R. N. H. Pugh

Malumfashi Endemic Diseases Research Project. XI. Water-contact activities in the schistosomiasis study area.

Fishing, bathing, swimming and playing in water were the most important activities at the Ruwan Sanyi dam site, northern Nigeria, in terms of schistosomiasis transmission. Various washing activities were important in exposure to the infection. Males were responsible for 98% of activity involving contamination and exposure. This accounted for the marked male predominance of Schitosoma haematobium infection in the Muslim communities of this area, where boys under the age of 21 years were responsible for more than 77% of environmental egg contamination. Peak water-contact activity occurred in the afternoon and this coincided with the peak cercarial shedding period and the peak urinary egg output. As a result of the construction of many such dams in this part of northern Nigeria, the recent upward trend in schistosomiasis tramission is likely to be maintained. Fishing is a new and a potentially important activity in transmission. Any future programme to control urinary schistosomiasis in this area should pay particular attention to this activity as well as group swimming activity by young males, who should be the prime target.

A clinical study of viper bite poisoning

Thirty-one consecutive cases of snake bite were studied in the Benue Valley, Nigeria where carpet viper (Echis carinatus) bite constitutes a serious health problem. E. carinatus was responsible for 26 cases, the night adder (Causus maculatus) for three and the puff adder (Bitis arietans) for two. There were two fatalities, both late admissions following E. carinatus poisoning. One patient died after a subarachnoid haemorrhage and the other after tissue necrosis and the complications of a tightly applied tourniquet. Another fatality after E. carinatus bite was suspected in a patient who discharged himself from hospital after Behringwerke antivenom failed to control bleeding and coagulopathy. Other cases of Behringwerke antivenoms failure and of slow response to treatment confirmed the pressing need for a more effective Echis antivenom in West Africa. The enzyme-linked immunosorbent assay (ELISA) was used for diagnosing the biting species and was the only means of identifying the three cases bitten by C. maculatus and one case bitten by B. arietans.

Malumfashi Endemic Diseases Research Project, XIII. Epidemiology of human encounters with the spitting cobra, Naja nigricollis, in the Malumfashi area of northern Nigeria.

The spitting cobra, Naja nigricollis, is responsible for most cases of snake bite in the Malumfashi area. A survey revealed an incidence of N. nigricollis bite of 15 to 20 per 100 000 population per year in this part of northern Nigeria, with an estimated natural mortality of 5%. Of 106 victims of previous spitting cobra bite, only 8·5% were treated in hospital, and physical deformity as a result of necrosis from poisoning was present in 19%. This emphasized the fact that statistics based on hospital admissions seriously underestimate snake bite incidence, morbidity and mortality. Naja nigricollis is also important because of its ability to spit venom into the eyes of an assailant. Snake venom ophthalmia is usually regarded as having a benign course, but victims were described who had suffered more serious effects, including blindness. The epidemiology of human encounters with the spitting cobra is discussed, and it is shown that N. nigricollis is able to maintain a close association with man. The cobra i...

Albendazole in children with hookworm infection

Efficacite en dose unique contre les parasitoses intestinales. Dans le cas des ankylostomiases, il est tres efficace et bien tolere

Malumfashi Endemic Diseases Research Project, X. Schistosoma haematobium and bacteriuria in the Malumfashi area.

No association was found between bacteriuria and Schistosoma haematobium infection in the Malumfashi area, and no male had a confirmed significant bacteriuria. The overall bacteriuria prevalence rate in a separate group of schoolgirls was 0.96%, while in females over the age of 20 it was 1.37%; there was an estimated prevalence of 3.2% in women over the age of 30. These figures for females agree with those from populations which have no experience of bilharzia. No urinary S. typhi carriers were found. The lack of association between urinary bacterial infection and schistosomiasis probably reflects the low intensity of S. haematobium infection in the Malumfashi area of northern Nigeria.

Malumfashi Endemic Diseases Research Project XII. Schistosoma bovis and Fasciola gigantica in Livestock.

Slaughter-slab surveys of livestock within the human schistosomiasis study area of Malumfashi revealed a very low prevalence of snail-borne trematode infections. The drought of 1973 was responsible for a decline in Schistosoma haematobium transmission, but there were other factors responsible for the less than 5% prevalence of bovine schistosomiasis and fascioliasis in the surveyed animals. The husbandry method of the settled farmers accounted for a low prevalence of trematode infections in their goats and sheep, and most of the infected animals probably acquired S. bovis and Fasciola gigantica outside the study area. The dry seasonal conditions had been unfavourable for fascioliasis transmission, but there may have been the added factor of S. bovis incompatibility with available snail hosts to account for the low level of bovine schistosomiasis transmission.The recent construction of several low earth dams in this dry part of northern Nigeria is likely to sustain the recent upward trend in S. haematobium...

Malumfashi Endemic Diseases Research Project. XVI. The findings of a survey for schistosomiasis mansoni. Hookworm, giardiasis and nutritional status.

A parasitological stool survey was conducted on a 10% random sample of villagers living around a recently constructed low-earth dam in an area in rural northern Nigeria. Hookworm (Necator americanus) was the most common intestinal parasite, with a prevalence as high as 89% in adult males from one farming community. However, the intensity of hookworm infection was low (less than 5000 eggs/g) and was unlikely to be responsible for an iron deficiency anaemia in the area studied. Giardiasis was also highly endemic and it was probable that most villagers experienced the infection in childhood. There was a low prevalence of Schistosoma mansoni infection (4% in children aged five to 15 years). Previous studies of the same population have concentrated on S. haematobium infection, but it will be important to monitor the long-term effects of the dam on transmission of both forms of schistosomiasis.A further study was then conducted on pre-school children living in the area surrounding the dam. Stool microscopy show...