Deploying unqualified personnel in health records practice: Role substitution or quackery? Implications for health services delivery in Nigeria.

Healthcare professionals are obliged to work collaboratively regardless of their professional differences in order to provide the highest possible standard of care to patients. However, this type of collaboration can also lead to role substitution and, in effect, engagement of unqualified personnel in all health professions, including the health information management profession. This is a particular problem in developing nations such as Nigeria, where this trend has the potential to undermine the delivery of health services, the quality and the confidentiality of health information and trust between patients and healthcare professionals.

Acute psychosis after mefloquine. Report of six cases.

A self-limiting psychosis characterized by acute onset of visual and auditory hallucinations and poor sleep developed in six adults between 8 and 24 hours after oral administration of 750-1500 mg of the antimalarial mefloquine. All patients had no personal or family history of psychosis and were neurologically and mentally normal before mefloquine ingestion. These cases illustrate that acute psychotic symptoms may occur in patients treated with mefloquine.

Artemether in moderately severe and cerebral malaria in Nigerian children.

Intramuscular artemether was compared with intramuscular sulfadoxine-pyrimethamine in Nigerian children with moderately severe malaria requiring parenteral therapy. Artemether produced significantly shorter parasite and fever clearance times but a higher parasite recrudescence rate than sulfadoxine-pyrimethamine. There was no significant difference in their initial parasitological cure rates--100% for artemether, 98% for sulfadoxine-pyrimethamine.

Mefloquine-sulphadoxine-pyrimethamine (Fansimef, Roche) in the prophylaxis of Plasmodium falciparum malaria: a double-blind, comparative, placebo-controlled study.

From July 1987 to June 1988 a randomized, double-blind, comparative placebo-controlled field trial was conducted in a group of villages near Ibadan, Nigeria. The aim of the study was to assess the suppressive tolerability and efficacy of four antimalarials (Fansimef, Lariam, Fansidar, chloroquine) given for 24 weeks. Fansimef and Lariam were given with loading and maintenance doses, Fansidar and chloroquine as one tablet per week for 24 weeks.

Parenteral sulphadoxine-pyrimethamine (Fansidar): an effective and safe but under-used method of anti-malarial treatment.

One hundred and eighteen patients with acute falciparum malaria were randomized into treatment with either intramuscular or oral sulfadoxine-pyrimethamine (Fansidar, Roche) and the results were compared with those from 68 patients treated in parallel with chloroquine. Parasitological cure rate was 97% with oral sulfadoxine-pyrimethamine, 95% with the injection, and only 63% with chloroquine. The time for the disappearance of parasitaemia in sensitive cases was the same with oral and intramuscular sulfadoxine-pyrimethamine and shorter than with chloroquine.