Evaluation of the potential of the marine sponges of the Zanzibar Island to yield antimalarial and antimicrobial active compounds

Emergence of new and re‐emergence of old infections continue to elude prospects of reducing morbidity and mortality caused by microbial infections. Trends of resistance to currently in use antimicrobials and antimalarials threaten to increase mortality caused by these infections. This study explores the potential of marine invertebrates as a source for new antimicrobials and antimalarials. The lactate dehydrogenase method was used to assay marine sponges for activity against Plasmodium falciparum, while the disc diffusion method was used to assay the extracts for antibacterial and antifungal activity. Extracts of some marine sponges from the Zanzibar Island exhibited both antiplasmodial and antimicrobial activities. Among the 55 marine sponge extracts that were tested 23 (41.8%) inhibited Plasmodium falciparum W2 strain by more than 50% at both 250 and 50 μg/ml concentrations. Moderate polar extracts were more active against Plasmodium falciparum W2 strain than polar and non‐polar extracts. None of the 12 extracts that were tested on Plasmodium falciparum strain D6 exhibited inhibitory activity reaching 50%. Among 18 marine sponge extracts that were tested for antimicrobial activity 12 (66.7%) showed activity against one or more of the bacteria and fungi used ranging from weak to strong on an arbitrary criterion. The ethyl acetate extracts of Agelas mauritania and Oceanopia sp. exhibited high activity against the fungi Candida albicans and Cryptococcus neoformans. The best antibacterial profile was exhibited by ethyl acetate extracts of Aplysinopsis sp., Halichondrida sp. 1 and Oceanopia sp. In conclusion, these results support the need for intensified efforts to search for active antimalarial and antimicrobial compounds from the Zanzibar marine sponges

Proactive risk assessment of vincristine use process in a teaching and referral hospital in Kenya

Background: The chemotherapy use process is considered as potentially risky for cancer patients due to its complex process, use of agents with narrow therapeutic indeces, multiple drug use and use of potentially toxic compounds adding to morbidity and mortality for patients with cancer. Vincristine, a "High Alert" medicine, has been associated with fatal but preventable medication errors. Objective: To determine hazards associated with vincristine use process by performing proactive risk assessments using Healthcare Failure Mode Effect Analysis (HFMEA). Methods: A multidisciplinary health team identified and evaluated potential failure modes based on vincristine use process flow diagram using a hazard scoring matrix in a leading referral hospital in Kenya treating patients with cancer. The hazard score matrix was based on the published literature. Failure modes were prioritized using decision tree analysis in which recommendations to counteract the risks were determined. Results: The processes evaluated were; prescribing, preparation and dispensing, transportation and storage, administration and monitoring of use. A total of 77 failure modes were identified over the 3 months period of the study, April to June 2017, of which 25 were classified as high risk. Thirteen were adequately covered by existing control measures while the other 12 required the development of mitigation strategies. Two of the 12 failure modes were single-point weaknesses. Conclusions: Multiple medication errors, some with serious consequences, can occur at each stage of the chemotherapy use process making it a high-risk process. HFMEA is a useful tool to identify improvements to medication safety and reduce patient harm. The HFMEA process brings together the multidisciplinary team involved in patient care in actively identifying potential failure modes and therefore owning the recommendations made. This is now being followed up

Pattern of distribution of AIDS-related Kaposi’s sarcoma lesions in HIV patients in a referral hospital in Kenya

Background: Kaposi’s sarcoma (KS) is an angioproliferative malignancy caused by infection with human herpes virus -8 (HHV-8). The tumour has four subtypes including Classic KS, African- endemic, Iatrogenic and Acquired immunodeficiency syndrome (AIDS)-related KS. AIDS- related KS is the most common malignancy in patients with human immunodeficiency virus (HIV) infection and has variable clinical presentation with diverse distribution of lesions. Objective: To assess the pattern of distribution of KS lesions in patients with AIDS-related KS at Kenyatta National Hospital. Methods: We carried out a descriptive study on patients with HIV infection with histological diagnosis of KS. The study commenced upon approval by KNH-University of Nairobi Ethics and Research Committee. Following consent, clinical and demographic data was obtained from participants through verbal interviews and from medical records using a data capture form. Follow up was until 10 weeks. Management of patients was at the discretion of the attending clinician. Data was analyzed by a statistician using Instat Biostatistics program. Results Seventy-four participants aged between 13 to 55 years were enrolled into the study. Males were 42 (56.7%) and females 32 (43.2%). Mean age was 36.8 years. The distribution of KS lesions was variable. We demonstrate high predilection of lesions for skin and lymph nodes at 62.6%. Other sites were involved were the oral cavity 14.9%. Twenty-eight (38%) of the participants had multifocal lesions with a male predominance in skin and viscera with male to female ratio of skin 1.8:1 and viscera 7:1 respectively. Conclusion: We demonstrate reduced male: female ratio and multifocal distribution of AIDS-related KS lesions with predominance in skin and lymph nodes and male predominance in visceral lesions. Future studies should aim to determine what favours increase in, KS in women and visceral lesions in males among patients with HIV infection. Keywords: Kaposi’s Sarcoma, human immunodeficiency virus (HIV), Acquired Immunodeficiency Syndrome (AIDS

Estrogenic and Anti-Inflammatory Activities of a Steroidal Indoxyl

The estrogenic and anti-inflammatory activities of 3-methoxy-16, 17-seco-16-norestra-1,3,5-trien-15-(2'-indoxyliden)-17-oic acid is reported. After intraperitoneal administration, the dose of this compound required to reduce swelling of the rat paw by 50% (ED50) was 14.1 mg/kg using the carrageenan-induced rat paw oedema anti-inflammatory assay method. Indomethacin had an ED50 of 3.2 mg/kg in this assay while dexamethasone had an ED50 of 1.7 mg/kg. The estrogenic activity of the compound after intramuscular administration in rats was 0.72 relative to diethylstilbestrol, when the two compounds were assayed at three dose levels of 1.0, 0.3 and 0.1 mg/kg. Key Words: Steroidal indoxyl, synthesis, estrogenic, anti-inflammatory East and Central African Journal of Pharmaceutical Sciences Vol.5(3) 2002: 44-4

Abandonment of treatment and loss to follow up: a potential cause of treatment failure in patients with AIDS-related Kaposi’s sarcoma

Background: Management of patients with cancer is complex, multi-disciplinary, longitudinal and costly. Abandonment of treatment by patients and loss to follow up is a common scenario, especially in resource poor countries and severely compromises health outcomes. Objective: To assess the commitment to drug treatment protocol of patients with Acquired Immunodeficiency Syndrome (AIDS)-Related Kaposi’s Sarcoma at Kenyatta National Hospital, Kenya, over a 10 week period . Methods: The study design was prospective, observational, cross-sectional period prevalence study on patients infected with human immunodeficiency virus (HIV) with Kaposi’s sarcoma. Patients with histological diagnosis of Kaposi’s sarcoma were sequentially enrolled into the study as they attended either the Haematology or Radiotherapy clinic or during their admission in the wards. The choice of the treatment protocol was left at the discretion of the attending physician. A pretested data collection form was used to collect demographic and clinical information about the patients, including treatments prescribed and completion of follow up. Results: A total of 74 patients were enrolled into the study, 42 (56.8%) males and 32 (43.2%) females. The age ranged between 13 years to 55 years. Their treatment protocols included: Vincristine only, Vincristine plus Bleomycin, Vincristine plus Bleomycin plus Doxorubicin, Radiotherapy plus Vincristine and Radiotherapy only. Few of the patients were not assigned any antitumor treatment. Antiemetic and other conventional medicines were also prescribed when necessary. Fifty four (73%) of the patients abandoned treatment, five (6.8%) died, 15(20.3%) continued to attend clinic over the 10 week period.  There was no significant association between sex and outcome (p=0.661). Discussion: The results of this study demonstrate that abandonment of treatment is a major problem among patients on treatment for cancer in Kenyatta National Hospital in Kenya. Abandonment of treatment heavily contributes to poor clinical outcome hence complicating the burden of cancer in the country. It is therefore important to develop and establish follow-up systems to improve adherence to treatment for the cancer patients at Kenyatta National Hospital. Key words: Abandonment of treatment, Loss to follow up, AIDS-Related Kaposi’s Sarcom

Interactions between integrated pest management, pollinator supplementation, and normalized difference vegetation index in pumpkin, Cucurbita maxima (Cucurbitales: Cucurbitaceae), production

Sustainable production of pumpkin (Cucurbita maxima Duchesne) partly relies on integrated pest management (IPM) and pollination services. A farmer-managed field study was carried out in Yatta and Masinga Sub- Counties of Machakos County, Kenya, to determine the effectiveness of a recommended IPM package and its interaction with stingless bee colonies (Hypotrigona sp.) for pollinator supplementation (PS). The IPM package comprised Lynfield traps with cuelure laced with the organophosphate malathion, sprays of Metarhizium anisopliae (Mechnikoff) Sorokin isolate ICIPE 69, the most widely used fungal biopesticide in sub-Saharan Africa, and protein baits incorporating spinosad. Four treatments—IPM, PS, integrated pest and pollinator management (which combined IPM and PS), and control—were replicated 4 times. The experiment was conducted in 600 m2 farms in 2 normalized difference vegetation index (NDVI) classes during 2 growing seasons (October 2019–March 2020 and March–July 2020). Fruits showing signs of infestation were incubated for emergence, fruit fly trap catches were counted weekly, and physiologically mature fruits were harvested. There was no effect of IPM, PS, and NDVI on yield across seasons. This study revealed no synergistic effect between IPM and PS in suppressing Tephritid fruit fly population densities and damage. Hypotrigona sp. is not an efficient pollinator of pumpkin. Therefore, we recommend testing other African stingless bees in pumpkin production systems for better pollination services and improved yields.The German Federal Ministry of Economic Cooperation and Development (BMZ) through icipe to KALRO, administered through the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) Fund for International Agricultural Research (FIA); the Norwegian Agency for Development Cooperation, the Section for Research, Innovation, and Higher Education; the Swedish International Development Cooperation Agency (Sida); the Swiss Agency for Development and Cooperation (SDC); the Australian Centre for International Agricultural Research (ACIAR); the Federal Democratic Republic of Ethiopia; and the Government of the Republic of Kenya.https://academic.oup.com/eeam2024Zoology and EntomologySDG-02:Zero Hunge

How can natural products serve as a viable source of lead compounds for the development of new/novel anti-malarials?

Malaria continues to be an enormous global health challenge, with millions of new infections and deaths reported annually. This is partly due to the development of resistance by the malaria parasite to the majority of established anti-malarial drugs, a situation that continues to hamper attempts at controlling the disease. This has spurred intensive drug discovery endeavours geared towards identifying novel, highly active anti-malarial drugs, and the identification of quality leads from natural sources would greatly augment these efforts. The current reality is that other than compounds that have their foundation in historic natural products, there are no other compounds in drug discovery as part of lead optimization projects and preclinical development or further that have originated from a natural product start-point in recent years. This paper briefly presents both classical as well as some more modern, but underutilized, approaches that have been applied outside the field of malaria, and which could be considered in enhancing the potential of natural products to provide or inspire the development of anti-malarial lead compounds