Author: Morikwe Ugonna Chinwe
Department: Pharmaceutical Microbiology and Biotechnology
Affiliation: Nnamdi Azikiwe University Awka

A cross-sectional study on the prevalence and the molecular surveillance of P. falciparum was done between February and August 2013 in Awka, an urban community in Anambra State-Nigeria. Semi-structured questionnaires were used to gather personal data of 210 respondents, and to assess the knowledge of the symptoms of malaria, attitude towards preventive measures, as well as treatment-seeking behaviors among the respondents. Using the questionnaires, Knowledge, Attitude and Practice (KAP) was analyzed. Two hundred and ten blood (210) samples were collected from the participants and microscopy was used to detect malaria parasites in the blood. Parasites’ deoxyribonucleic acid (DNA) confirmed by nanodrop spectrophotometer were extracted from dried blood sample, the association between Pfmdr1 and Pfatp6 polymorphisms was investigated in 23 samples with good genomic yield and concentration. Mutations of Pfmdr1 at codon 86 and Pfatp6 at codons 769 and 37 were analyzed by PCR-RFLP. Males 92(43.86 %) and females 118(56.19 %) aged between 5-64 were classified into 6 age groups of nine years intervals each, gender, employment and educational status,. 157(74.76 %) of the 210 participants were positive with P. falciparum malaria. The age group 35-45 had the highest prevalence of 27(84.38 %), there was a greater prevalence among the men 69(75 %) and the least prevalence among those with primary education 15(55.55 %); 93(44.29 %) of the respondents had good knowledge, 142(67.62 %) displayed poor attitude, 91(43.3 3 %) had poor health screening practice. In the molecular studies, 13(56.52 %) isolates carried Pfmdr1 gene at the investigated codon, a frequency of 9(39.13 %) isolates had resistant genes of R37K codon and 4(17.39 %) isolates carried the mutant gene at codon S769N, a single double mutant was observed in the age group 25-34 and a 2 double mutant in the age group 45-54. Mutations of pfmdr-1 at codon N86Y inferred that although the use of chloroquine has been prohibited, it is either quinolines are still in use or the arm of ACT as Amodiaquine and Mefloquine is providing the drug pressure, and the mutants observed in Pfatp6 genes infers that ACT use is being threatened, therefore a need for immediate attention. Attitude and management practices of malaria need to be improved. It is suggested that malaria public enlightenment efforts should be intensified, effective malaria preventive methods be made affordable and support be provided to make malaria treatments at public hospitals free. It is evidenced that artemisinin monotherapy is still being used in the treatment of malaria and should therefore, be completely eradicated by enforcing an end to its production by the manufacturers.

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