In-vitro Anti-cercarial activity of extracts and steroidal alkaloids from the stem bark of Holarrhena floribunda (G. Don) Dur. & Schinz

Context: Schistosomiasis continues to be the leading cause of morbidity and mortality among the neglected tropical diseases. Apart from the high cost of chemotherapy, concerns over drug resistance and tolerance have been raised in the past decade. Objective: The aim of the study was to evaluate the anticercarial activity of extracts and compounds from the stem bark of Holarrhena floribunda on cercaria of Schistosoma haematobium. Methods: Hydroethanolic and alkaloidal extracts from the stem bark of H. floribunda were tested on cercaria at concentrations between 500.00 and 15.625 μg/mL for 180 minutes and assessing the percentage viability at time intervals of 0, 15, 30, 60, 120 and 180 minutes. Praziquantel, used as reference drug, and the isolated compounds were tested at similar concentrations. The cercaria mortalities and IC50 of extracts and compounds were estimated after 30 minutes of incubation. Results: The 70 %v/v ethanol extract showed the highest activity (IC50=20.09±1.11 μg/mL) with praziquantel giving IC50 of 695.50±1.12. The alkaloids holonamine, holadienine and conessine, isolated from the stem bark, showed considerable cercaricidal activity with the latter recording an IC50 of 33.28±1.04. Conclusion: The study gives first-hand knowledge of the anti-cercarial activity of H. floribunda and its steroidal alkaloids. This gives credence to the traditional uses of the plant as an anti-parasitic agent

Circumcising daughters in Nigeria: To what extent does education influence mothers' FGM/C continuation attitudes?

Education has been adjudged as an important behavioural change intervention and a key player in combating Female Genital Mutilation/Cutting (FGM/C). An assumed pathway is that it influences FGM/C attitudes. However, empirical evidence that explores this assumption is scarce. Hence, our study examines whether the associative effect of FGM/C continuation attitudes on circumcision of daughters is influenced by the level of a mother's education in Nigeria. We extracted data from the 2018 Nigeria Demographic and Health Survey (NDHS). The study focused on youngest daughters that were born in the last five years preceding the survey. A sample of 5,039 children with complete data on variables of interest to the study were analysed. The main outcome variable for this study is "circumcision among youngest daughters". The key explanatory variables were maternal "FGM/C continuation attitudes" and "education". At 95% confidence interval, we conducted a two-level logistic regression modelling and introduced interaction between the key independent variables. In the study's sample, the prevalence of FGM/C was 34%. It was lower for daughters whose mothers had higher education (12%) and believe FGM/C should discontinue (11.1%). Results from the multivariate analysis show statistically significant odds of circumcision for a daughter whose mother has had higher education and believes FGM/C should discontinue (OR-0.28, 95%CI: 0.08-0.98). For women who believe FGM/C should discontinue, the probability of daughter's circumcision reduced by 40% if the mother has attained higher education. Among those who believe FGM/C should continue, the probability of daughter's circumcision worsened if the mother had attained higher education (64%), however, this result was influenced by mothers' experience of circumcision. Education influences FGM/C attitudes, nonetheless, women's cutting experience can be a conduit for which the practice persists. Promoting female education should be accompanied by strong political commitment towards enforcing laws on FGM/C practice

Sepsis among Neonates in a Ghanaian Tertiary Military Hospital: Culture Results and Turnaround Times.

In this study, we described the bacterial profile, antibiotic resistance pattern, and laboratory result turnaround time (TAT) in neonates with suspected sepsis from a tertiary-level, military hospital in Accra, Ghana (2017-2020). This was a cross-sectional study using secondary data from electronic medical records. Of 471 neonates clinically diagnosed with suspected sepsis in whom blood samples were collected, the median TAT from culture request to report was three days for neonates who were culture-positive and five days for neonates who were culture-negative. There were 241 (51%) neonates discharged before the receipt of culture reports, and of them, 37 (15%) were culture-positive. Of 471 neonates, twenty-nine percent (n = 139) were bacteriologically confirmed, of whom 61% (n = 85) had late-onset sepsis. Gram-positive bacterial infection (89%, n = 124) was the most common cause of culture-positive neonatal sepsis. The most frequent Gram-positive pathogen was coagulase-negative Staphylococcus (55%, n = 68) followed by Staphylococcus aureus (36%, n = 45), of which one in two were multidrug resistant. The reasons for large numbers being discharged before the receipt of culture reports need to be further explored. There is a need for improved infection prevention and control, along with ongoing local antimicrobial resistance surveillance and antibiotic stewardship to guide future empirical treatment

Indigenous Medicinal Plants as Biofilm Inhibitors for the Mitigation of Antimicrobial Resistance

The majority of indigenes in the rural areas of Ghana use herbal medicines for their primary health care. In this study, an ethnobotanical survey was undertaken to document medicinal plants used by traditional healers in the Ejisu-Juaben district in the Ashanti region of Ghana to treat infections and to further investigate the antibiofilm formation properties of selected plants in resisting pathogenic bacteria. Seventy medicinal plants used by traditional practitioners for the treatment of skin infections and wounds were documented from the ethnobotanical survey. Forty out of the seventy plants were collected and their methanol extracts evaluated for antimicrobial activity by the agar diffusion assay. Extracts that showed antibacterial activity were tested for biofilm inhibitory activity, and the most active plant was subsequently purified to obtain the active constituents. Biofilm formation was significantly mitigated by petroleum ether, ethyl acetate, and methanol extracts of Holarrhena floribunda stem bark. Bioassay-guided fractionation of an alkaloidal extract prepared from the methanol fraction led to the isolation of three steroidal alkaloids, namely, holonamine, holadienine, and conessine. The isolated compounds demonstrated varying degrees of biofilm formation inhibitory properties. The current study reveals that screening of indigenous medicinal plants could unravel potential leads to salvage the declining efficacy of conventional antibiotics. Holarrhena floribunda stem bark extract has strong biofilm formation inhibition properties, which could be attributed to the presence of steroidal alkaloids

Weighted percentage distribution of circumcision among youngest daughters by background characteristics.

Weighted percentage distribution of circumcision among youngest daughters by background characteristics.</p

Supporting tables and figure.

(DOCX)</p

Values for Fig 1.

Values for Fig 1.</p

Logistic regression results of circumcised daughters by background characteristics.

Logistic regression results of circumcised daughters by background characteristics.</p

Predicted probabilities of circumcision among youngest daughters by mother’s education and attitude to FGM/C continuation.

Predicted probabilities of circumcision among youngest daughters by mother’s education and attitude to FGM/C continuation.</p

Inclusivity in global research.

(DOCX)</p