M.A. Mafe

The diagnostic potential of three indirect tests for urinary schistosomiasis in Nigeria

Schistosomiasis is one of the major parasitic infections of man in the tropical and subtropical areas of the world. Diagnosis of the disease is usually based on microscopic detection of eggs in excreta which is both laborious and time consuming. In Nigeria, the Governments emphasis on the control of the disease dictates the need for a simple, fast, reliable and affordable diagnostic test for the identification of infected communities and detection of infected persons. Three indirect diagnostic tests for urinary schistosomiasis: interview technique, visual examination for macrohaematuria and the use of a chemical reagent strip were employed in screening 1056 individuals of the Kainji Lake area of Nigeria for urinary schistosomiasis, using haematuria as the disease indicator. The sensitivity of the three tests were determined using the filtration (egg counting) technique as the reference test. The sensitivity of the reagent strip test was 69.0% and 44 and 38% for the interview technique and visual examination respectively. The reagent strip test was particularly useful for screening children (5-19 years old). The implication of these findings are discussed.

Willingness to seek HIV testing and counseling among pregnant women attending antenatal clinics in Ogun State, Nigeria.

HIV counseling and testing (CT) is slowly being introduced as one of several key components of the comprehensive package of HIV/AIDS prevention and care in Nigeria, particularly in the prevention of mother-to-child transmission of HIV (PMTCT). Across-sectional survey of 804 women attending antenatal clinics (ANC) in Ogun State, Nigeria was done using questionnaires to assess their willingness to seek and undergo CT and know the determinants. Focus group discussions were also held in the general community: 84.3% of respondents believed in AIDS reality, while 24.3% thought they were at risk of HIV infection. Only 27% knew about MTCT, while 69.7% of 723 who had heard of HIV/AIDS did not know about CT. Only 71 (8.8%) had thought about CT and 33 (4.5%) mentioned HIV testing as one of antenatal tests. After health education on CT, 89% of the women expressed willingness to be tested. Their willingness for CT was positively associated with education (p < 0.05), ranging from 77% (no education) to 93% (post-secondary). More of those with self-perceived risk expressed willingness to test for HIV (p < 0.05). Those willing to be tested had a higher knowledge score on how HIV spreads than those not willing. Multiple regressions identified four key factors that were associated with willingness for CT: increasing educational level; not fearing a blood test; perception that the clinic offered privacy; and perceptions of higher levels of social support from relatives and peers. Those unwilling or undecided about CT expressed strong fear of social stigma/rejection if tested positive. The results provided insights for planning promotional programs and showed that not only are IEC efforts needed to boost knowledge about HIV/AIDS, but that change in clinic setting and community are imperative in creating supportive environment to encourage uptake of CT services.

Knowledge and perception of HIV/AIDS among pregnant women attending antenatal clinics in Ogun State, Nigeria

Mother-to-child transmission of HIV (MTCT) is responsible for more than 90% of the cases of HIV infection in infants and children in sub-Saharan Africa. Accurate data on the knowledge and perceptions of HIV/AIDS among women attending antenatal clinics in Nigeria are scarce. A cross-sectional survey of 804 women attending antenatal clinics in Ogun State, South-West Nigeria was done using interviewer-administered questionnaires. Approximately 90% of the women respondents had heard of HIV/AIDS, but only about 27% knew HIV could be transmitted from mother to child; of those, almost 94% believed in the reality of HIV disease; in contrast, the majority (64%) believed they were not at risk of HIV infection, and a slightly greater proportion (70%) did not understand the benefits of voluntary HIV counselling and testing (VCT). Nonetheless, almost 90% of respondents were willing to know their status following health education about VCT. Those that were older, attending public hospitals, and with a higher level of education had more knowledge and better perceptions about HIV. The results suggest an urgent need for public health education on HIV/AIDS and the benefits of VCT to control MTCT, particularly targeting young women and those with little or no education.

Perception and affordability of long-lasting insecticide-treated nets among pregnant women and mothers of children under five years in Ogun State, Nigeria

Despite the distribution of long-lasting insecticide-treated nets (LLINs) in Nigeria, access to and use of LLINs continues to be minimal. Little is also known about the perceived fair price people are willing to pay for LLINs in Ogun State, South-West Nigeria. Data were collected using semi-structured questionnaire among pregnant women attending antenatal clinics and mothers of under-five children in randomly-selected malaria holo-endemic communities of Ijebu North and Yewa North local government areas of Ogun State. Results showed that only 23.6% of 495 respondents owned and were using LLINs. One of the main reasons for non-use of LLINs was unaffordability of LLIN cost. 84.2% of the 495 respondents were willing to pay at a hypothetical price of N800.00 (US

Urinary schistosomiasis in school aged children of two rural endemic communities in Edo State, Nigeria

5.00) for a LLIN, 15.6% were unwilling and 0.2% was indifferent to buying it at the price. Their willingness to pay was significantly determined by education and occupation (p=0.00). Health education strategies need to be developed to increase awareness and demand for LLINs. However, there is the need to take into account preferred access outlets and the diversity in willingness to pay for LLINs if equity to access is to be ensured in the study communities.

Effectiveness of different approaches to mass delivery of praziquantel among school-aged children in rural communities in Nigeria

BACKGROUND Urinary schistosomiasis is endemic in many rural communities of Nigeria and school aged children are mostly affected. A cross-sectional study was carried out to assess the prevalence and intensity of urinary schistosomiasis infection among 251 school aged children in two communities of Ovia South West LGA of Edo State, Nigeria, as well as their knowledge on the control/elimination measures. METHODS Urine samples were collected and examined by microscopy using filtration technique. In addition, a questionnaire survey was conducted among school-aged children and health care providers, probing their knowledge, attitude and practices on on-going control activities. RESULTS The prevalence of urinary schistosomiasis among the school-aged children was 65.3%. The prevalence was generally higher among females (68.8%) and children in the age groups 10-14 (69.9%). The intensity of infection ranged from 1 to 5044 (mean=449.8) eggs/10ml of urine with a higher proportion having heavy infections (76.8%, P<0.05). Water contact was attested by 123 (49.0%) of the children; of these 123, 74 (60.1%) were infected. The childrens knowledge on urinary schistosomiasis was deficient. CONCLUSION The high prevalences reported in these communities require integrated approach to control which essentially should incorporate the provision of safe water supply and sanitary facilities, and health education in addition to the annual mass praziquantel distribution, to reduce transmission.