Ekene Nwaefuna - Academia.edu (original) (raw)

Papers by Ekene Nwaefuna

This study investigated the influence of the level of education on HIV infection among pregnant w... more This study investigated the influence of the level of education on HIV infection among pregnant women attending antenatal care in Sekondi-Takoradi, Ghana. A crosssectional study was conducted at four hospitals in the Sekondi-Takoradi metropolis. The study group comprised 885 consenting pregnant women attending antenatal care clinics. Questionnaires were administered and venous blood samples were screened for HIV and other parameters. Multivariable logistic regression analyses were performed to determine the association between the level of education attained by the pregnant women and their HIV statuses. The data showed that 9.83% (87/885) of the pregnant women were HIV seropositive while 90.17% (798/885) were HIV seronegative. There were significant differences in mean age (years) between the HIV seropositive women (27.45 ± 5.5) and their HIV seronegative (26.02 ± 5.6) counterparts (p = .026) but the inference disappeared after adjustment (p = .22). Multivariable logistic regression analysis revealed that pregnant women with secondary/ tertiary education were less likely to have HIV infection compared with those with none/ primary education (adjusted OR, 0.53; 95% CI, 0.30-0.91; p = .022). Our data showed an THE AUTHORS are affiliated with the

Antimalarial drugs will continue to be a major control tool for controlling malaria, through trea... more Antimalarial drugs will continue to be a major control tool for controlling malaria, through treatment and prophylaxis, until an effective malaria vaccine is developed. Plasmodium falciparum, the major malaria parasite, has developed resistance to most available antimalarial drugs. The last decade has seen an increase in malaria burden due to drug resistant strains of P. falciparum. Currently combination therapy has been recommended by World Health Organization (WHO) for treating uncomplicated malaria, with formulations containing an artemisinin compound as policy standard. This is aimed at improving treatment as well as delaying resistance. Research has, however, reported in vitro resistance to artemisinins a few years after implementation of Artemisinin-based Combination Therapy (ACT) policy. The objective of this review is to provide comprehensive information on the Single nucleotide polymorphisms (SNPs) of the Plasmodium falciparum adenosine triphosphatase 6 (PfATPase6) gene and also to argue the significance of PfATPase6 SNPs in malaria treatment. Articles used for this review were searched from Hinari, Pubmed and JSTOR electronic databases. So far about forty-four SNPs have been identified in the PfATPase6 gene in samples collected from thirty-five (35) countries. In vitro resistance tests have not been carried out on most of the identified SNPs. Again the E431K, A623E, S769N and L263E mutations that have been shown to confer resistance to artemisinins have not been found in most analyzed samples. The identified PfATPase6 SNPs have not been shown to have arisen as a result of drug selection pressure. The prevalence of SNPs which are associated with decrease in artemisinin susceptibility may increase under the new drug selection pressure and eventually impair ACT treatment.

Malaria and typhoid fever are among the most endemic diseases in the tropics. The emergence of mu... more Malaria and typhoid fever are among the most endemic diseases in the tropics. The emergence of multi-drug resistant strains of Salmonella typhi and Plasmodium falciparum poses a big challenge to eradication of both diseases. Both diseases share similar transmission factors, putting individuals in areas endemic for both infections at a substantial risk of contracting both infections concurrently. The main objective of the study was to determine the incidence of malaria and typhoid fever co-infection in the Sunyani and Kumasi metropolises. One hundred and twenty-nine participants were recruited for the study. Twenty-two (17.0%) of the subjects tested positive for typhoid fever, twenty-four (18.6%) tested positive for falciparum malaria, and five (3.9%) were co-infected with falciparum malaria and typhoid fever. No association (P=0.585) was found between malaria and typhoid fever infection.

Malaria infections undetectable by microscopy but detectable by Polymerase Chain Reaction (PCR) (... more Malaria infections undetectable by microscopy but detectable by Polymerase Chain Reaction (PCR) (submicroscopic malaria) are common in endemic areas like Ghana. Submicroscopic malaria has been linked with severe pregnancy outcomes as well as contributing to malaria transmission. In this cross-sectional study 872 consenting pregnant women (gestation ≥ 20 weeks) were recruited from 8 hospitals in Central Region, Ghana, between July and December 2009. Malaria infection was detected by microscopy and PCR. Haemoglobin was measured and anaemia was defined as haemoglobin lower than 11 g/dL. Majority of the women, 555 (63.6%), were Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) users while 234 (36.4%) were nonusers. The prevalence of malaria by microscopy was 20.9% (182/872) and 9.7% (67/688) of microscopy negative women had submicroscopic malaria. IPTp-SP usage significantly (odds ratio = 0.13, 95% confidence interval = 0.07-0.23, = 0.005) reduced the prevalence of submicroscopic malaria as more nonusers (51/234) than users (16/454) were PCR positive. After controlling for other variables the effect of IPTp-SP remained statistically significant (odds ratio = 0.11, 95% confidence interval = 0.02-0.22, = 0.006). These results suggest that Intermittent Preventive Treatment with Sulphadoxine-Pyrimethamine is useful in the reduction of submicroscopic malaria in pregnancy.