Prevalence and antibiotic susceptibility pattern of bacteriuria among HIV-seropositive patients attending the Bamenda Regional Hospital, Cameroon

Background: HIV causes a decrease in CD4+ lymphocyte cells count, exposing the individual to infections (urinary tract infections). This study was carried out to determine the prevalence of bacteriuria and antimicrobial susceptibility pattern of bacteria isolates among HIV patients. Methods: Clean catch mid-stream urine samples were collected from 135 HIV- seropositive patients, cultured on Cystein lactose electrolyte deficient (CLED) agar and incubated at 370C for 24 hours. The modified Kirby-Bauer\u2019s disc diffusion method was used to assess susceptibility to antimicrobial agents. Results: The prevalence of bacteriuria was 67.4% (91/135). Staphylococcus aureus was the most predominant (42.9%) isolate, followed by Escherichia. coli (24.2%), then Coagulase negative Staphylococci (10.9%). The highest proportion of bacteria was isolated from patients having a CD4+ T-cell count of less than 300 cells/mm3 (39.6%). There was an association between the level of CD4+cell count and bacterial urinary tract infection (P= 0.001). Most sensitive drugs were gentamycin, vancomycin and amoxicillin-clavulanic acid while the drug with the greatest resistance was sulphamethoxazole-trimethoprim, with Enterococcus and Proteus showing 100% resistance to this drug. Conclusion: Bacteriuria and resistance to commonly used antibiotics is prevalent among HIV/AIDS patients attending the Bamenda Regional Hospital. Therapy based on antimicrobial susceptibility test is encouraged

Strategies used by Nurses in Paediatric Critical Nursing Practice at the Bamenda Health District

Background: This study titled: “Strategies used by nurses for paediatric critical nursing practice” was conducted in selected hospitals in the Bamenda Health district in the North West Region of Cameroon. There is a great burden on critically ill children in developing countries. (7) Greater than 80% of the global 6.64 million annual deaths in children and adolescents in 2017 occurred Low-and middle-income countries LMICs. (19) The major objective: To assess strategies used by nurses in paediatric critical and emergency care at the Bamenda health district. Methods: The study population included nurses of the Bamenda health district. This study made use of a descriptive and analytical cross-sectional method that employed both the survey and the observational methods of data collection. Purposive convenience and sampling techniques were used to select the study sites and the study population respectively. The instrument for data collection was a well-structured questionnaire and an observational/interview guide. Pretesting was done to validate these instruments in Kumbo. Data were analysed using SPSS version 21.0 and presented using frequency tables and charts. Results: A relative majority 42 (39.25 %) of nurses were within the age range of 18-28, and 79 (73.83%) were females. Findings on the first steps in an emergency revealed that 64.49% of the respondents said they will first assess the airway. The majority 84(78.5%) of the nurses had no training in critical care while 23(21.50%) had in-service training in critical/emergency care and not in paediatric critical /emergency care. Training of paediatric critical and emergency nurses and building separate ICUs and EDs for critically ill children was identified by 78 (72.90%) as a major area that needs improvement. Chi-square statistical analysis on in-service training in critical/emergency care and successes of care registered showed a significant relationship between in-service training and non-invasive airway management(p= 0.002) and invasive airway management (p= 0.026)at 95% CI. Conclusion: From the findings, it can be deduced that most of the nursing strategies used by nurses for paediatric critical care are not adequate as many nurses do not have formal training in paediatric critical and emergency care

Haematological changes and recovery associated with treated and untreated Plasmodium falciparum infection in children in the Mount Cameroon Region

Pre-hospital antimalarial treatment of febrile children remains a significant common practice among individuals in the Mount Cameroon region. To evaluate the effect of routinely administered monotherapy sulphadoxine pyrimethamine (SP), treatment using amodiaquine artesunate (AQAS) combination therapy and untreated malaria on haematological and parasitological parameters, 332 malaria positive subjects were assigned to three groups comprising 138 children treated with AQAS, 43 treated with SP and 151 untreated. The changes and recovery in red cell indices, white blood cell and differential and platelets counts were compared. The highest haematological recovery (39.1%) occurred in the AQAS treatment group. The majority (94%) of the untreated cases never achieved haematological recovery even though there was spontaneous clearance of parasites in some cases. Haematological insult was greatest in untreated children followed by those treated with SP, the 1.1 -3 year age group whether or not they received treatment and in those with high parasitaemia. Delayed parasite clearance observed in the untreated and SP treatment group may be responsible for the occurrence of haematological insult. Treatment type and parasitological cure was associated with haematological recovery. Prompt use of effective arthemisinin combination therapy reduced the burden of malaria, hence the greater clinical and haematological benefits observed in our study

Integrated dataset of screening hits against multiple neglected disease pathogens.

New chemical entities are desperately needed that overcome the limitations of existing drugs for neglected diseases. Screening a diverse library of 10,000 drug-like compounds against 7 neglected disease pathogens resulted in an integrated dataset of 744 hits. We discuss the prioritization of these hits for each pathogen and the strong correlation observed between compounds active against more than two pathogens and mammalian cell toxicity. Our work suggests that the efficiency of early drug discovery for neglected diseases can be enhanced through a collaborative, multi-pathogen approach

SERUM LIPID AND TRACE MINERAL PROFILES AMONG TYPE 2 DIABETICS AND HYPERTENSIVE DIABETICS AT THE BAMENDA REGIONAL HOSPITAL

Objective: Diabetes mellitus has become a clinical condition of public health importance, especially in developing countries due to its high mortality and morbidity. The aim of this study was to measure and compare the lipid and serum trace mineral profile among type 2 diabetics and hypertensive diabetics with controls. Methods: This cross-sectional study was carried out at the Regional Hospital, Bamenda, involving 50 diabetic normotensives, 50 hypertensive diabetics, and 50 normal recruited subjects. Serum levels of lipids and minerals were determined using standard methods. Results: Of the four trace elements assessed, except for copper (Cu) whose mean values in diabetics were abnormally increased (p=0.01), zinc (Zn), magnesium (Mg), and chromium (Cr) showed significantly decreased mean values in diabetics compared to the controls (p<0.05). The mean levels of these trace elements were also significantly reduced in hypertensive diabetic patients (p<0.05). In diabetics, there was no significant difference in the lipid levels. However, only total cholesterol (TC) and low-density lipoprotein mean values were significantly higher in hypertensive diabetic patients compared to the normal controls. There was also a positive significant correlation between the body mass index and Cr (r=+0.3, p=0.045) in diabetics. Conclusion: This study saw statistically significant differences in the serum lipid and trace element levels between diabetics, hypertensive diabetics, and controls: With diabetic and diabetic hypertensive patients having higher serum Cu levels and decreased serum Mg, Zn, and Cr levels compared to the normal controls. The lipid profile levels in diabetics and hypertensive diabetics were not significant differences within the study groups for all lipid profile estimations except for TC and LDL which were significantly higher only in hypertensive diabetic patients

Evaluation of anti-onchocercal activity of pseudopalmatine, a quaternary protoberberine alkaloid of Enantia chlorantha (Syn. Annickia chlorantha)

As part of our efforts towards identifying and subsequently developing lead compounds from medicinal plants of Cameroon to combat neglected tropical diseases, we embarked to phytochemically investigate Enantia chlorantha (Syn. Annickia chlorantha). The rationale for choosing this plant is its numerous uses in folk medicine in Cameroon and other parts of Africa. In Cameroon the quaternary protoberberine alkaloids, columbamine (2), palmatine (3) and jatrorrizine (4) have been isolated from the stem back and combined to produce a phytomedicine (HEPAZOR®) used in the treatment of viral hepatitis. An alkaloidal extraction of the methanolic extract of the stem bark of the plant was carried-out and this afforded yellow amorphous solids whose structure was obtained using routine nuclear magnetic resonance spectroscopy (NMR), high pressure liquid  chromatography coupled to an electrospray mass spectrometer (HPLC-ESI-MS) and comparison with literature. The compound was identified as   pseudopalmatine (1), a quaternary protoberberine alkaloid. Preliminary screening of the compound on both adult and juvenile worms of Onchocerca ochengi, a close relative of Onchocerca volvulus, the parasite responsible for human onchocerciasis (river blindness), showed that compound (1) was inactive at a concentration of 500 μg/mL on the adult worms, but inhibited microfilariae motility completely at this same concentration and by 50 % at 250 μg/mL and was thus considered active. While this work to the best of our knowledge constitutes the first report on the anti-onchocercal activity of quaternary protoberberine alkaloids in general and pseudopalmatine (1) in particular isolated from E. Chlorantha, it has however opened a window for further investigation of the anti-onchoceral activity of this class of  compounds.Key words: anti-onchocercal, pseudopalmatine, alkaloid, Enantia chloranth

Filaricidal properties of Lantana camara and Tamarindus indica extracts, and Lantadene A from L. camara against Onchocerca ochengi and Loa loa.

Ivermectin is the only drug currently recommended for the treatment of onchocerciasis, the second leading infectious cause of blindness in the world. This drug kills only the first stage larvae-microfilariae (mf) of Onchocerca volvulus and is to be used cautiously in areas where Loa loa is prevalent because of severe adverse events observed with coinfected patients.This study investigated the anti-filarial activities of two Cameroonian medicinal plants, Lantana camara and Tamarindus indica locally used to treat onchocerciasis. Twelve (12) extracts were prepared and tested in vitro on the bovine model parasite, O. ochengi as well as L. loa mf. Both mf and adult male worm viabilities were assessed by motility scoring, while adult female worm viability was determined biochemically by standard MTT/formazan colorimetry. Cytotoxicity and acute toxicity were determined respectively, in monkey kidney epithelial cells and in BALB/c mice. Pure compounds were isolated by LC/MS using a bio-assay guided strategy. All the extracts showed 100% activity at 500 μg/mL against O. ochengi adult worms and mf. The highest activity against O. ochengi was observed with the hexane extract of L. camara leaves (LCLhex), with IC50 of 35.1 μg/mL for adult females and 3.8 μg/mL for the mf. Interestingly, this extract was more active against O. ochengi mf than L. loa mf. Further studies on the extracts led to the isolation of lantadene A from the methylene chloride extract of L. camara leaves, with IC50s of 7.85 μg/mL for adult males, 10.38 μg/mL for adult females, 10.84 μg/mL for O. ochengi mf and 20.13 μg/mL for L. loa mf.We report for the first time the anti-onchocercal activities of these locally consumed medicinal plants and lantadene A, a potential lead for further development as an onchocerciasis cure

Filaricidal activity of Daniellia oliveri and Psorospermum febrifugum extracts

Abstract Background Drugs currently used for controlling onchocerciasis and lymphatic filariasis (LF) are mainly microfilaricidal, with minimal or no effect on the adult worms. For efficient management of these diseases, it is necessary to search for new drugs with macrofilaricidal activities that can be used singly or in combination with existing ones. Daniellia oliveri and Psorospermum febrifugum are two plants commonly used in the local management of these infections in Bambui, a township in the North West Region of Cameroon, but there is currently no documented scientific evidence to support their claimed anthelmintic efficacy and safety. The aim of this study was to provide evidence in support of the search for means to eliminate these diseases by screening extracts and chromatographic fractions isolated from these plants for efficacy against the parasitic roundworms Onchocerca ochengi and Brugia pahangi. Methods The viability of O. ochengi adult worms was assessed using the MTT/formazan assay. Fully confluent monkey kidney epithelial cells (LLC-MK2) served as the feeder layer for the O. ochengi microfilariae (mfs) assays. Viability of the mfs was assessed by microscopic examination for mean motility scoring (relative to the negative control) every 24 h post addition of an extract. The Worminator system was used to test the effects of the extracts on adult B. pahangi motility, and mean motility units were determined for each worm. Cytotoxicity of the active extracts on N27 cells was assessed using the MTS assay. Results Extracts from D. oliveri and P. febrifugum were effective against the adult roundworms O. ochengi and B. pahangi. Interestingly, extracts showing macrofilaricidal activities against O. ochengi also showed activity against O. ochengi mfs. The hexane stem bark extract of D. oliveri (DOBHEX) was more selective for adult O. ochengi than for mfs, with a half maximal and 100% inhibitory concentration (IC50 and IC100, respectively) against adult O. ochengi of 13.9 and 31.3 μg/ml, respectively. The in vitro cytotoxicity of all active extracts on N27 cells showed selective toxicity for parasites (selectivity index > 1). Bioassay-guided fractionation of the extracts yielded fractions with activity against adult B. pahangi, thus confirming the presence of bioactive principles in the plant extracts. Conclusions Our study supports the use of D. oliveri and P. febrifugum in the traditional treatment of onchocerciasis and LF. The further purification of active extracts from these plants could yield lead compounds for filarial drug discovery and development. Graphic abstrac

Comparison of the effect of different extracts and concentrations on the mean activity of <i>O</i>. <i>ochengi</i> males.

<p>Comparison of the effect of different extracts and concentrations on the mean activity of <i>O</i>. <i>ochengi</i> males.</p

Comparison of the effect of different extracts and concentrations on the mean activity of <i>O</i>. <i>ochengi</i> microfilariae.

<p>Comparison of the effect of different extracts and concentrations on the mean activity of <i>O</i>. <i>ochengi</i> microfilariae.</p