An epidemiological survey of intestinal helminthiases was conducted on 766 primary school children aged 5-16 years from Ile-Ife, Nigeria. On the basis of stool examinations, the prevalence of Ascaris lumbricoides, Trichuris trichiura, hookworm and Strongyloides stercoralis was 88.5, 84.5, 33.1 and 3% respectively. Intensity of infection was measured indirectly by egg counts for each species of helminth and also by counting worms passed after chemotherapy in the case of A. lumbricoides. The influence of host age and sex on infection levels was assessed. Relationships between the intensities of A. lumbricoides, T. trichiura and hookworm in individual children were identified. After anthelmintic treatment with levamisole, the frequency distribution of A. lumbricoides per host and the relationship between parasite fecundity and worm burden were investigated. Reinfection patterns of A. lumbricoides were assessed at two 6-monthly intervals and even within the narrow age range described, differences were found. In addition, evidence was obtained for predisposition of individuals to heavy or light infection with A. lumbricoides.

Six Nigerian women aged from 22 to 56 years who had not recently been pregnant were successfully relactated by breast suckling alone. All of them produced enough milk to exclusively breastfeed 'motherless' infants. All except one child have continued to breastfeed up to the time of this report and show adequate growth.

SummaryOBJECTIVE Neonatal tetanus (NNT) is the leading cause of neonatal deaths in developing countries. The objective of this study was to determine prognostic indicators in NNT. METHODS We reviewed the clinical records of all neonates (n ϭ 174) admitted to Ife State Hospital with the diagnosis of NNT from 1991 through 1995. RESULTS Delivery had occurred at home in 73.3% of cases. Only 37/164 of the mothers had had adequate immunization with tetanus toxoid. The umbilical cord appeared to be the portal of entry in 58.6% of cases. Mean age of infants at presentation was 7.2 days. Mortality was 57.5%; non-survivors succumbed after mean stay in the hospital of 5.0 days. Mortality was significantly associated with an incubation period of 6 days or less (P ϭ 0.0026), infant's weight of less than 2.5 kg (P ϭ 0.0113), lack of antenatal care in a health facility (P ϭ 0.0279), birth at home (P ϭ 0.0455), but not with lack of adequate maternal immunization (P = 0.2081; not significant). Multivariable analysis showed that a short (р 6 d) incubation period was the strongest predictor of mortality (OR ϭ 3.11, P ϭ 0.0030) while low infant weight (Ͻ 2.5 kg) was also a significant predictor (OR ϭ 2.46, P ϭ 0.0408). CONCLUSIONS Hygienic deliveries and adequate cord care are very important for the prevention of neonatal tetanus deaths, and universal prenatal care, including education programmes on appropriate perinatal and cord care, can significantly reduce NNT incidence and mortality in developing countries.

The excretion of chloroquine and the major metabolite, desethylchloroquine, in breast milk was investigated in eleven lactating mothers following a single oral dose of chloroquine (600 mg base). The average milk to plasma concentration ratio at the 24th hour was 6.6 ± 2.4 for chloroquine and 1.5 ± 0.6 for desethylchloroquine in five of the volunteers. In five other volunteers the elimination half-life of chloroquine in milk was 8.8 ± 4.7 days which was longer than that in saliva (3.9 ± 1.0 days) from the same volunteers. The maximum daily dose of the drug that the infant can receive from breastfeeding was about 0.7% of the maternal start dose of the drug in malaria chemotherapy. It is, therefore, suggested that it is safe for mothers to breastfeed their infants when undergoing treatment for malaria with chloroquine.

An epidemiological study of Ascaris lumbricoides infections was carried out in primary school children aged 5-16 yr from Ile-Ife, Nigeria. Intensity of infection was assessed directly by means of counting worms passed during a 48-hr period after chemotherapy. Reinfection patterns of A. lumbricoides were assessed at 2 6-mo intervals and statistical evidence of predisposition to infection status was obtained. An investigation of 3 groups of children who were judged to be predisposed not to be infected, to be lightly infected, and to be heavily infected was undertaken. Assignment to the groups was based upon the mean worm burden plus 1 SD above the mean, measured at 2 6-mo intervals. The distribution of class I human leucocyte antigens among the 3 groups of children was described. None of the children who were predisposed to remain uninfected was found to possess the A30/31 antigens in contrast to those children who remained infected.