A household survey of medicine storage practices in Gondar town, northwestern Ethiopia

Abstract Background Household surveys are crucial to get accurate information on how medicines are acquired, and used by consumers, as they provide the best evidence in the area. The objective of this study was to document household medicine storage practices in Gondar town, northwestern Ethiopia. Methods A cross-sectional household survey was conducted from April 5 to May 6, 2015. In the study, 809 households were surveyed from four sub-cities in the town selected through multistage sampling with 771 included in the final analysis. Data on the extent of storage, storage conditions, sources of medicines and their current status among others were collected through structured interviews and observations. The data were entered in to Epidata version 3.1, exported to and analyzed using Statistical Packages for Social Sciences (SPSS) version 21. Results Of the 771 households in the study, 44.2% stored medicines. Presence of family members with chronic illness(es) and higher levels of household incomes predicted higher likelihood of medicine storage. In the households which allowed observation of stored medicines (n = 299), a mean of 1.85 [SD = 1.09] medicines per household were found. By category, anti-infectives for systemic use (23.9%), medicines for alimentary tract and metabolism (19.2%) and those for cardiovascular system (17.7%) ranked top. Among individual medicines stored, diclofenac (10.7%), paracetamol (9.9%) and amoxicillin (8.0%) were on top of the list. Dispensaries (97.8%) and physicians (83.5%) were almost exclusive sources of medicines and advices/orders for medicines respectively. Nearly two-thirds of the medicines found were on use and a vast majority (76.5%) were stored in chests of drawers. Proportion of expired medicines was very low (3.14%). Conclusions The use of physicians’ and pharmacists’ advice to get medicines; use of dispensaries as principal sources, large proportion of medicines being in use and very low proportion of expiry showed good practices. However, storage places of medicines were not purpose built. Encouraging good practices through continued medicine use education and advocating appropriate medicine storage in medicine cabinets is required to improve storage conditions and consequent use of medicines

Antidiabetic Activities of Hydromethanolic Leaf Extract of Calpurnia aurea (Ait.) Benth. Subspecies aurea (Fabaceae) in Mice

Diabetes mellitus is one of the largest global health problems demanding preventive and new therapeutic interventions. Currently, there is a need for safe, effective, and less costly antidiabetic medications, and investigating medicinal plants for new antidiabetic medication is an interesting research area. Thus, the present study was done to evaluate the antidiabetic activities of 80% methanolic leaf extract of Calpurnia aurea (Ait.) Benth. subspecies aurea (Fabaceae) in mice. Hypoglycemic and antihyperglycemic activity of the three doses (100mg/kg, 200 mg/kg, and 400 mg/kg) of crude hydromethanolic leaf extract was studied on normoglycemic, oral glucose loaded, and streptozotocin-induced diabetic mice models. The effect of the extract on body weight and diabetic dyslipidemia was also studied on streptozotocin-induced diabetic mice. Glibenclamide (5 mg/kg) was used as a standard drug in all cases. A glucose meter and an automated chemistry analyzer were used to measure blood glucose and serum lipid level respectively. Data were analyzed using one-way analysis of variance followed by Tukey’s post hoc multiple comparison test. All the three doses of the plant extract (100mg/kg, 200 mg/kg, and 400 mg/kg) showed a significant (p<0.05) antihyperglycemic activity in the diabetic mice at the 7th and 14th day of repeated daily dose administration as compared to the negative diabetic control. But, the extract did not show significant blood glucose lowering activity in normoglycemic, oral glucose loaded, and diabetic mice after single dose administration, and it did not significantly improve the body weight loss and diabetic dyslipidemia of diabetic mice after repeated daily dose administration for 14 days. This study revealed that the hydromethanolic extract of Calpurnia aurea leaves possesses significant antihyperglycemic activity justifying the traditional use of the plant for diabetes

Antiplasmodial activity of Indigofera spicata root extract against Plasmodium berghei infection in mice

Abstract Background In addition to pharmacovigilance and pharmaco-economic concerns, resistance to anti-malarial medicines has been documented in all classes of anti-malarials and this is further worsened by resistance to common insecticides by malaria vector, which is a major threat to malaria control. As a means of facing the challenges of searching for new anti-malarial agents, the current study focused on evaluation of anti-malarial activity of root extract of Indigofera spicata. Methods Chloroquine-sensitive rodent malaria parasite, Plasmodium berghei (ANKA strain) was used to infect the Swiss Albino mice in 4-day suppressive and curative models. The crude hydromethanolic root extract of I. spicata at 200, 400 and 600 mg/kg doses was administered to a group of five mice. Important parameters, such as level of parasitaemia, packed cell volume (PCV), survival time, and body weight were determined and the significance of the differences between mean values of the five groups was analysed by one-way ANOVA followed by post hoc Tukey’s Multiple Comparison test. Results In both the suppressive and curative models, 400 and 600 mg/kg doses of the extract suppressed the level of parasitaemia significantly (p < 0.001) compared to the vehicle-treated groups, 34.93 and 53.42%, respectively. However, only the mice which were treated with the 600 mg/kg dose of the extract had significant difference in their mean survival time. In other parameters, namely PCV and mean body weight, there was no statistically significant difference between the extract-treated groups when compared to the negative control. Conclusions This study revealed that the root extract of I. spicata possesses anti-malarial activity and necessitates further scientific validation

Antimalarial Activity of Crude Extract and Solvent Fractions of the Leaves of Bersama abyssinica Fresen. (Melianthaceae) against Plasmodium berghei Infection in Swiss Albino Mice

Background. Treatment of malaria has been compromised by the emergence of drug-resistant parasites. Consequently, novel agents are urgently needed from different sources including from medicinal plants. Thus, the current study aimed at evaluating the antimalarial activity of crude extract and solvent fractions of the leaves of Bersama abyssinica (B. abyssinica) against Plasmodium berghei infection in Swiss Albino mice. Method. A 4-day suppressive test was employed to evaluate the antimalarial effect of crude extract and solvent fractions against early infection. The curative and prophylactic effects of crude extract and fraction with the highest chemosuppression were further tested by Rane’s test and residual infection procedure. Parasitemia, survival time, packed cell volume (PCV), body weight, and rectal temperature of mice were used as evaluation parameters. Windows SPSS version 20 was used to analyze the data and analysis of variance (ANOVA) followed by Tukey’s post hoc test was used to compare data between groups. Results. The crude extract and aqueous fraction significantly (P<0.05 to 0.001) suppressed parasitemia followed by protection of PCV reduction resulting in prolonging the survival time but failed to protect body weight and rectal temperature reduction in all tested models. The ethyl acetate and chloroform fractions also showed significant chemosuppression and PCV protection in the 4-day suppressive test. The crude extract exhibited a chemosuppression of 49.51%, 57.94%, and 44.11% while the aqueous fraction showed suppression of 47.69%, 51.62%, and 37.07% in 4-day suppressive, curative, and prophylactic tests, respectively, at 400 mg/kg. Conclusion. The crude extract and fractions showed fairly moderate antimalarial activity, and the finding supports the traditional claims and previous in vitro studies. Thus, this may call for further studies to isolate chemical entities for additional safety and efficacy tests

Potentially inappropriate prescribing in Ethiopian geriatric patients hospitalized with cardiovascular disorders using START/STOPP criteria.

There was a paucity of data on the magnitude of potentially inappropriate prescriptions (PIPs) among Ethiopian elderly cardiovascular patients.The aim of this study was to assess PIPs and associated factors in the elderly population with cardiovascular disorders using the START/STOPP screening criteria.A hospital-based cross-sectional study was conducted at medical wards of a teaching hospital in Ethiopia from 1 December 2016-30 May 2017. Included patients were hospitalized elderly patients aged 65 years or older with cardiovascular disorders; their medications were evaluated using the START/STOPP screening criteria from admission to discharge. Multivariable logistic regression was applied to identify factors associated with inappropriate medications. One Way Analysis Of Variance (ANOVA) was carried out to test significant differences on the number of PIPs per individual diagnosis.Two hundred thirty-nine patients were included in the analysis. More-than a third of the patients were diagnosed with heart failure, 88 (36.82%). A total of 221 PIPs were identified in 147 patients, resulting in PIP prevalence of 61.5% in the elderly population. Of the total number of PIPs, occurrence of one, two and three PIPs accounted for 83 (56.4%), 52(35.4%), and 12(8.2%) respectively. One way ANOVA test showed significant differences on the mean number of PIPs per individual diagnosis (f = 5.718, p<0.001). Angiotensin Converting Enzyme Inhibitors (ACEIs) were the most common inappropriately prescribed medications, 32(14.5%). Hospital stay, AOR: 1.086 (1.016-1.160), number of medications at discharge, AOR: 1.924 (1.217-3.041) and the presence of co-morbidities, AOR: 3.127 (1.706-5.733) increased the likelihood of PIP.Approximately, two-thirds of elderly cardiovascular patients encountered potentially inappropriate prescriptions. ACEIs were the most commonly mis-prescribed medications. Longer hospital stay, presence of comorbidities and prescription of large number of medications at discharge have been correlated with the occurrence of inappropriate medication. It is essential to evaluate patients' medications during hospital stay using the STOPP and START tool to reduce PIPs

Pattern of acute organophosphorus poisoning at University of Gondar Teaching Hospital, Northwest Ethiopia

Abstract Background Despite the apparent benefits of organophosphate compounds (OPCs) acute organophosphate (OP) pesticide poison is an increasing problem worldwide. In a country like Ethiopia, where agriculture is a major component of the economy, these compounds are readily available to the general public. There is paucity of evidence from Ethiopia showing the pattern of organophosphate poisoning (OPP) in healthcare facilities. The objective of this study was to evaluate retrospectively the pattern of acute OPP at the University of Gondar Teaching Hospital in northwest Ethiopia, during September 2010 through December 2014 was conducted. Data was collected through chart review of patients who were admitted due to poisoning. Data was analysed using SPSS 20. Results Organophosphate poisoning in University of Gondar teaching hospital accounts for about 38.46% of all emergency room admissions for poisoning. Out of the 90 cases studied 60% (54) were women, with male to female ratio of 1:1.5. The mean age of the patients was 25.5 with a standard deviation of 9.45. 56.7% of the cases studies lived in an urban environment compared to 43.3% who lived rurally. In the vast majority of patients, 90% (81) patients had ingested OP as an act of suicide. Regarding the route of exposure, oral ingestion was most common in suicidal cases (88.9%). The elapsed time between the time of poison ingestion and the start of the treatment, ranged from 13 min to 1 day. Health care professionals’ useds decontamination methods such as gastric lavage and activated charcoal (45.6%) and 36.7% use atropine for OPP treatment. The mean hospital stay was 0.74 days. In the present study family problems were a leading cause of suicides and accounted for 45.8% of all cases. Conclusion As a developing nation who economy relies heavily on agriculture, Ethiopia continues to have OP compounds remain a common cause of acute poisonings. This is particularly concerning for younger generation who have high rates of OPP and whose numbers continue to raise. This data suggests that it is essential to strengthen Ethiopians regulatory policy concerning the availability of OPCs. Additionally, it will be important to design an appropriate health education program for the prevention of both suicidal and accidental OPPs for the benefit of the public at large

Magnitude of hemorrhagic complications and its associated factors among patients on anticoagulant therapy at University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia

Background: Despite the well-established effectiveness of anticoagulants, the risk of their hemorrhagic complications withheld many patients from being maintained on anticoagulant therapy. However, there is no sufficient data on the magnitude and factors associated with anticoagulant-related hemorrhagic complications in resource-constrained settings. Thus this study aimed to assess the magnitude of hemorrhagic complications and associated factors related to anticoagulant therapy among patients at the University Of Gondar Comprehensive and Specialized Hospital. Methods: A retrospective follow-up study was done on 154 individuals starting from June 2018 to June 2019 on adult patients who had completed their anticoagulant therapy at the University of Gondar specialized and comprehensive hospital. They were selected using a systematic random sampling technique among all patients who had completed their anticoagulant therapy which is heparin, warfarin, or both. A retrospective data after the initiation of anticoagulant therapy was collected. The data collection was conducted from July 1 to August 30, 2019. Bivariable and multivariable logistic regression was used to identify factors. Variables with p < 0.05 were considered statistically significant. Results: Out of 154 patients who received anticoagulant therapy during the study period, more than half 83 (53.9%) of the participants were female, and the mean age of participants was 54.8 ± 21.1 years. A quarter of patients, 38 (24.7%), 95% CI (17.8, 31.6) who had been on anticoagulant therapy experienced bleeding complications. Being female (AOR = 6.12, 95% CI: 1.81, 20.71, P = 0.004) Aspirin use (AOR = 7.71, 95% CI: 2.24, 26.53, P = 0.001), type of anticoagulant (AOR = 4.94, 95% CI: 1.58, 15.49, P = 0.006), and number of co-morbidities(AOR = 4.99, 95% CI: 1.47, 16.95, P = 0.010) were found to be significantly associated with hemorrhagic complications. Conclusions: Hemorrhagic complications related to anticoagulant therapy are not rare. Therefore close monitoring of coagulation profiles as well as minimization of risk factors is crucial and needs collaborated work of all health care professionals and decision-makers

The top ten common drugs associated with IP among CVPs admitted to UOGH, 2016/2017.

<p>The top ten common drugs associated with IP among CVPs admitted to UOGH, 2016/2017.</p