[Show abstract][Hide abstract]ABSTRACT: Effective control and management of severe malaria cases depends on a clear understanding of the local epidemiological factors and specific clinical manifestations of the disease in the different endemic regions.
To determine the prevalence of severe malaria and epidemiological factors that affect the development of malaria anaemia.
A cross-sectional survey was carried out among children below 5 years of age, at the Adeoyo State Maternity Hospital, Ibadan, Nigeria. Questionnaires and case histories were taken from patients clinically diagnosed of malaria. Thus, 372 volunteers were recruited into the study from the 3131 paediatric cases that reported over the 10-week period to the out-patient department (OPD) of the hospital. 229 (61.6%) of the recruited volunteers presented with fever (>37.5 degrees C) at consultation. These had malaria parasite and PCV tests done.
Clinical diagnosis was confirmed microscopically in 78% (290/372) for Plasmodium infection using thick film slides. Anaemia (PCV <28%) prevalence was 28.2%. Factors that contributed to the rapid progression of uncomplicated malaria to severe status included: age of the child, level of parasitaemia, careless response and attitude of parents or guardians to fever in the children; parents' preoccupation with their jobs or other healthy children and unwillingness to use available health facilities.
The study underscores the need for community involved partnership for malaria control especially through health education for the home management of malaria, especially among those experiencing some form of inequity in access to healthcare.
Full-text available · Article · Jul 2007 · African health sciences
[Show abstract][Hide abstract]ABSTRACT: There is a dearth of information on the reference values for haematological indices particularly according to the relevant trimesters of pregnant women in Nigeria. The objective of this study was to provide reference values for Nigerian pregnant women. The study took place at the Adeoyo Maternity Hospital and the University College Hospital, both in Ibadan. This descriptive study was carried out over a period of 8 months. Subjects were apparently healthy pregnant women that satisfied the inclusion and exclusion criteria. The mean values (and 95% confidence intervals, CI) of haematological indices were as follows -- First trimester: Haemoglobin (Hb) 112.44 (101.64 - 123.25) g/l, haematocrit (hct) 35 (32 - 38)%, WBC 5.488 (4.025 - 6.950) x 10(9)/l and platelet counts 227.56 (165.21 - 289.90) x 10(9)/l;Second trimester: Hb 100.39 (97.85 - 102.92) g/l, hct 29.3 (28.5 - 30.1)%, WBC 6.57 (6.19 - 6.95) x 10(9)/l, platelet count 229.56 (211.86 - 247.26); and the Third trimester: Hb 98.06 (96.12 - 100.00) g/l, hct 29.4 (28.7 - 29.9)%, WBC 6.92 (6.53 - 7.30), platelet count 186.52 (177.67 - 195.38) x 10(9)/l. These results were compared with those of 52 non-pregnant age matched women volunteers as controls whose mean haematological indices and 95% CI were: Hb 120.51 (116.61 - 124.41) g/l, hct 36 (25 - 48)%, WBC 5.28 (2.9 - 8.7) x 10(9), platelet count 330.87 (176 - 538) x 10(9)/l. The following haematological indices: WBC, platelet counts, RBC, PCT, and PDW, of women between the trimesters showed statistical significance (p value < 0.001 in each case). The WBC is inversely proportional to the PCT and the MCV in the pregnant women was slightly raised. In this study, pregnancy is characterised by lowest values of haemoglobin parameters in trimester three and there are statistically significant differences between the WBC, platelet counts, RBC, PCT, and PDW of women between the three trimesters.
Article · Dec 2006 · Journal of Obstetrics and Gynaecology
[Show abstract][Hide abstract]ABSTRACT: The study investigated the episode of malaria infection and anaemia in pregnancy of 226 women. The overall prevalence of malaria infection among pregnant women was 23.08%, while only 7.1% of non-pregnant women were malaria positive. The mean parasite density was significantly higher in the primigravidae than in the multigravidae (3144±107 versus 1014±158; p<0.05). The mean parasite densities were significantly higher in both primigravidae and multigravidae than in the non-pregnant control (3144±107 and 1014±158 respectively versus 101±70; P<0.05). The mean haemoglobin (Hb0 concentration was significantly higher in the malaria negative non-pregnant control than in the malaria negative primigravidae (12.60±1.01versus 10.33±1.40; p>0.05), but there was no significant difference between the mean Hb concentration of malaria negative non-pregnant women and malaria negative pregnant women (12.60±1.01versus11.01±1.06p>0.05). The haemoglobin concentration was significantly higher in malaria positive non-pregnant controls than in the malaria positive primigravidae (11.56±1.01 versus 9.85±1.85p<0.05), but not significantly higher than that of the malaria positive multigravidae (11.56±1.01versus 10.45±1.45). Primigravidae were found to be more susceptible to malaria infection and severe anaemia than the multigravidae, hence, primigravidae are considered to need more medical attention than the multigravidae. Nigerian Journal of Parasitology Vol. 25, 2004: 51-55
Article · Aug 2006 · Nigerian Journal of Parasitology
[Show abstract][Hide abstract]ABSTRACT: To determine the effect of self-medication with chloroquine and pyrimethamine on malaria infection and anaemia during pregnancy.
The study involved 210 women who attended Ade Oyo Maternity State Hospital, Ibadan, Nigeria. Of these, 156 were pregnant women while 54 were not pregnant (controls). Of the pregnant women, 66 were primigravidae, while 90 were multigravidae. History of treatment of malaria with antimalarial drugs was obtained from the subjects. Gravidity and gestation period were also documented. Two millilitres of blood was withdrawn from each subject, for haematological parameters. Thin and thick films were prepared for malaria parasite identification and quantification.
Of the primigravidae and multigravidae 68 and 16.4%, respectively, had taken antimalarial drugs prior to booking. Among primigravidae, only 18% of those with drugs compared with 32% without drugs were malaria-positive. The parasite density was significantly lower among those who took antimalarial drugs than among those who did not (976 +/- 60 versus 2,421 +/- 78, p < 0.05). Similarly, among multigravidae, only 16.4% of those who took antimalarial drugs compared with 34% of those who were not malaria-positive. The parasite density was also significantly lower in multigravidae with drugs than among those without drugs (350 +/- 45 versus 1,000 +/- 65, p < 0.05). The prevalence of anaemia (packed cell volume, PCV < 33) was high, 89% in primigravidae and 70% in multigravidae. Severe anaemia (PCV < 21) was more common in malaria-positive primigravidae and multigravidae than in malaria-negative women.
The findings indicate that self-medication with chloroquine and pyrimethamine at booking was able to reduce the prevalence of malaria and anaemia in pregnancy.
Full-text available · Article · Jan 2005 · Medical Principles and Practice
[Show abstract][Hide abstract]ABSTRACT: There is a dearth of information on the incidence and prevalence of rubella infection in Nigeria. The risk of congenital rubella in sero-negative pregnant women has been found to produce congenital abnormalities even in developed countries.
The aim of this study is to determine the prevalence of rubella virus antibody in pregnant women.
The place of study is the antenatal care clinic of Adeoyo State Hospital, Ibadan.
This is a cross-sectional study of primigravida women attending the antenatal care facilities in a general hospital The rubella IgG antibody of the women was detected in sera using the RUB IgG Test kit. This is a quantitative ELISA technique.
The prevalence of rubella antibody in 159 pregnant women that participated in this study was 68.5% with a confidence interval of 64.8% - 72.2%. Women living in rural -urban areas have statistically significant higher prevalence of antibody than those in urban areas.
This prevalence of rubella antibody in pregnant women suggests 1 in 4 pregnant woman is susceptible and the foetus at risk of congenital rubella malformation.
Full-text available · Article · Nov 2004 · West African journal of medicine
[Show abstract][Hide abstract]ABSTRACT: A 10-week cross-sectional study was carried out at the Adeoyo State Maternity Hospital (Beere, Ibadan), Southwestern Nigeria in order to determine (a) the prevalence of severe malaria, (b) identify the predominant clinical presentations that characterise the disease in children below 5 years and the pattern of antibody responses to MSP 19 elicited in severe malaria complications. Three thousand, one hundred and thirty-one cases reported to the Out Patients' Department; of these, 372 (11.8%) subjects were recruited on the basis of doctors' diagnosis of severe malaria, malaria and other complications. Six per cent (188/3131) ofthe patients were admitted. Serum samples for 320 ofthe 372 subjects were analysed for antibodies specific to MSP 1(19) by ELISA. The highest antibody responses occurred in the age group 2-5 years. Parasite prevalence was 77.9% (290 of 372 subjects) and parasite density ranged from 80 to >100000 parasites/microL blood. Fever (an average temperature of 38.6 +/- 0.4 degrees C and peak at 41 degrees C) and severe malaria were the major clinical manifestations of malaria amongst the study population. Severe malaria was found to be associated with other features such as cough, vomiting and diarrhoea.
Article · Apr 2004 · African journal of medicine and medical sciences