Delayed clearance of Plasmodium falciparum in patients with human immunodeficiency virus co-infection treated with artemisinin

We investigated the effect of artemisinin on the rate of clearance of Plasmodium falciparum in patients with or without human immunodeficiency virus (HIV) co-infection. Initial mean (+/- SEM) parasite density was not different between HIV-infected and HIV-uninfected groups (27,486 +/- 2,643 versus 32,892 +/- 6,583, respectively; P = 0.55). The mean (+/- SEM) time to clear 75% and 90% of the parasites was 23.1 hr +/- 1.8 and 29.3 hr +/- 1.9, respectively, for the HIV seropositive patients compared with 16.0 hr +/- 1.4 and 20.8 hr +/- 1.4, respectively for the HIV seronegative patients (P = 0.0075 and 0.0026, respectively). By 32 hr, almost all (6/7) HIV positive patients remained parasitemic in contrast with 2/12 HIV seronegative patients. Moreover, the mean parasite density was almost 12-fold higher in the HIV seropositive patients than in the HIV seronegative patients at the same period (1789 +/- 616 versus 150 +/- 118, respectively; P = 0.0037). Overall, the mean parasite clearance time was 37.7 hr +/- 2.1 in the HIV seropositive group and 30.0 hr +/- 2.1 in those who were HIV seronegative (P = 0.0284). Whereas mean fever clearance time was 40.6 hr +/- 2.4 for the HIV seropositive group, it was 28.7 hr +/- 1.2 for those who were HIV seronegative (P = 0.0001). These observations are compatible with the hypothesis that the host's immunity affects the activity of antimalarial drugs, and our data suggest for the first time that clearance of P. falciparum after administration of artemisinin is delayed in patients with HIV co-infection.     

Diuretic effect of the crude extracts of Carissa edulis in rats

Carissa edulis (forssk) vahl (Apocynaceae) is used traditionally for the treatment of headache, chest complaints, rheumatism, gonorrhoea, syphilis, rabies and as a diuretic. In the present study, the diuretic activity of different extracts of Carissa edulis was investigated. The diuretic activity of the different extracts of Carissa edulis in a dose range of 50-1000 mg/kg was assessed orally in rats using hydrochlorothiazide as a standard drug. The root bark maceration extract showed no effect on the urine output up to a dose of 1000 mg/kg, while the root bark soxhlet extract produced a significant increase (P < 0.05) in urine output at a dose of 1000 mg/kg. The root wood maceration and root wood soxhlet extracts produced a significant increase in urine output at a dose of 50 mg/kg, with a P-value of <0.05. Urinary electrolyte excretion was also affected by the extracts: the root bark soxhlet extract increased urinary excretion of sodium, potassium and chloride ions; root wood maceration extract increased excretion of sodium and potassium, while root wood soxhlet extract increased excretion of potassium ion. These findings support the traditional use of Carissa edulis as a diuretic agent.     

Glucosinolates in Moringa stenopetala

Bio-guided fractionation of seed extracts from Moringa stenopetala resulted in a myrosinase hydrolysis product, 5,5-dimethyloxazolidine-2-thione. It is formed from the glucosinolate glucoconringiin, which was identified together with O-(rhamnopyranosyloxy)benzyl glucosinolate from M. stenopetala for the first time. The glucosinolates in seeds, leaves and roots of M. stenopetala were quantified as des-sulphoglucosinolate by HPLC. The seeds without testa contained the highest concentration of glucoconringiin and of O-(rhamnopyranosyloxy)benzyl glucosinolate within the plant, 3 % and 19 % of dry mass, respectively. Abbreviations. GLS:glucosinolate GC:glucoconringiin RB-GLS: O-(rhamnopyranosyloxy)benzyl glucosinolate     

The potentially deleterious functional variant flavin-containing monooxygenase 2*1 is at high frequency throughout sub-Saharan Africa

BACKGROUND: The drug-metabolizing enzyme flavin-containing monooxygenase 2 (FMO2) is the predominant FMO isoform present in the lung of most mammals, including non-human primates. All Europeans and Asians tested have been shown to be homozygous for a non-functional variant, FMO2*2A, which contains a premature stop codon due to a single-nucleotide change in exon 9 (g.23238C>T). The ancestral allele, FMO2*1, encodes a functionally active protein and has been found in African-Americans (26%) and Hispanics (2% to 7%). Possessing this variant increases the risk of pulmonary toxicity when exposed to thioureas, a widely used class of industrial compounds. FMO2 may also be involved in the metabolism of drugs that are used to treat diseases that are prevalent in Africa. RESULTS AND CONCLUSION: We conducted a survey of g.23238C>T variation across Africa that revealed that the distribution of this SNP is relatively homogeneous across sub-Saharan Africa, with approximately one third of individuals possessing at least one FMO2*1 allele, though in some populations the incidence of these individuals approached 50%. Thus many sub-Saharan Africans may be at substantially increased health risk when encountering thiourea-containing substrates of FMO2. Analysis of HapMap data with the Long-Range Haplotype test found no evidence for positive selection of either 23238C>T allele and maximum-likelihood coalescent analysis indicated that this mutation occurred some 500,000 years before present. This study demonstrates the value of performing genetic surveys in Africa, a continent in which human genetic diversity is thought to be greatest, but where studies of the distribution of this diversity are few.     

Response to malaria epidemics in Africa

Malaria epidemics affect nonimmune populations in many highland and semi-arid areas of Africa. Effective prevention of these epidemics is challenging, particularly in the highlands where predictive accuracy of indicators is not sufficiently high to allow decisions involving expensive measures such as indoor residual spraying of insecticides. Advances in geographic information systems have proved useful in stratification of areas to guide selective targeting of interventions, including barrier application of insecticides in transmission foci to prevent spread of infection. Because rainfall is associated with epidemics in semi-arid areas, early warning methods based on seasonal climate predictions have been proposed. For most areas, response measures should focus on early recognition of anomalies and rapid mass drug administration. Vector control measures are useful if abnormal transmission is highly likely and if they can be selectively implemented at the early stages of an outbreak.     

Determinants and perceptions of the utilization of tetanus toxoid immunization among reproductive-age women in Dukem Town,Eastern Ethiopia: a community-based cross-sectional study

Background

Maternal and neonatal tetanus (MNT) is still the major public health problem in about 25 countries, mainly in Africa and Asia. However, the utilization of intervention strategies, like tetanus toxoid (TT) immunization remains low in these countries. In Ethiopia, only 49% of the pregnant mothers received TT2+ in 2016. This study was designed to evaluate perceptions and factors affecting the utilization of TT immunization among reproductive-age women in Dukem town, Eastern Ethiopia, 2016.

Methods

We conducted a community-based cross-sectional study from May to October 2016. A simple random sampling method was employed to select samples of 422 women. Data were collected using a, pretested semi-structured and a face-to-face interviewer-administered questionnaire. We entered data in to Epi Info version 7 and analyzed them by SPSS version 20 software. Odds ratios and a 95% CI at 0?<?0.05 p-value were calculated to ascertain the significance of associations.

Results

Response rate was 98.6% (N?=?416). Mean age with standard deviation was 29.25±?5.11 years, and average family size was 4.19. Our study showed the utilization of TT immunization was 39.2% (N?=?163). Of the participants, 33.9% (N?=?141) had never been vaccinated. ANC follow up service [AOR: 2.56, 95% CI: (1.18, 5.49)], distance from health facilities [AOR: 2.27, 95% CI: (1.27, 4.09)], knowing vaccination date [AOR: 1.98, 95% CI: (1.23, 3.18)], having a TV set in the house [AOR: 1.80, 95% CI: (1.11, 2.917)], maternal education [AOR: 1.41, 95% CI: (1.84, 2.30), and place of delivery [AOR: 1.19, 95% CI: (1.00, 1.43)] were factors significantly associated with the utilization of TT immunization.

Conclusions

This study indicated the utilization of TT immunization was low. ANC service follow up, distance from health facilities, knowing vaccination date, having a TV in the house, mothers’ educational status, and place of delivery were significant predictors. Our study suggests that policymakers and other stakeholders should consider the need for increasing access to maternal education, like basic adult education, ANC follow up services, providing accessible health facilities, improving varieties of communication media, promoting female occupational status, and providing appropriate vaccination cards.