Prevalence and determinants of undernutrition in schoolchildren in the Kilombero district, south-eastern Tanzania

Childhood undernutrition is a major issue in low- and middle-income countries, affecting the health, well-being, and educational outcomes of schoolchildren. This study aimed to assess the prevalence and associated factors of stunting, wasting, and underweight among schoolchildren in peri-urban areas in the south-eastern part of Tanzania. A cross-sectional study was conducted involving 930 children aged 6–12 years from four primary schools from July to August 2019. The WHO Anthro Survey Analyzer was employed to estimate the prevalence of stunting, wasting, and underweight, while logistic regression analyses examined sociodemographic background, malaria infection, anaemia, anthropometric measures, and dietary diversity score as potential factors. The prevalence of stunting, wasting, underweight, overweight, and obesity was 11.8%, 4.3%, 3.9%, 11.1%, and 2.0%, respectively. Overall, 1.5% of the children had malaria, as determined by rapid diagnostic tests, and 0.4% had severe anaemia. Univariate analysis indicated higher odds of undernutrition among children aged 9–12 compared to their younger peers. Stunting was more common among children with low and medium dietary diversity. Anaemia was found in 11.2% of schoolchildren, and severe anaemia was associated with wasting. Multivariate analysis revealed that age and low dietary diversity were significantly associated with undernutrition. These findings emphasise the need for school-based health and nutrition programmes targeting children beyond the age of 5 to improve their nutritional status and mitigate potential adverse effects on health, cognition, and academic achievement. Regular assessment of the nutritional status of schoolchildren is warranted

Moderate-to-vigorous physical activity is associated with cardiorespiratory fitness among primary schoolchildren living in Côte d'Ivoire, South Africa, and Tanzania

Background:; Physical inactivity and low cardiorespiratory fitness (CRF) are independent cardiovascular risk factors among children, but have rarely been investigated concurrently in sub-Saharan Africa. The purpose of this study was to compare physical activity (PA) and CRF of primary schoolchildren living in Côte d'Ivoire (CI), South Africa (ZA), and Tanzania (TZ), to test sex- and age-related differences, and to examine whether PA and CRF are associated with each other.; Methods:; Baseline data from an ongoing cluster-randomized controlled trial were used, including 499 children from CI (Taabo, 49% girls,; M; = 8.0 ± 1.6 years), 1,074 children from ZA (Gqeberha, 49% girls,; M; = 8.3 ± 1.4 years), and 593 children from TZ (Ifakara, 51% girls,; M; = 9.4 ± 1.7 years). PA was assessed by accelerometry and CRF by a 20 m shuttle-run test. The data were analyzed using multi-/univariate analyses of variance and mixed linear models.; Results:; Most children met recommendations put forward by the World Health Organization for moderate-to-vigorous PA (MVPA) and achieved high CRF scores. In CI, 89.6% of the children met MVPA recommendations (boys: 91.7%, girls: 87.4%), whereas this rate was 76.9% in ZA (boys: 91.0%, girls: 62.4%), and 93.8% in TZ (boys: 95.5%, girls: 92.0%). Children from TZ had the highest CRF and MVPA levels, followed by children from CI and ZA. Boys had higher MVPA levels than girls, whereas girls engaged in more sedentary behavior. Sex differences were strongest in ZA. Sedentary behavior and MVPA were higher among older schoolchildren compared to their younger peers. Higher MVPA, but not sedentary behavior, was associated with better CRF.; Conclusions:; In all three settings, higher levels of MVPA were associated with higher CRF scores. Nevertheless, children living in the most urbanized setting (such as observed in ZA) were physically less active and had lower CRF than peers living in more rural areas (such as observed in CI and TZ). Particularly for girls, urbanization might increase the risk for insufficient MVPA, which may have negative effects on their CRF, thus negatively influencing health and well-being at later age

Synthesis and transdermal properties of acetylsalicylic acid derivates

Thesis (M.Sc. (Pharm.))--North-West University, Potchefstroom Campus, 2004.The skin is an amazing elastic and relatively impermeable barrier that provides protective, perceptive and communication functions to the body. The stratum corneum is widely accepted as the barrier of the skin - limiting the transport of molecules into and across the skin. It is evident that the transdermal permeation of drugs depend on a number of factors of which the physicochemical properties play the most prevalent role. The potential of using intact skin as the site of administration for dermatological preparations to elicit pharmacological action in the skin tissue has been well recognised. Transdermal drug delivery offers several advantages over oral and parenteral dosing. They include avoiding hepatic first pass metabolism, maintaining constant blood levels for longer periods of time, improving bioavailabiliv, decreasing the administered dose, adverse effects and gastrointestinal side effects, easy discontinuation in case of toxic effects and improved patient compliance. Optimal transport through the skin requires a drug to possess lipophilic as well as hydrophilic properties. Research has indicated that the ideal log P value for optimal transdermal permeation is between 1 and 2. Acetylsalicylic acid (aspirin) possesses anti-inflammatory, analgesic and antipyretic activity, and as an anti-inflammatory analgesic agent it is used in the treatment of musculoskeletal disorders, such as rheumatoid arthritis. Its use is limited to the relief of pain and inflammation, as it does not halt the progression of the pathological injury caused to the tissue. Acetylsalicylic acid is also used in the treatment of fever, prevention of thromboembolic disorders, reducing the incidence of colon cancer and it delays the onset of Alzheimer's disease. The most common adverse effect of acetylsalicylic acid occurring with therapeutic doses is gastro-intestinal disturbances. The primary aim of this study was to determine the transderrnal penetration of acetylsalicylic acid and some of its derivatives and to establish a correlation, if any, with selected physicochemical properties. The ten derivatives of acetylsalicylic acid were prepared by esterification of acetylsalicyloyl chloride with ten different alcohols. The structures of the products were confirmed by mass spectroscopy (MS), nuclear magnetic resonance spectroscopy (NMR), infrared spectroscopy (IR) and differential scanning calorimetry (DSC) for methyl acetylsalicylate. Experimental aqueous solubility and partition coefficients were determined for acetylsalicylic acid and its different derivatives at a pH of 4,5. In vitro penetration was measured through excised female human abdominal skin in diffusion cells. The prediction software Interactive Analysis (IA) was used to predict aqueous solubility, while prediction software IA, &,Win and ACD Labs were used to predict the log P values for each derivative. None of the predicted values correlated with the experimental values. The experimental aqueous solubilily, partition coefficient and transdermal flux values were determined for acetylsalicylic acid and its derivatives. The experimental aqueous solubilily of acetylsalicylic acid (6,56 mg/ml) was higher than that of the synthesised acetylsalicylate derivatives (ranging from 1,76 x lo3 to 3,32 mg/ml), and the partition coefficient of acetylsalicylic acid (-0,85) was lower than that of its derivatives (ranging from -0,25 to 1,954. There was thus a direct correlation between the aqueous solubility data and the partition coefficients. The experimental transdermal flux of acetylsalicylic acid (4733 pg/cm2/h) was much higher than that of its derivatives (ranging from 0,03 to 28,32 pg/cm2/h). With the ethyl derivative (28,32 pg/cm2/h) and the methyl derivative (10,06 pg/cm2/h) being the only derivatives with appreciable flux. Pentyl acetylsalicylate (0,03 pg/cm2/h) had the lowest flux. The higher flux values of acetylsalicylic acid and its methyl and ethyl derivatives might be due to the fact that it is more hydrophilic and had better aqueous solubilily, thus permeating through the proteins of the skin. Pentyl acetylsalicylate had a log P value of 1,95, but had the lowest flux (0,03 pg/cm2/h), just proving once again that to cross the stratum corneum a drug should posses both hydrophilic and lipophilic properties. Tert-butyl acetylsalicylate had a flux (7,30 &cm2/h) lower than that of methyl and ethyl acetylsalicylate, but a higher flux than the other synthesised derivatives which could be due to its log P value being slightly greater than 1 and having an average aqueous solubility. The low transdermal permeation may also be attributed to the fact that at the pH (45) chosen for transdermal studies, acetylsalicylate was only 9,09 % unionised. A higher degree of unionised species results in higher flux values. This study has confirmed that transdermal flux is dependent on several factors including optimum solubility, partitioning, diffusion and the degree of ionisation in the stratum corneum in addition to a suitable partition coefficient and high aqueous solubilily. The solution to the increased transdermal delivery of lipophilc drugs does not simply lie in producing a derivative with a higher aqueous solubilily and more ideal partition coefficient. Other means of increasing the transdermal permeation of lipophilic acetylsalicylic acid derivatives will have to be investigated in further studies.Master

Synthesis and transdermal penetration of selected lamivudine derivatives

Thesis (Ph.D. (Pharmaceutical Chemistry))--North-West University, Potchefstroom Campus, 2007.The skin is the most extensive and readily accessible organ in the body. The outermost layer of the skin, the stratum corneum, functions as a barrier, limiting the transport of molecules into and across the skin. Transdermal drug delivery offers several advantages over oral and parenteral dosing that include a non-invasive treatment, improving bioavailability and patient compliance, bypassing of hepatic first pass metabolism, decreasing the administered dose and gastrointestinal adverse effects as well as the quick discontinuation of treatment. A hydrophilic compound will have trouble partitioning into the stratum corneum from its vehicle and a lipophilic compound may have difficulty leaving the stratum corneum. Optimal transport through the skin requires a drug to possess lipophilic as well as hydrophilic properties. Research suggests that a drug should have an aqueous solubility of more than 1 mg/ml and an octanol-water partition coefficient (log P) between 1 and 2 to optimally penetrate the skin. Approximately 40.3 million people were living with HIV/AIDS at the end of 2005, which is generally treated with Nucleoside Reverse Transcriptase Inhibitors (NRTls), like zalcitabine and lamivudine. NRTls have a bitter taste and the most common adverse effects occurring with these two compounds are abdominal pain, nausea, vomiting, diarrhoea and mouth ulcers. The aim of this study was primarily to determine the transdermal permeation of zalcitabine, lamivudine and the synthesised amide esters of lamivudine, with and without the use of pheroidTM as delivery system and to establish a correlation, if any, with selected physicochemical properties. The six amide ester derivatives of lamivudine were prepared by acylation esterification of lamivudine with six different acid chlorides. The structures of the products were confirmed by mass spectrometry (MS), nuclear magnetic resonance spectroscopy (NMR) and infrared spectroscopy (I R). The aqueous solubility of all compounds was higher at pH 5 than at pH 7. The aqueous solubility of lamivudine at both pH 5 and 7 (114.36 mg/ml and 91.57 mg/ml, respectively) was lower than that of zalcitabine (144.78 mg/ml and 110.16 mg/ml, respectively), but was distinctly higher than that of the synthesised amide esters of lamivudine (ranging from 1.00 x 10-4 to 8.34 mg/ml and 1.00 x 10-4 to 6.16 mg/ml, respectively). The octanol-PBS partition coefficient (log D) of lamivudine and its amide esters was lower at pH 5 than at pH 7. Of all compounds zalcitabine had the lowest log D at both pH 5 and 7 (-1.50 and -1.78, respectively). The log D of lamivudine at both pH 5 and 7 (-1.19 and -1.15, respectively) was lower than that of the amide esters (ranging from 0.12 to 4.55 and 0.25 to 4.88, respectively). Hence, there was a direct correlation between the aqueous solubility and the log D at both pH 5 and 7 for all compounds. A comparison between average and median flux of the amide esters of lamivudine show that there is a good correlation between the flux values in PBS and in pheroidTM, (except for N-butyryllamivudine-5'-buterate). Compounds with higher flux, like zalcitabine and lamivudine, seem to be prone to larger differences between average and median flux. In the occurrence of large variation and skewed distributions of experimental values, the median flux is a more robust measurement. Therefore median flux was used as a more accurate method for determining flux. In vitro penetration was measured through excised female human abdominal skin in Franz diffusion cells. The median flux of lamivudine (4.289 mol.cm-2.h-2) in PBS was higher than that of zalcitabine (0.442 mol.cm-2.h-1), but in pheroidTM, zalcitabine had a slightly higher median flux (0.015 mol.cm-2.h-1) than lamivudine (0.011 mol.cm-2.h-1). In both PBS and pheroidTM, the median flux of lamivudine was higher than that of the amide esters (2.0 x10-4 to 0.046 mol.cm-2.h-1 in PBS and 2.0 x 10-4 to 9.3 x 10-3 mol.cm-2.h-1 in pheroidTM). Of all the amide esters of lamivudine, N-acetyllamivudine-5'-acetate (in PBS) and N-propionyllamivudine- 5'-propionate (in pheroidTM) presented the highest flux. When comparing flux in PBS with that in pheroidTM it is observed that all the compounds have lower flux in pheroidTM except N-hexanoyllamivudine-5'-hexanoate. Hence, pheroidTM does not improve transdermal flux of this series of compounds. In this study a direct correlation between the aqueous solubility and transdermal flux was found. A strong statistically significant correlation was observed between flux in both PBS and in pheroidTM and each of molecular weight, aqueous solubility (at pH 5 and 7), and log D (at pH 5 and 7); as was determined with a 5 % level of confidence using the Spearman correlation. Yellow spots were observed in the confocal laser scanning microscopy (CLSM) micrographs which confirmed that the compounds were entrapped in pheroidTM. The more hydrophilic compounds had a decrease in microsponge size as they became more lipophilic from zalcitabine to N-butyryllamivudine-5'-buterate and thereafter an increase was noticed from N-butyryllamivudine-5'-buterate to N-decanoyllamivudine-5'-decanoate. Hence, it seems that hydrophilic drugs permeate easier when entrapped in pheroidTM than lipophilic compounds.Doctora

Cure-All cannabidiol? The cannabidiol content of commercial products

Background: The recent easing of regulations around the world regarding Cannabis sativa and its main active compounds, such as cannabidiol (CBD), led to an explosion in the number of over-the-counter consumer products. The number of product types is surpassed by the vast quantity of products of each type, but even this is exceeded by the associated health claims which range from the benign, such as ‘fighting inflammation’, to the completely asinine such as ‘fighting the tyranny of the urgent’ or ‘shedding light on your inner darkness’. Any health claim should in the first instance be supported by the product containing the correct actives at the correct dosage. Purpose: The purpose of this study was to test a diverse range of commercially available product types including soft drinks, honey, coffee, oils, gummy bears, chocolate, etc. that claim to contain CBD and compare the results to their label claims. Study design: Forty commercially available products were extracted and quantitatively analyzed. Methods: Extraction efficiency for all product types was conducted over a 1 h period using acetonitrile and ultrasonication. Samples were taken every five min and analyzed using a validated HPLC method. All products were then extracted in triplicate using the applicable extraction time and quantitatively analyzed. Results: Fifteen min of sonication was found to be adequate for the oils and drinks samples. The honey, chocolate and gummies samples required initial dissolution in water followed by extraction with acetonitrile. The remaining products required sonication of 45 min. It was found that only three products (7.5 %) contained CBD levels within 90–110 % of their label claim. Two products had trace amounts of delta-9-tetrahydrocannabinol and some of the products were completely devoid of CBD. Conclusion: Mislabeling is of serious concern and this study shows that the problem not only includes problems with the content of CBD, but also regarding the chemical properties such as containing “water-soluble CBD” while it is insoluble in water, and the diverse number of health claims that in some cases have no foundation in reality. This highlights not only the lax attitude of producers but also of the regulatory authorities in ensuring the consistent quality of these products