Medicinal plants administered to control hypertension in Ethiopia: ethnomedicine, pharmacology, nutraceutical, phytochemistry, toxicology, and policy perspectives

In traditional folk medicine, medicinal plants are widely employed. High blood pressure, a major cause of morbidity and mortality in healthcare settings, is linked to the risk of cardiovascular illnesses and many other serious health issues that can develop from it. This review provides background regarding hypertension, including introductory concepts, risk factors, and treatment approaches. Hypertension may not be effectively treated with the use of diuretics, ACE inhibitors, beta-blockers, alpha-blockers, calcium channel blockers, direct vasodilators, renin inhibitors, etc. These drugs’ side effects include intolerance, weakened disease control, and improper therapy management. Therefore, an approach for extracting new therapeutic chemicals from medicinal plants is receiving attention today. As a result, this article provides a list of 85 plant species from 40 families, compiling data on ethnobotanical claims, plant parts used to make extracts, different types of extracts and study animals, nutracuticals’ intended use, the antihypertensive effect of the extracts, their mode of action, clinical trials, toxicity profile, etc. It also mentions 55 specific chemical compounds that have shown potential to lower blood pressure in lab tests and live subjects, along with their dosage and how they work, based on online searches of published studies from different sources. Researchers looking into and developing new anti-hypertensive therapies to treat hypertension would benefit from our current work. We also tried to address the policy implications

Traditional herbal medicine regulatory implementation in Ethiopia: a qualitative study

Background: Approximately 80% of the Ethiopian population predominantly depends on herbal medicines (HMs) for their primary healthcare needs. Nevertheless, worries regarding the safety, efficacy, and standard of herbal-based treatments have been escalating due to the lack of strong regulatory frameworks. Therefore, the study aimed to assess the presence of regulatory frameworks for traditional herbal medicines and their enforcement in Ethiopia.Methods: The qualitative–phenomenological study design was conducted from November 2021 to March 2022 G.C. The study included 25 regulatory official key informants (KIs) who work for national and regional medicine regulatory agencies, and 15 traditional herbal medicine (THM) practitioners who work at the regional level were purposefully selected for an in-depth interview (IDI). An in-depth interview guide was developed through the purposive sampling technique. The collected data were analyzed using thematic content analysis techniques.Results: The study found that the current national medicine proclamation is deemed inadequate in the regulation of THM. Both conventional and traditional herbal medicines are regulated by a single agency. Weak legal enforcement, a lack of government commitment and support, resource constraints, and inadequate regulatory tools are the main challenges faced in THM regulation.Conclusion: Overall, the study found inadequate legal frameworks and weak THM regulatory implementations in Ethiopia. Consequently, it is critical for all regulatory authorities in Ethiopia to exert their utmost efforts to effectively regulate THM

Traditional Herbal Medicine Regulation in Ethiopia: A Critical Evaluation of Legal Basis and Its Implementation

Background: The majority of Ethiopians' primary healthcare relies on herbal medicine (HM) based traditional medicine (TM) products and practices. Therefore, the presence of adequate regulatory framework for traditional herbal medicines (THMs) and its effective implementation is vital to improve the quality and standard of public healthcare system in Ethiopia. Objective: To assess the traditional herbal medicines regulation legal basis and its practical implementation in Ethiopia from November 2021 to March 2022 Methods: An institutional-based descriptive cross-sectional study design mixed with qualitative approach (in-depth interviews) was conducted. The study data was obtained from archival review of legal basis, a survey of random selected 237 regulatory personnel, and in-depth interview conducted with purposely- selected 25 regulatory officials and 15 herbalists. Quantitative data analyzed by SPSS version 26, and a thematic analysis approach was utilized to analyze qualitative data. The study results were presented in text, tables, and figures form. Results: Ethiopia has now regulated THMs based on the 1993 medicine policy and, 2019 proclamation of Ethiopian Food and Drug Authority (EFDA). Current medicine law of Ethiopia has inadequateness on TM/HM product and practice recognition; TMs executive bodies name, power and functions; and regulated TM/HM product sources, categories and requirements. The presence of exclusive regulation (80.7%, n=57) and registration (89.5%, n=57) system for TMs products at EFDA were reported. The majority of EFDA and regional health regulatory (RHR) study participants agreed on the absence of authorized TMs products and manufacturer, and pharmacovigilance (PV) regulation systems. Most of RHR workers were informed the existence of a system for most THM practice and providers basic regulatory activities. Functionality of herbalist registration (97.8%, n=180), and THM practice regulation (87.8%, n=180) were reported. (70.2%, n = 57) of EFDA and 41.7% (n=180) of RHR respondents believed as THM regulatory activities were poorly enforced by their respective offices. The indicators of THM weak practical regulation identified by study participants were HM sells without restriction, registered herbalists small in number, THM not regulated in some regions‟, most THM regulatory tools not available, presence of quack herbalists, and ignorance of THM regulation at rural. THM regulation mainly challenged by weak legal enforcement, weak government commitment and supports, regulatory resources constrains, TM regulatory administrative and activities fragments, and regulatory tools inadequateness. Moreover, the presence of TM healers over suspicion, regions level TM regulation inconstancy, THM regulatory requirement difficultness, federal and RHR offices weak cooperation, HM research and development negligence, and TM healers‟ association weakness were identified common challenges of THM regulatio

COVID – 19 related knowledge and preventive practices early in the outbreak among health care workers in selected public health facilities of Illu aba Bor and Buno Bedelle zones, Southwest Ethiopia

Abstract Background Novel-coronavirus 2019 (COVID-19) disease is currently a worldwide health risk and public health emergency concern. The virus is transmitted from an infected person to another person through close contact and droplets. Frontline health care workers are the most at risk of infection, and so a WHO interim guidance document was issued by the World Health Organization (WHO) which underscores the importance of proper sanitation and waste management practices for COVID- 19 in health-care settings. This study aimed at assessing knowledge and preventive practices towards Covid-19 among health care providers in selected health facilities of Illu Aba Bor and Buno Bedele zones, Southwest Ethiopia. Methods An institution-based cross-sectional study was conducted from April to May 2020 among 330 health workers in selected health facilities of Illu Aba Bor and Buno-Bedelle Zones, Southwest Ethiopia. Data were collected using a self-administered structured questionnaire. The collected data were entered into Epidata version 3.1 and exported to SPSS version 23 for analysis. Bivariate and multivariable logistic regression analysis was used to identify independent predictors of preventive practices towards Covid-19. Statistical significance was declared at a p-value of &lt; 0.05. Result The majority of respondents (93.3%) demonstrated good knowledge of COVID-19, and the mean (SD) knowledge score was 9.04 ± 1.06. Nearly two-thirds (64.2%) of the study participants had good infection prevention practices. Being male (AOR = 3.65, 95% CI: (1.96, 6.80)), education level (AOR = 1.82, 95% CI (1.02, 3.22)), profession (AOR = 3.17, 95% CI (1.08, 9.33)), service year (5–10 years) (AOR = 2.00 (1.02, 3.92)) and more than 10 years (AOR = 3.14 (1.51, 6.52)), availability of personal protective equipment (AOR = 1.96 (1.06, 3.61)) and Knowledge level (AOR = 2.61 (1.48, 4.62)) were independent predictors of COVID-19 preventive practices. Conclusion The overall level of knowledge of HCWs was good. However, the practice was relatively low. Gender, educational status, profession, year of service, knowledge towards COVID-19, and availability of personal protective equipment were independent predictors of good infection prevention practices. Optimizing the infection prevention and control loop of the health facilities is recommended. </jats:sec

Epidural and Intrathecal Drug Delivery Systems for Chronic Pain Management: Progress, Promises, and Challenges: a narrative review

Millions of people worldwide suffer from chronic pain, which significantly impacts their quality of life. Managing chronic pain is often complex and time-consuming. In this narrative review, we explore the use of epidural and intrathecal drug delivery systems (EIDDS) as a solution for chronic pain management. The purpose of this review is to provide an overview of recent approaches in targeted implantable drug delivery systems for chronic pain management, including their long-term safety, efficacy, cost-effectiveness, risks, and future opportunities and challenges. The data was gathered through extensive research using MEDLINE, PubMed, and Google Scholar databases, including studies published until June 13, 2023. The visual analogue scale, Karnofsky Performance Status (KPS), respiration, and oxygen saturation in the group receiving drugs through a targeted implantable drug delivery system were significantly better than those in the group receiving conventionally administered analgesia in a study on patients with advanced cancer. Whereas in comparison to conventional treatment alone, the targeted implantable drug delivery system alone or in combination therapy exhibited some advantages or similar effects in reducing chronic pain during a 1-year follow-up in patients with chronic non-cancer pain. Implantable drug delivery systems are a promising new treatment option for chronic pain treatment. All forms of pain, including those that are still challenging to treat with traditional methods, can now be targeted with devices and treatments

Inventory management performance for laboratory commodities in public hospitals of Jimma zone, Southwest Ethiopia

Abstract Background Maintaining an efficient and effective inventory management system ensures a reliable supply of laboratory commodities. The aim of this study was, therefore, to assess the performance of inventory management for laboratory commodities in public hospitals in the Jimma zone. Methods A facility-based cross-sectional descriptive study, accompanied by a qualitative method, was conducted in seven public hospitals between April 30 and May 29, 2019. We collected data through document reviews (225 bin-cards), physical observation, self-administered questionnaires, and in-depth interviews. The quantitative data were analyzed using Excel spreadsheets and SPSS version 24. Fifteen key informants of different backgrounds took part in the qualitative study. The data were then analyzed using thematic analysis techniques. Results All the public hospitals in the zone were included in the study, making a response rate of 100%. Of the total estimated bin-cards, 225 (69.9%) of them held along with the items, and only 30.4% of them filled accurately. In four of the hospitals, pharmacists determined how much to order. Five of the hospitals used average monthly consumption data to calculate purchase quantity. Over the past 6 months, four of the hospitals had placed at least one or two emergency orders. The wastage rate of the commodities in the hospitals was 27.2% and resulted in a loss of about 10,248.5 US dollars. The hospitals had met 70.6% of the criteria for proper storage conditions. Budget constraints, absence of prompt administrative support, lack of staff commitment, and frequent shortages of commodities on the part of suppliers were major bottlenecks of inventory management. Conclusions The hospitals had weak inventory management practices, showed by inaccurate records, stock-outs (frequent emergency orders), a high wastage rate compared to national baseline statistics, and the storage conditions below the standard. </jats:sec

In Vivo Antimalarial Activity of the Solvent Fractions of Fruit Rind and Root of Carica papaya Linn (Caricaceae) against Plasmodium berghei in Mice

Background. Currently, antimalarial drug resistance poses a serious challenge. This stresses the need for newer antimalarial compounds. Carica papaya is used traditionally and showed in vitro antimalarial activity. This study attempted to evaluate in vivo antimalarial activity of C. papaya in mice. Methods. In vivo antimalarial activity of solvent fractions of the plant was carried out against early P. berghei infection in mice. Parasitemia, temperature, PCV, and body weight of mice were recorded. Windows SPSS version 16 (one-way ANOVA followed by Tukey’s post hoc test) was used for data analysis. Results. The pet ether and chloroform fractions of C. papaya fruit rind and root produced a significant (p<0.001) chemosuppressive effect. A maximum parasite suppression of 61.78% was produced by pet ether fraction of C. papaya fruit rind in the highest dose (400 mg/kg/day). Only 400 mg/kg/day dose of chloroform fraction of C. papaya root exhibited a parasite suppression effect (48.11%). But, methanol fraction of the plant parts produced less chemosuppressive effect. Conclusion. Pet ether fraction of C. papaya fruit rind had the highest antimalarial activity and could be a potential source of lead compound. Further study should be done to show the chemical and metabolomic profile of active ingredients