Browsing by Author "Falade, C. O."

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Attitude of health care workers to the involvement of alternative healthcare providers in the home management of childhood malaria
(Baywood Publishing Co., inc, 2005) Falade, C. O.; Osowole, O. S.; Adeniyi, J. D.; Oladepo, O.; Oduola, A. M. J.
The attitudes of 193 healthcare workers (Nurses (35.7%), auxiliary nurses' (35.7%), followed by community health officers (26.4%) in 55 primary and secondary healthcare facilities to home management of malaria were evaluated in four local government areas in Southwestern Nigeria. Results showed that mothers and patent medicine sellers were perceived as offering useful services in home management of malaria by giving first aid and selling antimalaria drugs, respectively. Although 79% of respondents expressed the opinion that mothers are the most appropriate to give first line management to children suffering from malaria, 56% were also of the view that such children should receive definitive treatment in a formal health care facility. Furthermore, 45% of the respondents felt that only formal healthcare workers should treat children who have malaria irrespective of the location of the treatment because mothers, patent medicine sellers, and traditional healers have not been formally trained. Healthcare workers were willing to train mothers and patent medicine sellers on effective management of childhood malaria, but were not favorably disposed toward collaboration with traditional healers in the home management of malaria. There is an urgent need for formal healthcare workers to seek better understanding of traditional healers' practices as well as their cooperation for improved home management of childhood malaria among indigenous groups.
Case management of childhood fever by traditional healers in Southwest Nigeria: Identification of training and collaborative needs
(Baywood Publishing Co., inc, 2008) Fawole, O. I.; Akinboye, D. O.; Falade, C. O.; Arulogun, O. S.; Adeniyi, J. D.
Traditional healers play an important role in the provision of healthcare in many communities in Africa. This study aimed to improve home management of malaria in children by assessing the healer's knowledge and practice. A semi-structured questionnaire interview of 127 traditional healers selected by proportionate sampling technique from two rural and two urban local government areas (LGAs) of southwestern Nigeria was followed by a training program. Malaria ranked first (87%) among the illnesses managed by the healers. Diagnosis of fever was often (72%) based on client history, physical examination (24.4%), consulting oracles (18.9%), and interpretation of dreams (3.1%). Treatment of malaria was with boiled herbs ("agbo"; 72%), ground herbs ("agunmu"; 14%), and incisions and scarifications (3%). Forty-one (32.5%) healers had referred febrile children to a health facility. Younger healers and those who had at least a secondary education were more likely to refer patients (p < 0.05 in both cases). Thirty-six healers (28.4%) had previous formal training on management of fevers, most of whom were the younger (p < 0.(5), educated healers (p> 0.05), with fewer years of practice (p> 0.05). Research into traditional herbs (48%), better acknowledgment by government (23.6%); and collaboration with other health sectors were suggestions to improve practice. Traditional healers, especially the older, less-educated, and long-practicing healers, urgently require formal training and collaboration with other healthcare providers to improve knowledge and promote early referral of children with fever.
Contribution of the indigenous health care givers to the herbal management of febrile illnesses in Rivers state, South-south, Nigeria
(2005-12) Ebong, O. O.; Ajaiyeoba, E. O.; Ononiwu, I. M.; Eteng, M. J.; Akinbiye, D. O.; Gbotosho, G. O.; Falade, C. O.; Bolaji, O. M.; Oladepo, O.; Osowole, O. S.; Happi, T. C.; Fawole, O. F.; Ogundahunsi, O. A. T.; Agbagwa, I. M.; Oduola, O.; Oduola, A. M. J.
This study was carried out in two rural communities; kaani and Boue, in Khana Local Government Area (LGA) and in one urban community, Elomo, in Elomo LGA, all in Rivers state, South-south, Nigeria. The investigations involved in-depth interview conducted with 104 health care givers comprising indigenous healers: herberlists, sellers of herbal remedies and community elders. Information was obtained on types of fevers (febrile illnesses) treated, symptoms and methods of establishing illnesses, and traditional herbs used in the prevention and treatment of febrile illnesses. On types of febrile illnesses treated, respondents presented the following: malaria (78.8%), typhoid (23.1%), yellow fever (21.2%), high fever (19.2%), convulsion (15.4%), and pregnancy fever (2.9%). Other illnesses treated were yellow eyes (4.8%), headache (11.5%), waist pain (14.4%), and joint pains (8.7%). Respondents determined whether a person had fever by the following: physical examination (85.4%), listening to patients' complaints (9.4%), through divination and inspiration (9.4%), while others (0.2%) were not quite explicit on their methods of diagnosis. On the treatment of febrile illnesees, respondents used herb teas (88.5%), herb powders (42.3%), incantation (3.3%), and performance of sacrifice (4.8%) or use of special fluids (27.9%). Majority of the respondents in describing the best herbal medicines for the treatment of febrile illnesses, 62.5% said that dogonyaro (Azadiracta indica) was the best medicine. Other responses were: lemon grass (Cymbepegon papaya) leaf/fruit (20.2%): guava (Psidium guajava) leaf (18.3%), akpagbogoro (Salacia nitida), 7.7%, plantain (Musa sapientum) sucker (6.7%), lipton tea (3.8%) and scent leaf (Ocimum gratissimum), 1.9%
Cultural categorization of febrile illnesses in correlation with herbal remedies used for treatment in Southwestern Nigeria
(Elsevier Science Ireland Ltd, 2003) Ajaiyeoba, E. O.; Oladepo, O.; Fawole, O. l.; Bolaji, A. M.; Akinboye, D. O.; Ogundahunsi, O. A. T.; Falade, C. O.; Gbotosho, G. O.; Itiola, O. A.; Happi, T. C.; Ebong, O. O.; Ononiwu, I. M.; Osowole, O. S.; Oduola, O. O.; Ashidi, J. S.; Oduola, A. M. J.
The ethnographic study was conducted in two communities in Oyo state in Southwestern Nigeria. The study sites consisted of a rural and an urban local government area located in the tropical rain forest zone of Nigeria. The study was designed to obtain information on febrile illnesses and herbal remedies for treatment with the aim of identifying potential antimalarial drugs. The study revealed that fever is a general term for describing illnesses associated with elevated body temperature. The indigenous Yoruba ethnic population has categorized fever based on symptoms and causes. The present communication is the result of focus group discussion and semi-structured questionnaire administered to traditional healers, herb sellers, elders and mothers. This was on types of fevers, symptoms and causes of febrile illnesses. The investigation also included use of traditional herbs in the prevention and treatment of the illnesses in the two communities. A total 514 respondents were interviewed. This was made up of 266 (51.8%) from Atiba local government area (LGA), an urban centre while 248 (48.2%) respondents were interviewed from Itesiwaju LGA, a rural community. The LGAs are located in Oyo State of Nigeria. The respondents proffered 12 types of febrile illnesses in a multiple response answering system in Yoruba language. The most common ones (direct translation into English) were: yellow fever (39.1%), typhoid (34.8%), ordinary (28.8%), rainy season (20.8%) and headache (10.5%) fevers respectively. Perceived causes each of the febrile illnesses included stress, mosquito bites, unclean water, rains and over exposure to the sun. Methods of fever prevention were mainly with the use of herbal decoctions, powdered herbs, orthodox medications and maintenance of proper hygiene. Of a total or 112 different herbal remedies used in the treatment or the febrile illnesses compiled from the study, 25 recipes are presented. Recipes consisted of 2-7 ingredients. Oral decoctions (84%), oral powders (63%). use as soaps and creams (40%) in a multiple response system, were the most prevalent routes of administration of prepared herbs used in the treatment of the fevers. Boiling in water or alcohol was the most common method used in the preparation of the remedies. The four most frequently mentioned (multiple response system) plants in the Southwest ethnobotany for fevers were Azadirachta indica (87.5%). Mangifera indica (75.0%), Morinda lucida (68.8%) and Citrus medica (68.8%).
Efficacy of herbal remedies used by herbalists in Oyo State Nigeria for treatment of Plasmodium falciparum infections a survey and an observation
(2004) Ajaiyeoba, E. O.; Falade, C. O.; Fawole, O. I.; Akinboye, D. O.; Gbotosho, G. O.; Bolaji, O. M.; Ashidi, J. S.; Abiodun, O. O.; Osowole, O. S.; Itiola, O. A.|; Oladepo, O.; Sowunmi, A.; Oduola, A. M. J.
In the course of evaluating the contribution of phytomedicine to possible drug discovery of antimalarial drugs, an ethnomedical survey of specialized children traditional clinics was done. In the observational multi center study, efficacy of eight different herbal remedies, each consisting of 3-8 ingredients and administered by herbalists were investigated in clients enrolled in the six traditional clinics in Oyo (urban center) and Otu (rural center) of Oyo State, Nigeria. The clients, aged between six months and fifteen years with clinical symptoms of malaria were enrolled in the clinics of the herbalists, as their usual practice. Oral informed consents were obtained from their parents or guardians. Microscopic diagnosis of malaria infection was used, to evaluate parasitaemia and validate efficacy of herbal remedies. Results of the analyzed shows that, of the 163 clients of the herbalists, only 62 (30 Oyo, 32 from Otu) had microscopically confirmed P. falciparum infection. Only results from 54 clients (29/30 (Oyo) and 25/32 (Otu) with P. falciparurn infection could be evaluated. Plasmodium falciparum infection in 88% (23/29) of clients from Oyo responded to treatment with the herbal remedies while cure rate in clients from Otu was 42% (13/25). Parasite densities ranged from 171 to 53,613 parasites/ul blood and 87 to 36,209 parasites/ul blood in patients from Oyo and Otu respectively. The herbalists administered the remedies and Gossypium arboreum, Anarcudium occidentalis, Citrus medica, Phyllanthus amarus and Lippia multiflora were the main ingredients in the efficacious remedies. The herbalists gave detailed descriptions of each of the 8 herbal remedies proffered. The results confirm the efficacy of two of the eight herbal remedies, thereby validating the role of ethnomedicine as a possible source for the discovery of new cherno-therapeutic agents in the treatment of P. falciparum malaria.
Evaluation of paracheck - Pf™ rapid malaria diagnostic test for the diagnosis of malaria among HIV-positive patients in Ibadan, South-Western Nigeria
(Taylor and Francis, 2013) Falade, C. O.; Adesina-Adewole, B.; Dada-Adegbola, H. O.; Ajayi, I. O.; Akinyemi, J. O.; Ademowo, O. G.; Adewole, I. F.; Kanki, P.
Febrile illnesses occur frequently among HIV positive patients and these are often treated presumptively as malaria in endemic areas. Parasite-based diagnosis of malaria will eliminate unnecessary treatment, reduce drug–drug interactions and the chances for the emergence of drug resistant Plasmodium. We evaluated finger prick blood samples from 387 people living with HIV (PLWHIV) and suspected of having malaria by expert microscopy and Paracheck-Pf TM – a histidine-rich protein-II based malaria rapid diagnostic test. The study was conducted at the PEPFAR supported AIDS Prevention Initiative in Nigeria (APIN) Clinic of the University College Hospital Ibadan, southwest Nigeria. Outcome parameters were prevalence of malaria parasitemia, sensitivity and specificity of Paracheck-Pf as well as the positive and negative predictive values for Paracheck-Pf using microscopy of Giemsa-stained blood film as gold standard. Malaria parasites were detected in 19.1% (74/387) of enrollees by microscopy and 19.3% (74/383) by Paracheck-Pf. Geometric mean parasite density was 501/µl (range 39–749 202/µl). Sensitivity and specificity of Paracheck-Pf at all parasite densities were 55.4% and 89.3% while corresponding figures at parasite densities ≥200/µl were 90.9% and 90.3%. Sensitivity and specificity at parasite densities ≥500/µl was 97.6% and 90.3%. Positive and negative predictive values for parasite density ≥200/µl were 55.4% and 98.7%, respectively. Paracheck-pf was found to be a useful malaria diagnostic tool at parasite densities ≥200/µl facilitating appropriate clinical management.
Fighting a moving target: malaria the pains and the gains
(Ibadan University Press, 2014) Falade, C. O.
Nigerian antimalarial ethnomedicine 2: Ethnobotanica surveys of herbal remedies used in the treatment of febrile illnesses in the middle belt of Nigeria
(2002) Ajaiyeoba, E. O.; Osowole, O. S.; Oduola, O .O.; Ashidi, J. S.; Akinboye, D. O.; Gbotosho, G. O.; Falade, C. O.; Ogundahunsi, O. A. T.; Fawole, O. I.; Bolaji, O. M.; Falade, M. O.; Oladepo, O. O.; Itiola, O. A.; Oduola, A. M. J.
An ethnobotanical survey was conducted among residents of Gboko (urban) and Katsina Ala ( rural) local government areas in Benue state located in the middle belt of Nigeria. The Katsina-Ala and Gboko communities belong to the Tiv ethnic group. Documentation of the use of herbs as alternative in the treatment of fevers and identification of potential phytomedicines against malaria was done. Semi-structured questionnaires and focus group discussion guides were used to obtain information on description of febrile illness and utilization of herbal remedies for prevention and treatment. A total of 499 respondents comprising of mothers, fathers, community leaders/elders, herbs sellers and traditional healers were interviewed in the study. In the study, 9 types of febrile illnesses were proffered. The five most common type of febrile illnesses described were malaria (37.3%), yellow (28.8%), typhoid (27.3%), high fever (3.4%) and ordinary fever (0.5%). Perceived causes of febrile illness included mosquito bites, contamination of water and food, among others. Headache, general weakness, yellow coloration of eyes/uririe, elevated body temperature and diarrhoea, were the most common symptoms associated with febrile illnesses outlined by the respondents. Furthermore, malaria (81.5%) and high fever (57%) were reported to be common during the rainy season while typhoid (52%) is common during the dry season. Yellow fever was said to be non-dependent on season. Respondents believed children were more at risk of malaria compared with the other types of febrile illnesses mentioned. The respondents indicated that herbal recipes were effective treatment for Febrile illness. From the 105 recipes compiled, Azadirachto indica, Ficus thonningii, Annona senegalensis and Cymbopogon citratus were the most frequent herbs mentioned. Leaf (60.4%), was the most common part of plants used while boiling (92.5%), was frequently mentioned as method of herbal remedy preparation. The main route of administration of remedies mentioned was oral administration (97.9%). The study confirms the potential contribution of Phytomedicine to management of febrile illnesses, including malaria in the Tiv ethnomedicine.
A qualitative study of the feasibility and community perception on the effectiveness of artemether-lumefantrine use in the context of home management of malaria in south-west Nigeria
(Elsevier Ltd., 2008) Ajayi, I. O.; Falade, C. O.; Olley, B. O; Yusuf, B.; Gbotosho, S.; Iyiola, T.; Olaniyan, O.; Happi, C.; Munguti, K
Background: In Nigeria ACT use at the community level has not been evaluated and the use of antimalarial drugs (commonly chloroquine (CQ)) at home has been shown to be largely incorrect. The treatment regimen of ACT is however more complicated than that of CQ. There is thus a need to determine the feasibility of using ACT at the home level and determine community perception on its use. Methods: A before and after qualitative study using key informant interviews (KII) and focus group discussions (FGDs) was conducted in selected villages in Ona-Ara local government area. At baseline, 14 FGDs and 14 KIIs were conducted. Thereafter, community medicine distributors (CMDs) were trained in each village to dispense artemeter-lumenfantrine (AL) to febrile children aged 6–59 months presumed to have uncomplicated malaria. After one year of drug distribution, nine KIIs and 10 FGDs were conducted. Participants and key informants were mothers and fathers with children under five years, traditional heads of communities, opinion leaders and health workers. Results: None of the participants have heard of AL prior to study. Participants were favourably disposed to introduction of AL into the community. Mothers/caregivers were said to have used AL in place of the orthodox drugs and herbs reported commonly used prior to study after commencement of AL distribution. The use of CMDs for drug distribution was acceptable to the participants and they were judged to be efficient as they were readily available, distributed correct dose of AL and mobilised the community effectively. AL was perceived to be very effective and no significant adverse event was reported. Major concerns to the sustainability of the program were the negative attitudes of health workers towards discharge of their duties, support to the CMDs and the need to provide CMDs incentives. In addition regular supply of drugs and adequate supervision of CMDs were advised. Conclusion: Our findings showed that the use of AL at home and community level is feasible with adequate training of community medicine distributors and caregivers. Community members perceived AL to be effective thus fostering acceptability. The negative attitudes of the health workers and issue of incentives to CMDs need to be addressed for successful scaling-up of ACT use at community level.