BackgroundNigeria commenced a phased programmatic deployment of rapid diagnostic tests (RDT) at the primary health care (PHC) facility levels since 2011. Despite various efforts, the national testing rate for malaria is still very low. The uptake of RDT has been variable. This study was undertaken to determine the provider and patient perceptions to RDT use at the PHC level in Nigeria with their implications for improving uptake and compliance.MethodsA cross-sectional survey was conducted in 120 randomly selected PHCs across six states, across the six-geopolitical zones of Nigeria in January 2013. Health facility staff interviews were conducted to assess health workers (HW) perception, prescription practices and determinants of RDT use. Patient exit interviews were conducted to assess patient perception of RDT from ten patients/caregivers who met the eligibility criterion and were consecutively selected in each PHC, and to determine HW’s compliance with RDT test results indirectly. Community members, each selected by their ward development committees in each Local Government Area were recruited for focus group discussion on their perceptions to RDT use.ResultsHealth workers would use RDT results because of confidence in RDT results (95.4%) and its reduction in irrational use of artemisinin-based combination therapy (ACT) (87.2%). However, in Enugu state, RDT was not used by health workers because of the pervasive notion RDT that results were inaccurate. Among the 1207 exit interviews conducted, 549 (45.5%) had received RDT test. Compliance rate (administering ACT to positive patients and withholding ACT from negative patients) from patient exit interviews was 90.2%. Among caregivers/patients who had RDT done, over 95% knew that RDT tested for malaria, felt it was necessary and liked the test. Age of patients less than 5 years (p = 0.04) and “high” educational status (p = 0.0006) were factors influencing HW’s prescription of ACT to RDT negative patients.ConclusionThe study demonstrated positive perception to RDT use by HW and among community members with good compliance rate among health workers at the PHC level. This positive perception should be explored in improving the current low level of malaria testing in Nigeria while addressing the influence of age on HW administration of ACT to RDT negative cases.

Mosquitoes are the most important group of insects in terms of public health importance, which transmit serious human diseases. The continuous application of synthetic insecticides to control these mosquitoes causes development of resistance in vector species, and an adverse effect on environmental quality and non-target organisms including human health. Therefore, the use of active toxic agents from plant extracts as alternative mosquito control strategy cannot be over emphasized, as these are non-toxic, easily available at affordable prices, biodegradable and show target - specific activities against different species of vector mosquitoes. The aim of the present study was to evaluate the larvicidal efficacy of the aqueous and methanol leaf extracts of H. suaveolens against the fourth instars larvae of Anopheles species. Standard WHO protocols was adopted for the larvicidal bioassay. Larvicidal activity was evaluated at concentrations of 200, 400, 600, 800 and 1000 mg/L. The larval mortality was observed after 24 and 48hours bioassay. The results are mean of three replicates and the mortalities recorded were subjected to chi-square test and probit analysis to determine median lethal concentrations (LC50). TheGC-MS analysis ofthe methanolic leaf extract of the plantrevealed the presence of twelve compounds on the chromatogram. Among the major compounds areOleic Acid (33.33%), Octadecanoic acid (13.52%), 1,3-Cyclohexadiene-1-methanol,alpha.,2,6,6-(10.42%), 1,3-Cyclopentanediol, trans (9.60%), n-Hexadecanoic acid (9.01%) and 4-Hepten-3-one, 4-methyl (7.0%).The phytochemical screening of the aqueous and methanol leaf extracts of the plant revealed the presence of Tannins, Terpenoids, Flavonoids, Steroids, Carbohydrates, Cardiac glycoside and resins. The LC50 values estimated were 316.22mg/Lfor methanol extract and 323.59 mg/L for aqueous extract. The differences between the two extracts were however not significantly different at P>0.05. The findings also revealed that mortality was concentration dependent and both extracts showed promising larvicidal activity against Anopheles species larvae. Therefore, the crude leaf extract of the plant is recommended to be used as alternative to synthetic larvicides and further research is needed to test the activity of the plant on non-target organisms.