Department of Medicine & Surgery
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Item Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria: a cross-sectional study(Malaria Journal, 2014-02-02) Millar, K.R.; McCutcheon, J.; Coakley, E.H.; Brieger, W.; Ibrahim, M.A.; Mohammed, Z.; Bassi, A.P.; Sambisa, W.Background: Despite recent improvements in malaria prevention strategies, malaria case management remains aweakness in Northern Nigeria, which is underserved and suffers the country’s highest rates of under-five child mortality. Understanding malaria care-seeking patterns and comparing case management outcomes to World Health Organization (WHO) and Nigeria’s National Malaria Control Programme (NMCP) guidelines are necessary to identify where policy and programmatic strategies should focus to prevent malaria mortality and morbidity. Methods: A cross-sectional survey based on lot quality assurance sampling was used to collect data on malaria care-seeking for children under five with fever in the last two weeks throughout Sokoto and Bauchi States. The survey assessed if the child received NMCP/WHO recommended case management: prompt treatment, a diagnostic blood test, and artemisinin-based combination therapy (ACT). Deviations from this pathway and location of treatment were also assessed. Lastly, logistic regression was used to assess predictors of seeking treatment. Results: Overall, 76.7% of children were brought to treatment—45.5% to a patent medicine vendor and 43.8% to a health facility. Of children brought to treatment, 61.5% sought treatment promptly, but only 9.8% received a diagnostic blood test and 7.2% received a prompt ACT. When assessing adherence to the complete case management pathway, only 1.0% of children received NMCP/WHO recommended treatment. When compared to other treatment locations, health facilities provided the greatest proportion of children with NMCP/WHO recommended treatment. Lastly, children 7–59 months old were at 1.74 (p = 0.003) greater odds of receiving treatment than children ≤6 months. Conclusions: Northern Nigeria’s coverage rates of NMCP/WHO standard malaria case management for children under five with fever fall short of the NMCP goal of 80% coverage by 2010 and universal coverage thereafter. Given the ability to treat a child with malaria differs greatly between treatment locations, policy and logistics planning should address the shortages of essential malaria supplies in recommended and frequently accessed treatment locations. Particular emphasis should be placed on integrating the private sector into standardized care and educating caregivers on the necessity for testing before treatment and the availability of free ACT in public health facilities for uncomplicated malaria.Item The Impact of Integrated Community Case Management of Childhood Diseases Interventions to Prevent Malaria Fever in Children Less than Five Years Old in Bauchi State of Nigeria(PLoS ONE, 2016-02-04) Dele Abegunde; Nosa Orobaton; Bassi Amos Paul; Olugbenga Oguntunde; Moyosola Bamidele; Masduq Abdulkrim; Ezenwa NwizugbeMalaria accounts for about 300,000 childhood deaths and 30% of under-five year old mortality in Nigeria annually. We assessed the impact of intervention strategies that integrated Patent Medicines Vendors into community case management of childhood-diseases, improved access to artemisinin combination therapy (ACT) and distributed bed nets to households. We explored the influence of household socioeconomic characteristics on the impact of the interventions on fever in the under-five year olds in Bauchi State Nigeria.A cross-sectional case-controlled, interventional study, which sampled 3077 and 2737 under-5 year olds from 1,588 and 1601 households in pre- and post-intervention periods respectively, was conducted from 2013 to 2015. Difference-in-differences and logistic regression analyses were performed to estimate the impact attributable to the interventions: integrated community case management of childhood illness which introduced trained public and private sector health providers and the possession of nets on the prevalence of fever.Two-week prevalence of fever among under-fives declined from 56.6% at pre-intervention to 42.5% at post-intervention. Fever-prevention fraction attributable to nets was statistically significant (OR = 0.217, 95% CI: 0.08-0.33). Children in the intervention group had significantly fewer incidence of fever than children in the control group had (OR = 0.765, 95% CI: 0.67-0.87). Although being in the intervention group significantly provided 23.5% protection against fever (95% CI: 0.13-0.33), the post-intervention likelihood of fever was also significantly less than at pre-intervention (OR = 0.57, 95% CI: 0.50-0.65). The intervention protection fraction against fever was statistically significant at 43.4% (OR = 0.434, 95% CI: 0.36-0.50). Logistic regression showed that the odds of fever were lower in households with nets (OR = 0.72, 95% CI: 0.60-0.88), among children whose mothers had higher education, in the post-intervention period (OR = 0.39, 95% CI: 0.33-0.46) and in the intervention group (OR = 0.52, 95% CI: 0.48-0.66). The odds of fever increased with higher socio-economic status of households (17.9%-19.5%). Difference-in-differences showed that the interventions significantly reduced occurrence of fever in the intervention group (OR = 1.70, 95% CI: 1.36-2.14).The interventions were effective in reducing the prevalence and the likelihood of childhood malaria fever. Taken to scale, these can significantly reduce the burden of malaria fever in the under-five year old children.Item Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria(BioMed Central, 2014-11-21) Eugenie H Coakley; Bassi Amos Paul; Kathryn R Millar; Zainab Mohammed; Jennifer McCutcheon; Mohammed Auwal Ibrahim; William R. Brieger; William SambisaDespite recent improvements in malaria prevention strategies, malaria case management remains a weakness in Northern Nigeria, which is underserved and suffers the country's highest rates of under-five child mortality. Understanding malaria care-seeking patterns and comparing case management outcomes to World Health Organization (WHO) and Nigeria's National Malaria Control Programme (NMCP) guidelines are necessary to identify where policy and programmatic strategies should focus to prevent malaria mortality and morbidity.A cross-sectional survey based on lot quality assurance sampling was used to collect data on malaria care-seeking for children under five with fever in the last two weeks throughout Sokoto and Bauchi States. The survey assessed if the child received NMCP/WHO recommended case management: prompt treatment, a diagnostic blood test, and artemisinin-based combination therapy (ACT). Deviations from this pathway and location of treatment were also assessed. Lastly, logistic regression was used to assess predictors of seeking treatment.Overall, 76.7% of children were brought to treatment-45.5% to a patent medicine vendor and 43.8% to a health facility. Of children brought to treatment, 61.5% sought treatment promptly, but only 9.8% received a diagnostic blood test and 7.2% received a prompt ACT. When assessing adherence to the complete case management pathway, only 1.0% of children received NMCP/WHO recommended treatment. When compared to other treatment locations, health facilities provided the greatest proportion of children with NMCP/WHO recommended treatment. Lastly, children 7-59 months old were at 1.74 (p = 0.003) greater odds of receiving treatment than children ≤6 months.Northern Nigeria's coverage rates of NMCP/WHO standard malaria case management for children under five with fever fall short of the NMCP goal of 80% coverage by 2010 and universal coverage thereafter. Given the ability to treat a child with malaria differs greatly between treatment locations, policy and logistics planning should address the shortages of essential malaria supplies in recommended and frequently accessed treatment locations. Particular emphasis should be placed on integrating the private sector into standardized care and educating caregivers on the necessity for testing before treatment and the availability of free ACT in public health facilities for uncomplicated malaria.Item Comparative laboratory diagnosis of malaria(GSC Online Press, 2022-11-23) Aminat Omope Yusuf; Timothy Olugbenga Ogundeko; Mamzil Seljul Crown Ramyil; Catherine Nadabo; Philemon Adu; Olusegun Godwin Adeniyi; Bassi Amos PaulLaboratory diagnosis of malaria is a vital key for its effective management. Diagnosis of malaria includes rapid, sensitive, and specific test methods. This study was aimed to assess the diagnostic performance of PfHRP2 rapid malaria test with reference to light microscopy for the diagnosis of malaria at the Bingham University Teaching Hospital (BhUTH) Jos –Plateau State, Nigeria. A total of 150 febrile patients attending BHUTH who were sent to the Hospital Laboratory from the General out patients Department (GOPD) for malaria parasite test (MPT)request had their blood sample collected and tested for malaria parasites (MP) using Field Stain A and B stain microscopy and PfHRP2 rapid malaria test between September and November 2021.Results shows that the sensitivity and specificity of PfHRP2 rapid malaria were 9.23% and 90.0% respectively, with corresponding positive and negative predictive values (PPV) as 90.0%and (NPV) as13. 2%. PfHRP2 rapid malaria test showed good sensitivity and specificity that is in agreement with that of the reference light microscopy. The rapid diagnostic test (RDT) results compared well with the light microscopy (Gold standard) for Laboratory diagnosis for malaria. Sustained use of RDT as an alternative to light microscopy is recommended especially in malaria endemic areas and the rural communities where electricity is out of reach.