Udi Local Government Area Research Articles

Prevalence and Pattern of Ocular Diseases among Rural Dwellers in Affa, Enugu State

Background: The prevalence and pattern of different ocular diseases among rural dwellers vary in different parts of the world. It is usually influenced by a numerous factor, including but not limited to utilization of eye care services, socio-economic status, and level of education. Aim: To identify the most prevalent eye diseases and their pattern of occurrence, among rural dwellers in South East Nigeria, with a view to influence targeted health policies and subsequently, targeted interventions to improve eye health in the region. Methods: The study was a cross sectional study involving patients willing to participate in the study during a one-day free eye outreach organized by the Ophthalmology department, ESUTH Parklane at Affa Community in Udi Local Government Area of Enugu state. A preliminary visit was made one week prior to the health outreach, by some members of the outreach team to mobilize the community, seek their consent and fix a date through their leaders. On the day for the outreach, the objective of the eye screening was explained to the participants in both English and their local language. Subsequently, informed consent was obtained and each subject registered and the bio-data documented. Registered participant had their unaided and aided Visual Acuity (VA) of each eye determined. Then, the anterior and posterior segment was examined. Data collected were recorded using a proforma and later inputted into a computer, cleaned and analysed using SPSS version 21. Results were presented in tables and represented in frequencies percentages. Association between variables were done using t-test and p- value of <0.05 was considered significant. Results: One hundred and sixty-eight participants were screened during the outreach programme/study with mean age of 40+0.5years. There were more females 116 (69.1%) than males 52 (30.9%), giving a female to male ratio of 2:1 and they are predominantly Christians and farmers. The common ocular problems among the participants include cataract 53 (22.6%), refractive error 37 (15.8%), Pterygium 35 (14.9%). Cataract was the most common eye disease among the outreach participants and responsible for 22.6% of all ocular problems. Normal visual acuity was found more in participants < 50 years of age, mild visual impairment occurred more in participants 51-70 years while moderate visual impairment to blindness were seen more in patients >70 years. Conclusion: In this study, the commonest ocular problems among the participants include Cataract, Refractive error, and Pterygium which are reversible causes of visual impairment and blindness. Therefore, health policies and advocacies should be directed towards reducing the burden of these reversible causes of visual impairment and blindness among the rural dwellers which constitute greater proportion of our population.

Economic analysis of cashew nut marketing in Udi Local Government Area, Enugu State, Nigeria

Cashew nut (Anacardium occidentale L) is one of the most essential and major cash crops produced in Nigeria. This research, therefore, explored the economics of cashew nuts marketing in Udi Local Government Area of Enugu State, Nigeria. Primary data were sourced from cashew nut marketers through the use of well-designed questionnaires. Sixty respondents were randomly selected from three main markets in the study area. Descriptive statistics and (OLS) multiple regression models were used to achieve the study objectives. Descriptive statistics and (OLS) multiple regression models were used to achieve the objectives. Wherefore the study identified the marketing channels, analysed the cost and returns of the enterprise, determined the socio-economic factors affecting the quantity of cashew nuts marketed, and ascertained the constraints associated with cashew nuts marketing in the study area. From the results, the market was dominated by males (65%), most of the respondents (51.7%) were between 21 and 40 years, and majority were married (81.7%). An average number of the marketers (50%) had secondary school education, while 31.7% and 18.7% had primary and higher education, respectively. Most of the marketers (63.3%) bought directly from farmers, while 26.7% purchased from wholesalers. Total revenue, gross profit, and net profit were respectively ₦651,627.00, ₦120,618.00, and ₦81,067.70, showing that the business is profitable. Respondents’ socioeconomic characteristics which significantly affected quantity of cashew nut marketed were age (p < 0.1), household size (p < 0.05), and membership to market association (p < 0.05). Major constraints were seasonality of produce, high cost of transportation, bad weather (rain), and inadequate capital. It was recommended that government should provide good road networks to ease transportation problem. The marketers should form cooperative societies to facilitate easy access to credits and other relevant resources.

Antibacterial Effect of Raw Honey on Clinical Bacterial Isolates of Pseudomonas aeruginosa, Staphylococcus aureus, And Escherichia coli

The development of multiple drug resistant bacteria, causing human infection in clinical practice unfold the use of natural sources like honey, medicinal plants of non-antibiotic drugs, having antibacterial potentiality. Beside the medicinal plants, the antibacterial effects of raw honey on clinical bacterial isolates of Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli were studied. The raw honey samples were collected from the beekeepers at Umugwu Ezedike in Udi Local Government Area Enugu State Nigeria. The honey samples were prepared by diluting the honey with distilled water to produce honey of various concentrations, i.e. 20% v/v, 40% v/v, 60% v/v, 80% v/v and 100% v/v. The clinical isolates from Accident and Emergency Department University of Nigeria Teaching Hospital Ituku-Ozalla Enugu were cultured in Nutrient agar, Cetrimide agar, Macconkey agar, and Methylene Blue agar (EMB) for identification and confirmation. The antibacterial effects of raw honey on the clinical bacterial isolates were evaluated in-vitro using agar well diffusion methods with Gentamicin as control. The results showed that raw honey demonstrated antibacterial effect against the test isolates with higher effect in Staphylococcus aureus (with zone of inhibition of 21mm) followed by Pseudomonas aeruginosa (19mm) and Escherichia coli (18mm). The minimum inhibitory concentration (MIC) of the extract from this study ranges from 12.5-50mg/ml while the minimum bactericidal concentration (MBC) of the extracts ranges from 25-50mg/ ml. Hence, raw honey has antibacterial properties and can also serve as a therapeutic substance for the treatment of bed sores, and other infections resulting from burns.

Evaluation of Land Capability for Housing Deveopment at Nachi Built Environment, Enugu State, Nigeria

There are criteria that certify the sustainable potentials of any built environment. Low income housing scheme proposed by Enugu state government for its workers is targeted at Nachi, Udi local government area in Enugu state, Nigeria. To assess the capability of this location for the project, site investigation and experimental design methods were adopted to measure the geo-morphological and hydrologic features and conduct laboratory tests on the basic and strength properties of the formation respectively. Findings explain that Nachi lies on the slope of 700; hence the average runoff is high. Prolific confined aquifer result to underground water potential for consumption since the formation is porous with high elevation at 221 meters. It is also discovered that the area possesses low shear strength which is capable of resisting the high shear stress measured in the soil sample of the formation. Soil plasticity is measured as 10 indicating high erodible potential. The particle size distribution of the formation is poorly sorted with high percentage of sand particles, and very low percentage of gravel, with intercalation of compressible particles in the formation. The rain intensity is measured high with very high rate of runoff potential that is capable of causing erosion on the sloppy terrain with low bearing strength. The study therefore concludes that Nachi as a proposed site for the low housing scheme is not suitable considering the fact that the initial cost involved in preparing standard foundation of the buildings and the surrounding for sustainable housing will make it exorbitant for the low income earners. Any effort to compromise doing the right things from the beginning for a sustainable housing will degenerate the housing to high maintenance culture when in use. In the absence of no other available land the study therefore recommends that edicts and official programmes be enacted and instituted respectively to curb down erosion menace in the area with standard foundation designs that will guarantee safety to the buildings effectively in the area. If the housing scheme must stand for the low income earners the government must as matter of policy subsidize the cost of the houses reasonably such that the workers in the state can easily afford them.

Economics of piggery enterprise in Nigeria: A case study of Udi Local Government Area of Enugu State, Nigeria

The study examined the economics of pig enterprise in Udi Local Government Area of Enugu State, Nigeria. Despite the economic leverage and nutritional advantages of pig, its production still remains the least when compared to other livestock sub-sector. The study specifically described the socioeconomics characteristics of pig farmers, examined the factors influencing revenue from pig production, estimated the costs and returns in pig production and examined the problems faced by pig farmers in the area. Purposive and random sampling techniques were used in the selection of 60 farmers for the study. Primary data were collected from the selected farmers with the aid of structured questionnaire. Data were analysed using descriptive statistics, net income and multiple regression models. Results showed that majority of the respondents (85%) were male, married (81.7%), literate (100%) with mean age and household size of 48 years and five persons, respectively. Majority (88.3%) of the respondents sourced their capital from personal savings and 95% of them had crossed breeds of pigs. The determinants of net income from pig production were education (−0.271), cost of feed (0.687) and cost of labour (0.329). The profitability and the viability of piggery enterprise in the study area were shown by the gross margin, net farm income and the return on investment of ₦824,395.30 ($2,269.56), N747,797.42 ($2,058.69) and 0.84 (84%), respectively. Huge capital required for the investment, inadequate extension education, high cost of feed, diseases and parasite infestation, poor farm management, high cost of veterinary services, insufficient credit facilities and subsidies, and infant mortality and cannibalism were the major constraints faced by the farmers in the piggery enterprise. The study recommends that the government and other relevant agencies should provide subsidies and make credit facilities available and accessible to pig farmers in the study area.
 Key words: pig production, enterprise, gross margin, profitability, Nigeria

Nutraceutical and Health Benefits of Two Underutilized Leafy Vegetables (Pterocarpus santalinoides and Napoleona imperialis)

The aim of this study was to evaluate the nutritional and health implication of Pterocarpus santalinoides (Uturukpa) and Napoleona imperialis (Mkpodu) leaves. The vegetables were harvested from the forest in Udi Local Government area in Enugu State and identified at Department of Agronomy, Enugu State University of Science and Technology, Enugu, Nigeria. The vegetables were trimmed and washed with deionized water and drained. The vegetables were ground using hammer mill into paste separately and coded as sample A (Pterocarpus santalinoides) and sample B (Napoleona imperialis). Both samples were analyzed in the laboratory for proximate, vitamins, minerals, anti-nutrients and phytochemicals. The results were analyzed statistically using mean and standard deviation. The result showed that the proximate composition (on wet wt. basis) of sample A and B were protein 1.06 and 5.27%, fat 0.98 and 0.71%, fibre 0.90 and 1.01%, ash 2.73 and 1.27% and carbohydrate 30.63 and 23.54% respectively. The vitamin constituents were beta carotene 360.00 and 360.00 µg/100 g, vitamin C 5.20 and 7.13 mg/100 g and vitamin E 2.80 and 1.45 mg/100 g for sample A and B respectively. The result of the minerals were iron 3.49 and 1.40 mg/100 g, zinc 0.92 and 2.10 mg/100 g, calcium 36.00 and 25.60 mg/100 g, magnesium 20.01 and 25.20 mg/100 g and potassium 11.27 and 70.92 mg/100 g for sample A and B respectively. The result of the pyhtochemicals revealed that both leaves contained an appreciable amount of phytochemicals which are component of herbs use for ethnomedicine. The anti-nutrients in sample A and B were cyanide 0.48 and 0.94%, oxalate 1.08 and 3.87% and phytate 0.25 and 6.01% respectively. The high protein, fibre and mineral content of Napoleona imperialis is of interest, hence these lesser known vegetables are recommended due to its high nutritional content and health benefit.

Gully Erosion and Its Environmental Impact in Eke, Udi Local Government Area of Enugu State

This paper assessed the environmental impact of gully erosion in Eke, Udi Local Government Area of Enugu State, South East Nigeria. Data on the gully sites were collected using measuring instrument; observations were made with regards to the effects of the hazard on the study areas. Simple random sampling techniques were used to select respondents. A total of 150 questionnaires were returned out of 200 questionnaires distributed. Findings show that the gully in Enugu Eke has a mean cross-sectional dimension of 15.67 + 14.01m, that of Oma Eke 13.00 + 12.49m, while Ogui Eke has a mean cross-sectional dimension of 7.60 + 5.70m. From the mean values, differences was observed among the various study sites, however, with very high standard deviations and standard errors for Enugu Eke and Oma Eke, supported by the ANOVA results, having calculated F-value of 0.395, which is less than the critical F-value of 5.14, and the p-value of 0.69 > 0.05. The difference observed among the three study sites is not significant. Hence, the null hypothesis is accepted. The study revealed that the initiation and development of erosion gullies in the area is facilitated by natural (rainfall, topography, engineering geological properties of soil especially texture, etc) and anthropogenic factors especially road construction, excavation, drainage structure, farming, animal grazing. The study observed that gully erosion have caused a lot of pain and damage such as loss of life's, properties, communication routes, roads and has also modified the topography of the area. Recommendation made include planting of vegetative cover, construction of erosion channels, educating the populace and creating awareness on adequate practices to curtail the menace.

HOUSEHOLD LEVEL ANALYSIS OF FOOD INSECURITY AND COPING STRATEGIES: EVIDENCE FROM ENUGU STATE, NIGERIA.

The study analysed the strategies used by the rural households to cope with food insecurity in Udi local government area of Enugu state. Data were collected through household surveys using semi-structured questionnaires. Descriptive and inferential statistical tools were employed to analyse the data for the study. Households were grouped based on their food security status (food secure and food insecure). The study result showed that the two-group household differed significantly in some of their socio-economic characteristics. The study confirms that the coping strategies employed by the vulnerable households were not mutually exclusive, rather a mixed approach comprising multiple strategies were adopted to cushion food insecurity shocks . Furthermore, socioeconomic factors such as income (p<0.01), marital status (p<0.1) and educational level (p<0.01) were found to negatively influence the number of coping strategy adopted by rural households while the dependency ratio (p<0.01) was positively significant. Policy implications were drawn for education promotion, poverty alleviation programs and the creation of sustainable off-farm employment opportunities.

Complementary and alternative medicine use: Results from a descriptive study of pregnant women in Udi local Government area of Enugu state, Nigeria

BackgroundThe use of CAM by pregnant women is very popular in developed countries. The trend is increasing globally and lack of evidence of safety particularly when used during pregnancy may lead to complications. Pregnancy is a vulnerable period especially during the first trimester. There is scarcity of empirical evidence on CAM use particularly among women in Udi LGA of Enugu State and South East Nigeria. Moreover, studies carried out in Nigeria have been limited to herbal medicine use, which is one aspect of CAM. This study was designed to obtain information on the use of Complementary and Alternative Medicine among pregnant women.MethodsThe study was a cross sectional descriptive survey of 396 pregnant women systematically drawn from twenty political wards in Udi Local Government Area (LGA) of Enugu State. Interviewer administered questionnaire developed by the researchers was used for data collection. Data were analyzed using descriptive statistics.ResultsMajority (82.1%) of the pregnant women in Udi LGA used CAM during pregnancy out of which 53.8% had used CAM in previous pregnancies. CAM used ranges from one single type to sixteen different types with biological products eg, herbal tea, herbal mixture being the most commonly used CAM. Whereas most (89.5%) of the CAM used by pregnant women was consumed orally, approximately half of the pregnant women used CAM together with conventional medicine.ConclusionThe use of CAM by women during pregnancy was high in Udi LGA. Therefore, maternity care providers especially midwives need to elicit CAM commonly used by women during pregnancy and counsel them appropriately for best care and safety. Researchers should focus on establishing the efficacy of CAM products.

INDIGENOUS CLIMATE CHANGE ADAPTATION STRATEGIES AS PRACTICED BY FARM HOUSEHOLDS IN UDI LGA OF ENUGU STATE, NIGERIA

The study is on the indigenous climate change adaptation practices among farm households in Udi Local Government Area; Enugu State. 60 respondents were randomly selected for the study. Primary data were collected using a set of well-structured questionnaire. Data were analyzed using descriptive statistics, likert scale and inferential statistics. Result of the study showed that majority of the respondents (65%) was males and majority (51.7%) from household size of between 5 to 10 persons. About 55% of the respondents had at least Secondary school education and 93.3% engaged in farming as major occupation. 81.7% of the respondents have been in farming for more than five years (81.7%). The respondents·awareness on climate change includes impact of high temperature (76.6%), drying up of rivers/streams (63.3%), increased. Pest infestation (63.3%), increased disease infestation (51.7%) and poor quality of stored crops (58.3%). Indigenous negative adaptation practices practiced by the farmers were increased use of chemical fertilizers (63.3%), increased use of pesticides and insecticides (61.7%), cutting down of trees (66.7%), bush burning (71.7%). Continuous grazing (53.3%) while positive practices identified were rain water harvesting (60%), multiple or inter-cropping (65%), tree planting on farm lands (65%) and on-farm construction of ridges and gullies (60%). However, the constraints identified in adoption of these practices were poor access to credit (86.7%), lack of efficient input (83.3%), lack of awareness (78.3%), and lack 9f land (57.7%). The study therefore recommends sensitization on indigenous adaptation practices to distinguish between positive and negative approaches of adaptation; there is need for integration of fertilizer trees such as Faidherbia albida on farm lands for nutrient supply, erosion control and domestic use; more access to credit facilities; improved awareness creation by the relevant officers on all the impacts, and the needed adaptation practices to help curb the menace of climate change on agricultural lands and its effects on farmers' livelihoods.

Activities of Traditional Birth Attendants in Okpatu, Udi Local Government Area Enugu,Nigeria

This study was conducted to investigate the activities of Traditional birth attendants (TBAs) in Okpau community, Udi L.G.A of Enugu state. The respondents comprising of 10 TBAs that were resident within the 8 villages visited, constituted the study sample. Snowballing sampling technique was used. In-depth interview guide was the tool used for data collection and data was analyzed using thematically. The results reveal that TBAs generally provide some antenatal services though majority do not understand the meaning of the results, majority of TBAs use and understand signs of labour, the TBAs do not consider post -partum care as important, the TBAs knowledge of detecting risk factors is poor and majority of the TBAs make use of herbs and/or prayers to manage their clients. In conclusion, it was noted that TBAs have been unsuccessful in handling obstetric complications, but have contributed to successful maternal, neonatal, and child health interventions. Therefore, it was recommended that more and well staffed health centres and hospitals should be cited in okpatu to increase accessibilyto care especially at night, there should be proper training of TBAs on all round care and management of patints.

Economic Potentials of Oil Palm Production and Machinery Use in UDI, Enugu State, Nigeria

The economic potential of oil palm production and machinery-use in Udi Local Government Area Enugu State, Nigeria has been investigated. Questionnaires, personal work and oral interview were used as means of information retrieval. Statistical tool were used in data analysis. Farm holding/ownerships are of three categories; Individual (small holding (68%)), communal (medium holding (23%)) and cooperative efforts (large scale holdings (9%)) from social groups and friends reduce economic cost on labour. A larger percentage of the small scale holders (40%) inherited the farm while (5%) claimed ownership of establishing the farm. About 20% operate on rental arrangements and 30% communally owned. The result of the profitability analysis in palm oil processing in the area showed an increased trend in profitability while factors like transport costs, high cost of plantation rentals, and poor extraction processes were most critical to inhabiting profitable palm oil processing in the area.

Evaluation of hydrochemical characteristics and flow directions of groundwater quality in Udi Local Government Area Enugu State, Nigeria

A hydrogeological study was conducted at the Udi Local Government Area in south-eastern region of Nigeria to examine the hydrochemical constituent of groundwater and determine the quality for drinking and agricultural purposes. Results show that groundwater in the area is slightly acidic to slightly basic, soft and potable, when compared with the World Health Organisation standards for drinking water, and is suitable for agricultural purposes. The groundwater flow direction was determined to establish the implications of pollution from any water contamination. Twenty-one groundwater samples from existing boreholes were collected and analysed for various physicochemical parameters using standard field and laboratory techniques. Distribution of major ions was plotted on a Trilinear Piper diagram. Ajali Sandstone, known as major aquiferous layer in the area, outcrops predominately in sandy bed with medium to coarse-grained sediments. The aquifers are unconfined, semi-confined and with hydraulic conductivity values ranging from 9.0 × 10−2 to 8.5 × 10−2 m/day indicating medium transmissivity of groundwater in some areas and a flow net south to northward groundwater flow towards the coast. This explains why the aquifer does not appear to be very permeable and only provides a medium yield of good quality water in some regions of the study area.

Gender Differential in the Incidence of Diabetes Mellitus among the Patients in Udi Local Government Area of Enugu State, Nigeria

Diabetes Mellitus is a chronic metabolic disease characterized by hyperglycemia and disturbances of carbohydrate, fat and protein metabolism. It is a major public health problem and disease burden worldwide, and especially in Nigeria. This study determined the gender differential in the incidence of Diabetes mellitus among the patients in Udi L.G.A of Enugu State. Three research questions and one hypothesis were formulated to guide the study. Descriptive survey design was employed. A sample of 343 diabetes mellitus patients were randomly selected and used for the study. Researchers design data documentary profoma was used to collect the data from selected health facilities in respect to the patients’ gender and their fasting sugar level as contained in their folder or hospital record/register. Frequency and percentages was used to answer research question while the null hypothesis was tested using Chi- square at 0.05 level of significance. The finding of the result revealed a high incidence of Diabetes Mellitus in 2012, females recorded a high incidence of DM from 2008-2012 and high percentage of fasting blood sugar level than male. The finding also revealed no difference in the fasting blood sugar based on gender. It is recommended among others that diagnostic investigation on human placental lactose is advocated to reduce or stop its opposition to insulin secretion during pregnancy.

Gender Differential in the Incidence of Diabetes Mellitus among the Patients in Udi Local Government Area of Enugu State, Nigeria

Diabetes Mellitus is a chronic metabolic disease characterized by hyperglycemia and disturbances of carbohydrate, fat and protein metabolism. It is a major public health problem and disease burden worldwide, and especially in Nigeria. This study determined the gender differential in the incidence of Diabetes mellitus among the patients in Udi L.G.A of Enugu State. Three research questions and one hypothesis were formulated to guide the study. Descriptive survey design was employed. A sample of 343 diabetes mellitus patients were randomly selected and used for the study. Researchers design data documentary profoma was used to collect the data from selected health facilities in respect to the patients’ gender and their fasting sugar level as contained in their folder or hospital record/register. Frequency and percentages was used to answer research question while the null hypothesis was tested using Chi- square at 0.05 level of significance. The finding of the result revealed a high incidence of Diabetes Mellitus in 2012, females recorded a high incidence of DM from 2008-2012 and high percentage of fasting blood sugar level than male. The finding also revealed no difference in the fasting blood sugar based on gender. It is recommended among others that diagnostic investigation on human placental lactose is advocated to reduce or stop its opposition to insulin secretion during pregnancy.

Gender Differential in the Incidence of Diabetes Mellitus among the Patients in Udi Local Government Area of Enugu State, Nigeria

Diabetes Mellitus is a chronic metabolic disease characterized by hyperglycemia and disturbances of carbohydrate, fat and protein metabolism. It is a major public health problem and disease burden worldwide, and especially in Nigeria. This study determined the gender differential in the incidence of Diabetes mellitus among the patients in Udi L.G.A of Enugu State. Three research questions and one hypothesis were formulated to guide the study. Descriptive survey design was employed. A sample of 343 diabetes mellitus patients were randomly selected and used for the study. Researchers design data documentary profoma was used to collect the data from selected health facilities in respect to the patients’ gender and their fasting sugar level as contained in their folder or hospital record/register. Frequency and percentages was used to answer research question while the null hypothesis was tested using Chi- square at 0.05 level of significance. The finding of the result revealed a high incidence of Diabetes Mellitus in 2012, females recorded a high incidence of DM from 2008-2012 and high percentage of fasting blood sugar level than male. The finding also revealed no difference in the fasting blood sugar based on gender. It is recommended among others that diagnostic investigation on human placental lactose is advocated to reduce or stop its opposition to insulin secretion during pregnancy. DOI: 10.5901/mjss.2013.v4n8p131

Socio-economic inequalities in cost of seeking treatment for malaria in south-east Nigeria

Background: To investigate the socio-economic differentials in health seeking and costs of malaria treatment in Southeast NigeriaMethods: A cross-sectional study design using questionnaires was conducted. The study areas are four malaria holo-endemic communities (towns) in Enugu State, Southeast Nigeria, namely Udi and Nachi in Udi Local government area (LGA) with Inyi and Oji-river (Oji) in Oji-River LGA. Udi and Oji were the local government headquarters, while Nachi and Inyi were not. Principal components analysis was used to generate a socio-economic status (SES) index, which was used to examine inequity.Results: Similar pattern of health seeking was found for both adult and childhood malaria with treatment mostly sought from patent medicine dealers. All SES were likely to incur similar level of costs to treat malaria implying that the poorest are spending a greater proportion of their income on the disease. The non-financial costs were considerable at about 1000 Naira per episode of malaria. The huge time cost would inevitably lead to a reduction in household production and could lead to adverse coping mechanisms especially by the poorer households.Conclusion: In order to decrease the inequity in costs of treatment and ensure the ready availability of appropriate treatment to the poorest households, the government should increase the availability of formal healthcare services for the provision of near and appropriate treatment of malaria. This strategy would decrease the financial costs (especially transportation) and maybe non-financial costs of seeking care for treatment of malaria and other illnesses.Key words: socioeconomic, inequalities, malaria, treatment seeking

Compliance to correct dose of chloroquine in uncomplicated malaria correlates with improvement in the condition of rural Nigerian children

Non-compliance to correct dosing is thought to be one of the main causes of treatment failure of chloroquine in the home management of childhood malaria. There are few studies of compliance to drugs used for tropical diseases. In order to study compliance in the rural setting, chloroquine syrup was packaged with a novel pictorial insert for compliance to correct dosing. Compliance was assessed in a field trial in September 1996–December 1997, involving 632 children with uncomplicated malaria in Udi local government area in Nigeria. Written informed consent was obtained from mothers/guardians before children were enrolled in the study. There were 3 arms to the trial: control villages (group I) received chloroquine syrup without further intervention, group II received a pictorial insert with chloroquine syrup, and group III received chloroquine syrup, the pictorial insert and verbal instructions. Each group was made up of 3 health centres. Compliance was assessed by volumetric measurement of the chloroquine syrup left in 30-mL bottles and by questionnaires administered to mothers/helpers of the children. Control villages recorded full compliance for 36·5 ± 4·4% of the children, group II for 51·9 ± 7·9% and group III for 73·3 ± 4·2%. There was a significant correlation (P < 0·0001) between full compliance, improvement and time for improvement of the condition. This study is deemed important because it focuses on children, who bear the greatest burden of malaria. It is unique for introducing a pictorial insert that illiterate villagers, who may not understand the use of age or weight in drug dispensing, may utilize as a substitute.