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Previous report on the estimation of plasma ascorbic acid levels in patients with chronic osteomyelitis indicated that the plasma ascorbic acid level is reduced in patients on antibiotics. The plasma study of the effects of anti-bacterial agents on plasma ascorbic acid in vitro, was carried out to substantiate the hypothesis than these agents lower plasma ascorbic acid levels. Increasing amounts of each of seven anti-bacterial agents: ampicillin, chloramphenicol, cefotaxime, gentamycin, benzyl and procaine penicillin combination (seclopen), co-trimoxazole, and streptomycin significantly (P < 0.01, r = -0.9587) reduced plasma vitamin C levels in vitro. There was moderate but insignificant reduction in plasma vitamin C levels with clindamycin (r = -0.799). The reduction of the plasma vitamin C levels observed in the presence of the eighth anti-bacterial agent, clindamycin, lacked significance (r = -0.799). The cause of this reduction of plasma vitamin C levels by anti-bacterial agents in vitro is not yet understood. A supplement of vitamin C may be required in patients on anti-bacterial agents.

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Five hundred and fifteen homes of nursing mothers in Ile-Ife, Nigeria, who had earlier brought their children for treatment of diarrhoeal diseases at the IUTHC infant child welfare clinics were visited between January 1982 and June 1984. The mothers' perceptions as to causes, prevention and control of childhood enteritis were elicited: 49.7% of the mothers attributed the cause of the disease to evil spirits; and 9.5% believed enteritis in children to be due to contamination of children's feeds. Modern medicine was perceived to be the ideal method for treating this disease by only 7.4% of the mothers, while 88.8% opted for any of the traditional methods. In order to reduce the devasting effects of enteric diseases among children born to mothers in tropical countries of Africa and Asia, it is imperative that all health workers understand the cultural and social perceptions of their clients towards the disease in question. Illiteracy, and unsanitary and unhygienic environmental conditions were found to be the main factors precipitating enteritis. Implications and strategies for minimizing diarrhoea and other childhood enteric diseases are discussed in the text.

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Kinetoplastid hemoflagellates are sensitive to growth inhibition by various purine analogs. In this study the activities of 9-deazainosine (9-DINO), formycin B, and sinefungin were compared in experimental murine Trypanosoma brucei subsp. brucei infections, both singly and in combination with the ornithine decarboxylase inhibitor DL-alpha-difluoromethylornithine (DFMO, eflornithine). Used singly, all of the purine analogs were able to suppress an acute T. brucei subsp. brucei infection. 9-DINO and formycin B were the most active. None of the purine analogs was curative when used singly against a strain causing chronic central nervous system infection. 9-DINO was highly effective when used in combination with DFMO in curing this central nervous system infection and another more stringent experimental infection. Neither sinefungin nor formycin B was active in combination with DFMO in curing the central nervous system experimental infection. 9-DINO was metabolized to phosphorylated derivatives of 9-deazaadenosine and 9-deazaguanosine by bloodstream trypomastigotes, but not by murine erythrocyte suspensions or kidney or liver homogenates--a potential rationale for the selectivity of the analog. These studies indicate that 9-DINO is a potent, nontoxic purine analog which, in combination with DFMO, is capable of late-stage cures of African trypanosomiasis.

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The duration of usage of a tin of powdered formula and the incidence of underweight among 250 infants 14 days to 12 months old, whose parents were educated and uneducated, are reported. Twenty-two percent of the educated mothers and 42% of the uneducated mothers started their infants on formula from the 14th day of life. Only 6% of all the mothers exclusively breastfed for 1 month, and a meager 2% of the uneducated mothers exclusively breastfed for 3 months. There was a significant (p less than 0.001) increase in the duration of usage of a tin of powdered formula among the uneducated mothers as compared to the educated ones. Of the 250 infants, 93 (37.2%) greater than or equal to 1 month old were assessed as underweight for age. Most of the underweight infants had uneducated mothers. Practical ways of improving feeding practices and curbing early introduction of supplementary feeds are suggested.

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Investigation of 122 women early in the second trimester of pregnancy who complained of constant dizziness during pregnancy, and used traditional "black rings on their middle fingers" as a prophylactic measure, revealed that 59% were anaemic (haemoglobin less than 10 g/100 ml). None of them had blood pressure above 120/70 mmHg. After two months of treatment with ferrous gluconate 300 mg three times daily, folic acid, weekly antimalarial drug, and individual regular nutrition counselling, the incidence of anaemia was reduced to 22.7%. The mean haemoglobin levels before and after initiation of drug therapy were 8.5 and 10.8 g/100 ml respectively. There was a significant difference between the two means (P less than 0.05). There was also a marked difference between the mean haemoglobin levels of ring-wearers and non-ring-wearers in the less educated members of the two groups (P less than 0.001). It can be inferred from this study that the wearing of black rings indicates that the patients are likely to be anaemic, and that educated women seem less likely to rely on this type of traditional treatment of pregnancy anaemia.

PIP: Investigation of 122 women attending Modakele Maternity Center in Ile-Ife, southern Nigeria in 1980 who complained of constant dizziness during pregnancy and used traditional black rings on their middle fingers as a prophylactic against dizziness during pregnancy were screened for anemia. These women were asked what they thought were the causes of dizziness and how they treated it. 59% were anemic (hemoglobin less than 10g/100ml). None of them had blood prssure above 120/70 mm. Hg. More than were 25-30 years and multigravida; 82% of the experimental group and 27% of the control group were illiterate. All the women in the experimental group thought that insufficient blood caused dizziness. They were all wearing black rings presoaked in native medicine to prevent dizziness. They all believed that rubbing the black on their faces instantly alleviated dizziness. No other medicine was taken along with the use of the ring; to do otherwise would show lack of confidence in the balck medicine. After 2 months of treatment with ferrous gluconate 300 mg 3 times daily, folic acid, weekly antimalarial drugs, and individual regular nutrition counseling, the incidence of anemia was redued to 22.7%. The mean hemoglobin levels before and after initiation of drug therapy were 8.5 and 10,8g/100 ml respectively. There was a significant difference between the 2 means (P0.05). There was also a marked difference between the mean hemoglobin levels of ring-wearers and nonring-wearers in the less educated members of the 2 groups (P0.001). It can be inferred from this study that the wearing of black rings indicates that the patients are likely to be anemic, and that educated women seem less likely to rely on this type of traditional treatment of pregnancy anemia.

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PIP: The type of birth defects ever seen or heard of and beliefs as to the causation and means of preventing the defects were investigated among 225 newly deliverd and nursing mothers through interviews. The majority were between the ages of 20 to 29 years; 9.3% were between 35 and 40 years. The bulk of the respondents are illiterates. More than 75% of the mothers had 2 or more children. The most common birth defects seen were amputated leg; dislocated hips; lamed hand or funny elbows or ankles; extra digits; and missing digits. Common perceptions of the causes were God's will (32.9%) and evil doers or evil powers due to witchcraft or sorcery (40.9%). Poor nutrition or poor antenatal care was reported by only 2.2%; while 1.3% attributed the cause to an excessive combination of native and modern drugs. The majority believed that avoidance of walking at night and midafternoon during pregnancy would prevent birth defects. 10.2% and 5.3% were of the opinion that praying to God and going to the herbalist respectively would prevent birth defects. Prevention of birth defects is an essential task for all health workers in Nigeria. The causes of birth defects should be brodcast on radio and television and published in national dialects in the newspapers. 83.6% claimed that they were not informed of various means of preventing birth defects during prenatal clinic visits. The schools should include prevention and causation of birth defects in a health education curriculum.^ieng

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Ninety-five children, age range from 1 to 18 months, were followed for the types of weaning foods. Forty-five of the 95 children were evaluated for intestinal bacteria colonization. The most frequently isolated pathogens were enteropathogenic Escherichia coli (EPEC) and Staphylococcus aureus. Children who were not subjected to early initiation of weaning and supplementary foods had lower bacteria counts than their counterparts.

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This research examined children between 13 and 23 months of age with developmental delays in walking. Children in the experimental group received intensive infant stimulation and, subsequently approximately 71% were able to walk by themselves. In contrast, 32% of those children receiving only verbal instruction were able to achieve this important milestone. There was a significant difference (p less than 0.05) between the control and experimental group in acquiring walking skills. Mothers' lack of awareness about infant stimulation and lack of supervision on the part of health workers are the major contributing factors to delayed walking skill in these children. The study highlights the importance of taking health care to the home of clients, the most neglected aspect of primary health in this part of the world.

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One hundred eighty-five urine specimens were collected from an unselected group of non-gravid Nigerian women patients attending the infertility and gynaecologic clinics in Ile-Ife, Nigeria to investigate the aerobic urethral microflora. The specimens revealed that 25.9% of the total collected and processed contained bacteria flora. The most common aerobes isolated were Escherichia coli, P. mirabilis and S. epidermidis, in that order. The study has shown that there are changes in the urethral microflora from one physiologic age group to the other and that colonization of the urethral and urinogenital tract is important in the development of urinary tract infections.

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Candida albicans colony counts were far higher in patients with vaginitis wearing tight fitting clothing than in patients wearing loose fitting clothing. In Ile-Ife, Nigeria, tight fitting dresses, woolen and corduroy jeans, coupled with nylon underwear, appear to create an environment favorable to Candida albicans colonization.

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