Comparative evaluation of the chemotherapeutic efficacies of two salts of diminazene aceturate in Trypanosoma brucei brucei infected dogs

Purpose: To compare the anti-trypanosomal efficacies of 4,4-(diazoaminedibenzamidinetrihydrate) diacetate (4,4-DDBT) and 4,4-(diazoamino) benzamidine (4,4-DB) in experimental canine trypanosomosis. Methods: The efficacies of 4,4-DDBT and 4,4-DB were evaluated in 4 groups of dogs (n = 3) designated A-D. Group A was normal control without infection or drug treatment, group B did not receive any drug treatment but was infected with Trypanosoma brucei brucei, while groups C and D were infected with T. b. brucei and treated with 4,4-DDBT(3.5 mg/kg) and 4,4-DB (3.5 mg/kg), respectively. Results: The incubation period of the infection was 6 - 9 days post-infection. Treatment of the dogs with 4,4-DDBT led to zero parasitaemia 48 h post-treatment, while there was only a decrease in parasitemia to log 6 in 4,4-DB-treated dogs. Resurgence of parasite into the blood stream occurred in 4,4-DDBTtreated dogs 6 days after initial parasite clearance. Blood analyses post-treatment revealed elevated leucocytes and lymphocytes in 4,4-DB-treated dogs (p < 0.05). Packed cell volume was also observed to be higher in 4,4-DDBT-treated group when compared to 4,4-DB group (p < 0.05). Conclusion: These findings suggest that 4,4-DDBT is more efficacious in the clinical management of canine trypanosomosis caused by T. b. brucei. However, it does not prevent relapse of infection. Based on these findings, therefore, 4,4-DDBT should be the diminazene salt of choice when indicated in the clinical management of T. b. brucei infection in dogs

An assessment of the eye care workforce in Enugu State, south-eastern Nigeria

<p>Abstract</p> <p>Background</p> <p>The availability and distribution of an appropriate eye care workforce are fundamental to reaching the goals of "VISION 2020: The right to sight", the global initiative for the elimination of avoidable blindness launched jointly by the World Health Organization and the International Agency for the Prevention of Blindness with an international membership of nongovernmental organizations, professional associations, eye care institutions and corporations. Periodic evaluation of these parameters is important in the journey towards achieving these goals. The objectives of the study were to determine the availability and distribution of human resources for eye care delivery in Enugu Urban, south-eastern Nigeria.</p> <p>Methods</p> <p>The study was designed as a cross-sectional descriptive survey, the setting for which was all public and privately owned eye care facilities in Enugu Urban, Enugu State, south-eastern Nigeria, in October 2006. The health map of Enugu Urban and the hospital register of the Public Health Department of the Enugu State Ministry of Health were used to identify the eye health care facilities in Enugu Urban. A structured, pretested, researcher-administered questionnaire was used to capture data on cadre and distribution of the eye care personnel in these facilities.</p> <p>Relevant population data were obtained from the Enugu Regional Office of the National Population Commission. Descriptive statistical analysis was used to generate percentages and proportions. Eye care personnel-to-population ratios were calculated and compared to World Health Organization recommendations.</p> <p>Results</p> <p>Out of Enugu State's population of three million, Enugu Urban accounts for 22%. The population of Enugu Urban is distributed between the three-component Local Government Areas comprising Enugu North (31%), Enugu South (30%) and Enugu East (39%). There are 45 eye care facilities (public: 31 (69%); private: 14 (31%)) employing 252 eye care workers (public: 226 (90%); private: 26 (10%)) aged 18 to 63 (mean = 36.1 years, SD = 2 years) comprising males (36: 14%) and females (216: 86%), giving a male-to-female sex ratio of 1:6. The available eye care workforce is unevenly distributed between Enugu North (128: 51%), Enugu South (65: 26%) and Enugu East (59: 23%) Local Government Areas.</p> <p>Conclusion</p> <p>Using broad and crude World Health Organization standards for minimum provider-to-population ratios, there is a sufficient eye care workforce in Enugu Urban. However, the maldistribution of the workforce creates a major barrier to uptake of eye care services. Policy modifications could reverse this maldistribution.</p

Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in south-eastern Nigeria: socio-demographic and clinical correlates

<p>Abstract</p> <p>Background</p> <p>This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM) use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria.</p> <p>Methods</p> <p>In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between August 2004 - July 2006, all newly presenting ophthalmic outpatients were recruited. Participants' socio-demographic and clinical data and profile of TEM use were obtained from history and examination of each participant and entered into a pretested questionnaire and proforma. Participants were subsequently categorized into TEM- users and non-users; intra-group analysis yielded proportions, frequencies, and percentages while chi-square test was used for inter-group comparisons at P = 0.01, df = 1.</p> <p>Results</p> <p>Of the 2,542 (males, 48.1%; females, 51.9%) participants, 149 (5.9%) (males, 45%; females, 55%) used TEM for their current eye disease. The TEMs used were chemical substances (57.7%), plant products (37.7%), and animal products (4.7%). They were more often prescribed by non-traditional (66.4%) than traditional (36.9%) medicine practitioners. TEMs were used on account of vision loss (58.5%), ocular itching (25.4%) and eye discharge (3.8%). Reported efficacy from previous users (67.1%) and belief in potency (28.2%) were the main reasons for using TEM. Civil servants (20.1%), farmers (17.7%), and traders (14.1%) were the leading users of TEM. TEM use was significantly associated with younger age (p < 0.01), being married (p < 0.01), rural residence (p < 0.01), ocular anterior segment disease (p < 0.01), delayed presentation (p < 0.01), low presenting visual acuity (p < 0.01), and co-morbid chronic medical disease (p < 0.01), but not with gender (p = 0.157), and educational status (p = 0.115).</p> <p>Conclusion</p> <p>The incidence of TEM use among new ophthalmic outpatients at UNTH is low. The reasons for TEM use are amenable to positive change through enhanced delivery of promotive, preventive, and curative public eye care services. This has implications for eye care planners and implementers. To reverse the trend, we suggest strengthening of eye care programmes, even distribution of eye care resources, active collaboration with orthodox eye care providers and traditional medical practitioners, and intensification of research efforts into the pharmacology of TEMs.</p

Challenges in horizontal integration of eye care services into the pre-existing rural primary care structure: an operations research perspective from Nigeria

Background . The provision of population-wide, accessible, affordable, acceptable and evenly distributed qualitative eye care services remains a recurrent challenge to eye care organizations worldwide. Objectives . To report the challenges encountered in setting up eye care service in a pre-existing primary health care facility in rural Nigeria and also audit the common causes of eye disorders in rural setting southeast of Nigeria. Material and methods . The study was an operations research study conducted at Akpuoga-Nike between February and April 2011. Demographic and ophthalmic clinical data were collected. Health system-, community- and patient-determined challenges were catalogued and analyzed using Epi Info Statistical software for Windows, version 6. Univariate analysis was performed for data distribution testing. Analytical statistics were performed, with p < 0.05 considered statistically significant. Results . A total of 481 (males, 144 (29.9%); females, 377(70.1%)) patients aged 42.3 ± 20.2 SD years (range 4–80 years) were seen. The leading eye disorders were refractive error – 28.9%, and cataract – 16.4%. The operations challenges encountered included difficulties with community sensitization/advocacies, inadequate infrastructure and mobile equipment, as well as lack of eye care manpower, consumables and funding deficits. Conclusions . Health system-related issues were the main challenges encountered. Recruitment of an adequate number of rural eye care workforce, provision of needed material resources, adequate funding and engendering community participation in rural eye care delivery through grass roots advocacy and health service public education would overcome the challenges

Challenges in horizontal integration of eye care services into the pre-existing rural primary care structure: an operations research perspective from Nigeria

Background . The provision of population-wide, accessible, affordable, acceptable and evenly distributed qualitative eye care services remains a recurrent challenge to eye care organizations worldwide. Objectives . To report the challenges encountered in setting up eye care service in a pre-existing primary health care facility in rural Nigeria and also audit the common causes of eye disorders in rural setting southeast of Nigeria. Material and methods . The study was an operations research study conducted at Akpuoga-Nike between February and April 2011. Demographic and ophthalmic clinical data were collected. Health system-, community- and patient-determined challenges were catalogued and analyzed using Epi Info Statistical software for Windows, version 6. Univariate analysis was performed for data distribution testing. Analytical statistics were performed, with p < 0.05 considered statistically significant. Results . A total of 481 (males, 144 (29.9%); females, 377(70.1%)) patients aged 42.3 ± 20.2 SD years (range 4–80 years) were seen. The leading eye disorders were refractive error – 28.9%, and cataract – 16.4%. The operations challenges encountered included difficulties with community sensitization/advocacies, inadequate infrastructure and mobile equipment, as well as lack of eye care manpower, consumables and funding deficits. Conclusions . Health system-related issues were the main challenges encountered. Recruitment of an adequate number of rural eye care workforce, provision of needed material resources, adequate funding and engendering community participation in rural eye care delivery through grass roots advocacy and health service public education would overcome the challenges

Renoprotective effects of Cucumeropsis mannii seed oil on cisplatin-induced nephrotoxicity in Wistar rats

Background: The growing prevalence of cancer and the concomitant rise in chemotherapy use have led to an increased incidence of kidney-related diseases, including nephrotoxicity. Cisplatin (CP) is a widely used and potent anticancer drug, but nephrotoxicity limits its clinical application. Purpose: Our study aimed to determine the phytochemicals and median lethal dose of Cucumeropsis mannii seed oil (CMSO) using standard methods and to further investigate the effects of CMSO on CP-induced nephrotoxicity in male Wistar rats. Methods: Twenty-one rats (100 to 150 g) were randomly divided into seven groups (n = 3) and treated with CMSO or normal saline for ten days. Group A received 1.0 mL of normal saline, irrespective of the body weight (b.w.). Groups B-D received 2500, 5000, and 7500 mg/kg b.w., respectively, of the CMSO and a single intraperitoneal dose of CP (8 mg/kg) on the seventh day. Groups E and F were administered 2500 mg/kg and 7500 mg/kg b.w., respectively, of the CMSO without CP administration. Group G received a single intraperitoneal dose (8 mg/kg b.w.) of CP on the seventh day without CMSO treatment. Results: The analysis of CMSO revealed the presence of various phytochemicals such as hydrogen cyanide, glycosides, saponins, steroids, tannins, alkaloids, terpenoids, phenols, and flavonoids. Acute toxicity testing demonstrated the safety of CMSO up to 5000 mg/kg b.w. We discovered that the CP administration increased serum creatinine (sCr), urea, blood urea nitrogen (BUN), and malondialdehyde (MDA) levels in rats and markedly decreased renal superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities and glutathione (GSH) levels. CMSO attenuated kidney dysfunction, oxidative stress, and lipid peroxidation. Interestingly, CMSO prominently decreased sCr, urea, and BUN levels, boosted the activity of SOD, CAT, and GPx, increased GSH levels, and significantly (p < 0.05) decreased MDA levels. Histological assessment corroborated these biochemical findings. Conclusion: Our findings highlight the potential of CMSO as a protective agent against CP-induced nephrotoxicity. The observed effects are attributable to the rich phenolic and flavonoid content of CMSO. These findings have significant implications for developing complementary therapies to mitigate chemotherapy-associated kidney damage, potentially enhancing the safety and efficacy of cisplatin-based cancer treatments. Further investigation is needed to explore the clinical applications of CMSO for cancer patients