Phytochemicals: A Glimpse into their Structural and Biological Variation

Higher plants have afforded a plethora of structurally varied biologically active secondary metabolite organic molecules, and accordingly have been subjected to wide experimental scrutiny in countries all over the world. In this short review the promise of just one phytochemical group, the flavonoids, will be focused upon. Compounds of this type which have been recently isolated and characterized in this laboratory, with potential use as cancer chemopreventives, cancer chemotherapeutic agents, and sucrose substitutes, will be described.     

Chemotherapy of field cases of East Coast fever using halofuginone lactate

The chemotherapeutic effect of halofuginone lactate (Terit, Hoechst) was tested against natural pathogenic Theileria parva infections (East Coast fever, ECF) in 24 cattle. Halofuginone lactate, administered per os, 1.2 mg per kg b.wt and repeated after 48 h manifested a potent schizonticidal effect, observed between 5 and 11 days post treatment. Disappearance of erythrocytic forms (EF) took long, ranging from 6 to 34 days post treatment. Differences on efficacy between halofuginone lactate tablets and solution were not observed. The use of furosemide (Dimazon, Hoechst) to promote diuresis in pulmonary oedema and streptomycin sulphate for control of secondary pulmonary infections, as supportive therapy measures, enhanced recovery from ECF. A recovery rate of 96% was recorded. Relapses were not observed.     

Anticonvulsant Activity of Diospyros Fischeri Root Extracts

Diospyros fischeri Gurke (Ebenaceae) is used in traditional medicine for the treatment of epilepsy. Dichloromethane, ethylacetate, and ethanol extracts of the roots, at doses between 100 and 1600 mg/kg BW, inhibited convulsions induced by the γ-aminobutyric acid type A (GABAa) receptor antagonist, pentylenetetrazole (PTZ), in a dose dependent manner. The extracts also exhibited low toxicity against brine shrimps giving LC₅₀ values between 45.4 and 95.4 µg/ml. These results provide evidence for the potential of D. fischeri extracts to treat absence seizures, especially given their seemingly innocuous nature.     

Exploring the potential of a conditional cash transfer intervention to reduce HIV risk among young women in Iringa,Tanzania

Cash transfer programs seek to alter structural determinants of HIV risk such as poverty and gender inequality. We sought to explore the feasibility and potential effectiveness of a cash transfer intervention for young women as part of combination HIV prevention in Iringa, Tanzania. Qualitative, in-depth interviews were conducted with 116 stakeholders and residents from the region, including key informants, service delivery users, and members of key populations. Most respondents felt a cash transfer program would assist young women in Iringa to have more control over sexual decision-making and reduce poverty-driven transactional sex. Respondents were divided on who should receive funds: young women themselves, their parents/guardians, or community leaders. Cash amounts and suggested target groups varied, and several respondents suggested providing microcredit or small business capital instead of cash. Potential concerns included jealousy, dependency, and corruption. However, most respondents felt that some intervention was needed to address underlying poverty driving some sexual risk behavior. A cash transfer program could fill this role, ultimately reducing HIV, sexually transmitted infections, and unintended pregnancies. As increased attention is given to economic and structural interventions for HIV prevention, local input and knowledge should be considered in a program design.     

Health diplomacy and Adapting global health interventions to local needs: findings from project accept (HPTN 043), a community-based intervention to reduce HIV incidence in populations at risk in Sub-Saharan Africa and Thailand

ABSTRACT: BACKGROUND: Study-based HIV prevention interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of 'public health diplomacy' issues. We report on the adaptations development, approval and implementation process and describe adaptations from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. METHODS: We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations in terms of facilitating intervention implementation. RESULTS: Across sites, proposed adaptations were identified by field staff and submitted to project directors for review, on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approving. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa); environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of 'youth-friendly' services in South Africa, Zimbabwe and Tanzania), and social adaptations (e.g. modification of terminology to local dialects in Thailand; adjustment of service delivery schedules to suit seasonal and daily work schedules across sites). CONCLUSIONS: Adaptation selection, development and approval during multi-site HIV intervention research studies should be a planned process that maintains fidelity to the study protocol. The successful implementation of appropriate site-specific adaptations may have important implications for intervention implementation, from both a service uptake and a 'public health diplomacy' perspective.     

Traditional health practitioner and the scientist: bridging the gap in contemporary health research in Tanzania

Traditional health practitioners (THPs) and their role in traditional medicine health care system are worldwide acknowledged. Trend in the use of Traditional medicine (TRM) and Alternative or Complementary medicine (CAM) is increasing due to epidemics like HIV/AIDS, malaria, tuberculosis and other diseases like cancer. Despite the wide use of TRM, genuine concern from the public and scientists/biomedical heath practitioners (BHP) on efficacy, safety and quality of TRM has been raised. While appreciating and promoting the use of TRM, the World Health Organization (WHO), and WHO/Afro, in response to the registered challenges has worked modalities to be adopted by Member States as a way to addressing these concerns. Gradually, through the WHO strategy, TRM policy and legal framework has been adopted in most of the Member States in order to accommodate sustainable collaboration between THPs and the scientist/BHP. Research protocols on how to evaluate traditional medicines for safety and efficacy for priority diseases in Africa have been formulated. Creation of close working relationship between practitioners of both health care systems is strongly recommended so as to revamp trust among each other and help to access information and knowledge from both sides through appropriate modalities. In Tanzania, gaps that exist between THPs and scientists/BHP in health research have been addressed through recognition of THPs among stakeholders in the country's health sector as stipulated in the National Health Policy, the Policy and Act of TRM and CAM. Parallel to that, several research institutions in TRM collaborating with THPs are operating. Various programmed research projects in TRM that has involved THPs and other stakeholders are ongoing, aiming at complementing the two health care systems. This paper discusses global, regional and national perspectives of TRM development and efforts that have so far been directed towards bridging the gap between THPs and scientist/BHP in contemporary health research in Tanzania.     

Condom use among HIV-positive sexually active adults and partner's HIV status in Dar es Salaam, Tanzania

Consistent and proper use of condoms has been found to be effective in preventing HIV transmission and other sexually transmitted diseases. We examined the predictors of condom use and knowledge of partner's HIV status among 731 HIV-positive individuals who had sex in the past six months. Data are from an incoming service form administered to clients who visited the Muhimbili University College of Health Sciences' Voluntary Counseling and Testing (VCT) site in Dar es Salaam, Tanzania between 1997-2008 (N=45,071). Sixteen percent reported always using a condom in the past six months. Multivariate logistic regression revealed that age, and knowledge of partner's HIV status were the strongest predictors of consistent condom use. The risk of future HIV infections in this region remains high. Future efforts to prevent new HIV infections should aim to increase condom use, and prevention practices that facilitate HIV-positive individuals to communicate their HIV status with partners.     

Some Pharmacological Properties of An Aqueous Extract of Securinega Virosa Roots

An aqueous extract of Securinega virosa is used by traditional healers in Tanga (northeastern Tanzania) as an aphrodisiac and in the treatment of impotence, which is one of the manifestations of diabetes mellitus. An aqueous extract of the roots at doses of 0.1,0.2, 0.4 and 1.0 g/kg body weight lowered the area under the oral glucose tolerance curve (OGTT) in normal albino rabbits by 0.3 (P >0.05), 7.85, 11.0 and 9.6% (P =0.05), respectively. Chlorpropamide (0.1 g/kg body weight) had a greater effect on blood glucose and lowered area under the OGTT curve by 16.3%. The extract, at a dose of 0.4 g/kg body weight, had no effect on fasting blood glucose (FBG) when compared to controls given distilled water (P >0.05), except at 4 h, when the FBG for treated animals was higher. The LD 50 (95% confidence interval) determined by intraperitoneal administration of the extract to white albino mice was 0.30 (0.20–0.50) g/kg body weight. We conclude that the aqueous extract of Securinega virosa roots lowered the area under the OGTT curve dose-dependently at doses between 0.1 and 1.0 g/kg body weight. It did not lower blood glucose below fasting levels both in the fed and fasted state. More work is required to determine the toxic characteristics of the extract and the utility of the observed activity in the management of diabetes mellitus in humans.     

‘You already drank my beer,I can decide anything’: using structuration theory to explore the dynamics of alcohol use,gender-based violence and HIV risk among female sex workers in Tanzania

Abstract

Female sex workers experience high rates of gender-based violence and HIV. Alcohol has been shown to facilitate women’s risk of both gender-based violence and HIV; however, little research has explored how aspects of the sex work environment shape this risk. Drawing on structuration theory, this study explored how social conduct is patterned across time and space within the sex work environment to influence alcohol consumption, gender-based violence and HIV risk among female sex workers. Qualitative in-depth interviews were conducted with 24 female sex workers enrolled in an ongoing community randomised controlled trial of a combination HIV prevention intervention in Iringa, Tanzania. Data were analysed using both inductive and deductive approaches. Findings reveal how routine interactions between female sex workers and their clients occur at three moments of time and space during the sex exchange process to facilitate alcohol consumption and increase women’s risk of gender-based violence and HIV. Findings also highlight how sex workers utilise collective agency to address aspects of the sex work environment that place them at risk of alcohol abuse, gender-based violence and HIV. Implications for future interventions to prevent gender-based violence and HIV among female sex workers in Tanzania and similar contexts are discussed.