Objectives: Existing evidence in sub-Saharan Africa indicates that less than 40% of people living with HIV are aware of their status. HIV testing and counselling (HTC) is one of the key national strategies for HIV prevention but rural-urban inequalities exist in the uptake of this service. The aim of this study was to determine the factors associated with the uptake of HIV testing and counselling through the providerinitiated testing and counselling (PITC) and client-initiated testing and counselling (CITC) pathways in rural and urban areas in Kenya. Methods: Retrospective cross-sectional data were derived from the 2008-2009 Kenya Demographic and Health Survey. Descriptive statistics and multinomial logistic regression analysis were used to describe the characteristics of the sample and to identify the determinants of pathways to HIV testing. Results: Overall, in the rural areas, 66.3% of respondents had never tested for HIV, 17.3% had been tested through CITC and 16.3% through PITC. In urban areas, 49.6% of respondents had never tested, 30.4% had been tested through CITC and 19.9% through PITC. In both rural and urban areas, men were significantly more likely to test for HIV through CITC, while women were significantly associated with PITC. Individuals aged 15 to 19 years, households in the poorest quintile, and rural and urban areas in the North Eastern Province were less likely to utilize CITC and PITC services. Conclusion: The findings highlight the need to increase testing coverage in rural areas where a greater proportion of people had never been tested. There is also need to address existing disparities in HIV testing across different groups and geographic provinces. Targeted efforts aimed at reaching individuals aged 15 to 19 years, the poorest households, and people residing in the North Eastern Province are critical for increasing HIV testing uptake.
Objectives: The distribution of vivax malaria is uneven in India and Plasmodium vivax is predominant in the North-Western part. Distribution of Duffy blood groups and its prevalence are important for regions where P. vivax predominates, because this molecule on the surface of the red blood cell acts as a receptor for P. vivax. The tribal (aboriginal) and desert area of the state Rajasthan contributes 70% to the malaria disease burden. The study was undertaken to identify the Duffy phenotypes present in the Rajasthan population and their prevalence. Methods: The study population was divided in to tribal and non-tribal groups and into healthy and P. vivax malaria infected groups. Duffy blood groupings of 96 unrelated subjects were carried out by the indirect antiglobulin technique. Simultaneously, malaria status was assessed for all participants using peripheral blood. Results: In the tribal population the prevalence of Duffy phenotypes Fy(a+b-), Fy(a-b+) and Fy(a+b+) were 18.5%, 11.1% and 70.4%, respectively. The prevalence of Duffy phenotype Fy(a+b+) was 15.6% lower in the non-tribal population. The percentage of both tribal and non-tribal population with Duffy phenotype Fy(a+b+) were significantly (p<0.001) higher than the population with Duffy phenotype Fy(a+b-) and Fy(a-b+). The Duffy phenotype Fy(a-b-) was absent in the population of the desert region. A higher prevalence of Duffy phenotype Fy(a+b+) was recorded for malaria patients (83.3%) than for healthy participants (59.0%). Conclusions: The population of the North-Western part of India was susceptible for P. vivax malaria infection and the tribal population seemed to be more susceptible than the non-tribal population.
Objectives: The microbial qualities of some herbal medicinal products circulated within southern Nigeria were evaluated. Methods: sampling, isolation and characterization of contaminating microorganisms was carried out using established protocols. Agarose gel electrophoresis was employed for the characterization of possible R-plasmids. Results: Out of the 18 herbal preparations 13 (72.2%) showed contamination with either bacteria or fungal microorganisms or both. Bacillus anthracis was isolated from five (38.5%) of the contaminated preparations (liquid preparation), Staphylococcus aureus from one (7.70%) solid preparation, Corynebacterium diphtheriae from three (23.08%) preparations (2 liquid, 1 solid), and Candida albicans from 11 (84.62%) preparations (6 liquid, 5 solid). The antimicrobial susceptibility-resistance pattern of the contaminating microorganisms revealed that three out of the five B. anthracis strains isolated demonstrated resistance to four out of 12 antimicrobial agents (Ofloxacin, Ciprofloxacin, Pefloxacin, Augmentin, Ampiclox, Erythromycin, Cephalexin, Clindamycin, Ceftriaxone, Gentamicin, Co-trimoxazole, Amoxycillin) employed in the study. S. aureus displayed over 50% resistance coverage while the resistance pattern recorded by the Corynebacterium diphtheriae isolates appeared to be inconsistent. The various isolates of C. diphtheriae recorded 40, 0, and 50 percents respectively. Submerged agarose gel electrophoresis employed for the molecular characterization for possible R-plasmids revealed that one plasmid each was isolated from each of five resistant bacteria strains L4a (Corynebacterium diphtheriae), L4b (Bacillus anthracis), L10a (Corynebacterium diphtheriae), L10b (Staphylococcus aureus), S6 (Bacillus anthracis). It also shows that the largest plasmid size (23.05 kbp) was recorded for the C. diphtheriae strain L4a while the C. diphtheriae strain L10a gave the smallest plasmid size (2.03 kbp). Conclusions: The results of the study showed that herbal medicinal preparations are a potential source for the dissemination of multi-drug resistant microorganisms.
Objectives: Exposure to second-hand smoke (SHS) is a known child health hazard, but surveillance information concerning its prevalence in rural children living in the 13 U.S. states containing Appalachian counties is lacking. The purpose of this study was to determine the exposure to SHS, and exposure to a smoker’s clothing, hair, and breath (third-hand smoke; THS) of rural children living in states containing Appalachian counties as compared with urban children living in the same states. Methods: The 2007 U.S. National Survey of Children’s Health database was used to evaluate 22,196 participants aged 18 years or older who responded for a randomly selected child in the household. Participants addressed queries about the tobacco smoke exposure of the child. The households were dichotomized into rural or urban households based upon definitions utilized by the Rural Health Research Center. Results: The states containing Appalachian counties had an overall SHS exposure of 11.7% (95% confidence interval = 95%CI: 11.1, 12.3). Urban children in those states had a SHS exposure of 10.2% (95%CI: 9.6, 10.8); and rural children had a SHS exposure of 16.1% (95%CI: 14.6, 17.6). These states also had an overall THS exposure of 19.6% (95%CI: 18.4, 20.8). There were no significant difference between the urban children (19.0; 95%CI: 17.7, 20.3) and rural children (21.4; 95%CI: 19.2, 23.6) in THS exposure. Conclusion: In a large survey of the states containing Appalachian counties, more rural children were exposed to second-hand smoke than urban children living in the same states.
Objective: The metabolic syndrome (MetS) describes a clinical constellation of distinct but interrelated abnormalities that have been linked to many cardio-metabolic diseases which result in increased morbidity and mortality. Several indices have been developed to predict cardio-metabolic diseases. This study evaluated the accuracy of such indices as the lipid accumulation product (LAP), visceral adiposity index (VAI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHpR) and body mass index (BMI) to predict the metabolic syndrome in a male geriatric population. Methods: Forty geriatric males (age range 65 to 84 years) were studied. Their fasting blood glucose levels, serum lipid profile, blood pressures and relevant anthropometric indices were determined using standard protocols. Validated and appropriate equations were used to derive the necessary indices. Results: Only LAP (p<0.001) and WHtR (p=0.022) were significantly higher in subjects with MetS relative to those without the syndrome. The ROC analyses showed that LAP [Area under the curve (AUC) = 0.937] and WHtR (AUC = 0.905) predicted the MetS, better than the other indices. A LAP threshold of 4.391 had a MetS predictive sensitivity of 100% and specificity of 81%, while a WHtR threshold of 0.61 had a sensitivity of 100% and specificity of 78%. Conclusion: LAP and WHtR are associated with, and are sensitive and fairly specific predictors of, the MetS in this geriatric population.
Aim: This study aimed to explore the influence of gender and decision making roles on the uptake of Prevention of Mother to Child Transmission (PMTCT) services in rural areas of Blantyre and Balaka Districts, Malawi. Methods: A qualitative study was conducted. Six focus groups were held involving 47 community members in rural areas of Blantyre (Mdeka health centre) and Balaka (Kankao health centre) districts. Findings: The social status of men and women play a role in the uptake of the PMTCT services. There is lack of male involvement in reproductive health service delivery such as PMTCT. This might negatively affect accessibility of such services by HIV positive pregnant women. Women who make their own decisions regarding access to PMTCT services were often victimized by their spouses due to secrecy around HIV disclosure. Conclusions: In order to promote accessibility of PMTCT services by pregnant women, there is need to involve men in the decision making process. Raising awareness of the programme among the community with a focus on men will promote community involvement and enhance support for women to access PMTCT services.
Background: Pooling of epidemiological studies shows that hypertension is present in at least 25% of urban and 10% of rural adults in India. Prevalence of essential hypertension in the rural region Mullana block in the state of Haryana, India, has never been carried out. The objective of this study is to determine the prevalence of essential hypertension amongst this population, as well as investigating diseases and risk factors involved it its aetiology. Methods: An hospital based retrospective study was carried out investigating the demographic details of disease history of patients during the period June 2003 to September 2006 at M. M. Institute of Medical Sciences and Research. From a total of 2295 patients, 876 were identified as having essential hypertension. Age and sex matched essential hypertensive and normotensives patients were involved in a prospective study between December 2006 and June 2007. Results: Amongst the hospital based patients the overall prevalence of essential hypertension was 38.2%. The prevalence was 59.2% and 40.8% among males and females, respectively. Multivariate logistic regression analyses revealed that the risk of essential hypertension was significantly associated with body mass index, smoking status and a family history of essential hypertension. Conclusion: The prevalence of essential hypertension in the rural region Mullana block, Haryana, was higher than previously reported. Implementation of an effective awareness programme including lifestyle modification is necessary to control the cardiovascular disease burden in this population.
Background: The epidemiology and public health importance of cryptosporidiosis have not been widely reported in Nigeria. Methods: The prevalence of cryptosporidiosis was assessed in Imo State, Nigeria, between November and 0ctober 2007 using standard parasitological techniques. Stool specimen from consenting subjects registered at nine health institutions in the area were prepared using formalin/ether concentration methods, stained with modified acid fast stain and examined microscopically for oocyst of Cryptosporidium parvum. Results: Out of the 1,960 study participants examined, 391(19.9%; 95% confidence interval: 18.2, 21.8) were infected with oocyst. No oocysts were identified in the symptom-free control group (n=50; 95%-CI = 0, 7.1). Women (26.2%) were more likely infected than men (13.2; p<0.001). Infection was more prevalent among rural than urban dwellers (p<0.001). Children aged 0 to 14 years had the highest prevalence of Cryptosporidium oocyst as well as females older than 60 years (p<0.001). The prevalence was lowest in borehole users (14.1%) while those who used stream water (22.7%) and other sources (25.4%) were more likely infected (p<0.001). Immune-compromised (HIV/AIDS) participants were more likely infected (32.5%) than immune-competent participants (9.4%; p<0.001). Infection was more prevalent in watery stool samples (27.7%) than in formed stools (2.2%; p<0.001). Conclusions: These findings show that cryptosporidiosis remains a public health problem in the study area even though it is not well known. There is therefore a need to increase awareness among the general public on the public health implications of the disease as well as its prevention and control.
Objectives: The objective of this study was to assess the perceptions of recently-graduated junior medical staff prior to rotating to a rural clinical term. Methods: A self-administered, anonymous survey was provided by the postgraduate medical education unit in a tertiary referral centre which rotates interns out to one of three rural and regional sites. All interns undertaking a rural rotation were invited to participate. The structured questionnaire assessed perceptions of interns with respect to rural clinical rotations and compared students from a rural background with students from a non-rural background. Results: The participant response rate was 100% (n = 45). Participant responses were positive with respect to general perceptions of working in a rural health environment, practical matters relating to experience, education and supervision, plans to undertake further rural training/work and the change of environment in a rural health environment. Participants from a rural background were more likely to express plans to work in a rural location during and following their vocational training, were more likely to have an interest in rural medicine and were less concerned there may be cross-cultural barriers when working in rural areas. Conclusions: Recently-graduated junior medical staff tended to have a positive outlook when it comes to undertaking rural clinical rotations. This may further encourage research into rotation of junior medical staff in Australian metropolitan hospitals to more remote and regional areas.
Objectives: A longitudinal study was carried out to investigate the adult population dynamics and the physical and chemical factors affecting the distribution of Simulium damnosum complex, a vector of onchocerciasis (River blindness) along Osun river in a forest zone of southwestern Nigeria. Methods: Adult flies were collected on consented human baits from 7.00am to 6.00pm every fortnight at three communities; Osun Eleja, Osun Ogbere and Osun Budepo along Osun River from February 2008 to June 2009. Larval prospection was carried out in all accessible rivers around the study area and their physical-chemical parameters were determined. Results: A total of 1472 flies were caught during the study period with Osun Budepo accounting for the highest number of the flies (47.0%) followed by Osun Eleja (42.2%) and Osun Ogbere (10.8%). The fly abundance was significantly higher (p<0.05, respectively for the three sites) during the wet season, with a positive correlation between rainfall and fly abundance at the three sites. S. damnosum s.l was found breeding only in the wet season at the rivers with rocky substratum and submerged vegetations. Water velocity (p=0.050) and dissolved oxygen (p=0.042) were the only parameters showing significance with the distribution of S. damnosum s.l larvae at the breeding sites. The adults of S. damnosum s.l were found biting at the rivers hitherto scored negative for preimaginal stages showing that the presence of larvae has limitation as sole factor in determining the extent of the distribution of S. damnosum complex. Conclusions: The results suggest that the climatic and environmental conditions influence the distribution of S. damnosum s.l in the study area. The presence of the fly all year round calls for adequate control measures to curtail the transmission of onchocerciasis in particular during the wet season.
Introduction: In 2009, the Partnership for Reviving Routine Immunisation in Northern Nigeria (PRRINN) Maternal, Newborn and Child Health (MNCH) Programme, in collaboration with the Zamfara State Ministry of Health, launched the Nahuche Health and Demographic Surveillance System (HDSS) in a rural north Nigerian setting. Located in Bungudu Local Government Area in Zamfara State, the Nahuche HDSS will support studies aimed at assessing the impact of health systems interventions by monitoring health as well as demographic events and populations at risk over time. This paper reviews the Nahuche model of surveillance as well as selected demographic, maternal and health indicators and their potential in guiding programme planning particularly in resource-constrained northern Nigeria. Potential interventions to address these challenges are also discussed. Methods: In May 2010, a pilot census (194 households interviewed out of targeted 205 households) was conducted in Nahuche Keku District followed by a full baseline census in September 2010 and periodic event updates of 120day work cycles which begun in January 2011. Results: Poor maternal and child health indicators were observed. For example, 19.8% of all women (n=131) with live births in the five years preceding the pilot census had received antenatal care from a health professional for their last birth. Only 9.2% reported that their births were delivered by a health professional. An even lower proportion (6.6%) delivered in a health facility with 93.4% of all births occurring at home. Conclusion: Despite the fundamental problems associated with strengthening health systems in northern Nigeria, the Nahuche HDSS will generate opportunities for testing feasible interventions and set the stage for reducing the high maternal and child mortality rates. The Nahuche HDSS is a system to watch based on its location and the enthusiasm of Nigerians to accelerate progress in meeting the Millennium Development Goals of maternal and child mortality.
Background: Despite the acknowledgement that chronic pain may be a problem for adults in rural settings, there is a lack of epidemiological investigations on its occurrence in rural South Africa. Objectives: To estimate the prevalence of chronic pain among adults in a rural community in South Africa and characterize the localization, severity, risk indicators and responses of pain sufferers. Methods: Cross-sectional analytical study using face-to-face interviews. Interviews elicited information on socio-demographic characteristics, general health status and presence of pain. Among those reporting pain, the duration, frequency, severity, activity limitation and impact was determined. Univariate statistics were used to describe the prevalence of chronic pain while bivariable χ2 tests and multivariable logistic regression models were used to assess the relationship of socio-demographic characteristics and reported health status with chronic pain. Results: A total of 394 adults were interviewed representing a response rate of 92.8%. Of these, 169 (42.9%; 95% CI: 37.4%-47.1%) reported suffering from chronic pain. The common sites were the back, knee, ankles, head and shoulders. The median pain score was 6 on a scale of 0-10 (IQR= 5-8) and the median number of sites of pain was 1 (IQR= 1-2). The type of pain slightly varied with age with younger adults reporting more back pain and headaches while older people reported more joint pain. Female gender (adjusted odds-ratio AOR= 2.2, 95% CI: 1.9-2.8) and being older than 50 years (AOR= 3.1, 95% CI:2.7-3.9) were identified as risk indicators for chronic pain in the sample. Respondents reported that they self-treated (88.3%); consulted with a doctor or nurse (74.3%); traditional-healer (24.5%) and spiritual-healer (4%). Most respondents (63.4%) reported only transient relief of their pain. Conclusions: Chronic pain is an important health problem in the surveyed community. Further comparative studies on the relationship with risk factors are needed meanwhile interventions targeting females and the elderly are recommended.
Objectives: The internationally recommended tuberculosis (TB) control strategy, Directly Observed Treatment, Short course (DOTS) was implemented in most Pacific Island countries and territories during the year 2000, with expansion of DOTS into outer islands and rural areas over the past ten years. The objective of this study was to better understand successful strategies and challenges faced in implementing DOTS in outer islands and rural areas of selected high burden Pacific countries from the perspective of National TB Program (NTP) staff. Methods: National TB Program Managers or Coordinators from four Pacific countries, Solomon Islands, Vanuatu, Kiribati and Tuvalu, were surveyed and participated in in-depth interviews exploring what had been particularly effective and what challenges had emerged during DOTS implementation in outer islands and rural areas. Information from the interviews was analysed for shared experiences with data coded inductively using a thematic coding scheme. Results: The positive aspects of DOTS implementation in outer islands and rural areas were in three main themes: support from health workers and the community; enablers and incentives; and better treatment completion. The challenges could be categorised in five main themes: working with volunteers; stigma; traditional healers; distance and communication; and financial challenges. Local health workers, pastors, church leaders, chiefs and traditional healers were all key players in the TB Program in outer islands. Local health workers are integral to effective TB control due to accessibility and being known by the community. Conclusions: Reviewing the highlights and challenges of implementing DOTS in outer islands and rural areas in four Pacific countries has revealed some important issues. Increasing support to local health workers, actively engaging with pastors, church leaders, chiefs and traditional healers and addressing the barriers to communication and transport for people living in the outer islands are particular issues to address. Much has been achieved in TB control in outer islands but if the burden of TB is to be reduced and drug resistant TB is to be prevented, additional and ongoing investment is required.
Objectives: To examine current rates of participation in several child health practices promoted in the 1980s in urban Vietnam as part of the GOBI (growth monitoring, oral rehydration therapy, breastfeeding, immunisation) initiative. Methods: In the 1980s during the GOBI campaign, District 4 of Ho Chi Minh City offered community-based child health classes focused on the four GOBI areas. In 2008, 297 mothers of children aged 5 or younger in District 4 were interviewed about their child health practices. Results: In total, 84% of mothers reported using a growth chart for their child, 56% reported treating diarrhoea with oral rehydration therapy, 75% reported breastfeeding their child for at least some duration, and 98% said their child had received at least one immunisation. Additionally, nearly all women reported treating drinking water, about three-quarters reported washing their hands regularly, over two-thirds reported using insecticides in the home, and just over half reported that they and their children slept under a bed net. Conclusions: Mothers in the 2000s reported fairly high levels of adherence to the core child health practices promoted by the GOBI initiative in the 1980s. The rates of healthy parenting practices in this study appeared similar to those reported in the 1990s and higher than those from the early 1980s prior to the implementation of GOBI.
Objectives: This research aimed to investigate the influence of peer educator delivered seminars to older adults on physical activity and exercise uptake, and whether improvements in activity levels and functional wellbeing follow. Design: Two part evaluation. Data are from a post-seminar survey that informed a process evaluation (Part 1 - Seminar) and a non-controlled prospective investigation (Part 2 Cohort). Setting: Cohort data were collected from a regional community organisation and Seminar data at a number of meeting places for older adult organisations throughout Queensland. Participants: Seminar - 412 older adults, classified “Mostly third age” (> 65 years with average health), attended 23 seminars throughout the state. Cohort data were collected from nine adults (age 74.22 ± 4.43 years) at baseline and at two follow ups. Main outcome measures: Seminar satisfaction and intention to change data were collected by questionnaire post-seminars. Cohort data were collected for function, balance and quality of life pre-seminar, and four (PS1) and eight (PS2) weeks post. Results: Seminar data showed a raised awareness of the need for more movement, and an indication that individuals aimed to become more involved. For cohort, minutes per day sitting was significantly reduced at PS1 (p = 0.046) but not PS2, and a positive trend emerged for function and total METs-minutes per week. Conclusion: While further research is required, data suggest peer educator delivered seminars can have a positive impact on the intention to be active, and the activity levels and functional wellbeing of older adults. Peer educator delivered seminars may be a valuable complement to behaviour modification and social-ecological models in the drive towards seeing more adults become physically active.
Objectives: Studies were carried out to determine the status of urinary schistosomiasis among pre-school and school-aged children in three communities around Oyan dam, South Western Nigeria. Methods: A cross-sectional study was conducted in 2009. Urine samples were collected and investigated for the presence of microhaematuria using the Medi-Test Combi 9 reagent strip. Urine was also microscopically examined. Results: Of 120 urine samples collected at Ibaro-Oyan, Abule Titun and Abule Sikiru communities, both Medi-Test Combi 9 reagent strip and microscopy revealed prevalences were 66.7% (95% confidence interval: 57.5 to 75.0) and 71.7% (95%-CI: 62.7 to 79.5), respectively. There was no significant difference in infection rates between sexes, although rates were slightly higher in females. Overall, infection rates increased with age (microhaematuria: p=0.030; S. haematobium eggs: p=0.006). Conclusions: The results indicate that the communities around Oyan dam were still endemic with schistosomiasis and that there is an urgent need for mass drug distribution and public health education in curbing the disease in the study area. Moreover, the provision of basic public health facilities such as functional boreholes, electricity and a reliable waste disposal system is likely to decrease prevalence of schistosomiasis in the study area.
Aim: This study was carried out to determine the fate of bacteria exposed to sub lethal concentrations of bioactive extracts of some plants. Methods: Ethanolic extracts of Tetrapleura tetraptera (leaves), Prosopis africana (bark) and Buchholzia coriaceae (seeds) were assayed for phytochemical contents, antibacterial activities and induction of multidrug resistance in bacteria hitherto susceptible to test drugs using standard methods. Results: Results showed that the three plants contain alkaloids, glycosides, saponins, flavonoids and reducing sugars in addition to other metabolites. The extracts showed appreciable inhibitory effects on some species of Alcaligenes, Bacillus, Enterobacter, Escherichia, Klebsiella, Pseudomonas and Salmonella. The minimum inhibitory concentration (MIC) ranged (mg/ml) from 3.13 – 50.0 for P. africana; 3.13 – 6.25 for B. coriaceae to 1.25 – 50.0 for T. tetraptera. Exposure of drug susceptible bacterial species belonging to the genera Escherichia, Enterobacter, Klebsiella, Proteus, Pseudomonas and Salmonella to different concentrations of these extracts resulted in emergence of clones resistant to some commonly available antibacterial agents. Conclusion: Plant extracts are capable of dose-related inducement and sustenance of multiple antibiotic resistance among some bacteria. This study has shown that despite its positive contribution, herbal remedies incorporate the hitherto unexplained increase in emergence of multidrug resistance among (enteric) bacteria in our communities.
Objective: Knowledge, attitudes and preventative practices of risk groups for neglected tropical diseases such as intestinal schistosomiasis are important aspects for their control. This study aimed to determine the prevalence of Schistosoma mansoni, knowledge, perceptions and preventative practices of school children towards schistosomiasis in the Sengerema district, Tanzania. Methods: We conducted a crosssectional study using 400 randomly selected school children. Single faecal specimens were obtained from children and screened for S. mansoni using Kato Katz technique. Amongst those children who submitted faecal specimen, 200 randomly selected children responded to a structured questionnaire. Results: The prevalence of Schistosoma mansoni was 64.3% (257/400; 95% confidence interval (CI) = 59.3, 69.0). Less than 50% of the interviewed children demonstrated an understanding of control measures and transmission of schistosomiasis. About 87.5% (175/200; 95% CI = 82.1, 91.7) of the respondents reported to have heard of schistosomiasis and the main source of information were schools (34.5 %). 84% of the children reported going to the lake and 68% reported to participate in paddy cultivation. About 40.5% of the respondents associated schistosomiasis with water contact and 39.5% accurately quoted symptoms associated with schistosomiasis. Knowledge about transmission increased with age (p=0.005). The control measures mentioned by 34.5% of the respondents were in line with the World Health Organization’s control strategies against schistosomiasis. Most of respondents (96.5%) reported the use of toilets. A majority (82%) of the respondents reported that they had participated in previous mass drug administration. Conclusion: The prevalence of schistosomiasis was high despite repeated previous mass drug administration campaigns. There is a need to incorporate practical public health education in the school curriculum for the purpose of increasing knowledge and promoting behavioral changes in school children to improve disease control.
Objective: To evaluate the in vitro antimicrobial activity of ethanolic and methanolic fruit extracts of Xylopia aethiopica separately and in combination with three antibacterial antibiotics: gentamycin, ofloxacin and ciprofloxacin; and two antifungal antibiotics: fluconazole and ketoconazole. Methods: Clinically isolated strains of bacteria: Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli, Bacillus subtilis, Staphylococcus aureus and fungi: Candida albicans and Aspergillus flavus were used for the assay. The in vitro activities of the methanolic and ethanolic extracts of the X. aethiopica plant fruit and the conventional antibiotic discs were individually and initially investigated before the combined evaluation. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were studied. The agar diffusion method was used for the assays. Results: The extracts were active against P. aeruginosa, B. subtilis, S. aureus, A. flavus and C. albicans. Extracts showed little effect against K. pneumonia and no activity against E. coli. MIC ranged between 31.25 mg/ml and 125 mg/ml while MBC varied from 15.65 mg/ml to 62.50 mg/ml. There was synergistic interaction between the plant extracts and most of the antibiotics investigated. Conclusion: X. aethiopica extract shows antimicrobial activity and therefore the potential for further investigation with a view to finding its relevance in chemotherapy. X. aethiopica extract can be administered concurrently with ofloxacin, gentamycin, fluconazole and ketoconazole as against the previously held belief that plant extracts should not be administered together with conventional antibiotics because of apparent antagonism. These findings require in vivo confirmation in animal models.
