Antibacterial effect of Ocimum gratissimum against bacteria from paediatric diarrhoeal stool samples in the tropics

The upsurge in the prevalence of side effects of many synthetic antimicrobial agents and incidence of multidrug resistant bacteria has spurred scientists on the research for plant based antimicrobial of therapeutic potentials. Ocimum gratissimum presents such potential of high medicinal value. This plant is used in Nigeria traditionally as condiments and for the treatment of various ailments such as pyorrhea, dysentery and bronchitis. Aqueous and ethanolic leaf extracts of O. gratissimum was screened for antibacterial activity against bacteria recovered from paediatric diarrhoea stool samples. Both extracts were found to exhibit selective inhibition against the isolates. The diameter zones of inhibition exhibited by the extracts were between 2.50±0.50mm – 26.00±1.00mm. The ethanolic and aqueous extracts had minimum inhibitory concentrations that ranged between 15 and 25mg/ml, the extracts were bacteriostatic. Ethanolic extract showed more inhibitory effects compared to the aqueous extracts. The phytochemical analysis of both extracts revealed the presence of saponins, alkaloids, flavonoids, phenolics, tannins and glycosides, volatile oils, proteins and amino acids and terpernoids. In view of the efficacy of these extracts in inhibiting the growth of diarrhoea- causing organisms in paediatric stool samples, the utilization of the extracts in the formulation of new antibacterial drugs for the treatment of gastroenteritis caused by these organisms is strongly recommended especially when the availability and low cost of this medicinal plant are put into strong consideration.Keywords: Ocimum, diarrhoea, paediatric, stool, antibacteria

Third Joint Academic Opinion on the South African Copyright Amendment Bill [B13D-2017]

South Africa is in the process of reforming its copyright law, attempting to update and align it with constitutional rights and existing and prospective international treaty obligations. A coalition of copyright, human rights, and constitutional law experts have been engaging in the ongoing national and provincial public participation processes. This working paper chronicles the law reform process until April 2023, covering related constitutional court litigation, and then goes on to set out the submissions made on behalf of the group of experts. The process offers insights into the different but crucial roles played by the legislature and the judiciary in aligning copyright with the constitution. It also provides valuable comparative lessons for other jurisdictions seeking to reform their copyright laws

Experimental studies on the pathogenicity of Vibrio mimicus strains isolated in Bangladesh

Vibrio mimicus, a newly described species of the genus Vibrio has been isolated from stools of 14 patients with diarrhoea. Live cells of all the 14 strains tested caused accumulation of fluid in rabbit gut loops and diarrhoea in infant rabbits. Culture filtrates of all the strains caused increased capillary permeability in rabbit skin; however, five of the filtrates resembled cholera toxin in that they gave positive reactions in rabbit loops, chinese hamster ovarian and mouse adrenal cell monolayers and GM1 ELISA tests and were neutralized by cholera antitoxin. None of the strains produced heat-stable toxin or possessed invasive capability as determined by Sereny's test. Thus, V. mimicus strains were divided into a group which produced a toxin immunobiologically similar to cholera toxin and the rest producing a heat-labile toxin unrelated to that of V. cholerae

Identifying patients at high risk for obstructive sleep apnoea syndrome in Nigeria: A multicentre observational study

Background: Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in tertiary hospitals in Nigeria.Methods: This was a multicentre observational study of adult patients hospitalized in three selected hospitals from 15th January to 17th March 2015. Berlin questionnaire and Epworth sleepiness scale were used to assess for obstructive sleep apnoea risk and excessive daytime sleepiness respectively. Additional questions on traditional risk factors for obstructive sleep apnoea were also obtained.Results: Nine hundred and twenty-six patients were recruited into the study. Respondents’ mean age was 44.3 years ± 15.2years, 486 (52.5%) were females and 556 (60.0%) had one or more medical co-morbidity and none of the patients had a previous diagnosis of obstructive sleep apnoea. Factors that were independently associated with high risk for obstructive sleep apnoea include systemic hypertension(aOR-10.33;95%: CI 6.42-16.61), obesity(aOR-7.87;95% CI: 4.33-14.29); excessive daytime sleepiness (aOR-3.77;95% CI:2.28-6.22), tobacco smoking (aOR-2.99;95% CI: 1.76-5.07), snoring in a first-degree relative (aOR-1.83;95% CI: 1.19-2.81); and the use of sedative (aOR-1.82;95% CI: 1.06-3.15).Conclusions: This study shows that patients with systemic hypertension, obesity, excessive daytime sleepiness, history of smoking, snoring in a firstdegree relative and use of sedatives are at high risk of obstructive sleep apnoea. None of the patients at high risk had a previous diagnosis of sleep apnoea by a physician, highlighting the diagnostic challenges of this condition. The results of this study will assist health care professionals in early identification of individuals at risk of obstructive sleep apnoea and subsequent referral for a sleep study

Costs and Cost-Effectiveness of Hypertension Screening and Treatment in Adults with Hypertension in Rural Nigeria in the Context of a Health Insurance Program.

BACKGROUND: High blood pressure is a leading risk factor for death and disability in sub-Saharan Africa (SSA). We evaluated the costs and cost-effectiveness of hypertension care provided within the Kwara State Health Insurance (KSHI) program in rural Nigeria. METHODS: A Markov model was developed to assess the costs and cost-effectiveness of population-level hypertension screening and subsequent antihypertensive treatment for the population at-risk of cardiovascular disease (CVD) within the KSHI program. The primary outcome was the incremental cost per disability-adjusted life year (DALY) averted in the KSHI scenario compared to no access to hypertension care. We used setting-specific and empirically-collected data to inform the model. We defined two strategies to assess eligibility for antihypertensive treatment based on 1) presence of hypertension grade 1 and 10-year CVD risk of >20%, or grade 2 hypertension irrespective of 10-year CVD risk (hypertension and risk based strategy) and 2) presence of hypertension in combination with a CVD risk of >20% (risk based strategy). We generated 95% confidence intervals around the primary outcome through probabilistic sensitivity analysis. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the reference scenario. RESULTS: Screening and treatment for hypertension was potentially cost-effective but the results were sensitive to changes in underlying assumptions with a wide range of uncertainty. The incremental cost-effectiveness ratio for the first and second strategy respectively ranged from US$1,406 to US$ 7,815 and US$732 to US$ 2,959 per DALY averted, depending on the assumptions on risk reduction after treatment and compared to no access to antihypertensive treatment. CONCLUSIONS: Hypertension care within a subsidized private health insurance program may be cost-effective in rural Nigeria and public-private partnerships such as the KSHI program may provide opportunities to finance CVD prevention care in SSA

TH2.1: Understanding femininities: Implications for women's Participation in Agricultural interventions in central Uganda

Research has documented how men's behaviors in patriarchal settings affect women's economic empowerment outcomes, while less attention has been paid to how gender identity constructions around femininities influence these outcomes. We define femininities as gender based roles and expected behaviors of women in a given community and economic empowerment as women's decision-making regarding access and control of productive resources and management of income. This paper presents research on how female and male farmers in rural communities of central Uganda define what it means to be a woman and how those identity constructions influence women's economic empowerment. This qualitative case study is based on focus group discussions conducted with Sasakawa Africa Association intervention farmers (28 women and 25 men) of Kiboga District. Six focus group discussions were conducted, two with men only, women only, and both men and women respectively. Findings reveal co-existence of traditional and progressive femininities, dubbed "unruly" by men and some women. Traditional femininities were depicted as women complying to community values which deter them from financial decision making and owning productive resources. Progressive femininities on the other hand are noncompliant to these community values, and enjoy more economic empowerment. Men valued economically empowered women because they relieve men of financial responsibilities. Incorporating gender transformative approaches in women's economic empowerment interventions could decode traditional femininities and increase women's intrinsic agency within the context of economic empowerment

Does Intensive Treatment Select for Praziquantel Resistance in High-Transmission Settings? Parasitological Trends and Treatment Efficacy Within a Cluster-Randomized Trial.

BACKGROUND: Praziquantel mass drug administration (MDA) is recommended in schistosomiasis-endemic areas. Animal models demonstrate Schistosoma parasite resistance to praziquantel after repeated exposure. METHODS: We conducted a parasitological survey in 26 fishing communities in Uganda after 4 years of quarterly (13 communities) or annual (13 communities) praziquantel MDA, with Schistosoma infection detected by single-stool-sample Kato-Katz. A test of cure was done in participants who were positive on both urine circulating cathodic antigen test and 3-sample Kato-Katz. We calculated cure rates (CRs) and egg reduction rates (ERRs) based on 3-sample Kato-Katz and infection intensity using worm-specific circulating anodic antigen (CAA) in blood, comparing these between quarterly and annually treated participants. RESULTS: Single-sample Kato-Katz Schistosoma mansoni prevalence was 22% in 1,056 quarterly treated participants and 34% in 1,030 annually treated participants (risk ratio, 0.62; 95% confidence interval [CI], 0.40 to 0.94). Among 110 test-of-cure participants, CRs were 65% and 51% in annually and quarterly treated villages, respectively (odds ratio, 0.65; 95% CI, 0.27 to 1.58); ERRs were 94% and 81% (difference, -13%; 95% CI, -48% to 2%). There was no impact of quarterly vs annual praziquantel on S. mansoni by CAA. CONCLUSIONS: In this schistosomiasis hot spot, there was little evidence of decreased praziquantel efficacy. However, in the absence of alternative therapies, there remains a need for continued vigilance of praziquantel efficacy in the MDA era

Reference Intervals in Healthy Adult Ugandan Blood Donors and Their Impact on Conducting International Vaccine Trials

BACKGROUND: Clinical trials are increasingly being conducted internationally. In order to ensure enrollment of healthy participants and proper safety evaluation of vaccine candidates, established reference intervals for clinical tests are required in the target population. METHODOLOGY/PRINCIPAL FINDINGS: We report a reference range study conducted in Ugandan adult blood bank donors establishing reference intervals for hematology and clinical chemistry parameters. Several differences were observed when compared to previously established values from the United States, most notably in neutrophils and eosinophils. CONCLUSIONS/SIGNIFICANCE: In a recently conducted vaccine trial in Uganda, 31 percent (n = 69) of volunteers screened (n = 223) were excluded due to hematologic abnormalities. If local reference ranges had been employed, 83% of those screened out due to these abnormalities could have been included in the study, drastically reducing workload and cost associated with the screening process. In addition, toxicity tables used in vaccine and drug trial safety evaluations may need adjustment as some clinical reference ranges determined in this study overlap with grade 1 and grade 2 adverse events