International Journal of Advanced Research and Publications

ISSN: 2456-9992

Disease Diagnostic Techniques Of Contemporary

Times In Nigeria
Victor. N Enwemiwe, Clement. C Obi, Kolade S, Fasoore
Delta State University, Department of Animal and Environmental Biology, Delta State, Nigeria. PH-2347068078198
Chukszone1@gmail.com

Delta State University, Department of Animal and Environmental Biology, Delta State, Nigeria. PH-2347031882676
enwemiwevictor@gmail.com

University of Ibadan, Department of Zoology, Oyo State, Nigeria. PH-2347064907026

ksfasoore@gmail.com

Abstract: Diagnosis of parasitic diseases are globally important requisite to realization of wholesome treatment of ailment and reduction
in resultant morbidities and mortalities. Parasitic diseases are however hyper- and hypo-prevalent in Nigerian populace often due to socio-
economics factors and ranges of little or no sequels. Low mortality from parasitic infection is due to alternative medication other than
successful diagnosis as observed. Subsidizing cost of affording diagnosis, erection of government owned diagnostic facilities or mobile
diagnostic facilities and enlightening the general public on needs of diagnosis are key factors to adequate treatment, disease deterrence and
control of parasitic diseases. This review presents the qualities and drawbacks in parasitic disease diagnosis in Nigeria, pointing out major
disease occurrences and diagnosis techniques used in medical facilities as related globally. Thus, contemporary diagnostic techniques
available for prompt, accurate and easy presentation of results on pathobiology of disease patterns including immunoassays, conservative
and molecular techniques for different biopsy from zoonotic and human parasitic infections. However psychological limitation in Nigeria
such as affordability, variability in confirming results from other diagnostic areas, and adequate staffing, can be conquered by training
personnel annually on the use of the available tools.

Keywords: diagnosis techniques, contemporary times, and Nigeria

1. Introduction determine the mechanism of vector capacity to infecting host

Parasitosis also referred to as parasitic disease is an
infectious ailment transmitted by a parasite to a host from
important mechanical vector agents. Several vector agents
that act as parasites live in association with the host
particularly thriving in warm and moist climes. Diseases
caused by parasites are a deal of the world but most
commonly endemic in areas of sub-Saharan Africa, Indian
subcontinent, southeastern Asia, and Central and South
America. Insects for example act as a major blood-borne
vector which houses mutualistic parasites in the alimentary
canal that cause diseases to hosts and the insect themselves.
Several disease exists such as elephantiasis caused by a
nematode-based filarial worm for instance Brugia malayi,
Brugia timori, Wuchereria brancrofti and transmitted by the
female mosquito in the process of blood feeding from an
infected human, river blindness caused by Onchocerca
volvulus and transmitted by blackflies, Drancunculiasis, a
guinea worm infection is caused by Dracunculus medinensi
which results in sensational itching in infected persons,
visceral leishmaniasis caused by Leishmania tropica is
mechanically transmitted by the sand fly and an enlarged
splenomegaly is a chronic stage of this infection.
Contemporary techniques in disease diagnosis involves the
incorporation of modern laboratory procedures in the
diagnosis of zoonotic diseases and those affecting man.
These diseases exhibit life-threatening sequels ranging from
acute signs to chronic symptoms which plays a part in
reported clinical manifestations and histories resulting to
various degree of re-occurring morbidity and debilitation
with resultant death if left untreated. Fever, digestive
disorders, aches, allergens or nervousness, persistent skin
disorders, anemia and sleeplessness are primary sequels and
consequences of parasitic ailments. It is a serious hurdle to
but hypo-prevalence or hyper-prevalence, vector range,
disease endemics, identification of vector salivary proteins,
amongst many others are scholarly reiterations in various
studies. Present also in studies are methodology to
realization of parasitic infections but a concise review of
diagnosing techniques to better the masses are lacking in
Nigeria. A number of the Nigerian population are parasite
infected with Plasmodium species ranking the highest; as
about 300 million clinical cases are reported at cross-
intervals (Bogitsh and Chang, 1998). Malaria is reported as
the master minder of prevalent death cases in 2million
persons yearly in Africa (WHO, 2003). Factors such as
clime, living ethics, hygiene, housing and related factors may
contribute to the increase in disease infections and
environment optimal for development in Nigeria. Although,
about 370 parasite species infect man (Cox, 2002). Today,
the diagnostics of parasitic diseases is dependent on several
procedures reported for laboratory use and chronicle of
clinical sequels, pathobiology, reports of visits to endemic
areas, and prevalence reports. In the past, diagnosis of many
parasitic ailments was majored on visible sequels but a little
drift occurred with the development of microscope for
staining and magnification of cyst on slides. Painfully,
current techniques for disease diagnosis cannot differentiate
between historical, embryonic, severe, and reoccurring
infections and its usefulness as a follow up response for
prophylaxis or for disease prospects is not justifiable (Ndao,
2009). In Nigeria, medical and science laboratory
technologists have put up energies to develop new diagnostic
techniques, however, their laboratories are ever opened for
diagnosis of various ailments ranging from malaria parasites,
HIV/AIDS and many more for improved health. Diagnosis
technics still on record includes numerous serology-based

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 International Journal of Advanced Research and Publications
ISSN: 2456-9992

assays such as ELISA (Falcon assay screening test- and the
Dot- kinds), rapid antigen detection system (Shokoples et al.,
2009), and luciferase immune-precipitation system (LIPS)
(Burbelo et al., 2005). However, molecular diagnostic
methods including loop-mediated isothermal amplification,
real-time polymerase chain reaction (Parida et al., 2008;
Muldrew, 2009), and the use of tissue biopsy in molecular
biomarkers (Tait et al., 2009) are uncommon in Nigeria
laboratories but where they exist are not prevalent. This
review presents the qualities and drawbacks in parasitic
disease diagnosis in Nigeria, pointing out major disease
occurrences and diagnosis techniques used in medical
facilities as related globally in the quest to create awareness
in Nigerian laboratories.
2. Global disease burdens with some
pictographs
All of these diseases are hyper- and hypo-prevalent in
Nigeria. They include elephantiasis, drancunculiasis, river
blindness and leishmaniasis. The World Health Organization
has estimated that 489 million humans are infected and 1 to 2
million die annually of malaria infection, 200 million are
infected and 0.5 to 1 million die yearly of Schistosoma
infections, 900 million and 50-60 million die of hookworm
infection, 750 million persons are infected and 20-50+
thousands die of Filarial worms, 1.0 billion are infected and
20 thousand die annually while an aggregate of 4.5 billion
persons are infected with worms with variable death
occurring.

Fig. 2.1 Elephantiasis infection Fig 2.2. Drancunculiasis

Fig 2.3. River blindness Fig 2.4. Leishmaniasis infection

3. Contemporary techniques types proteomic techniques such as polymerase chain reaction of

The below contemporary techniques are utilized in the world
for diagnosis of parasitic infections. They include the use of
simple and compound microscope as conservative
techniques, non-conventional immunoassays such as Enzyme
Linked Immunosorbent Assay (ELISA) of different kinds
including falcon assay screening test, dot, and radio
immunoprecipitation assay kinds, direct or indirect
hemagglutination assay, direct or indirect
immunofluorescence assay, luciferase immunoprecipitation
assay and rapid Antigen diagnostic test, molecular and
two kinds including the general-PCR and real time-PCR,
amplification such as nucleic acid sequenced-based
amplification involving the general and the real-time kind,
loop-mediated isothermal amplification, luminex, and mass
spectrometry including the matrix-assisted laser desorption
and surface-enhanced laser desorption. In Nigeria,
Microscopy as conservative method is common to view
stool, blood slide stains, and many cyst prepared slides to a
designated magnification. Other methods utilized in Nigeria
diagnostic facilities include immunoassays and to a less

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extent molecular techniques commonly the general typed
PCR. Proteomic techniques are uncommon. Even Molecular
techniques are only sorted when critical accident occurs and
diagnosis is needed urgently. Many Nigerians prepare a trial
and error method of treatment of infection with reported
sequels as a blueprint guide to treating ailments instead of
spending money for diagnosis. The conservative method is
suitable for protozoan and helminth infections through blood
smearing, tissue specimen, lymph node, faeces preparations,
bone marrow and even cerebrospinal fluid (Cobo et al.,
2007; Chappuis et al., 2006; Croft et al., 2006; Healy and
Ruebush, 1980; Tanowitz et al., 1992). Within
immunoassay, the serology-based assays is precise in
diagnosis for example difficulty in distinguishing between
plasmodium caused and babesia infections (Carter et al.,
2003). In some cases low parasite load exists or
asymptomatic individuals e.g. Chagas disease infected are
difficult to detect using this method (Diez et al., 2007). In the
past, the falcon assay screening test ELISA was applied in
determining malaria, schistosomial, fasciola, taenial
infections (Campbell et al., 1987; Ko and Ng, 1998) but with
same specificity issues. The Dot-ELISA has extensively been
applied in the diagnosing zoonotic and human parasitic
infections such as amoeba infections, babesiosis, fascioliasis,
leishmaniasis, cysticercosis, echinococcosis, plasmodium
infections, schistosomiasis, toxocariasis, toxoplasmosis,
trichinosis, and Trypanosoma diseases (Pappas et al., 1988;
Kumar et al., 2008; Courtioux et al., 2005). Rapid antigen
detection tests (RDTs) have been reported to be successful
for use in detecting Plasmodium falciparum and P. vivax
infections only and being not useful for diagnosing very low
parasite load infections (Shokoples et al., 2009).The
advances in molecular approach has stepped diagnosis of
disease to the next level with the use of the polymerase chain
reaction (PCR) and proteomic techniques to conquer
specificity tools in diagnosis. But this is not widespread in
local diagnosis centres and are not accessed by infected
Nigerians. How many Nigerians can afford high quality
diagnosis? as pre-requisite to curing parasitic infections?
Most preferred is using the monies to get an affordable
alternative or self-medications.

Fig. 3.1. Simple microscope Compound microscope Fig 3.2. ELISA diagnostic kit

Fig 3. Rapid Antigen Detection System (RTDs)

MalWest535 model Fig 4. Polymerase Chain Reaction (PCR)

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 International Journal of Advanced Research and Publications
ISSN: 2456-9992
4. Impacts of contemporary laboratory
techniques in Nigeria
Since the discovery of contemporary laboratory techniques,
parasites difficult to be cured by herbal-traditional means
have been effectively diagnosed as a major role to
understanding the morpho-pathology and pathobiology of the
parasitic diseases in Nigeria. Sensorial perception and
religious beliefs which are among the failings eating into the
comparative efficacy of these contemporary techniques and
diagnostic approach are being corrected. Herbal medicine
although is a cultural gem and has it sting severe in various
communities around the world with Nigeria inclusive. This
well-known medical area encompasses all kinds of folk
medicine, unconventional medicine and indeed any kind of
pharmaceutical method that existed by the tradition of a
community or ethnic group (WHO 1993). In spite of the
effectiveness of contemporary techniques for infectious
disease diagnosis, herbal medicine has penetrated deep in the
vein of individual inhabitants of various communities in
Nigeria hampering with the health facilities provided by
government and effective drugs to better the health needs of
the people.
5. Qualities and drawbacks in modern
laboratories in Nigeria
Medical scientist and science laboratory technologies often
have less opportunities to diagnose diseases in Nigeria. The
tools available are most times not up to standards to provide
evidences needed to interact directly with the world in real
data sense. In reality, only a few documented case of
diagnosis exist for Nigeria medical centres where the use of
the available tools, data collection procedures, models, and
theories exist. The major setbacks facing the diagnostic area
for disease is the cost of carrying a diagnosis, ignorance, and
fear of the unknown. Since the discovery of contemporary
laboratory procedures for medical diagnosis in Nigeria,
medical centres have witness a huge turnout of commonly
only infected persons with various ailments that can afford
the diagnosis. Many Nigerians sign in for self-medication
when disease symptoms are reported and most often do not
go for diagnosis in these accredited centres across the
countries. Truthfully, contemporary laboratory technique has
come with fulfilled promises and has reduced to minimal
medical coincidence through awareness created by
successful diagnosis in various labs across the country. The
awareness creation by successful diagnosis has indeed
helped in avoidance mechanism for diseases. The better way
already proposed to helping out in realizing a successful
diagnosis is erecting facilities for diagnosis other than in
clinics and the best approach is erecting a health institute and
getting medical and research scientist to access the facility to
properly diagnose and study the disease. Some qualities of
contemporary techniques in medical diagnosis include the
Increased the desire for medical studies and parasitological
research in Nigeria, the increase in the number of person
non-resident to the medical facilities, high thoughtfulness
along with quality of the detected ailment is guaranteed,
novelty in disease diagnoses is attained an the reduction of
death due to the unknown disease pathology In Nigeria,
infected persons go through stress of traveling in order to
access medical facilities since they are lacking in their local
communities. The distance travel could be a barrier to
significant diagnosis in rural settings in Nigeria where
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westernized medical facilities is reportedly low and also
limited transportation due to poor road networks influences
poor diagnosis. Infected persons have to journey as
pedestrians in order to access medical facilities and through
the process dead may occur or alternative such as herbal
medicine is sorted. The poor technical know-how in most
medical centres is another demerit to proper diagnosis as
operation of available laboratory tool is not guaranteed,
particularly the primary health care centres which is an
important factor that discourages infected persons from
accessing these facilities. Due to the sophistication of
equipment, most of the diagnostic centres for disease in
developing countries, particularly in Nigeria, have recently
introduced a payment-on-delivery scheme for local infected
persons who in most cases have no money to fit the bill of
diets than to talk of medical diagnosis. This has been the
major drive to seeking the alternative source which in most
cases just give treatment without diagnosis and full
knowledge of disease infections. When diagnostic facilities
are not available or are not in order, faulty results as positive
is obtained sometimes, contamination is a frequent
occurrence, as an expert is required and also capital intensity
is a flaw.
Fig 4.1 Pictograph of a decrepit medical diagnostic
laboratory in Asaba, Delta State, Nigeria.
6. Major flaws in the Nigerian health care
system
Notwithstanding the private med laboratories and
government owned laboratories in medical centers for
various disease diagnosis, the number of Nigerian personnel
accessing is only but 43.3% (Onwujekwe et al., 2010). This
inadequacy in visits to medical facilities in Nigeria is
attributed to socio-economic factors and social trust on
medical personnel in carrying out the diagnosis. It is
estimated that 55% of Nigeria populace inhabit rural regions
with only 45% living in the urban regions (Steinberger et al.,
2008). This inhabitation is a function of finance. Most (about
70%) medical diagnostic laboratories are owned by private
suppliers as compared to 30% owned by the government
(Omoruan et al., 2009). When drugs are administered in
faulty diagnosis, it targets viable organs instead of shooting
the ailment at which it is meant to cure and in most case,
drugs administered are second-rated. Hence, the National
Bureau of statistics has in 2011 proposed that the
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ISSN: 2456-9992
ineffectiveness in Nigeria Health care System (NIHS) had
led to the low number of persons (40%) accommodated for
diagnosis while a greater percentage (52-60%) is been
manipulated by informal sector. Akande recently reiterated
that the flaws is due to poor referral system between the
various tiers of medical facilities which points out the poor
managerial roles of medical diagnostic facilities (Akande et
al., 2004). Another major flaw facing diagnosis of diseases
include adequate funding scheme to subsidize health bills
and quality assurance for the diagnosed (Onwujekwe et al.,
2010).
Conclusion
It is identified that many Nigerians do not gain access to
medical diagnosis of disease due to socio-economics and
other related outlined factors. Making readily available at
subsidized rate mobile or erect diagnostic facilities at
proximal site for inhabitant would divert risky alternative or
self-medication and even death that may result from delayed
diagnosis.
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