Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis

Most prescribers and patients in Ghana now opt for the relatively expensive artemether/lumefantrine rather than artesunate-amodiaquine due to undesirable side effects in the treatment of uncomplicated malaria. The study sought to determine the existence of substandard and/or counterfeit artemether-lumefantrine tablets and suspension as well as artemether injection on the market in Cape Coast. Six brands of artemether-lumefantrine tablets, two brands of artemether-lumefantrine suspensions, and two brands of artemether injections were purchased from pharmacies in Cape Coast for the study. The mechanical properties of the tablets were evaluated. The samples were then analyzed for the content of active ingredients using High Performance Liquid Chromatography with a variable wavelength detector. None of the samples was found to be counterfeit. However, the artemether content of the samples was variable (93.22%−104.70% of stated content by manufacturer). The lumefantrine content of the artemether/lumefantrine samples was also variable (98.70%–111.87%). Seven of the artemether-lumefantrine brands passed whilst one failed the International Pharmacopoeia content requirements. All brands of artemether injections sampled met the International Pharmacopoeia content requirement. The presence of a substandard artemether-lumefantrine suspension in the market should alert regulatory bodies to be more vigilant and totally flush out counterfeit and substandard drugs from the Ghanaian market

In vivo antiplasmodial and in vitro antioxidant properties of stem bark extracts of Haematostaphis barteri

Objective: To evaluate the antimalarial and antioxidant properties of stem bark extracts of Haematostaphis barteri (H. barteri). Methods: The prophylactic activity of the plant was performed by dosing mice with sulfadoxine-pyrimethamine (1.2 mg/kg), aqueous extract (30, 100, 300 mg/kg) and dichloromethane/methanol (D/M) (30, 100, 300 mg/kg) extracts of H. barteri for 3 days. On the 4th day, the mice were inoculated with Plasmodium berghei. The parasite density was estimated for each mouse 72 h post-parasite inoculation. The curative activity of the plant was also performed by inoculating mice with Plasmodium berghei. Three days later, they were treated with artemether-lumefantrine (4 mg/kg), aqueous and D/M extracts of H. barteri stem bark for 5 days. The in vitro antioxidant property of the aqueous extract was determined by using the reducing power, nitric oxide and total antioxidant capacity assays. Results: The aqueous extract exerted significant (P < 0.05) curative and prophylactic antimalarial activities. The D/M extract exhibited significant curative (P < 0.05) but not prophylactic antiplasmodial effect. The aqueous extract exhibited in vitro antioxidant property with IC50's of (0.930 ± 0.021) mg/mL, (0.800 ± 0.001) mg/mL and (0.22 ± 0.05) mg/mL in the total antioxidant capacity, reducing power and nitric oxide assays. Histological assessment of the liver of aqueous and D/M treated animals did not reveal any sign of toxicity. Conclusions: H. barteri is not toxic which exerted significant curative antiplasmodial effects but the prophylactic property was however fraction dependent. The mechanism of the antiplasmodial activity of H. barteri may partly be mediated by its antioxidant property

Functional paradox of leptin and adiponectin in diabetes patients and controls in the Cape Coast Metropolis of Ghana

Aim: To investigate the concept of obesity paradox in diabetes patients and nondiabetic control in the Cape Coast Metropolis of Ghana. Materials and Methods: Levels of leptin, adiponectin, total antioxidant power (TAP), lipid peroxides, and C-reactive protein (CRP) were assessed in 115 diabetics and an equal number of control respondents. Furthermore, various anthropometric indices and blood pressure were measured using standard methods. Levels of biomarkers were compared between groups based on body mass index or blood pressure classifications. Results: Control respondents exhibited higher (P 0.05) mean levels of the various biomarkers, except TAP level which was higher (P 0.05) levels of the other biomarkers between diabetes patients and their control counterpart. Irrespective of diabetes, obesity, or hypertensive status, leptin associated positively with various measures of adiposity. Adiponectin correlated positively with leptin (R > 0.38; P< 0.05) only in the control respondents, suggesting a possible functional paradox of the adipocytokines in this group of respondents. Conclusion: Overweight/obese respondents appear metabolically healthier than their normal-weight counterparts. However, further studies are needed for proper understanding of this concept in the Ghanaian context

Elevated adiponectin but varied response in circulating leptin levels to falciparum malaria in type 2 diabetics and non-diabetic controls

Background: To investigate effects of falciparum malaria on circulating levels of leptin and adiponectin in type 2 diabetes mellitus (T2DM) and non-diabetic controls in relation to measures of adiposity. Methods: Levels of leptin and adiponectin were measured in 100 type 2 diabetics and 100 age-matched controls before and during falciparum malaria in a 2-year prospective study. Also, waist circumference (WC), weight, height and hip circumference were measured. Body mass index (BMI) and waist-to-hip ratio (WHR) were computed. Results: At baseline, diabetics had significantly (p  0.05) between diabetics and controls. However, compared to baseline levels, significant (p < 0.001) elevation of adiponectin was found in both study groups. In respect of leptin, significant (p < 0.001) rise but decline was observed in diabetics and controls respectively. Malaria-induced leptin correlated negatively with adiponectin (r = â0.694; p < 0.001) in non-diabetic controls only. Conclusion: Diabetics and controls exhibited increased adiponectin levels due to falciparum malaria but differed in response in terms of leptin levels. Keywords: Falciparum malaria, T2DM, Leptin, Adiponectin, BM

Effect of pre-existing Schistosoma haematobium infection on Plasmodium berghei multiplications in imprinting control region mice

Objective: To investigate the effect of pre-existing Schistosoma haematobium (S. haematobium) infection on malaria disease severity. Methods: The study involved the use of twenty-five imprinting control region mice, fifteen of which were initially infected with S. haematobium. Five of the remaining ten schisto-uninfected mice together with five schisto-infected mice were infected with Plasmodium berghei (P. berghei) after four weeks (acute stage) of schistosoma infection. The remaining five schisto-uninfected mice together with five schisto-infected mice were also infected with P. berghei after seven weeks (chronic stage) of schistosoma infection. The last five schisto-infected mice were used as control group. They were then monitored for changes in P. berghei parasitaemia on Days 3, 5, 7, 9 and 11 post-infection. Records on their survivability were also taken. Results: The co-infected mice had significantly higher malaria parasitaemia, compared with the mono-infected mice during acute S. haematobium infection. In contrast, the co-infected mice had significantly lower malaria parasitaemia during chronic S. haematobium infection and a higher survival rate. Conclusions: Co-infection of mice with P. berghei during acute S. haematobium infection resulted in rapid P. berghei development and increased malaria parasitaemia. However, the co-infection resulted in slower P. berghei development and decreased malaria parasitaemia with enhanced survivability of the mice during chronic S. haematobium infection. Therefore, pre-existing chronic S. haematobium infection may provide some protection to the host by reducing parasitaemia

Asymptomatic urinary tract infections in pregnant women attending antenatal clinic in Cape Coast, Ghana

Urinary tract infections culminating from poor diagnosis during pregnancy puts pregnant women at high risk of serious complications. This study investigated the incidence of urinary tract infections among pregnant women attending antenatal clinics in the Cape Coast Metropolis of the Central Region of Ghana. Physical, chemical, microscopic, and microbial analysis were performed on urine samples obtained from 200 pregnant women aged 15 -45 years attending the University of Cape Coast Hospital, Cape Coast Metropolitan Hospital and Ewim Urban Health Centre. The prevalence of urinary tract infections in the three trimesters was determined together with sensitivity testing of the bacteria isolates to antimicrobial drugs. Overall prevalence stood at 56.5 %, although comparatively high in pregnant women in the second trimester (50.4 %). Escherichia coli were the most implicated organism (48.7 %). Pregnant women aged between 15 -32 years were the most affected and gentamycin was the most effective antimicrobial against the bacteria isolates. Results indicated that the incidence of urinary tract infections was high among pregnant women in the study area; therefore, urine microbial screening should be included in the routine antenatal checkups for pregnant women to detect the asymptomatic infections to reduce its risk to pregnancies