University of Nigeria, Nsukka

About: University of Nigeria, Nsukka is a education organization based out in Nsukka, Nigeria. It is known for research contribution in the topics: Population & Health care. The organization has 10211 authors who have published 13685 publications receiving 138922 citations.

Quality of artemisinin-based combination formulations for malaria treatment: prevalence and risk factors for poor quality medicines in public facilities and private sector drug outlets in Enugu, Nigeria.

Abstract: BACKGROUND: Artemisinin-based combination therapies are recommended by the World Health Organisation (WHO) as first-line treatment for Plasmodium falciparum malaria, yet medication must be of good quality for efficacious treatment. A recent meta-analysis reported 35% (796/2,296) of antimalarial drug samples from 21 Sub-Saharan African countries, purchased from outlets predominantly using convenience sampling, failed chemical content analysis. We used three sampling strategies to purchase artemisinin-containing antimalarials (ACAs) in Enugu metropolis, Nigeria, and compared the resulting quality estimates. METHODS: ACAs were purchased using three sampling approaches--convenience, mystery clients and overt, within a defined area and sampling frame in Enugu metropolis. The active pharmaceutical ingredients were assessed using high-performance liquid chromatography and confirmed by mass spectrometry at three independent laboratories. Results were expressed as percentage of APIs stated on the packaging and used to categorise each sample as acceptable quality, substandard, degraded, or falsified. RESULTS: Content analysis of 3024 samples purchased from 421 outlets using convenience (n=200), mystery (n=1,919) and overt (n=905) approaches, showed overall 90.8% ACAs to be of acceptable quality, 6.8% substandard, 1.3% degraded and 1.2% falsified. Convenience sampling yielded a significantly higher prevalence of poor quality ACAs, but was not evident by the mystery and overt sampling strategies both of which yielded results that were comparable between each other. Artesunate (n=135; 4 falsified) and dihydroartemisinin (n=14) monotherapy tablets, not recommended by WHO, were also identified. CONCLUSION: Randomised sampling identified fewer falsified ACAs than previously reported by convenience approaches. Our findings emphasise the need for specific consideration to be given to sampling frame and sampling approach if representative information on drug quality is to be obtained.

Low coverage of intermittent preventive treatment for malaria in pregnancy in Nigeria: demand-side influences

Abstract: Nigeria instituted intermittent preventive treatment for malaria (IPTp) using sulphadoxine-pyrimethamine (SP) for pregnant women in 2001, but coverage remains low. This study examined the influence of demand side factors on IPTp coverage. Data were collected using a household survey from 1307 women who were delivered of a live baby within the one-year period preceding the study and through an exit poll from 146 women attending antenatal clinics (ANC). Data analysis examined coverage based on the national and WHO guidelines for IPTp delivery which differ with regards to use of IPTp in the last month of pregnancy. Focus group discussions (FGDs) were undertaken to further explain demand side constraints to coverage. From the household survey, 96.1% of respondents attended ANC, with most having five or more visits. Overall IPTp coverage for the first and second doses was 13.7% and 7.3% respectively. The coverage was higher in the urban areas compared to rural areas (p < 0.01). Amongst women who could have received IPTp based on the timing of their attendance, only 14.1% and 14.3% were offered the first dose based on national and WHO guidelines, while 7.7% and 7.5% were offered the second dose respectively giving significant missed opportunities. Amongst ANC attendees offered first and second doses, 98.9% and 96.9% respectively took the medicine. Only 13.6% and 21.5% of these clients reported taking the drug under direct observation. The low level of coverage was confirmed by exit survey data, which found coverage of 11.6% and 3.0% for the first and second doses. The FGDs revealed that women do not have many concerns about side effects, but they take drugs providers give them because they believe such drugs must be safe. This study found low coverage of IPTp and high levels of missed opportunities supporting findings that high ANC attendance does not guarantee high IPTp coverage. Demand side factors such as ANC attendance, appropriate timing of attendance, and perceptions about side effects were not constraining factors to increased coverage, raising the need to examine supply side factors.

Convergence analysis for the proximal split feasibility problem using an inertial extrapolation term method

Abstract: In this paper, we present a proximal split feasibility algorithm with an additional inertial extrapolation term for solving a proximal split feasibility problem under weaker conditions on the step sizes. The two convex and lower semi continuous objective functions are assumed to be non-smooth. Some applications to split inclusion problem and split equilibrium problem are given. We demonstrate the efficiency of the proposed algorithm with numerical experiments.

The effect of water-saturation on the stability of problematic slopes at the Iva Valley area, Southeast Nigeria

Abstract: The Iva Valley area has one of the highest densities of landslides in Nigeria, and impacts the residents, local economy, and the environment. Slopes in the area sit on unconsolidated, cross-bedded, friable sandstone units with interbeds of claystone. Past research efforts had proposed theories explaining the mechanism of failure based on the limited-liquefaction behavior of the slope materials. But as landslide prevention works on the slopes began to fail, it became apparent that those theories were inadequate solutions to the devastating effect of mass wasting processes. This paper presents the results of landslide susceptibility assessment based on the new evidence of complete-liquefaction behavior observed in the samples when back-pressure is employed to accomplish full saturation. Loose, saturated specimens failed after attaining maximum strength at shear displacements less than 1 mm. The failure was marked by rapid reduction in shear strength and accompanied by a steady increase in pore water pressure until the ratio of pore pressure and normal stress approached unity indicating complete liquefaction. This behavior simulated the response of the slope soils to varying stress and drainage conditions in the field, and seems an adequate mechanism for the incessant failure of slopes and prevention works. Because the geology of a vast area of the South-East Nigeria is similar, the results obtained at the study area are also applicable in other areas within the region for sustainable preventive and mitigating measures.