Malaria Endemicity in the Rural Communities of Ebonyi State,Nigeria

Malaria remains a global health threat. Approximately 97% of the population is at risk in sub-Saharan countries, particularly Nigeria. This study compared the performance of 2 diagnostic methods in assessing malaria endemicity in the rural communities of Ebonyi State, Nigeria. A total of 1,140 study participants were screened for malaria parasite using Rapid Diagnostic Test kits (RDT) in the field, while thick and thin films for microscopy were examined in the laboratory. Our result showed that malaria prevalence was 56.8 by RDT and 38.6% by microscopic test. Age group under 10 years had the highest prevalence of 28.9% (RDT) and 23.6% (microscopy), respectively. The highest prevalence of 19.5% by RDT was recorded in Onicha Local Government Area, while the highest prevalence of 13.4% with microscopy was recorded in Ezza North Local Government Area. The sensitivity and specificity of microscopic examination were both 100%, while those of RDT were 95.5% and 75.9%, respectively.     

The schistosomiasis problem in Nigeria

Schistosomiasis is endemic in Nigeria as revealed by several prevalence studies but the degree of endemicity is low. The proliferation of several irrigation projects all over the country has stabilized the infection in Northern Nigeria while in the West rapid urbanisation, supply of portable water and mass chemotherapy have combined to reduce the prevalence rates. Human infection is measured by the determination of incidence, prevalence and intensity of infection. Heavy infections can rapidly be detected by use of urinalysis reagent strips to measure haematuria and protein levels in urine. The prevalence of severe pathological forms of the disease is very low and schistosomiasis is not associated with bacteriuria or hypertension in Nigeria, although isolated cases of ectopic lesions of the genitalis and uterus have been reported. Nodular filling defects occur early during infection, while bladder calcification comes at a later stage. The severity of the disease is related to the intensity of infection. Clinical trials with metrifonate and niridazole among other drugs have been carried out, with varying results. A new drug, praziquantel has been assessed and found suitable for mass use. Three methods of control include adequate provision of safe water, selective or targeted mass chemotherapy and use of molluscicides to kill the snails. Each method has its advantages and drawbacks, but the therapeutic approach is cheap, effects quicker result and treats the infected patients.     

Impact of biodiversity and seasonality on Lyme-pathogen transmission

Lyme disease imposes increasing global public health challenges. To better understand the joint effects of seasonal temperature variation and host community composition on the pathogen transmission, a stage-structured periodic model is proposed by integrating seasonal tick development and activity, multiple host species and complex pathogen transmission routes between ticks and reservoirs. Two thresholds, one for tick population dynamics and the other for Lyme-pathogen transmission dynamics, are identified and shown to fully classify the long-term outcomes of the tick invasion and disease persistence. Seeding with the realistic parameters, the tick reproduction threshold and Lyme disease spread threshold are estimated to illustrate the joint effects of the climate change and host community diversity on the pattern of Lyme disease risk. It is shown that climate warming can amplify the disease risk and slightly change the seasonality of disease risk. Both the “dilution effect” and “amplification effect” are observed by feeding the model with different possible alternative hosts. Therefore, the relationship between the host community biodiversity and disease risk varies, calling for more accurate measurements on the local environment, both biotic and abiotic such as the temperature and the host community composition.     

The prevalence, intensity and clinical signs of urinary schistosomiasis in Imo state, Nigeria

Urine samples were assayed for urinary schistosomiasis in four local government areas (LGA) of Imo State, Nigeria between May 1998 and September 2000. A total of 3504 persons were sampled, with 880 (25.1%) being positive for urinary schistosomiasis, based on records of eggs of Schistosoma haematobium. The prevalence of S. haematobium infection differed in the various LGAs, with Oguta (38.9%) and Owerri-West (10.4%) showing the highest and the lowest values, respectively. Prevalence was higher in males (67.4%) than in females (32.6%) and in subjects 11-20 years of age (31.5%), while prevalence varied among different occupational groups, with farmers ranking the highest (41.6%). Visible haematuria was the predominant symptom (P<0.05). Of 880 persons positive for eggs of S. haematobium, 452 (51.4%) had visible haematuria, followed by suprapubic pains 214 (24.3%) and painful micturition 97 (11.0%). Although 367 (10. 5%) of the sampled subjects with eggs of S. haematobium showed no visible haematuria, 513 (14.6%) clearly demonstrated haematuria.     

Diversity,ecology, and seasonality of hard ticks (Acari: Ixodidae) in eastern Croatia

The diversity of hard tick fauna was studied in different forest communities in 48 localities of eastern Croatia using the dragging‐flagging method and by hand from ten different vertebrate hosts. A total of 2,225 specimens comprising seven species in three genera were identified. Ixodes ricinus, the most abundant species (72.8% of all collected specimens) was recorded in 44 localities, followed by Dermacentor reticulatus in 19 localities, while the other five species (D. marginatus, H. concinna, H. inermis, I. canisuga, and I. hexagonus) were recorded in fewer localities. The highest ratio (67% of collected ticks) was in the adult stage with the predominance of females. The numbers of collected females, males, and nymphs of I. ricinus and H. concinna differed significantly. Ten new tick‐host associations in Croatia were recorded. Fifty‐three animals were infested with one tick species. Single species infestation with I. ricinus was found in 45.8% of animals, followed by D. reticulatus with 25.4%, D. marginatus with 10.2%, H. inermis and I. hexagonus with 3.4%, and I. canisuga with 1.7%. Coinfestation with two species of ticks were recorded in six animals. Ixodes ricinus, H. inermis, and D. reticulatus showed bimodal seasonal activity; for other species unimodal activity patterns were recorded.     

Reinfection, exposure and immunity in human schistosomiasis

In this review Paul Hagan will focus on the results of the reinfection studies that have been completed on Schistosoma mansoni in Kenya and Brazil and on S. haematobium in The Gambia. The review will also draw on the data from other immunological, molecular and epidemiological studies that have provided information that may be relevant to an understanding of immunity in human schistosomiasis. No attempt will be made to describe the latest advances that have been reported from studies of the animal models of schistosomiasis; these are adequately dealt with elsewhere.     

Endemicity of human metapneumovirus subgenogroups A2 and B2 in Yamagata, Japan, between 2004 and 2009

To clarify a longitudinal epidemiology,we isolated 280 hMPV strains from patients with acute respiratory infections in Yamagata, Japan, between 2004 and 2009.We observed that the high season for hMPV was from winter to spring (between January and May) and the low season was in the fall (around September and October). A further molecular analysis revealed that subgenogroup A2 (A2) strains were the most commonly isolated (151/280; 53.9%), followed by B2 (108/280; 38.6%) and B1 (19/280; 6.8%). Our results suggested that A2 and B2 have been endemically in circulation as the major types almost every year, whereas other subgenogroups have appeared less frequently.     

On transmission and control of schistosomiasis, with comments on Macdonald''s model

A hybrid model for the transmission of schistosomiasis with snail latency is established, based on hypotheses that are essentially identical to those used by Macdonald. Measures of the efficiencies of control of endemic schistosomiasis are introduced. Relations are derived between control efficiency ratios and epidemiological quantities. A measure of resilience of an endemic infection is introduced; it quantifies the minimum effort required for eradication. Studies are made of the control efficiency ratios and an eradication effort ratio as functions of the minimum eradication effort. The results are applied in an objective analysis of Macdonald's 1965 model of schistosomiasis. Some weaknesses in Macdonald's methodology are discovered, and we prove that Macdonald's conclusion of inefficiency of improved sanitation does not have general validity.     

Prevalence of urogenital and intestinal schistosomiasis among school children in South-west Nigeria

BackgroundThe risk of co-infection with Schistosoma haematobium and S. mansoni and the potential harmful effect on morbidity and control is enhanced by the overlapping distribution of both species in sub-Saharan Africa. Despite the reported high endemicity of both species in Nigeria, studies on the spread and effect of their mixed infection are limited. Therefore, a cross-sectional survey was conducted among school children in two communities in South-west Nigeria to investigate the prevalence of mixed human schistosome infection, intensity, and possible ectopic egg elimination.MethodsUrine and stool samples were collected from consenting school children in Ilie and Ore communities of Osun State, Nigeria. Schistosoma haematobium eggs were detected in urine using the urine filtration technique, while S. mansoni eggs were detected in stool using the Kato–Katz thick smear technique.ResultsThe study enrolled 466 primary and secondary school children (211; 45.3% males vs. 255; 54.7% females; mean age 11.6 ± 3.16 years). The overall prevalence of schistosomiasis was 40% (185/466), with 19% (89/466) recording single S. haematobium infection while 9% (41/465) had a single S. mansoni infection. The geometric mean egg count for S. haematobium was 189.4 egg/10ml urine; 95% CI: range 115.9–262.9, while for S. mansoni, it was 115.7 epg; 95% CI: range 78.4–152.9. The prevalence of ectopic S mansoni (S. mansoni eggs in urine) was 4.7%, while no ectopic S. haematobium (S. haematobium eggs in stool) was recorded. Mixed infection of S. haematobium/S. mansoni had a prevalence of 9.5% (44/466). More females (54.5%) presented with S. haematobium/S. mansoni co-infection. For both parasites, males had higher infection intensity, with a significant difference observed with S. haematobium (p = 0.0004). Hematuria was significant in individuals with single S. haematobium infection (p = 0.002), mixed ectopic S. haematobium/S. mansoni (p = 0.009) and mixed S. haematobium/S. mansoni/ectopic S. mansoni (p = 0.0003).ConclusionsThese findings suggest the probability of interspecific interactions between S. haematobium and S. mansoni. Scaling up of mass administration of praziquantel and control measures in the study areas is highly desirable.     

Immunity in human schistosomiasis

Field studies on immunity in human schistosomiasis are expensive, labour-intensive and extremely time-consuming, requiring many years to yield even provisional results. In this review, Anthony Butterworth and Paul Hagan summarize the need for such studies, the evidence for immunity in man, the immunological factors that may govern the expression of immunity, and the implications of such work for the development of new methods of control through vaccination.     

Bacterial agents associated with bronchopulmonary disorders in eastern Nigeria

Altogether 16,539 sputum specimens were examined microbiologically from 1980 to 1984. Out of these 12,588 were screened by Ziehl-Neelsen's staining technique and 782 were (6.3%) found AFB-positive. Age and sex distributions of the AFB-positive individuals were statistically significant (at 0.05), incidence being most prevalent among those 20 years and above (90.2%) and among males (61.2%). From other specimens cultured, non-AFB organisms were isolated at the following frequencies: coliform-like organisms (15.1%), Streptococcus pneumoniae (55.5%). Klebsiella pneumoniae (5.3%), Streptococcus pyogenes (3.9%), Pseudomonas aeruginosa (3.4%), Haemophilus influenzae (3.0%). Proteus Spp. (0.7%) and Escherichia coli (0.5%). The antibiogram of these isolates revealed a high incidence of multiple antibiotic resistance, a situation that has most probably arisen from the high degree of antibiotic misuse in Nigeria.     

A study of an outbreak of schistosomiasis in two resettlement villages near Abeokuta, Ogun State, Nigeria

Frequent reports of haematuria among resettlers at Ibaro and Abule-titun located close to a newly constructed reservoir, 20 km north-west of Abeokuta, Ogun State, Nigeria, prompted a pre-control survey to assess age and sex distribution of urinary schistosomiasis in the communities. 210 persons were examined at Ibaro and 145 at Abule-titun between April 1988 and February 1989. Overall prevalence was about 80% in both villages, and all age and sex groups examined were affected. The pattern of infection in both villages was similar, prevalence being high in all age and sex groups, and, unlike most endemic communities, the rate of infection was not significantly higher among the 5-14 year age groups. Intensity of infection was also high in all age and sex groups with mean range egg output of between 73 +/- 73 and 2016 +/- 3875 ova/10ml urine at Ibaro and between 231 +/- 122 and 1340 +/- 1786 ova/10ml urine at Abule-titun. This is attributed to an occupation-related high rate of human water contact in both villages.     

Low transmission areas of schistosomiasis in Venezuela: consequences on the diagnosis, treatment, and control

Schistosomiasis low transmission areas as Venezuela, can be defined as those where the vector exists, the prevalence of active cases is under 25%, individuals with mild intensity of infection predominate and are mostly asymptomatic. These areas are the consequence of effective control programs, however, "silent" epidemiological places are difficult to trace, avoiding the opportune diagnosis and treatment of infected persons. Clinic and abdominal ultrasound have not shown to discriminate infected from uninfected persons in areas where besides Schistosoma mansoni, intestinal parasites are the rule. Under these conditions, serology remains as a very valuable diagnostic tool, since it gives a closer approximation to the true prevalence. In this sense, circumoval precipitin test, ELISA-SEA with sodium metaperiodate, and alkaline phosphatase immunoassay joined to coprology allow the identification of the "schistosomiasis cases". In relation to public health, schistosomiasis has been underestimated by the sanitary authorities and the investment on its control is being transferred to other diseases of major social and political relevance neglecting sanitary efforts and allowing growth of snail population. Some strategies of diagnosis and control should be done before schistosomiasis reemergence occurs in low transmission areas.