Arterolane and piperaquine Vs. artemether and lumefantrine in uncomplicated malaria: A randomized study in Nigeria Olufunsho Awodele, Ibrahim Sebutu Bello, Babatunde Abdulmajeed Akodu, Abdulakeem Ayanleye Ahmed, Sikiru Usman, Rahman Ayodele Bolarinwa, Akinwumi Akinyede, Hameed Adewale Adelabu, Emmanuel Oluwatimilehin Akande, Jayanta Dey, Vinay Kudrigikar, P Sameer Rao, Suyog Mehta International Journal of Infectious Diseases, 2025 OBJECTIVE: To compare the efficacy and safety of Arterolane maleate-Piperaquine phosphate (AMP) and Artemether-lumefantrine (AL) in Nigerian patients with acute, uncomplicated Plasmodium falciparum malaria. METHODS: This phase IV, randomized, multicenter, open-label, active-controlled study included patients aged 12-65 years with acute symptomatic, uncomplicated P. falciparum malaria. A total of 350 patients were randomized (1:1) to Test group [AMP (150 mg+750 mg) once daily] or Comparator group [AL (80 mg+480 mg) twice daily] for 3 consecutive days. The primary endpoint was polymerase chain reaction (PCR)-corrected adequate clinical and parasitological response (ACPR) on Day 28. Secondary endpoints included PCR-corrected ACPR (Day 42), PCR-uncorrected ACPR (Days 28 and 42), fever clearance time (FCT), and parasite clearance time (PCT). RESULTS: PCR-corrected ACPR was 100% on Day 28 and sustained till Day 42 in both groups. PCR-uncorrected ACPR rates were comparable in both groups (AMP: 98.2%, AL: 99.4% on Day 28, P = 0.352; AMP: 98.2%, AL: 98.8% on Day 42, P = 0.674). No significant differences in FCT and PCT were observed between the groups. No drug-related adverse events (AEs) or severe AEs were reported. CONCLUSION: Once-daily dosing of AMP demonstrates comparable efficacy and safety to standard twice-daily dosing of AL in the treatment of uncomplicated P. falciparum malaria. TRIAL ID: May 2023), URL: pactr.samrc.ac.za/Search.aspx.
Parasite clearance of two commonly administered artemisinin-based combination therapies in under-five children with uncomplicated malaria in a comprehensive healthcare facility in South-Western Nigeria: a randomised controlled trial Abdulakeem Ayanleye Ahmed, Ibrahim Sebutu Bello, Temitayo Oluwatoyin Adewole, Samuel Anu Olowookere, Olanrewaju Oloyede Oyegbade, Akinjide Olurotimi Ogundokun, Temitope Oluwafemi Olajubu, Roland I. Funwei, Olusola Ojurongbe, Daniel Adeife Adepoju, Abdulhakeem Bolaji Bello, Abdulwasiu Akanfe Adegboyega, Atinuke Olu Anjorin, Andrew Olushola Anjorin, Olubunmi Olateju Akinola, Kolawole Muideen Adewumi, Michael Kelechi Omenugha, Oluwasina Tajudeen Salami, Akintayo Olayinka Familusi, Emmanuel Oluwatimilehin Akande BMC Infectious Diseases, 2025 This research work aimed to study the parasite clearance of two commonly prescribed artemisinin-based combination therapies (ACTs) in under-five children with uncomplicated malaria in a comprehensive healthcare facility in Southwestern Nigeria. An open-label, randomised controlled clinical trial was conducted. The participants were randomised into two treatment groups using simple randomisation by computer-generated random numbers. Children between the ages of six and 59 months with uncomplicated malaria in a comprehensive healthcare facility in southwestern Nigeria were enrolled after fulfilling the study criteria between July 2020 and December 2020. They had either artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine phosphate (DHAPQ) for three days. The participants were monitored for 42 days by examining blood films for malaria parasite density on days 1, 2, 3, 7, 14, 21, 28, 35, and 42. Malaria parasite genotyping by polymerase chain reaction (PCR) was done to differentiate between reinfection and recrudescence. The main outcome measures were malaria parasite clearance, adequate clinical and parasitological response on days 28 and 42 (ACPR28 and ACPR42), and tolerability. A total of 122 participants were randomised to receive either AL (61 participants) or DHAPQ (61) with a mean age of 23.6 ± 13.0 (months) and 27.6 ± 16.6 (months), respectively. Day 42 per protocol analysis included 113 participants – 57 in the AL group and 56 in the DHAPQ group after excluding the nine that were lost to follow-up. Although not statistically significant, the median baseline malaria parasite density of participants in AL group was higher than that in the DHAPQ group (3,600.0 parasite/µL, lower quartile (LQ) 2,420 parasite/µL, upper quartile (UQ) 5,399 parasite/µL versus 3,440.0 parasite/µL, LQ 2,640 parasite/µL, UQ 5,597 parasite/µL; p = 0.636). The mean fever clearance time was significantly lower in the AL group compared to the DHAPQ group (46.16 ± 3.31 h vs. 48.83 ± 8.95 h; p = 0.032). Parasite clearance time was shorter in the AL treatment group compared to DHAPQ (61.30 ± 23.75 h vs. 63.97 ± 23.42 h; p = 0.541), but this difference was not statistically significant. The day 42 PCR uncorrected cure rate in the AL group and DHAPQ group was 94.7% and 92.9% respectively (p = 0.679). The cure rate increased to 100% in both groups after PCR correction. Five participants in the DHAPQ group reported mild adverse events compared to none of those in the AL group. The study concluded that both DHAPQ and AL had good parasite clearance. Registered on 10/07/2020 with the Pan African Clinical Trials Registry, Cochrane South Africa (PACTR202007553348930).
Asymptomatic bacteriuria in patients with type 2 diabetes mellitus in rural southwestern Nigeria: a cross-sectional study Azeez Oyemomi Ibrahim, Ibrahim Sebutu Bello, Oluwaserimi Adewumi Ajetunmobi, Kolawole Michael Olusuyi, Gbadebo Oladimeji Ajani, Kayode Rasaq Adewoye, Oluwatosin Oluwagbenga Oguntoye, Omowonuola Olubukola Sonibare, Ayodele Kamal Alabi Journal of International Medical Research, 2024 Objectives We aimed to identify the prevalence, bacterial isolates, antimicrobial susceptibility profile, and factors associated with asymptomatic bacteriuria (ASB) in patients with type 2 diabetes mellitus (T2DM) in rural southwestern Nigeria. Methods We performed a hospital-based cross-sectional study of patients with T2DM and ASB. Demographic and clinical data were collected using questionnaires. Urine samples were cultured using standard laboratory procedures, and bacterial colonies were isolated and antimicrobial sensitivity was performed using the disc diffusion technique. Relationships between variables were assessed using adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results Of the 280 participants, 73 (26.1%) had ASB (95% CI: 20.9%–31.2%). The most commonly identified isolate was E. coli (45/73; 61.7%), 100.0% of which were sensitive to cefuroxime but resistant to ciprofloxacin. Female sex (AOR, 6.132; 95% CI: 2.327–16.157), living below the poverty line (AOR, 2.066; 95% CI: 1.059–4.029), uncontrolled blood glucose (AOR, 2.097; 95% CI: 1.000–4.404), and a history of indwelling urethral catheterization (AOR, 14.521; 95% CI: 4.914–42.908) were associated with ASB. Conclusion The findings suggest that cefuroxime should be used as an empirical treatment, pending urine culture and sensitivity, and that efforts should be made to prevent ASB in rural southwestern Nigeria.
Malaria infection and its association with socio-demographics, long lasting insecticide nets usage and hematological parameters among adolescent patients in rural Southwestern Nigeria Azeez Oyemomi IBRAHIM, Tosin Anthony Agbesanwa, Shuaib Kayode AREMU, Ibrahim Sebutu BELLO, Olayide Toyin ELEGBEDE, Olusegun Emmanuel GABRIEL-ALAYODE, Oluwaserimi Adewumi AJETUNMOBI, Kayode Rasaq ADEWOYE, Temitope Moronkeji OLANREWAJU, Ebenezer Kayode ARIYIBI, Adetunji OMONIJO, Taofeek Adedayo SANNI, Ayodele Kamal ALABI, Kolawole OLUSUYI Plos One, 2023 Background There is increasing evidence suggesting that adolescents are contributing to the populations at risk of malaria. This study determined the prevalence of malaria infection among the adolescents and examined the associated determinants considering socio-demographic, Long Lasting Insecticide Nets (LLINs) usage, and hematological factors in rural Southwestern Nigeria. Methods A hospital-based cross-sectional study was conducted between July 2021 and September 2022 among 180 adolescents who were recruited at a tertiary health facility in rural Southwestern Nigeria. Interviewer administered questionnaire sought information on their socio-demographics and usage of LLINs. Venous blood samples were collected and processed for malaria parasite detection, ABO blood grouping, hemoglobin genotype, and packed cell volume. Data were analyzed using SPSS version 20. A p-value <0.05 was considered statistically significant. Results The prevalence of malaria infection was 71.1% (95% CI: 68.2%-73.8%). Lack of formal education (AOR = 2.094; 95% CI: 1.288–3.403), being a rural residence (AOR = 4.821; 95% CI: 2.805–8.287), not using LLINs (AOR = 1.950; 95% CI: 1.525–2.505), genotype AA (AOR = 3.420; 95% CI: 1.003–11.657), genotype AS (AOR = 3.574; 95%CI: 1.040–12.277), rhesus positive (AOR = 1.815; 95% CI:1.121–2.939), and severe anemia (AOR = 1.533; 95% CI: 1.273–1.846) were significantly associated with malaria infection. Conclusion The study revealed the prevalence of malaria infection among the adolescents in rural Southwestern Nigeria. There may be need to pay greater attention to adolescent populations for malaria intervention and control programs.
Prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido-Ekiti, Southwestern Nigeria Azeez Oyemomi Ibrahim, Ibrahim Sebutu Bello, Adewumi Oluwaserimi Ajetunmobi, Abayomi Ayodapo, Babatunde Adeola Afolabi, Makinde Adebayo Adeniyi Plos One, 2023 Background Asymptomatic malaria infections have received less attention than symptomatic malaria infections in major studies. Few epidemiological studies on asymptomatic malaria infections have often focused on pregnant women and children under-five years of age as the most vulnerable groups. However, there is limitation on data regarding asymptomatic infections among the old adult populations, particularly in the study area. Therefore, this study determined the prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido- Ekiti, Southwestern Nigeria. Methods A hospital-based cross-sectional study was conducted between July and September 2021 among 232 consenting apparently healthy individuals aged 40 years and above who were recruited during a free health screening program using a standardised interviewer-administered questionnaire. The questionnaire sought information on respondents’ socio-demographics, presence and types of co-morbidity, and the prevention methods being adopted against malaria infection. Venous blood samples were collected and processed for asymptomatic infections using Giemsa-stained blood smear microscopy. Data were analysed using SPSS version 21. Multivariate logistic regression was used to identify factors associated with asymptomatic infections. Results Of the total 232 respondents, 19.0% (48/232) were confirmed to be infected with Plasmodium falciparum (95% confidence interval (CI): 14.1% - 24.6%). Lack of formal education (Adjusted odds ratio (AOR): 5.298, 95% (CI): 2.184-13.997), being diabetic (AOR: 4.681, 95% CI: 1.669-16.105), and not sleeping under Long Lasting Insecticide Net (LLINs) (AOR: 4.594, 95% CI: 1.194-14.091), were the determinants of asymptomatic Plasmodium falciparum infection. Conclusion The prevalence of asymptomatic Plasmodium falciparum was 19%. Lack of formal education, being diabetic, and not sleeping under LLINs were the determinants of asymptomatic infections.
Malaria among the elderly in five communities of Osun East district, Southwest Nigeria: Prevalence and association with non-communicable diseases Ibrahim Sebutu Bello, Temitope Oluwafemi Olajubu, Olusegun Olumuyiwa Osundiya, Oluwasina Tajudeen Salami, Azeez Oyemomi Ibrahim, Abdulakeem Ayanleye Ahmed Sage Open Medicine, 2023 Objective: The level of immunity against pathogens decreases with old age. As a result, the elderly may be regarded to be at increased risk of malaria morbidity and fatality. There is paucity of studies on malaria among the elderly population in Osun East district, Southwest Nigeria. This study aimed to determine the prevalence of malaria and its association with medical comorbidities among the elderly. Methods: A descriptive cross-sectional study was carried out, which involved 972 adult residents of five communities in Osun State, who were selected using a multistage random sampling technique. Data was collected with aid of a structured questionnaire. The medical history of respondents and anthropometric measures were obtained. The presence of malaria parasitaemia in the respondents was determined by rapid diagnostic test (RDT). Appropriate descriptive and inferential analyses were done. Results: Out of the 972 respondents, 504 (51.9%) were 60 years and above. The overall prevalence of malaria RDT positivity was 4%. The positivity rate was higher among the elderly (4.6%) compared to those less than 60 years (3.4%), albeit not statistically significant ( p = 0.36). Among these elderlies, 52.6% and 16.1% used insecticide-treated nets and insecticide sprays, respectively. There was no association between the prevalence of malaria positivity and comorbid conditions, such as hypertension ( p = 0.37), overweight/obesity ( p = 0.77), or diabetes ( p = 0.15). Malaria positivity rate was also not significantly associated with the use of insecticide-treated nets ( p = 0.64) or insecticide sprays ( p = 0.45). Conclusion: The malaria positivity rate was higher among the elderly in the study area, although not statistically significant. The prevalence was not associated with comorbid medical conditions.
Agreement among rapid diagnostic tests, urine malaria tests, and microscopy in malaria diagnosis of adult patients in southwestern Nigeria Jonathan Ayobami Oyeniyi, Ibrahim Sebutu Bello, Olanrewaju Oloyede Oyegbade, Azeez Oyemomi Ibrahim, Oyeladun Funmi Okunromade, Oladipupo Omolade Fakoya Journal of International Medical Research, 2022 Objective We determined the malaria prevalence and ascertained the degree of agreement among rapid diagnostic tests (RDTs), urine malaria tests, and microscopy in malaria diagnosis of adults in Nigeria. Methods This was a cross-sectional study among 384 consenting patients recruited at a tertiary health facility in southwestern Nigeria. We used standardized interviewer-administered questionnaires to collect patients’ sociodemographic information. Venous blood samples were collected and processed for malaria parasite detection using microscopy, RDTs, and urine malaria tests. The degree of agreement was determined using Cohen’s kappa statistic. Results The malaria prevalence was 58.3% (95% confidence interval [CI]: 53.0–63.1), 20.6% (95% CI: 16.6–25.0), and 54.2% (95% CI: 49.0–59.2) for microscopy, RDTs, and urine malaria test, respectively. The percent agreement between microscopy and RDTs was 50.8%; the expected agreement was 45.1% and Cohen’s kappa was 0.104. The percent agreement between microscopy and urine malaria tests was 52.1%; the expected agreement was 50.7% and Cohen’s kappa was 0.03. Conclusion The malaria prevalence was dependent on the method of diagnosis. This study revealed that RDTs are a promising diagnostic tool for malaria in resource-limited settings. However, urine malaria test kits require further improvement in sensitivity prior to field use in malaria-endemic settings.
Malaria infection and its association with socio-demographics, preventive measures, and co-morbid ailments among adult febrile patients in rural Southwestern Nigeria: A cross-sectional study Azeez Oyemomi Ibrahim, Ibrahim Sebutu Bello, Olabode Muftau Shabi, Adejumoke Oluwatosin Omonijo, Abayomi Ayodapo, Babatunde Adeola Afolabi Sage Open Medicine, 2022 Objectives: The study determined the prevalence of malaria infection and its association with socio-demographics, environmental, housing, and co-morbid ailment factors. Methods: The study was a cross-sectional of 330 consented adult febrile patients who were recruited at a tertiary health facility in rural Southwestern Nigeria. The standardized interviewer-administered questionnaire sought information on their socio-demographics, environmental, housing, and co-morbid ailment factors. Venous blood samples were collected and processed for malaria parasite detection, retroviral screening, glycated hemoglobin, and hemoglobinopathy. Data were analyzed using SPSS version 20. The strength of the association between independent and dependent variables was measured using odds ratio and 95% confidence interval with a significant level ( p value <0.05). Results: The prevalence of malaria parasitemia was 63.3% (95% confidence interval: 57.9%–68.5%). Being a farmer ( p = 0.002), lack of formal education ( p = 0.043), low-income earners ( p = 0.031), presence of bushes ( p = 0.048), stagnant water ( p = 0.042), not sleeping under long-lasting insecticide-treated nets ( p < 0.001), and sickle cell disease ( p = 0.041) were significantly associated with malaria infection. Conclusion: The study revealed that there is a high prevalence of malaria infection in rural Southwestern Nigeria. There may be a need to pay greater attention to adult populations in rural areas for malaria intervention and control programs.
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