained from all the interviewed CDD showed that inadequate supplies of ivermectin (P<0.01), lack of supervision (P<0.05) and a lack of monetary incentives (P<0.001) led to significant increases in attrition. Conversely, CDD retention was significantly enhanced when the distributors were selected by their community members (P<0.001), supervised (P<0.001), supplied with adequate ivermectin tablets (P<0.05), involved in educating their community members (P<0.05), and/or involved in other health programmes (P<0.001). Although CDD who were involved in other health programmes were relatively unlikely to cease participating in the distributions, they were more likely to take longer than 14 days to complete ivermectin distribution than other CDD, who only distributed ivermectin. Data obtained in interviews with present and past CDD appear vital for informing, directing, protecting and enhancing the performance of CDTI programmes, in Nigeria and elsewhere.
• 1.37

  Impact points

  Missed treatment opportunities, for pregnant and breast-feeding women, in onchocerciasis mass-treatment programmes in south-eastern Nigeria.

  C U Maduka, L N Nweke, E S Miri, U Amazigo, E C Emukah, F O Richards

  Annals of tropical medicine and parasitology. 11/2004; 98(7):697-702.

  During annual rounds of mass treatment against onchocerciasis, women who are pregnant or nursing neonates should not to be offered ivermectin. The aim of the present study was to determine how many women were not treated, as a result of this policy, in four villages in south-eastern Nigeria. Of the ... [more] During annual rounds of mass treatment against onchocerciasis, women who are pregnant or nursing neonates should not to be offered ivermectin. The aim of the present study was to determine how many women were not treated, as a result of this policy, in four villages in south-eastern Nigeria. Of the 1714 women of reproductive age present during the 2000 round of mass treatment, 599 (35%) were excluded because they were pregnant or nursing babies aged < 1 month. Most (56%) of the 599 excluded women were, however, treated individually later in the year. Of the 264 excluded women who did not receive a dose of ivermectin at all in 2000, 123 (47%) said they would have actively sought ivermectin treatment had they been made aware of the short duration of exclusion for nursing. If they had all known of the short duration of the exclusion and when and how to locate and receive treatment in their villages after the round of mass treatment, 91% of the women excluded from the round of mass treatment would probably have been treated later in the year. Better treatment systems, follow-up and health education, targeted at pregnant and lactating women, would improve treatment coverage of this group after parturition and early nursing.
• 2.80

  Impact points

  A longitudinal study of impact of repeated mass ivermectin treatment on clinical manifestations of onchocerciasis in Imo State, Nigeria.

  Emmanuel C Emukah, Edith Osuoha, Emmanuel S Miri, Jude Onyenama, Uche Amazigo, Christopher Obijuru, Nkeiru Osuji, Josephine Ekeanyanwu, Stanley Amadiegwu, Kenneth Korve, Frank O Richards

  The American journal of tropical medicine and hygiene. 06/2004; 70(5):556-61.

  We conducted a cohort study on impact of effects of eight years of annual ivermectin mass treatment administered in eight villages in Imo State, Nigeria. Physical and visual acuity examinations carried out in 462 persons in 1995, prior to the launching of mass drug administration with ivermectin, we... [more] We conducted a cohort study on impact of effects of eight years of annual ivermectin mass treatment administered in eight villages in Imo State, Nigeria. Physical and visual acuity examinations carried out in 462 persons in 1995, prior to the launching of mass drug administration with ivermectin, were compared with re-examinations of 411 (89%) of these same individuals in 2002. We found that gross visual impairment decreased from 16% to 1%, nodule prevalence decreased from 59% to 18%, and papular dermatitis was reduced from 15% to 2%. No change was seen in leopard skin rates (14%). The only incident lesions were three subjects from a single community having the appearance of new nodules (e.g., nodules not identified in the 1995 examinations). Differences in community coverage did not appear to influence the benefit from treatment of individual residents.