A price and availability survey of essential medicines in Harare Province, Zimbabwe.

Master of Science in Pharmacy. University of KwaZulu-Natal, Durban 2015.Access to essential medicines is both a fundamental basic right and necessity for everyone, thus governments should make concerted efforts to ensure that all have access to safe, quality and comparative cost-effective medicines. Efforts aimed at identifying factors hindering full access are key in informing relevant policy makers. Thus in pursuant of making significant contributions to the above, a survey was carried-out in Harare metropolitan province of Zimbabwe to determine prices, price components, pricing policies, source and availability of essential medicines (their innovator and/or generic equivalents) in both private and public retail sectors. Comparisons with 36 other low to middle-income countries in the rest of Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia and Western Pacific were also conducted. A standardized methodology developed by World Health Organization and Health Action International (WHO/HAI) was used to survey a selected basket of 40 medicines. The selection was based on the WHO/HAI core medicines list and the latest version of the essential drug list of Zimbabwe. The survey was conducted in 110 private pharmacies, of which 55 were from the central business district, 33 from the high density and 22 from the low density suburbs. In both private and public sectors, availability of the selected essential medicines (low priced generics) was quite high (>80%). Fewer innovator brands were found for the selected medicines. Median price ratios (MPR) of the lowest priced generics revealed that many people still might be having their accesses to essential medicines compromised by high prices, particularly in the private sector (4.52). The public sector showed significant progress towards procurement efficiency (MPR of 1.5). More than 70% of the surveyed medicines were from manufacturers outside Zimbabwe with more than 60% being produced by Indian generic manufacturers. Zimbabwe still needs to do more on pricing, particularly in the private sector as well as promoting local production among other efforts in its quest to ensure all its people have access to quality, safe and effective medicines

The effect of Acacia karroo supplementation and thermal preparation on meat sensory characteristics of the indigenous Xhosa lop-eared goat genotype

The objective of the current study was to determine the effect of Acacia karroo supplementation and thermal preparation on consumer sensory scores of meat from indigenous Xhosa lop-eared goat breed. 18 castrated four-month-old Xhosa lop-eared kids were kept at the University of Fort Hare Farm until slaughter. Sample cuttings for meat tasting were made from the Longistimus dorsi muscle. A. karroo supplementation improved meat tenderness and juiciness. There were no (P > 0.05) significant effects of A. karroo supplementation on meat flavour of the supplemented goats. Thermal preparation and consumer background had a significant (P < 0.05) effect on meat sensory characteristics. Results from this study show that A. Karroo supplementation and thermal preparation have an effect on meat quality attributes such as tenderness and juiciness.Key words: Boiling, roasting, consumer sensory scores, thermal preparation, consumer background

Roles of single nucleotide polymorphisms in the promoter regions of tumour necrosis factor-α and interleukine-1o genes in Schistosoma haematobium infection susceptibility.

Doctoral Degree. University of KwaZulu-Natal, Durban.Background: Schistosomiasis remains a public health threat in sub-Saharan Africa which carries 85% of the global burden. With effective vaccines a distant future away, and no one allround intervention, research is still required to ensure that only effective programmes are introduced and implemented as well as evaluated and/or monitored. It is therefore key for researchers, policy makers and implementers to understand the epidemiology, immunology, immunopathology, immunogenetics, chemotherapy, management and control of Schistosoma haematobium for optimal elimination strategies to be implemented. A research study was therefore instituted to determine the prevalence, risk factors and host immunogenetic factors in S. haematobium infections among pre- and school going children living in endemic regions of Manicaland and Mashonaland central provinces in rural Zimbabwe. The relationship between single nucleotide polymorphisms (SNPs) of the promoter regions of tumor necrosis factor alpha (TNF-α or rs1800629) and interleukin- 10 (IL-10 or rs1800871) and susceptibility to Schistosoma haematobium was investigated. In addition, the relationship between these SNPs and cytokine levels, as well as the relationship between actual cytokine levels and susceptibility to Schistosoma haematobium was assessed. Methods: In this cross-sectional immune-epidemiological study Schistosoma haematobium was diagnosed by the microscopic examination of urine specimens for the presence of parasite eggs using the urine filtration technique. DNA for the genotyping was extracted from approximately 300μl whole blood using the QiagenFlexiGene DNA extraction kit, following the manufacturer’s protocol. IL-10 and TNF-α promoter region single nucleotide polymorphisms were genotyped using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR).The allele frequencies and genotype distribution of S. haematobium infected and uninfected participants were then analysed using the chi-square test. All analyses were performed using SPSS (version 21) and p-values <0.05 were considered statistically significant. The levels of the cytokines (IL-10 and TNF-α) were measured by indirect enzyme linked immunosorbent assay (ELISA) using MABTECH, 3510-1H-6 kits, according to the manufacturer’s instruction. Results: The overall prevalence of S. haematobium among children in endemic rural and farming communities of the two provinces of Zimbabwe assessed was 17.1% (158/924). Gender specific prevalences were similar (17.5% in girls and 16.7% in boys; p = 0.735). Age and location were significant risk factors for schistosomiasis in children living in endemic regions surveyed. The older the child the higher the risk of getting infected by S. haematobium xvii (10.5% in 0-5 year olds; 24.0% in 6-10 year olds and 30.7% in 11-15 year olds; p < 0.001). IL-10 -1082 G/A, IL-10 -819 C/T and TNF-α -308 G/A single nucleotide polymorphisms were not significantly associated with susceptibility to S. haematobium infection. TNF- α genotypes AA, GA and GG were associated with high, moderate to high and low production of TNF-α respectively. IL-10 TT, CT and CC genotypes were associated with low, moderate and high IL-10 plasma levels respectively. Higher TNF-α and lower IL-10 serum levels were negatively associated with schistosomiasis infection. Praziquantel treatment reduced prevalence among the study participants as reinfections were only recorded in 6 of the 59 (10.2%) who were infected at baseline of children. Discussion and Conclusion: The determined schistosomiasis prevalence puts the regions of Zimbabwe studied within the moderate range as described by the World Health Organisation (10 – 49% prevalence), hence more concerted efforts are required to fight schistosomiasis. Although cytokine genotypes were associated as expected with cytokine levels, genotypes did not directly correlate with schistosomiasis infection while cytokine levels did. This indicates that circulating TNF-α and IL-10 levels are a result of many factors apart from genotypes. Taken together with previous work, this study suggests that high TNF-α and low IL-10 serum levels confer protection against schistosomiasis infection. Since schistosomiasis prevalence was similar between boys and girls and prevalence was high in all age groups (increasing with age), all programmes aimed at eliminating schistosomiasis should include both genders and children of all age groups. Specific locations could be targeted in resource limited settings as location was a significant risk factor for infection. Praziquantel is effective, with few reinfections observed, and therefore remains central in schistosomiasis management. To clearly understand the role host genetic factors in infection and to inform effective control, elimination and eradication programmes, more research on risk factors and host immunogenetics is necessar

Agnathia-synotia-microstomia (otocephaly): a case report in an African woman

A journal article on a "defective pregnancy" in an African woman.Pharyngeal arches appear in the 4th and 5th weeks of development of the human embryo. The Is1 pharyngeal arch develops into the incus and malleus, premaxilla, maxilla, zygomatic bone; part of the temporal bone, the mandible and it contributes to the formation of bones of the middle ear. The musculature of the 1st pharyngeal arch includes muscles of mastication, anterior belly of the digastric mylohyoid, tensor tympani and tensor palatini.1 The second pharyngeal arch gives rise to the stapes, styloid process of the temporal bone, stylohyoid ligament, the lesser horn and upper part of the body of the hyoid bone. The stapedius muscle, stylohyoid, posterior belly of the digastric, auricular and muscles of facial expressional all derive from the 2nd pharyngeal arch. Otocephaly has been classified as a defect of blastogenesis, with structural defects primarily involving the first and second branchial arch derivatives. It may also result in dysmorphogenesis of other midline craniofacial field structures, such as the forebrain and axial body structures

Correlations among sensory characteristics and relationships between aroma scores, flavour scores, off-flavour scores and off-flavour descriptors of chevon from four goat genotypes

The objective of the current study was to determine the correlations among sensory characteristics and relationships between flavour scores and off-flavour descriptors of chevon. Forty-eight male 6-months old Xhosa lop-eared, Nguni, Xhosa-Boer cross and Boer goat kids were kept at the University of Fort Hare Farm until slaughter. Sample cuttings for meat tasting were made from the hind leg. Aroma score was independent of off-flavour descriptors from meat from all goat genotypes (P &gt; 0.05). Off-flavour descriptors and their frequencies varied with genotypes. There were significant (P&lt; 0.001) correlations between most sensory characteristics of meat across genotypes although; there were variations in some goat genotypes. There were relationships among sensory scores, while flavour scores, aroma scores, off-flavour scores and off-flavour descriptors of chevon are independent. This implies that, all sensory characteristic scores and off-flavour descriptors should be included when carrying out sensory evaluations with meat from different goat genotypes.Key words: Goat genotypes, off-flavours, off-flavour descriptors, sensory  evaluations, sensory score relationships

Inappropriate use of promethazine and promethazine-containing products in children under the age of three years in Harare, Zimbabwe

A journal article on Inappropriate use of Promethazine and Promethazine-containing products in children under the age of three years in Zimbabwe.In Zimbabwe, promethazine, Stopayne® and Goldgesic® syrups are classified as pharmacy drugs (P) by the Medicines Control Authority of Zimbabwe (MCAZ). A pharmacy drug, according to the Medicines and Allied Substances Control Act (1991),8 is a medicine that is to be sold only, by a pharmacist, any person under the continuous personal supervision of a pharmacist, from licensed pharmacies or by a wholesale dealer with a valid wholesale dealer's permit. Promethazine, Stopayne® and Goldgesic® syrups are available over-the-counter (OTC), without need for a prescription

Consumer sensory evaluation of meat from South African goat genotypes fed on a dietary supplement

The objective of the study was to evaluate the effect of genotype and supplementary feeding on sensory scores of chevon from different indigenous goat genotypes prepared using different thermal treatments. 48 6-month-old Xhosa lop-eared (XLE), Nguni (NGN), Xhosa-Boer cross (XBC) and Boer (BOR) castrated goats with a body weight range of between 20 and 25 kg was used in the study. Half of the goats were supplemented with 200 g per head per day of sunflower cake. A consumer sensory evaluation was done with consumers of different ages, tribes and gender. In the non-supplemented XLE and BOR goats, the aroma intensity scores of the fried meat were significantly higher than the cooked meat. Female respondents gave higher (P &lt; 0.05) scores than male respondents for both cooked and fried meat on aroma intensity. Shona consumers gave higher (P &lt; 0.05) aroma intensity scores than the Xhosa and the Zulu consumers for both cooked and fried meat. In the non-supplemented goats, fried meat for all the genotypes was superior (P &lt; 0.05) to the cooked meat for initial impression of juiciness. The age and gender of respondents and thermal treatment influenced initial impression of juiciness scores (P &lt; 0.05). In meat from the non-supplemented XLE and NGN goats, the consumers gave higher (P &lt; 0.05) muscle fibre and overall tenderness scores in cooked meat than the fried meat.Key words: Dietary supplementation, fried chevon, cooked chevon, Xhosa lop-eared goats, Nguni goats, Boer goats

Meat quality of weaner steers adapted to a diet containing potassium humate in the feedlot

The objective of the study was to determine the meat quality responses of weaner steers fed diets containing potassium humate (PH) in a feedlot. Twenty-two yearling male steers were randomly allocated to two treatments: control (n = 11), fed a standard feedlot diet and PH (n = 11), fed a standard diet with added PH (5.8g/kg feed). The steers were housed in individual stanchions, with each steer as the experimental unit. At the end of the feeding trial at Day 112, the steers were slaughtered and the m. longissimus thoracic et lumborum muscle was sampled for meat quality measurements. Results of the study showed that diet had no effect on carcass characteristics and meat quality measurements, apart from meat pH and shear force values. Meat pH decline was more pronounced in the control group and higher shear force values were observed in the control group (6.58 and 4.91 kg) than the PH group (5.12 and 4.14 kg) at Day 1 and Day 7 of measurement respectively. The total intramuscular fat (IMF) was higher (by 16%) in the PH- fed weaner steers compared with the control. With regard to saturated fatty acids (SFA), higher amounts of myristic acid and heneicosanoic acid were observed in the PH-fed steers than in the control. However, the control had higher amounts of eicosatrienoic acid and eicosatetraenoic acid. PH inclusion in steer diets could therefore provide an alternative growth promotant in the production of safe and healthier meat in the feedlot.Keywords: Carcass characteristics, fatty acids, nutritional indices, shear forc

Determinants of Dietary Patterns and Obesity among Secondary School Adolescents in Harare, Zimbabwe, 2016

Background: The dietary patterns are becoming a major public health concern. The current data from various studies in Zimbabwe shows that there was an increase in the prevalence of obesity among secondary school adolescents in Harare. There is a link between eating habits and obesity. This study was conducted to explore the factors influencing dietary practices among adolescents in Zimbabwean schools. Methods: A school based analytic cross sectional study was conducted with 283 pupils aged 13-19 years. Systematic random sampling was used. Data was collected using self-administered questionnaire based on the ecological framework. The aim of the study was to identify the relationship between dietary patterns and occurrence of obesity. Bivariate and multivariate logistic regression analysis was used to identify the relationship between dietary patterns and obesity. Findings: The prevalence of obesity was 11.4%. Females were 6.79 (95% CI: 2.17-21.22 p=0.001) more likely to be obese. Consumption of sugar and sweetened beverages were associated with occurrence of obesity; beverages (AOR=3.62, 95%CI=1.99-10.91 p=0.025); eating of snacks in between meals (AOR=2.40, 95%CI=1.03-5.64 p=0.004); so was being located in high density suburb (0R=0.45, 95CI=0.21-0.99 p=0.023); consuming burgers (OR=4.41, CI=1.54-12.64 p=0.006); being a pupil in lower adolescent with age less than 16 (OR=1.99 95%CI=0.99-4.27 p=0.038). Consuming a special diet that is recommended or as a choice was protective from obesity though this was not statistically significant. Not removing visible fat from meat was a risk factor for developing obesity. Eating the traditional maize meal staple food, sadza was protective to being obese (OR=0.3514, 0.16-0.78) Conclusions: The study showed that obesity is a cause for concern among school children as seen by 11.4% prevalence. Choice of meals is done by parents, eating a home cooked meal such as sadza, participating in meal planning was found to be reinforcing factors. There is need to create awareness on students, parents, teachers and the wider community to increase the adoption of healthy dietary practice among school children

Lactation performance and blood metabolites in lactating dairy cows micro-supplemented with Moringa oleifera leaf meal

This study examined the effects of micro-supplementation of Moringa oleifera leaf meal on lactation performance and blood metabolites of lactating dairy cows. Thirty Jersey cows (± 40 days in milk (DIM)) were supplemented with Moringa oleifera leaf meal (M) at 0 (M0), 30 (M30) and 60 g/cow/day. The experiment lasted until 90 DIM with 14 days adaptation. Milk yield was recorded daily and samples were collected once weekly to determine milk composition and total antioxidant capacity (MTAC). Blood samples were collected on days 54, 68 and 90 in milk to determine serum total protein (TSP), albumin (Alb), immunoglobulin G (IgG) and serum total antioxidant capacity (STAC). Body weight (BW) and milk yield were not affected (P &gt;0.05) by Moringa supplementation. Moringa supplementation at M60 increased (P &lt;0.05) milk fat and MTAC with a significant reduction in somatic cell count (SCC). Increased (P &lt;0.05) total serum protein (TSP) and IgG with reduced (P &lt;0.05) non-esterified fatty acids (NEFA) levels were observed in M60. Increased (P &lt;0.05) STAC levels were noted in all groups supplemented with Moringa. Micro-supplementation with Moringa oleifera at 60 g/cow/day markedly reduced oxidative stress, which resulted in improved milk quality and immunity in lactating Jersey cows.Keywords: antioxidant herbs, antioxidative status, immunity, Jersey cows, milk yiel