Antidiarrheal Activity of Aqueous Extract of the Stem Bark of Sapium Ellipticum (Euphorbiaceae)

Purpose: To investigate the antidiarrheal activity of the aqueous extract of the stem bark of S. ellipticum (Euphorbiaceae) (AESE).Methods: AESE was prepared by decoction of the powder from the dry stem bark of S. ellipticum. Its oral antidiarrheal effect was evaluated in vivo at the doses of 5.2, 10.4 and 20.8 mg/kg on castor oil induced diarrhea and on gastro-intestinal transit. AESE was also evaluated in vitro (0.125 – 4 mg/ml) on ileal smooth muscle motility. The acute oral toxicity of AESE (5, 10, 15, 20 and 25 mg/kg) was also assessed in mice.Results: AESE significantly and dose dependently delayed the time of appearance of the first stools, decreased the frequency of defecation and the intestinal transit with respective percentage of 319.14, 62.50 and 36.51 % at the dose of 20.8 mg/kg in comparison with negative control (distilled water). AESE, in a concentration-dependent manner, reduced the tone and amplitude of spontaneous contractions of the ileal smooth muscle with EC50 of 33.29 and 45.43 μg/ml, respectively. None of the doses used in acute toxicity test induced any significant behavioral changes or mortality.Conclusion: These results suggest that AESE possesses antidiarrheal properties mediated at least partially by the inhibition of intestinal motility and may be devoid of acute toxicity.Keywords: Sapium ellipticum, Antidiarrheal, Intestinal transit, Spasmolytic, Acute toxicity

Social and Cultural Factors Affecting Uptake of Interventions for Malaria in Pregnancy in Africa: A Systematic Review of the Qualitative Research

Malaria during pregnancy (MiP) results in adverse birth outcomes and poor maternal health. MiP-related morbidity and mortality is most pronounced in sub-Saharan Africa, where recommended MiP interventions include intermittent preventive treatment, insecticide-treated bednets and appropriate case management. Besides their clinical efficacy, the effectiveness of these interventions depends on the attitudes and behaviours of pregnant women and the wider community, which are shaped by social and cultural factors. Although these factors have been studied largely using quantitative methods, qualitative research also offers important insights. This article provides a comprehensive overview of qualitative research on social and cultural factors relevant to uptake of MiP interventions in sub-Saharan Africa.A systematic search strategy was employed: literature searches were undertaken in several databases (OVID SP, IS Web of Knowledge, MiP Consortium library). MiP-related original research, on social/cultural factors relevant to MiP interventions, in Africa, with findings derived from qualitative methods was included. Non-English language articles were excluded. A meta-ethnographic approach was taken to analysing and synthesizing findings. Thirty-seven studies were identified. Fourteen concentrated on MiP. Others focused on malaria treatment and prevention, antenatal care (ANC), anaemia during pregnancy or reproductive loss. Themes identified included concepts of malaria and risk in pregnancy, attitudes towards interventions, structural factors affecting delivery and uptake, and perceptions of ANC.Although malaria risk is associated with pregnancy, women's vulnerability is often considered less disease-specific and MiP interpreted in locally defined categories. Furthermore, local discourses and health workers' ideas and comments influence concerns about MiP interventions. Understandings of ANC, health worker-client interactions, household decision-making, gender relations, cost and distance to health facilities affect pregnant women's access to MiP interventions and lack of healthcare infrastructure limits provision of interventions. Further qualitative research is however required: many studies were principally descriptive and an in-depth comparative approach is recommended