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BACKGROUND:Accurate laboratory diagnosis of suspected malaria is the hallmark to the control of the disease.AIM:The clinical proficiency of commercial Rapid Diagnostic test kits (RDTs) using nested PCR as quality control was evaluated among patients attending two public healthcare providing institutions in Ilorin, Kwara state, North-Central, Nigeria.METHOD:A cross-sectional evaluation of finger prick blood samples of volunteer patients were accessed for malaria parasites with pLDH, HRP2, Pf, Pf/PAN and nested PCR molecular assays. The data derived were analysed using standard formulae for diagnostic accuracy, and the obtained predictive values were subjected to a comparison with one-way analysis of variance (ANOVA).RESULT:Three hundred and sixty-eight (368) patients comprising 203 (55%) females and 165 (45%) males participated in this study. Routine microscopy revealed that 54 (32.7%) males and 80 (39.4%) was infected with Plasmodium falciparum. SD Bioline (pLDH) 47.4%; Carestart Malaria (HRP2) 49.8% recorded low sensitivities. Micropoint (pfPAN) 82.8% and Micropoint (Mal. Pf) 64.4% recorded a high sensitivity. SD Bioline (pLDH) 67.4%; Carestart Malaria (HRP2) 85.9%; Micropoint (PfPAN) 62.2% and Micropoint (Mal. Pf) 86.7% had high specificities. The positive predictive value (PPV) ranged from 67.7% to 85.94%, while the negative predictive values (NPV) of 64.4% for SD Bioline (pLDH); 86.7% for Carestart Malaria (HRP2); 89.3% for Micropoint (pfPAN) and 58.5% for Micropoint (Mal. Pf). Agarose gel analysis of P. falciparum ssrRNA gene (206 bp) for 28 specimens containing 10% concordant and discordant samples showed that all 12 negative specimens for RDTs and routine microscopy were truly negative for nPCR. However, the remaining 16 specimens were positive for nPCR and showed discrepancies with routine microscopy and RDTs. Cohen’s interrater diagnostic measure analysis revealed that the weighted kappa for the RDTs was moderate 0.417 (p=0.027), 95%CI (0.756, 0.078) and good for nPCR 0.720 (p < 0.001), 95%CI (0.963, 0.477). The area under the curve (AUC) specify that nPCR has been more effective than the RDTs (nPCRAUC = 0.875; p < 0.001 and RDTsAUC = 0.708; p = 0.063).CONCLUSION:A thorough large-scale quality control is advocated on all commercial RDTs being used in most sub-Saharan African countries. This is to avoid double jeopardy consequent upon misdiagnosis on unidentified positive cases serving as pool reservoir for the insect vector and cyclical infection and re-infection of the populace.

Fascioliasis is a serious infectious parasitic disease of human and domestic ruminants. It is caused by the common liver flukes Fasciola hepatica and Fasciola gigantic and it is of public health concern in some countries of the world. Species-level identification of these species using only morphological methods is unconvincing, unreliable and sometimes difficult. Molecular methods enhance the prospects of species-level identifications using a well established and highly reliable DNA-based approach. We used PCR-RFLP analysis for precise identification of Fasciola species collected from Nigeria. One hundred Fasciola adult worms were collected from selected abattoirs in Ilorin, North-central Nigeria. The parasitic worms were first identified by morphometric analysis using AmScope digital camera fastened to the ocular eye piece of the light microscope. For the molecular identifications, genomic DNA was extracted, Polymerase Chain Reaction (PCR) technique and RFLP were used to characterise the Fasciola adult worms. Morphometric data showed that 70 out of the 100 Fasciola adult worms have characteristic features similar with that of F. gigantica as described from previous studies while the remaining 30 adult worms have characteristics that deviate from that of F. gigantica but did not confirm with characteristic features of F. hepatica. Agarose gel electrophoresis result confirmed successful amplification of two gene regions of Sodium Dehydrogenase I (ND1) from mitochondrial DNA of Fasciola spp. The PCR-RFLP analysis did not show any noticeable genetic variation in the Fasciola adult worms. We suggest more studies to be done using DNA sequence analysis and other molecular markers such as random amplified polymorphic DNA (RAPD) and simple sequence repeat (SSR) to better understand the genetic variability and population structure within Fasciola spp. in Nigeria.

BackgroundRecent ethnomedicinal studies on Bridelia ferruginea Benth (family Phyllanthaceae) as an antiplasmodial remedy have established its potency as a strong prophylactic and chemosuppressive agent. Human consumption of medicinal herbs without adequate evaluation of its efficacy and safety can result in grave physiological and pathological consequences. Therefore, this study assessed the antiplasmodial bioactivity, biochemical, hematological, histopathological and toxicity profile of the ethanolic stem bark extract of B. ferruginea in mice.MethodsEthanolic stem bark extract of B. ferruginea (200, 400 and 800 mg/kg) were orally administered to Plasmodium berghei-infected mice in models and were subsequently observed for mortality, behavioral changes and signs of toxicity. Acute evaluation was experimented at 1,000 mg/kg for 28 days. Occult blood obtained from the euthanized mice were subjected to biochemical and hematological assays. A comprehensive assessment of the histology of the liver and kidney was also ascertained. The median lethal dose (LD50) was determined and extrapolated using the regression equation obtained from the plot of the probits of mortalities (y) and the log of doses (log10C).ResultsDifferent concentrations of the phytochemical secondary metabolites were revealed. Antiplasmodial bioactivity was established at the 200, 400 and 800 mg/kg of the herbal extract with a dearth in parasitemia at different days post-treatment. The 800 mg/kg group responded by exhibiting a dose-dependent decrease in parasitemia comparable with the chloroquine bi-phosphate group. Significant alterations in the histology of the liver and kidney of the 1,000 mg/kg group was documented. There was a reduction in the titers of LDH, ALT, AST, and urea in the treated group when compared with the control (p < 0.05). Antioxidant profiles were also highly significant with elevation in SOD, GPx, and CAT, but a reduction in MDA. LD50 was established at 424 mg/kg.ConclusionB. ferruginea Benth (family Phyllanthaceae) is a potent antiplasmodial, antioxidant, regenerative and ameliorative herbal remedy if administered in controlled dosage.