The prevalence of side-effects: ciprofloxacin 500 mg single dose prophylaxis against Neisseria meningitidis outbreak in Potchefstroom during July 2003: research

Potchefstroom experienced an outbreak of Neisseria meningitidis (N. meningitidis) during May-July 2003. An opportunity for obtaining valuable data arose when mass prophylactic treatment to approximately 28% of the Potchefstroom community was provided by the Department of Health, North-West Province. The aim of this study was to investigate the prevalence of side-effects experienced by staff and students of the Potchefstroom University for Christian Higher Education (PU for CHE) who received a single prophylactic dose of oral ciprofloxacin 500 mg between 23 and 29 July 2003. Information gained from the Potchefstroom outbreak may be valuable for the future management of similar outbreaks in other communities. Various stakeholders have published related reports, protocols, recommendations and guidelines, which mostly focused on the prevention, management and control of meningococcal disease. Very little has been reported about the side-effects experienced, especially in cases where ciprofloxacin 500 mg single dose had been dispensed. One or more side-effects were reported by 24.2% of the participants, while 5.4% had to consult with a health care worker due to the severity of side-effects resulting from a single dose. Practical significance could not be demonstrated for any of the side-effects reported after single versus multiple doses nor when the effects of gender or requirement for medical consultation were tested. Key Words: Neisseria meningitidis; Ciprofloxacin; Single dose; Side effects; Prophylactic OPSOMMING ‘n Uitbraak van Neisseria meningitidis (N. meningitidis) gedurende Mei-Julie 2003 en die daaropvolgende verskaffing van massa-profilakse deur die Departement van Gesondheid, Noordwesprovinsie aan ongeveer 28% van die plaaslike gemeenskap het ‘n geleentheid geskep om waardevolle inligting in te win. Die doel van die studie was om die voorkoms van newe-effekte te ondersoek wat deur die personeel en studente van die Potchefstroomse Universiteit vir Christelike Hoër Onderwys ervaar is na toediening van ‘n enkel profilaktiese dosis van siprofloksasien 500 mg tussen 23-29 Julie 2003. Inligting wat hieruit voortspruit mag waardevol wees tydens toekomstige bestuur van uitbrake in ander gemeenskappe. Verskillende belanghebbendes het verslae, protokolle, aanbevelings en riglyne gepubliseer, wat meestal op die voorkoming, bestuur en beheer van meningokokkale siekte gefokus het. Daar is egter min gerapporteer oor die newe-effekte wat ondervind is veral waar siprofloksasien 500mg enkeldosis toegedien is. Een of meer newe-effekte is deur 24.2% van die deelnemers ervaar en 5.4% het dit nodig geag om ‘n gesondheidswerker te konsulteer in verband met die newe-effekte wat ervaar is. Geen prakties betekenisvolle verskille is aangedui indien die effeksgrootte bereken is vir die newe-effekte getoets tussen die enkeldosis versus die meervoudige dosis nie, selfs ook nie nadat die effek van geslag of konsultasie getoets is nie. Health SA Gesondheid Vol.9(3) 2004: 42-5

The Identification Of Realistic Export Opportunities For The South African Pharmaceutical Industry

South Africa needs to advance its industrialisation process and diversify its exports if it is to enhance its global competitiveness ranking and meaningfully tackle the double scourge of unemployment and poverty. The pharmaceutical industry makes a significant contribution to the country’s economy, and has a growing international footprint. However, export activity is largely centred on Southern and Eastern Africa, while markets in other parts of the world remain largely untapped. A longstanding concern of the government has been that export market selection has not been conducted in a scientific manner. Added to this is the problem of limited resources on the part of export promotion organisations. A Decision Support Model (DSM), originally conceived by Cuyvers et al. (1995) and then developed for the South African environment by Viviers, Steenkamp, Rossouw, and Cuyvers (2009, 2010), was used in this study to identify those export opportunities with the greatest potential for the South African pharmaceutical industry. Through a systematic filtering and elimination process, the DSM revealed that there are a large number of export opportunities for South African pharmaceutical products, particularly in Western Europe, North America, and Africa. Such information constitutes an important basis for strategic decision making on the part of industry and government stakeholders

A cross-sectional analysis of the association between age and gender and prescribed minimum benefit chronic disease list conditions among South Africans with concomitant hypertension, diabetes and dyslipidaemia.

Background: Prescribed Minimum Benefit Chronic Disease List (PMB CDL) conditions are a regulated list of conditions most common to South Africa. Objectives: To investigate the prevalence and association between PMB CDL conditions and age and gender among patients with concomitant hypertension, diabetes and dyslipidaemia. Methods: The study population consisted of patients (n = 17 866) with a prescription containing at least one co-prescribed antilipemics, antihypertensive and antidiabetic (identified using the MIMS Desk Reference). ICD-10 codes on claims for PMB CDL conditions were counted. Results: 39.5% of patients had a PMB CDL condition. Women had higher odds for hypothyroidism (OR 6.30, 95% CI; 5.52, 7.19, p < 0.001) and lower odds for coronary artery disease (CAD) (OR 0.63, 95% CI; 0.55, 0.72, p < 0.001) than men. In combination with hypothyroidism the odds for CAD were reversed and strongly increased; 3.54 (95% CI; 2.38, 5.25, p < 0.001). The odds for females having cardiac failure (CF) was insignificant and low (OR 0.87, 95% CI; 0.75, 1.01, p = 0.063); however combined with hypothyroidism, the odds increased to 5.35 (95% CI; 3.52, 8.13, p < 0.001). Conclusion: Hypothyroidism was an important discriminating factor for co-morbidity in women with concomitant hypertension, diabetes and dyslipidaemia, in particular with cardiovascular disease

Initiative to progress research on medicine utilization in Africa : formation of the Medicines Utilization Research in Africa group

This two day meeting brought together drug utilisation researchers from across Africa. The purpose was to share current drug utilisation (DU) research findings to further DU research across Africa including the development of a medicines utilisation research group. This led to the formation of the MURIA (Medicine Utilisation Research in Africa) Group, with a tentative vision and mission as well as the first planned research methodology training course and a symposium in Botswana later in the year. Future research projects were also planned including studies on drug utilisation of ARVs in Botswana and across Africa as well as ways to enhance the appropriate use of antibiotics and increase generic utilisation

Challenges and issues in drug utilization research identified from the Latin American and African regions

Background: Despite advancements in drug utilization research (DUR), these have not been universal. Some regions such as the Latin America (LatAm) and African regions are facing challenges that are impeding the development of DUR. Objectives: To identify the main challenges and issues for DUR in the LatAm and African regions Methods: A collaborative initiative by the International Society of Pharmacoepidemiology Global Development Committee in partnership with the Latin America Drug Utilization Group and the Medicines Utilization Research in Africa Group was undertaken. A comprehensive literature review was conducted to identify local and international DUR publications. A core group of investigators and experts in DUR reviewed the publications and identified the main methodological challenges and issues. Subsequently, the group exchanged materials, participated in WebEx discussions, and reviewed the draft document. Results: Main issues: 1) Socioeconomic: high unemployment rate with poor standard of living, socioeconomic inequalities, low literacy levels, urban segregation, high migration rates, high rates of violent crime including drug trafficking and possession. 2) Healthcare-related: Disparities of social determinants of health, differences in the quality of public and private health sectors; and epidemiologic transition from communicable diseases to non-communicable diseases. Most health care systems are fragmented with variable access to medical care and medicines, and substandard record keeping. 3) Drug utilization-related: Inappropriate use of medicines including the elderly; limited infrastructure to reliably collect DU data; over-prescription of antimicrobials; polypharmacy; high rates of self-medication; and poor patient adherence (e.g. HIV/AIDS, diabetes mellitus and hypertension). Planning for DUR is affected by the multiplicity of drug distribution channels; trading in sub-standard, counterfeit medicines and insufficient quality control centers. Some publications are generated by local investigators, often suffering of methodological issues such as lack of representativeness of the population, limited data validity, and small sample sizes. Conclusions: There are common challenges for DUR when working within the LatAm and African regions. Based on our findings, the group is developing Guidance on Good Practices of Drug Utilization Research in those regions to assist researchers with issues pertaining to the planning, conduct, and evaluation of DUR

The potential market demand for biokinetics in the private health care sector of South Africa

Objective. Biokinetics, a profession registered with the Health Professions Council of South Africa (HPCSA) address inter alia chronic diseases of lifestyle (CDL) with exercise as treatment modality. The purpose of this investigation is to determine the potential market demand for biokinetic services in the private health care sector of South Africa. Methods. Secondary data from a pharmaceutical benefit management system (PBM) were analysed to determine the prevalence of chronic diseases in the private health care sector for 2007. Telephonic interviews on a sub-sample of 50 biokineticists revealed the average number of patients that can be treated monthly per biokineticist. The number of biokineticists with active practice numbers was obtained from the Board of Health Care Funders (BHF). Results. The results indicate that 46.71% (747 199/1,600,000) of the patients managed by the PBM are treated with medication for one or more CDL. The prevalence of non-steroid anti-inflammatory medication (20.8%), medication for cardiovascular diseases (13.1%) and bronchodilators (10.95%) had the highest prevalence. The sub-sample of biokineticists indicated that one biokineticist can treat an average of 100 patients per month. The potential market demand calculated from the above numbers indicate that 7 472 biokineticists are needed in the private health care sector, while only 625 active practice numbers were registered with the BHF in 2007. Conclusion. In conclusion, it is estimated that only 7.6% of patients with CDL can potentially be treated by the current number of registered biokineticists. Therefore there is an enormous potential market for biokinetics in the private health care sector of South Africa

A cross-sectional analysis of the association between age and gender and prescribed minimum benefit chronic disease list conditions among South Africans with concomitant hypertension, diabetes and dyslipidaemia

Background: Prescribed Minimum Benefit Chronic Disease List (PMB CDL) conditions are a regulated list of conditions most common to South Africa. Objectives: To investigate the prevalence and association between PMB CDL conditions and age and gender among patients with concomitant hypertension, diabetes and dyslipidaemia. Methods: The study population consisted of patients (n = 17 866) with a prescription containing at least one co-prescribed antilipemics, antihypertensive and antidiabetic (identified using the MIMS Desk Reference). ICD-10 codes on claims for PMB CDL conditions were counted. Results: 39.5% of patients had a PMB CDL condition. Women had higher odds for hypothyroidism (OR 6.30, 95% CI; 5.52, 7.19, p < 0.001) and lower odds for coronary artery disease (CAD) (OR 0.63, 95% CI; 0.55, 0.72, p < 0.001) than men. In combination with hypothyroidism the odds for CAD were reversed and strongly increased; 3.54 (95% CI; 2.38, 5.25, p < 0.001). The odds for females having cardiac failure (CF) was insignificant and low (OR 0.87, 95% CI; 0.75, 1.01, p = 0.063); however combined with hypothyroidism, the odds increased to 5.35 (95% CI; 3.52, 8.13, p < 0.001). Conclusion: Hypothyroidism was an important discriminating factor for co-morbidity in women with concomitant hypertension, diabetes and dyslipidaemia, in particular with cardiovascular disease. Keywords: Concomitant hypertension, diabetes and dyslipidaemia, South Africa, prescribed minimum benefit chronic disease list (PMB CDL) condition

The prevalence of side-effects: Ciprofloxacin 500 mg single dose prophylaxis against Neisseria Meningitidis outbreak in Potchefstroom during July 2003

Potchefstroom experienced an outbreak of Neisseria meningitidis (N. meningitidis) during May-July 2003. An opportunity for obtaining valuable data arose when mass prophylactic treatment to approximately 28% of the Potchefstroom community was provided by the Department of Health, North-West Province. Opsomming ‘n Uitbraak van Neisseria meningitidis (N. meningitidis) gedurende Mei-Julie 2003 en die daaropvolgende verskaffing van massa-profilakse deur die Departement van Gesondheid, Noordwesprovinsie aan ongeveer 28% van die plaaslike gemeenskap het ‘n geleentheid geskep om waardevolle inligting in te win. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text