Electrolyte disturbances in diabetic patients in Cotonou, Benin

Background: As globally observed in low income countries, the incidence of diabetes rise rapidly in Benin. Electrolytes imbalance contribute to complications observed in diabetes. The aim of this study was to estimate electrolytes disturbances in diabetic patients in Cotonou, Benin.Methods: A total of 260 participants were included in the study: 150 diabetic patients and for the control group110 age and sex matched non diabetic subjects. Glucose, Ca2+, Mg2+, K+, Na+ and Cl- were determined in fasting blood samples. The proportions of subjects with abnormal values in the diabetic population and in the control group were compared using Chi-square test. The diabetic population was divided in three groups in regard of the fasting plasma glucose (FPG) level. For each group, the mean values of the parameters were compared to those of the control group using the Student’t-test.The significance level was set to 5%.Results: Near half of the diabetic patients suffered from hyperkalemia (48%). Hypocalcemia was observed in 41.3% of the diabetic patients and hypercalcemia was found in 23.3%. Hypomagnesemia and hyponatremia affected more than 40% of the diabetic subjects.  The mean values of serum potassium were significantly elevated in all three groups of diabetic patients compared to the control group.Conclusions: This study showed that electrolyte imbalances affect the diabetic patients in Cotonou

Some Medicinal Plants with Anti-breast Cancer Activity and the Input of Phytotherapy in the Treatment of Breast Cancer

Aim: Breast cancer is the most commonly diagnosed cancer leading to death among women worldwide. Despite the advances in the diagnosis skills and in the treatment of breast cancer, it has been observed that the recurrence rate experienced by breast cancer patients is quite high. Many plants have been reported to have anti-breast cancer properties. This paper focuses on determining the role of phytotherapy in the treatment of breast cancer. Methods: The following key search terms were used on Pubmed, Google scholar, and Researchgate: breast cancer, breast cancer cell lines, phytotherapy, medicinal plants in the treatment of breast cancer, treatment of breast cancer, cytotoxics effects of plant extracts on breast cancer in vitro/ in vivo, integrative oncology, and natural products as sources of drugs. Pertinent reviews in English language were examined. Results: It has been observed that many studies were conducted in vitro and in vivo to demonstrate the anti-breast cancer activities of a myriad of plants. While investigations are being made to prove the anti-breast cancer effects of many plants, the use of phytomedicine is not generating enough attention by mainstream practitioners. Some significant results were observed by patients with breast cancer history through the combination of phytotherapy and conventional medicines. Discussion: The conventional treatment of breast cancer is often accompanied with side effects. Many patients in low-income countries are faced off with the enormous cost of conventional treatment. Hence, there is a need to search for new bioactive substances in the treatments of breast cancer. Phytotherapy is a promising approach and herbal preparations are to be used in the same way as conventional medicine in the treatment of breast cancer. Conclusion: Phytotherapeutics products are used more often in the treatment of breast cancer as adjuvant therapy. In Africa, the use of herbal products in the treatment of breast cancer still remains in the hands of traditional-practitioners, without any control of quality and efficacy. Standard methods for the preparation of herbal products are to be determined in order to adopt phytotherapy in the treatment of breast cancer as much as conventional treatment

Current Perspectives in the Use of Phytotherapy for the Treatment of Breast Cancer

Breast cancer is  the most commonly diagnosed cancer leading to death among women worldwide. However, there is a significant improvement in the treatment of breast cancer. Today, the conventional treatment of breast cancer combines surgery , chemotherapy, radiation, targeted therapy, hormone therapy and immunotherapy.  Despite the advances in the diagnosis skills and in the treatment of breast cancer it has been observed that the recurrence rate experienced by breast cancer patients  is quite high. Moreover, the conventional treatment is often accompained with side effects. Thus, there is a need to search for new bioactive molecules.  Plant derived natural compounds can play a major role as sources of new bioactive substances for the treatment of breast cancer. Many plants have been reported to have anti-breast cancer properties. While investigations are being made to demonstrate the cytotoxic activities of many plants, the use of phytomedicine is not generating fully attention by mainstream practitioners. Some significant results were observed by patients with breast cancer history by combining phytotherapy and the conventional medicines.  Hence, plant extracts are more being used   in the treatment of breast cancer as adjuvant therapy. In this review we will present a summary of the advances of the researches on the efficacity of phytotherapeutic products when discussing their use in the treatment of breast cancer

Pre-intervention characteristics of the mosquito species in Benin in preparation for a randomized controlled trial assessing the efficacy of dual active-ingredient long-lasting insecticidal nets for controlling insecticide-resistant malaria vectors.

BACKGROUND: This study provides detailed characteristics of vector populations in preparation for a three-arm cluster randomized controlled trial (RCT) aiming to compare the community impact of dual active-ingredient (AI) long-lasting insecticidal nets (LLINs) that combine two novel insecticide classes-chlorfenapyr or pyriproxifen-with alpha-cypermethrin to improve the prevention of malaria transmitted by insecticide-resistant vectors compared to standard pyrethroid LLINs. METHODS: The study was carried out in 60 villages across Cove, Zangnanando and Ouinhi districts, southern Benin. Mosquito collections were performed using human landing catches (HLCs). After morphological identification, a sub-sample of Anopheles gambiae s.l. were dissected for parity, analyzed by PCR for species and presence of L1014F kdr mutation and by ELISA-CSP to identify Plasmodium falciparum sporozoite infection. WHO susceptibility tube tests were performed by exposing adult An. gambiae s.l., collected as larvae from each district, to 0.05% alphacypermethrin, 0.75% permethrin, 0.1% bendiocarb and 0.25% pirimiphos-methyl. Synergist assays were also conducted with exposure first to 4% PBO followed by alpha-cypermethrin. RESULTS: An. gambiae s.l. (n = 10807) was the main malaria vector complex found followed by Anopheles funestus s.l. (n = 397) and Anopheles nili (n = 82). An. gambiae s.l. was comprised of An. coluzzii (53.9%) and An. gambiae s.s. (46.1%), both displaying a frequency of the L1014F kdr mutation >80%. Although more than 80% of people slept under standard LLIN, human biting rate (HBR) in An. gambiae s.l. was higher indoors [26.5 bite/person/night (95% CI: 25.2-27.9)] than outdoors [18.5 b/p/n (95% CI: 17.4-19.6)], as were the trends for sporozoite rate (SR) [2.9% (95% CI: 1.7-4.8) vs 1.8% (95% CI: 0.6-3.8)] and entomological inoculation rate (EIR) [21.6 infected bites/person/month (95% CI: 20.4-22.8) vs 5.4 (95% CI: 4.8-6.0)]. Parous rate was 81.6% (95%CI: 75.4-88.4). An. gambiae s.l. was resistant to alpha-cypermethrin and permethrin but, fully susceptible to bendiocarb and pirimiphos-methyl. PBO pre-exposure followed by alpha-cypermethrin treatment induced a higher 24 hours mortality compared to alphacypermethrin alone but not exceeding 40%. CONCLUSIONS: Despite a high usage of standard pyrethroid LLINs, the study area is characterized by intense malaria transmission. The main vectors An. coluzzii and An. gambiae s.s. were both highly resistant to pyrethroids and displayed multiple resistance mechanisms, L1014F kdr mutation and mixed function oxidases. These conditions of the study area make it an appropriate site to conduct the trial that aims to assess the effect of novel dual-AI LLINs on malaria transmitted by insecticide-resistant vectors

Efficacy of pyriproxyfen-pyrethroid long-lasting insecticidal nets (LLINs) and chlorfenapyr-pyrethroid LLINs compared with pyrethroid-only LLINs for malaria control in Benin: a cluster-randomised, superiority trial.

BACKGROUND: New classes of long-lasting insecticidal nets (LLINs) combining mixtures of insecticides with different modes of action could put malaria control back on track after rebounds in transmission across sub-Saharan Africa. We evaluated the relative efficacy of pyriproxyfen-pyrethroid LLINs and chlorfenapyr-pyrethroid LLINs compared with standard LLINs against malaria transmission in an area of high pyrethroid resistance in Benin. METHODS: We conducted a cluster-randomised, superiority trial in Zou Department, Benin. Clusters were villages or groups of villages with a minimum of 100 houses. We used restricted randomisation to randomly assign 60 clusters to one of three LLIN groups (1:1:1): to receive nets containing either pyriproxyfen and alpha-cypermethrin (pyrethroid), chlorfenapyr and alpha-cypermethrin, or alpha-cypermethrin only (reference). Households received one LLIN for every two people. The field team, laboratory staff, analyses team, and community members were masked to the group allocation. The primary outcome was malaria case incidence measured over 2 years after net distribution in a cohort of children aged 6 months-10 years, in the intention-to-treat population. This study is ongoing and is registered with ClinicalTrials.gov, NCT03931473. FINDINGS: Between May 23 and June 24, 2019, 53 854 households and 216 289 inhabitants were accounted for in the initial census and included in the study. Between March 19 and 22, 2020, 115 323 LLINs were distributed to 54 030 households in an updated census. A cross-sectional survey showed that study LLIN usage was highest at 9 months after distribution (5532 [76·8%] of 7206 participants), but decreased by 24 months (4032 [60·6%] of 6654). Mean malaria incidence over 2 years after LLIN distribution was 1·03 cases per child-year (95% CI 0·96-1·09) in the pyrethroid-only LLIN reference group, 0·84 cases per child-year (0·78-0·90) in the pyriproxyfen-pyrethroid LLIN group (hazard ratio [HR] 0·86, 95% CI 0·65-1·14; p=0·28), and 0·56 cases per child-year (0·51-0·61) in the chlorfenapyr-pyrethroid LLIN group (HR 0·54, 95% CI 0·42-0·70; p<0·0001). INTERPRETATION: Over 2 years, chlorfenapyr-pyrethroid LLINs provided greater protection from malaria than pyrethroid-only LLINs in an area with pyrethroid-resistant mosquitoes. Pyriproxyfen-pyrethroid LLINs conferred protection similar to pyrethroid-only LLINs. These findings provide crucial second-trial evidence to enable WHO to make policy recommendations on these new LLIN classes. This study confirms the importance of chlorfenapyr as an LLIN treatment to control malaria in areas with pyrethroid-resistant vectors. However, an arsenal of new active ingredients is required for successful long-term resistance management, and additional innovations, including pyriproxyfen, need to be further investigated for effective vector control strategies. FUNDING: UNITAID, The Global Fund

Assessing the efficacy of two dual-active ingredients long-lasting insecticidal nets for the control of malaria transmitted by pyrethroid-resistant vectors in Benin: study protocol for a three-arm, single-blinded, parallel, cluster-randomized controlled trial.

BACKGROUND: Long-lasting insecticidal nets (LLINs) are currently the primary method of malaria control in sub-Saharan Africa and have contributed to a significant reduction in malaria burden over the past 15 years. However, this progress is threatened by the wide-scale selection of insecticide-resistant malaria vectors. It is, therefore, important to accelerate the generation of evidence for new classes of LLINs. METHODS: This protocol presents a three-arm superiority, single-blinded, cluster randomized controlled trial to evaluate the impact of 2 novel dual-active ingredient LLINs on epidemiological and entomological outcomes in Benin, a malaria-endemic area with highly pyrethroid-resistant vector populations. The study arms consist of (i) Royal Guard® LLIN, a net combining a pyrethroid (alpha-cypermethrin) plus an insect growth regulator (pyriproxyfen), which in the adult female is known to disrupt reproduction and egg fertility; (ii) Interceptor G2® LLIN, a net incorporating two adulticides (alpha-cypermethrin and chlorfenapyr) with different modes of action; and (iii) the control arm, Interceptor® LLIN, a pyrethroid (alpha-cypermethrin) only LLIN. In all arms, one net for every 2 people will be distributed to each household. Sixty clusters were identified and randomised 1:1:1 to each study arm. The primary outcome is malaria case incidence measured over 24 months through active case detection in a cohort of 25 children aged 6 months to 10 years, randomly selected from each cluster. Secondary outcomes include 1) malaria infection prevalence (all ages) and prevalence of moderate to severe anaemia in children under 5 years old, measured at 6 and 18 months post-intervention; 2) entomological indices measured every 3 months using human landing catches over 24 months. Insecticide resistance intensity will also be monitored over the study period. DISCUSSION: This study is the second cluster randomised controlled trial to evaluate the efficacy of these next-generation LLINs to control malaria transmitted by insecticide-resistant mosquitoes. The results of this study will form part of the WHO evidence-based review to support potential public health recommendations of these nets and shape malaria control strategies of sub-Saharan Africa for the next decade. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03931473 , registered on 30 April 2019

Electrolyte disturbances in diabetic patients in Cotonou, Benin

Background: As globally observed in low income countries, the incidence of diabetes rise rapidly in Benin. Electrolytes imbalance contribute to complications observed in diabetes. The aim of this study was to estimate electrolytes disturbances in diabetic patients in Cotonou, Benin.Methods: A total of 260 participants were included in the study: 150 diabetic patients and for the control group110 age and sex matched non diabetic subjects. Glucose, Ca2+, Mg2+, K+, Na+ and Cl- were determined in fasting blood samples. The proportions of subjects with abnormal values in the diabetic population and in the control group were compared using Chi-square test. The diabetic population was divided in three groups in regard of the fasting plasma glucose (FPG) level. For each group, the mean values of the parameters were compared to those of the control group using the Student’t-test.The significance level was set to 5%.Results: Near half of the diabetic patients suffered from hyperkalemia (48%). Hypocalcemia was observed in 41.3% of the diabetic patients and hypercalcemia was found in 23.3%. Hypomagnesemia and hyponatremia affected more than 40% of the diabetic subjects.  The mean values of serum potassium were significantly elevated in all three groups of diabetic patients compared to the control group.Conclusions: This study showed that electrolyte imbalances affect the diabetic patients in Cotonou

Effects of Oyster Shell Powder on the Microbial and Physicochemical Quality of Afitin, a Traditional Fermented Condiment

Aims: Afitin is a perishable condiment due to its high water content. Various preservatives are used to extend its shelf life, and among them, salt (NaCl) has generated controversy due to potential health risks associated to exposure to elevated concentrations of salt. The present study aims at assessing the effect of oyster shell powder on the quality changes of Afitin during storage at 30°C. Methodology: Oyster shell powder was added to the condiment just before the natural fermentation at concentrations of 0.5%, 1% and 2%. At the end of the 24 h natural fermentation, the product was stored at 30°C. Afitin samples which did not receive the oyster shell powder served as controls. Samples were taken for microbiological, pH, water activity, and sensory analyses just before the fermentation, at the end of the fermentation, and at days 2 and 4 during storage. Results: Oyster shell powder had a significant effect on the growth of microorganisms, on pH and water activity during the storage of Afitin. The average Total Viable Count (TVC) in the control samples was 8.9 Log CFU/g, whereas in the Afitin with 2% oyster shell powder, this load was 6.9 Log CFU/g after 2 days of storage. At the same time, the enterobacteria load in the control Afitin was 7.7 Log CFU/g, whereas in the Afitin with 2% oyster shell powder, it was below the detection limit. There was also a significant difference between the samples inoculated with 1% oyster shell powder and the control. From the sensory analysis, the control Afitin was rejected by the panellists after 48 h of storage, whereas the Afitin with 1% or 2% oyster shell powder was not rejected until the end of storage (4th day), indicating a notable prolongation of the product's shelf life by at least 100%. Conclusion: The results show that oyster shell powder can potentially be used to improve the preservation of Afitin