Rate and Predictors of Adherence to Antiretroviral Therapy among Clients on Antiretroviral Therapy at Tepi Health Center, South-west Ethiopia

Highly Active Antiretroviral Therapy (HAART) has resulted reduction of mortality and improved quality of life of peoples living with HIV/AIDS. Maximum benefits can only be achieved through maximum adherence. We designed this study to assess rate and predictors of adherence to antiretroviral therapy at Tepi health center. A facility based cross-sectional study was conducted through patient’s self report using structured pre-tested questionnaires and medical record of the clients in a total of 341 samples using systematic random sampling technique. The data were collected from January1, 2012 to February15, 2012 in Tepi health centre. The data was analyzed using SPSS version 16. Multiple logistic regression model was constructed to determine predictors of adherence. Self-reported dose adherence in the study area was 78.6% and that of combined indicator was 43.4%. Positive predictors of adherence includes alcohol drinking (AOR=4.36, 95% CI =2.03, 9.35), and a belief of ART cures HIV (AOR = 1.95, 95% CI = 1.21, 3.13) while long-duration on HAART (≥49 months) (AOR=0.29, 95%CI=0.11, 0.75) was negative predictor. The adherence rate in this study was much less than studies in many parts of Ethiopia. Interventions should target on reduction of alcohol use and on imparting appropriate knowledge of HAART that will address false beliefs of “ART cures HIV”.Keywords: Adherence HAART Rate and Predictors HIV/AIDS Combined Adherenc

General Extraction, Isolation and Characterization Techniques in Drug Discovery: A Review

Extraction, isolation and characterization techniques of compounds from plant tissues are the basic foundations of drug discovery from plants. Research has been conducted using these techniques and publications are available on the same. However, it is important to put them together and discuss their fundamental descriptions including comparative advantages and disadvantages. The aim of this work is to provide choices in the field of drug discovery and allied research areas on the optimal techniques that can be employed. Through a basic literature review method on the techniques that are systematically employed in drug discovery from natural sources, students, researchers and project managers can make an informed choice of the techniques to employ in their projects

Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis

Background Mupirocin is widely used for nasal decolonization of Staphylococcus aureus to prevent subsequent staphylococcal infection in patients and healthcare personnel. However, the prolonged and unrestricted use has led to the emergence of mupirocin-resistant (mupR) S. aureus. The aim of this systematic review was to investigate the prevalence, phenotypic and molecular characteristics, and geographic spread of mupR S. aureus in Africa. Methods We examined five electronic databases (EBSCOhost, Google Scholar, ISI Web of Science, MEDLINE, and Scopus) for relevant English articles on screening for mupR S. aureus from various samples in Africa. In addition, we performed random effects meta-analysis of proportions to determine the pooled prevalence of mupR S. aureus in Africa. The search was conducted until 3 August 2016. Results We identified 43 eligible studies of which 11 (26%) were obtained only through Google Scholar. Most of the eligible studies (28/43; 65%) were conducted in Nigeria (10/43; 23%), Egypt (7/43; 16%), South Africa (6/43; 14%) and Tunisia (5/43; 12%). Overall, screening for mupR S. aureus was described in only 12 of 54 (22%) African countries. The disk diffusion method was the widely used technique (67%; 29/43) for the detection of mupR S. aureus in Africa. The mupA-positive S. aureus isolates were identified in five studies conducted in Egypt (n = 2), South Africa (n = 2), and Nigeria (n = 1). Low-level resistance (LmupR) and high-level resistance (HmupR) were both reported in six human studies from South Africa (n = 3), Egypt (n = 2) and Libya (n = 1). Data on mupR-MRSA was available in 11 studies from five countries, including Egypt, Ghana, Libya, Nigeria and South Africa. The pooled prevalence (based on 11 human studies) of mupR S. aureus in Africa was 14% (95% CI =6.8 to 23.2%). The proportion of mupA-positive S. aureus in Africa ranged between 0.5 and 8%. Furthermore, the frequency of S. aureus isolates that exhibited LmupR, HmupR and mupR-MRSA in Africa were 4 and 47%, 0.5 and 38%, 5 and 50%, respectively. Conclusions The prevalence of mupR S. aureus in Africa (14%) is worrisome and there is a need for data on administration and use of mupirocin. The disk diffusion method which is widely utilized in Africa could be an important method for the screening and identification of mupR S. aureus. Moreover, we advocate for surveillance studies with appropriate guidelines for screening mupR S. aureus in Africa

Data for: Efficacy and safety of Cinnamon in Type II Diabetes Mellitus and Pre-diabetes patients: A Meta-analysis and Meta-regression

This is Stata data set for the manuscript titled Efficacy and safety of Cinnamon in Type II Diabetes Mellitus and Pre-diabetes patients: A Meta-analysis and Meta-regressio

Data for: Efficacy and safety of Cinnamon in Type II Diabetes Mellitus and Pre-diabetes patients: A Meta-analysis and Meta-regression

This is Stata data set for the manuscript titled Efficacy and safety of Cinnamon in Type II Diabetes Mellitus and Pre-diabetes patients: A Meta-analysis and Meta-regressionTHIS DATASET IS ARCHIVED AT DANS/EASY, BUT NOT ACCESSIBLE HERE. TO VIEW A LIST OF FILES AND ACCESS THE FILES IN THIS DATASET CLICK ON THE DOI-LINK ABOV

Antimicrobial resistance profile of Staphylococcus aureus isolates isolated from ear discharges of patients at University of Hawassa comprehensive specialized hospital

Abstract Background Drug-resistant microorganism are a growing global danger. Strains of S. aureus have developed resistance to many commonly used antimicrobials due to indiscriminate use of antimicrobials, and treatment becoming a challenge. Studies assessing pattern and determinants of S. aureus resistance in ear infection in Ethiopia are very scarce. This study presents overview of pattern and determinants S. aureus resistance from samples of ear discharge in Ethiopia. Method A prospective cross-sectional study was conducted on patients who visit ENT clinic of University of Hawassa comprehensive specialized hospital from February 1, 2016 to November 1, 2016. 117 specimens were collected with sterile applicator cotton swab from 117 patients with ear discharge visiting the clinic. Data was fed and then edited, cleared, entered and analyzed using SPSS version 20. Result The prevalence of S.aureus infection was 28.2%. S. aureus isolates revealed up to 97.0% level of resistance pattern to the antimicrobials tested. In the determination of the susceptibility of S. aureus on nine selected antibiotics by disk diffusion technique, 97.0% of the isolates were resistant to cloxacilin and 74.2% showed resistance to vancomycin. The overall rate of MDR was 100%, all of the isolates were found to be resistant to more than two tested antimicrobials. Conclusion S. aureus has gotten frighteningly resistant to many of common antimicrobials. Resistance rate to vancomyin is terrifyingly high. It urges us to take measures to delay resistance. Emergence of resistance highlights the value of prudent prescribing of antimicrobials and avoiding their irrational use. Further researches focusing on identifying dynamics promoting resistance, identifying high risk strains and molecular basis of resistance are required

Prevalence and antimicrobial resistance of coagulase negative staphylococci clinical isolates from Ethiopia: a meta-analysis

Abstract Background Antimicrobial resistant Coagulase-negative Staphylococci (CoNS) have limited treatment options, rendered diseases untreatable and made hospitals to be reservoirs of the resistant strains. The aim of this study was to estimate the pooled prevalence and antimicrobial resistance of clinical isolates of CoNS from Ethiopia. Results The electronic database search yielded 6511 articles of which 21 met predefined inclusion criteria. The pooled prevalence of CoNS from Ethiopia was 12% (95% confidence interval (CI): 8, 16%). The analyses revealed high level of CoNS resistance to methicilin (37%[95% CI: 21, 55%]), vancomycin (911%[95% CI: 0, 35%]), penicillin (58%[95% CI: 42, 74%]), amoxicillin (42%[95% CI: 23, 61%]), amoxicillin-clavulanate (27%[95% CI: 2, 27%]), ampicillin (64%[95% CI: 46, 80%]), tetracycline (60% [95% CI: 49, 70%]), doxycycline (36%[95% CI:19,55%]), Sulfamethoxazole-trimethoprim (50%[95% CI: 36, 64%]), ceftriaxone (27% [95% CI: 18, 38%]), cephalothin (32% [95% CI: 7, 62%]), norfloxacin (39%[95% CI: 24, 56%]), chloramphenicol (40%[95% CI: 23, 58%]), clindamycin (11% [95% CI: 2, 27%]), ciprofloxacin (14%[95% CI: 6, 22%]), gentamicin (27%[95% CI:19,36%]) and erythromycin (30%[95% CI:20%,42%]). High heterogeneity, I2 ranging from 69.04 to 96.88%; p-values ≤0.01, was observed. Eggers’ test did not detect publication bias for the meta-analyses and low risk of bias was observed in included studies. Conclusions CoNS has gotten resistant to commonly used antimicrobials from Ethiopia. There is a need of launching national antimicrobial treatment, development and implementation of policy guidelines to contain the threat. Further research focusing on factors promoting resistance and the effect of resistance on treatment outcome studies are warranted

Resistance of Staphylococcus aureus to antimicrobial agents in Ethiopia: a meta-analysis

Abstract Background Emergence of antimicrobial resistance by Staphylococcus aureus has limited treatment options against its infections. The purpose of this study was to determine the pooled prevalence of resistance to different antimicrobial agents by S. aureus in Ethiopia. Methods Web-based search was conducted in the databases of PubMed, Google Scholar, Hinari, Scopus and the Directory of Open Access Journals (DOAJ) to identify potentially eligible published studies. Required data were extracted and entered into Excel spread sheet. Statistical analyses were performed using Stata version 13.0. The metaprop Stata command was used to pool prevalence values. Twenty-one separate meta-analysis were done to estimate the pooled prevalence of the resistance of S. aureus to twenty-one different antimicrobial agents. Heterogeneity among the studies was assessed using the I2 statistic and chi-square test. Publication bias was assessed using Egger’s test. Because of significant heterogeneity amongst the studies, the random effects model was used to pool prevalence values. Results The electronic database search yielded 1317 studies among which 45 studies met our inclusion criteria. Our analyses demonstrated very high level of resistance to amoxicillin (77% [95% confidence interval (CI): 68%, 0.85%]), penicillin (76% [95% CI: 67%, 84%]), ampicillin (75% [95% CI: 65%, 85%]), tetracycline (62% [95% CI: 55%, 68%]), methicillin (47% [95% CI: 33%, 61%]), cotrimoxaziole (47% [95% CI: 40%, 55%]), doxycycline (43% [95% CI: 26%, 60%]), and erythromycin (41% [95% CI: 29%, 54%]). Relatively low prevalence of resistance was observed with kanamycin (14% [95% CI: 5%, 25%]) and ciprofloxacin (19% [95% CI: 13%, 26%]). The resistance level to vancomycin is 11% 995% CI: (4%, 20%). High heterogeneity was observed for each of the meta-analysis performed (I2 ranging from 79.36% to 95.93%; all p-values ≤0.01). Eggers’ test did not show a significant publication bias for all antimicrobial agents except for erythromycin and ampicillin. Conclusions S. aureus in Ethiopia has gotten notoriously resistant to almost to all of antimicrobial agents in use including, penicillin, cephalosporins, tetracyclines, chloramphenicol, methicillin, vancomycin and sulphonamides. The resistance level to vancomycin is bothersome and requires a due attention. Continued and multidimensional efforts of antimicrobial stewardship program promoting rational use of antibiotics, infection prevention and containment of AMR are urgently needed

Phytochemistry, efficacy, and safety of medicinal plants used traditionally for the management of peptic ulcer diseases in Ethiopia: a systematic review

Abstract Background Despite significant advances in synthetic medicine, medicinal plants are still widely utilized to treat peptic ulcer disease. This study synthesized evidence on commonly used medicinal plants to manage peptic ulcer disease in Ethiopia. Methods The evidence was synthesized using electronic databases such as PubMed/Medline, Web of Science, Science Direct, Hinari, and Google Scholar. This review considers all controlled in vivo and ex vivo anti-ulcer studies evaluating Ethiopian medicinal plants with regards to phytochemistry, efficacy, and safety. The search technique covered all published papers using descriptors like Ethiopia, medicinal plants, and anti-ulcer until January 30, 2022. The percentage of ulcer reduction was used to measure the success of the treatment. Results Anti-ulcer properties were investigated in 13 papers. Twelve in vivo and one ex vivo study were retrieved. Osyris quadripartita, Plantago lanceolata, Ensete ventricosum, Taverniera abyssinicia, Crotonmacrostachyus Persea Americana and Moringa stenopetala showed effect close to a standard control in difference ulcer induced model. Osyris quadripartite in the dose of 200 mg/kg, Ficus thonningii in dose of 200 and 400 mg/kg, Plantago lanceolata in dose of 400 mg/kg, Trigonella feonum-gracum in dose of 500 and 1000 mg/kg, Linum ussitatissimum in dose of 1000 and 1500 mg/kg, Urtica simensis 400 mg/kg have higher activity compared with standard control in difference different models. Phytochemistry studies revealed presence of numerous components, including flavonoids, phenols, tannins, and saponins, which may be responsible for the anti-ulcer activity. Conclusion This study revealed that there are some promising medicinal plant extracts that have been used in Ethiopia for centuries that could be used as anti-ulcer agents. The most effective anti-ulcer agents in animal models are Indigofera spicata Forssk, Thymus schimperi, and Urtica simensis. Identification of most active pharmacological agents and clinical evaluation of Ethiopian medicinal plants used to treat peptic ulcers are worthy of further investigation

Antifungal Activity of the Essential Oil of Echinops kebericho Mesfin: An In Vitro Study

Background. Echinops kebericho is an endemic medicinal plant in Ethiopia widely used in the treatment of infectious and noninfectious diseases. Essential oils are known for their antibacterial, antifungal, antiviral, insecticidal, and antioxidant properties. This study evaluated the antifungal activity of essential oil from E. kebericho against four common pathogenic fungi and two standard strains. Methods. The essential oil was obtained by hydrodistillation. The antifungal screening was done by agar well diffusion method. Minimal inhibitory concentrations (MICs) were determined by broth microdilution. Minimal fungicidal concentrations (MFCs) were determined by subculturing fungal strains with no visible growth onto a Sabouraud dextrose agar (SDA) plate. Results. Candida albicans and Cryptococcus neoformans were highly sensitive while Aspergillus flavus did not show sensitivity up to 1 mg/ml of essential oil; MICs ranged from 0.083 mg/ml to 0.208 mg/ml. Concentration and fungal species showed significant dose-dependent associations (p<0.0001) with antifungal activity. The MICs of essential oil were comparable to those of the standard drug (fluconazole) against C. glabrata and C. krusei. The lowest MFC of the essential oil was observed against Candida parapsilosis (0.145 mg/ml) while the highest MFC was against Candida krusei (0.667 mg/ml). Conclusion. Echinops kebericho essential oil showed noteworthy antifungal activity against Cryptococcus neoformans, Candida albicans, and Candida glabrata and could be a potential candidate for further antifungal drug development