Christopher P . Ekiyor - Academia.edu (original) (raw)
Papers by Christopher P . Ekiyor
<p>Patient recommendations for improving management of malaria/HIV Co-infection.</p
<p>Malaria treatment medication: Sources, types and usage patterns.</p
<p>Self-reported suspected malaria occurrence pattern and completion of treatment.</p
<p>Socio-demographic characteristics.</p
<p>Reaction on suspicion of malaria.</p
International Journal of Infectious Diseases, 2014
Results: Treatment with antimalarial drug in the last two days was reported by 10.3% of the child... more Results: Treatment with antimalarial drug in the last two days was reported by 10.3% of the children. Antimalaria drug resistance mutations were detected in all the samples with pfdhfr S108T(76%) and pfdhps A438G(72%) recording the highest prevalence. Mutation in the pfcrt gene however was only detected in 43% of the samples. Mixed polymorphisms were observed more in triple mutations of pfdhps (69%) and pfdhfr (64%) respectively while quintuple and sextuple mutations accounted for 20% and 32% respectively. Conclusion: These results ascertain the prevalence of antimalarial drug resistance polymorphisms in South Eastern Nigeria with their changing patterns of occurrence. This may form a baseline for the continuous monitoring of drug resistance in South Eastern Nigeria to inform more effective and sustainable planning and implementation of evidence based antimalarial drug policies.
Journal of Community Health, 2013
PLOS ONE
This study assesses malaria prevention and treatment behaviour among people living with HIV/AIDS ... more This study assesses malaria prevention and treatment behaviour among people living with HIV/AIDS (PLWHA) in Owerri, South Eastern Nigeria. Although Nigeria bears one of the world's largest burdens of both malaria and HIV, there is almost no research studying how co-infected patients manage their care. We systematically sampled 398 PLWHA receiving care at Imo State Specialist Hospital and the Federal Medical Centre in Owerri to complete a structured, pre-tested questionnaire on malaria care-seeking behaviour. Descriptive statistics were reported and chi-square tests and multivariate logistic regressions were also used. The majority of HIV-infected patients (78.9%) reported having had an episode of suspected malaria quarterly or more often. There was a large variation in care-seeking patterns: on suspicion of malaria, 29.1% of participants engaged in self-medication; 39.2% went to drug shops, and only 22.6% visited HIV/AIDS care centres. Almost 40% waited more than 24 hours before initiating treatment. Most (60.3%), reported taking recommended artemisinin-based combination treatments (ACT) but a significant minority took only paracetamol (25.6%) or herbal remedies (3.5%). Most (80%) finished their chosen course of treatment; and completion of treatment was significantly associated with the frequency of suspected malaria occurrence (p = 0.03). Most (62.8%) did not take anti-malaria medication while taking antiretroviral treatment (ART) and almost all (87.6%) reported taking an ACT regimen that could potentially interact with Nigeria's first-line ART regimen. Our findings suggest the need to pay more attention to malaria prevention and control as a crucial element in HIV/ AIDS management in this part of Nigeria and other areas where malaria and HIV/AIDS are co-endemic. Also, more research on ART-ACT interactions, better outreach to communitylevel drug shops and other private sector stakeholders, and clearer guidelines for clinicians and patients on preventing and managing co-infection may be needed. This will require improved collaboration between programmes for both diseases.
Background: This preliminary study reports the first documented evidence of antimalarial drug resi... more Background: This preliminary study reports the first documented evidence of antimalarial drug resistance polymorphisms in South Eastern Nigeria. Methods & Materials: Real Time PCR (RT-PCR) assay was used to type for pfmdr1 genes whereas pfdhfr, pfdhps and pfcrt genes were typed with the Restriction Fragment Length Polymorphism of PCR(PCR-RTLP) from blood spots of two hundred under five children attending pediatric clinics in the Federal Medical Centre, Owerri, South Eastern Nigeria. Results: Treatment with antimalarial drug in the last two days was reported by 10.3% of the children. Antimalaria drug resistance mutations were detected in all the samples with pfdhfr S108T(76%) and pfdhps A438G(72%) recording the highest prevalence. Mutation in the pfcrt gene however was only detected in 43% of the samples. Mixed polymorphisms were observed more in triple mutations of pfdhps (69%) and pfdhfr (64%) respectively while quintuple and sextuple mutations accounted for 20% and 32% respectively....
Journal of Community Health, 2013
According to the World Health Organization (WHO), current estimate of maternal mortality ratios i... more According to the World Health Organization (WHO), current estimate of maternal mortality ratios is at more than 1000 per 100,000 live births in most African countries. Despite the existence of modern health facilities in Nigeria, over 58% of deliveries take place at home whereas only 37% take place in hospitals. As outcomes of pregnancy and their sequelae are purely left to the providence of women in many rural communities, the place of delivery is a great determinant of maternal and child morbidity and mortality. With the shortage of skilled birth attendants and uneven geographical distribution of the few available ones; traditional birth attendants tend to fill in the gap. This study employed a cross sectional design and using a simple random sampling technique, 420 women within the reproductive age (18 -45 years) meeting the inclusion criteria for the study were selected. Results from the study indicated a high (88.8%) knowledge of Traditional Birth Attendants (TBAs) but a poor (51.1%) perception about their practices. A significant relationship was shown between age (P<0.05), education status (P<0.05) and the frequency of patronage of TBAs Services. Although, perception about TBAs practices was poor, the role of TBAs in the improvement of women's health (maternal and child health) in rural Nigeria cannot be ignored. TBAs remain major health resources in rural communities in developing countries as well as some parts of urban areas. Efforts need to be harnessed for training of TBAs through the Ministry of Health and Primary Health Care facilities close to their area of practices.
<p>Patient recommendations for improving management of malaria/HIV Co-infection.</p
<p>Malaria treatment medication: Sources, types and usage patterns.</p
<p>Self-reported suspected malaria occurrence pattern and completion of treatment.</p
<p>Socio-demographic characteristics.</p
<p>Reaction on suspicion of malaria.</p
International Journal of Infectious Diseases, 2014
Results: Treatment with antimalarial drug in the last two days was reported by 10.3% of the child... more Results: Treatment with antimalarial drug in the last two days was reported by 10.3% of the children. Antimalaria drug resistance mutations were detected in all the samples with pfdhfr S108T(76%) and pfdhps A438G(72%) recording the highest prevalence. Mutation in the pfcrt gene however was only detected in 43% of the samples. Mixed polymorphisms were observed more in triple mutations of pfdhps (69%) and pfdhfr (64%) respectively while quintuple and sextuple mutations accounted for 20% and 32% respectively. Conclusion: These results ascertain the prevalence of antimalarial drug resistance polymorphisms in South Eastern Nigeria with their changing patterns of occurrence. This may form a baseline for the continuous monitoring of drug resistance in South Eastern Nigeria to inform more effective and sustainable planning and implementation of evidence based antimalarial drug policies.
Journal of Community Health, 2013
PLOS ONE
This study assesses malaria prevention and treatment behaviour among people living with HIV/AIDS ... more This study assesses malaria prevention and treatment behaviour among people living with HIV/AIDS (PLWHA) in Owerri, South Eastern Nigeria. Although Nigeria bears one of the world's largest burdens of both malaria and HIV, there is almost no research studying how co-infected patients manage their care. We systematically sampled 398 PLWHA receiving care at Imo State Specialist Hospital and the Federal Medical Centre in Owerri to complete a structured, pre-tested questionnaire on malaria care-seeking behaviour. Descriptive statistics were reported and chi-square tests and multivariate logistic regressions were also used. The majority of HIV-infected patients (78.9%) reported having had an episode of suspected malaria quarterly or more often. There was a large variation in care-seeking patterns: on suspicion of malaria, 29.1% of participants engaged in self-medication; 39.2% went to drug shops, and only 22.6% visited HIV/AIDS care centres. Almost 40% waited more than 24 hours before initiating treatment. Most (60.3%), reported taking recommended artemisinin-based combination treatments (ACT) but a significant minority took only paracetamol (25.6%) or herbal remedies (3.5%). Most (80%) finished their chosen course of treatment; and completion of treatment was significantly associated with the frequency of suspected malaria occurrence (p = 0.03). Most (62.8%) did not take anti-malaria medication while taking antiretroviral treatment (ART) and almost all (87.6%) reported taking an ACT regimen that could potentially interact with Nigeria's first-line ART regimen. Our findings suggest the need to pay more attention to malaria prevention and control as a crucial element in HIV/ AIDS management in this part of Nigeria and other areas where malaria and HIV/AIDS are co-endemic. Also, more research on ART-ACT interactions, better outreach to communitylevel drug shops and other private sector stakeholders, and clearer guidelines for clinicians and patients on preventing and managing co-infection may be needed. This will require improved collaboration between programmes for both diseases.
Background: This preliminary study reports the first documented evidence of antimalarial drug resi... more Background: This preliminary study reports the first documented evidence of antimalarial drug resistance polymorphisms in South Eastern Nigeria. Methods & Materials: Real Time PCR (RT-PCR) assay was used to type for pfmdr1 genes whereas pfdhfr, pfdhps and pfcrt genes were typed with the Restriction Fragment Length Polymorphism of PCR(PCR-RTLP) from blood spots of two hundred under five children attending pediatric clinics in the Federal Medical Centre, Owerri, South Eastern Nigeria. Results: Treatment with antimalarial drug in the last two days was reported by 10.3% of the children. Antimalaria drug resistance mutations were detected in all the samples with pfdhfr S108T(76%) and pfdhps A438G(72%) recording the highest prevalence. Mutation in the pfcrt gene however was only detected in 43% of the samples. Mixed polymorphisms were observed more in triple mutations of pfdhps (69%) and pfdhfr (64%) respectively while quintuple and sextuple mutations accounted for 20% and 32% respectively....
Journal of Community Health, 2013
According to the World Health Organization (WHO), current estimate of maternal mortality ratios i... more According to the World Health Organization (WHO), current estimate of maternal mortality ratios is at more than 1000 per 100,000 live births in most African countries. Despite the existence of modern health facilities in Nigeria, over 58% of deliveries take place at home whereas only 37% take place in hospitals. As outcomes of pregnancy and their sequelae are purely left to the providence of women in many rural communities, the place of delivery is a great determinant of maternal and child morbidity and mortality. With the shortage of skilled birth attendants and uneven geographical distribution of the few available ones; traditional birth attendants tend to fill in the gap. This study employed a cross sectional design and using a simple random sampling technique, 420 women within the reproductive age (18 -45 years) meeting the inclusion criteria for the study were selected. Results from the study indicated a high (88.8%) knowledge of Traditional Birth Attendants (TBAs) but a poor (51.1%) perception about their practices. A significant relationship was shown between age (P<0.05), education status (P<0.05) and the frequency of patronage of TBAs Services. Although, perception about TBAs practices was poor, the role of TBAs in the improvement of women's health (maternal and child health) in rural Nigeria cannot be ignored. TBAs remain major health resources in rural communities in developing countries as well as some parts of urban areas. Efforts need to be harnessed for training of TBAs through the Ministry of Health and Primary Health Care facilities close to their area of practices.