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.

Cardiovascular diseases (CVDs) are the main causes of death in industrialized countries, and are significant causes of morbidity and mortality in sub-Saharan Africa. Hypertension is the most common cardiovascular disease in Nigerians, and the risk of CVD associated with hypertension is independent of other risk factors. Despite the high level of awareness of its presence in the developed countries, the level of control is still poor. CVDs tend to be commoner in urban settlements, and it has been hypothesized that rural sub-Saharan Africa is at an early stage of epidemiological transition from communicable to non-communicable diseases (NCD) because of the gradual adoption of unhealthy lifestyles. This study aimed at describing the pattern of blood pressure indices among the hypertensive residents of a rural community in South East Nigeria. A total of 858 individuals comprising 247 males and 611 females took part in the study. 46.4% of the subjects had hypertension. Hypertension was commoner in the males (50.2% vs. 44.8%) (χ 2(1) = 1.484; P = 0.223). The males were significantly older and heavier than the females while the females had higher mean values of BMI and WC. The prevalence of hypertension is becoming alarmingly high in the rural communities of sub-Saharan Africa.

Cardiovascular diseases (CVDs) causes of worldwide preventable morbidity and mortality. CVDs are a leading cause of mortality and morbidity in developing countries, and rates are expected to rise over the next few decades. The prevalence of CVD risk factors is dramatically increasing in low-and middle-income African countries, particularly in urban areas. We carried out a cross-sectional population-based survey in Imezi-Owa, a rural community in South East Nigeria to estimate the prevalence of major cardiovascular risk factors in both men and women aged 40–70 years. A total of 858 individuals made up of 247 (28.8%) males and 611 (71.2%) females were recruited. The mean age of the subjects was 59.8 ± 9.9 years. The prevalence of the different cardiovascular risk factors among the 858 subjects was as follows: hypertension 398 (46.4%) subjects, generalized obesity as determined by BMI 257 (30%) subjects, abdominal obesity 266 (31%) subjects, dysglycaemia 38 (4.4%) subjects and hypercholesterolaemia 32 (3.7%) subjects. Prevalence of hypertension and dysglycaemia was higher in men while the others were higher in women. Only hypertension (P = .117) and hypercholesterolaemia (P = .183) did not reveal any significant association with gender. Prevalence of CVD risk factors was highest in subjects aged 65 to 70 years.

Fixed drug eruption (FDE) causes cosmetic embarrassment in Nigerian patients, particularly when the characteristic hyperpigmented patches affect the face and lips. Drugs that have been implicated in the etiology of FDE, and the sites of lesions, may vary from country to country. Antimalarials, such as Fansidar, Fancimef, Maloxine, Amalar, and Metakelfin, were the most common offending agents, accounting for 38% of FDEs, followed by trimethoprim + sulfamethoxazole (co-trimoxazole) (28%), dipyrones (10%), Butazolidin (6%), thiacetazone (6%), metronidazole (4%), paracetamol (3%), and naproxen (3%). Lesions induced by the combination of sulfadoxine and pyrimethamine (in antimalarials) mainly involved the face and lips. In most cases, patients took these sulfa-containing antimalarials in combination with numerous other drugs, particularly analgesics. Unlike chloroquine-induced pruritus, which affects most Africans, the association between antimalarials and FDE has not been well documented in our region. Co-trimoxazole was associated more often than antimalarials with FDEs involving the mucocutaneous junctions of the genitalia and lips. Males with genital lesions on the glans penis represented 11 (48%) of those with co-trimoxazole hypersensitivity. The trunk and limbs were affected mainly by pyrazoles and Butazolidin, respectively; however, solitary lesions on the trunk were usually due to co-trimoxazole, whereas solitary lesions on the limbs were associated with Butazolidin.