Effects of methanol and aqueous extracts of Acacia xanthophloea, Strychnos heninningsii and Microglossa pyrifolia on Immunoglobin E using asthma induced mice model

Background: The increasing prevalence of asthma in developing countries during the last decade continues to represent a significant public health problem, causing both economic and social burdens. It remains an area of considerable unmet medical need which affects 235–330 million and kills about 300,000 people worldwide. Low and middle income countries make up more than 80% of the mortality and the prevalence of Asthma in Kenya is 15.8%.Treatment of asthma still remains far from being satisfactory, which is severely limited by undesirable adverse effect and high cost. Methanol and aqueous extracts of Acacia xanthophloea, Strychnos heninningsii and Microglossa pyrifolia have shown efficacy on antimicrobial and antioxidant properties but have not been investigated for anti-asthmatic activities. Objectives: This study was aimed at evaluating the anti-asthmatic activities of extracts of Acacia xanthophloea, Strychnos heninningsii and Microglossa pyrifolia on asthma induced mice. Materials and Methods: Female Swiss Albino mice aged 8weeks old and weighing 20 +/- 2g, were asthma induced by using 1% Ovalbumin (grade VI; Sigma, Steinheim, Germany) followed by treatment using methanol and water extracts of A xanthophloea, S heninningsii and M pyrifolia in concentrations of 50, 100 and 200mg/kg body weight except for positive control group of mice which was induced and not treated. Standard reference drug control group was given 10mg/kg Prednisolone. After treatment, serum total Immunoglobin E (IgE) levels were determine using mouse OVA specific IgE Enzyme Linked Immunosorbent Assay (ELISA) (BioLegend).Cytotoxicity screening of the plant extracts was also done using Vero E6 cells and MTT dye. Data were analyzed and expressed as Means and Standard Deviation and the parametric data was statistically analyzed using one way Analysis of Variance (ANOVA) followed with unpaired student’s t-test at p-value < 0.001. Results: The results showed that the extracts were able to reduce the serum total IgE levels by upto100% in reference to the positive control. Conclusion: The extracts tested have the ability to reduce IgE levels in an asthmatic attack. The results can to be used for future possible large scale implementation in an effort to solve the burden of asthma as well as the current anti-asthmatic drug side effects. Keywords: Anti-asthma, Immunoglobin E, Acacia. xanthophloea, Strychnos heninningsii, Microglossa pyrifoli

CIRCULATORY CYTOKINES AND HEMATOLOGICAL PROFILES: POSSIBLE BIOMARKERS OF HIV/AIDS DISEASE PROGRESSION

Introduction: This study sought to identify circulatory cytokines and hematological profiles measureable in blood plasma in newly diagnosed HIV patients as possible biomarkers that could predict the progression of HIV and AIDS disease in the course of acute HIV infection.Methodology: A prospective cross sectional study design was used to recruit the participants at the Nakuru Provincial General hospital in Kenya.  The study group included those who were HIV positive before and after commencing therapy and those who were HIV negative. The study group composed of male and female of different ages ranging from 7-72 years.  Hematology auto analyzer system was used to analyze hematological parameters and indices.  Types and concentrations of cytokines were determined using multiplex cytokine immunoassay by flow cytometry using Becton and Dickinsonfluorescence activated cell sorter (BD FACS) count.  Descriptive statistics were applied and a p- value < 0.05 was considered statistically significant.Results: This study found a significant difference in mean Interleukin 12p70 (p<0.001), Tumor Necrosis Factor (p<0.05), Interleukin 10 (p<0.05), Interleukin 6 (p<0.005) and interleukin 1β (p<0.05) between HIV negative patients, treatment naïve HIV patients and HIV patients on highly active antiretroviral therapy (HAART). Among the treatment naïve HIV patients, significant associations were observed between IL-12p70 and HGB (p<0.05); between TNF and MPV (p<0.001); between IL-10 and PDW (p<0.005); between IL-6 and Gran# (p-0.05); between IL-1β and PDW (p<0.005).Conclusion: The early period of infection with HIV is characterized by high circulatory cytokines levels and could be useful biomarkers and indicators of early immune activation of HIV infection. The results from this study also showed that acute HIV infection induces several hematological changes, involving all the blood parameters and indices, some of which may act as indicators of HIV/AIDS disease progression

Immunological profiles in HIV positive patients following Haart initiation in Kigali, Rwanda

Background: Interleukin-10, IL-2 and IFN -γ are some of the crucial cytokines associated with HIV infection and pathogenesis. While IL-2 and IFN-γ play critical roles in host resistance to infection, IL-10 inhibits the synthesis IFN-γ, IL-2 at mRNA and protein level; exacerbating damage to immune system.Objective: To determine the levels of, changes in and correlation between CD4 count, viral load, IL-10, IL-2 and IFN-γ before HAART and at six months of HAART among HIV positive patients in Kigali; with a view to understand cytokine networks particularly in relation to HAART ; and to see whether they can be used as alternative markers of the disease progression.Design: Longitudinal study.Setting: Kagugu, Kimironko, Biryogo, Gitega Health Centres and Centre Medico-Social Cornum; all located in Kigali.Subjects: Thirty three (33) HAART initiation eligible HIV positive patients including 13 women and 20 men.Results: A drop in viral load (though only a small number of patients achieved an undetectable viraemia); a recovery of CD4+ cells, a decrease in IL-10 (though it remained high for many patients especially those with unchanged viraemia); and an increase in IL-2 and IFN-γ indicated a successful HAART . A negative correlation between CD4 count and viral load and between CD4 count and IL-10 (but r <-0.5) was observed. IL-10 correlated positively and strongly with viremia (r > 0.5 at both time points: p-values <0.05). There was no significant correlation between CD4 count, IL-2 and IFN-γ.Conclusion: Results demonstrated the down-regulatory effect of IL-10 on Th1 cytokines and that a shift from Th1 to Th2 cytokine is associated with HIV disease progression. A successful HAART results in CD4+ cells recovery, drop in viraemia and IL-10 with up-regulation of Th1 cytokines. Also, findings show potential usefulness of IL-10 as a marker of HIV disease progression

Use of mobile learning technology among final year medical students in Kenya

Introduction: Mobile phone penetration has increased exponentially over the last decade as has its application in nearly all spheres of life including health and medical education. This study aimed at assessing the use of mobile learning technology and its challenges among final year undergraduate students in the College of Health sciences, University of Nairobi. Methods: This was a cross-sectional descriptive study conducted among final year undergraduate students at the University of Nairobi, College of Health Sciences. Self-administered, anonymous questionnaires were issued to all final year students in their lecture rooms after obtaining informed consent. Data on demographics, mobile device ownership and mobile learning technology use and its challenges was collected. Data entry and analysis was done using SPSS®. Chi-square and t-test were used for bivariate analysis. Results: We had 292 respondents; 62% were medical students, 16% were nursing students, 13% were pharmacy students and 9% were dental surgery students. The majority were female (59%) and the average age was 24 years. Eighty eight percent (88%) of the respondents owned a smart device and nearly all of them used it for learning. 64% of the respondents used medical mobile applications. The main challenges were lack of a smart device, lack of technical know-how in accessing or using apps, sub-optimal internet access, cost of acquiring apps and limited device memory. Conclusion: Mobile learning is increasingly popular among medical students and should be leveraged in promoting access and quality of medical education.Pan African Medical Journal 2015; 2

Intestical polyparasitism in a rural Kenyan community

Background: Polyparasitism seems to be a common feature in human populations in sub-Saharan Africa. However, very little is known about its epidemiological significance, its long term impact on human health or the types of interactions that occur between the different parasite species involved.Objectives: To determine the prevalence and co-occurrence of intestinal parasites in a rural community in the Kibwezi, Makueni district, Kenya.Design: A cross sectional study.Setting: Kiteng’ei village, Kibwezi, Makueni district, between May and September 2006.Subjects: One thousand and forty five who comprised of 263 adult males, 271 adult females> 15 years of age and 232 boys, and 279 girls < 15 years of age.Interventions: All infected members of the community were offered Praziquantel (at dosages of 40 mg/ kg body weight) for Schistosomiasis and Albendazole (600 mg) for soil transmitted helminths.Results: A total of ten intestinal parasite species (five protozoan and five helminth parasite species) were present in this community and polyparasitsm was common in individuals 5- 24 years of age with no gendar related differences. Most of the infections were mild. The protozoan parasites of public health significance present were Entamoeba histolytica and Giardia lamblia with prevalence of 12.6% and 4.2%, respectively. The helminth parasites of public health significance in the locality were Schistosoma mansoni with a prevalence of 28%, and hookworms prevalence of 10%. About 53% of the study population harboured intestinal parasite infections, with 31 % of the infected population carrying single parasite species infections, and 22% harbouring two or more intestinal parasite species per individual. Significant positive associations (p value

Primary HIV-1 Infection Among Infants in sub-Saharan Africa: HPTN 024.

Our objectives were to assess clinical signs and diagnoses associated with primary HIV-1 infection among infants. We analyzed data from a clinical trial (HIV Prevention Trials Network Protocol 024) in sub-Saharan Africa. Study visits were conducted at birth, at 4-6 weeks, and at 3, 6, 9, and 12 months. The study population comprised live born, singleton, first-born infants of HIV-1-infected women with negative HIV-1 RNA assays who were still breastfeeding at 4-6 weeks. Of 1317 HIV-1-exposed infants, 84 became HIV-1 infected after 4-6 weeks and 1233 remained uninfected. There were 102 primary and 5650 nonprimary infection visits. The most common signs were cough and diarrhea, and the most common diagnoses were malaria and pneumonia. Primary infection was associated with significantly increased odds of diarrhea [odds ratio (OR) = 2.4], pneumonia (OR = 3.5), otitis media (OR = 3.1), and oral thrush (OR = 2.9). For the clinical signs and diagnoses evaluated, sensitivity was low (1%-16.7%) and specificity was high (88.2%-99%). Positive predictive values ranged from 0.1%-1.4%. Negative predictive values ranged from 28.0%-51.1%. Certain clinical signs and diagnoses, although more common during primary HIV-1 infection, had low sensitivity and high specificity. Efforts to expand access to laboratory assays for the diagnosis of primary HIV-1 infection among infants of HIV-1-infected women should be emphasized

Integrating family planning services into HIV care: use of a point-of-care electronic medical record system in Lilongwe, Malawi

Background: Integrating family planning (FP) services into human immunodeficiency virus (HIV) clinical care helps improve access to contraceptives for women living with HIV. However, high patient volumes may limit providers’ ability to counsel women about pregnancy risks and contraceptive options

Long term study on the effect of mollusciciding with niclosamide in streamhabitats on the transmission of schistosomiasis mansoni after community-basedchemotherapy in Makueni District, Kenya

Background: Schistosoma mansoni infection is a persistent public health problem in many Kenyan communities. Although praziquantel is available, re-infection after chemotherapy treatment is inevitable, especially among children. Chemotherapy followed by intermittent mollusciciding of habitats of Biomphalaria pfeifferi, the intermediate host snail, may have longer term benefits, especially if timed to coincide with natural fluctuations in snail populations. Methods: In this cohort study, the Kambu River (Intervention area) was molluscicided intermittently for 4 years, after mass chemotherapy with praziquantel in the adjacent community of Darajani in January 1997. The nearby Thange River was selected as a control (Non-intervention area), and its adjacent community of Ulilinzi was treated with praziquantel in December 1996. Snail numbers were recorded monthly at 9–10 sites along each river, while rainfall data were collected monthly, and annual parasitological surveys were undertaken in each village. The mollusciciding protocol was adapted to local conditions, and simplified to improve prospects for widespread application. Results: After the initial reduction in prevalence attributable to chemotherapy, there was a gradual increase in the prevalence and intensity of infection in the non-intervention area, and significantly lower levels of re-infection amongst inhabitants of the intervention area. Incidence ratio between areas adjusted for age and gender at the first follow-up survey, 5 weeks after treatment in the non-intervention area and 4 months after treatment in the intervention area was not significant (few people turned positive), while during the following 4 annual surveys these ratios were 0.58 (0.39-0.85), 0.33 (0.18-0.60), 0.14 (0.09-0.21) and 0.45 (0.26-0.75), respectively. Snail numbers were consistently low in the intervention area as a result of the mollusciciding. Following termination of the mollusciciding at the end of 2000, snail populations and infections in snails increased again in the intervention area. Conclusion: The results of this study demonstrate that in the Kenyan setting a combination of chemotherapy followed by intermittent mollusciciding can have longer term benefits than chemotherapy alone

Association of Body Mass Index, Waist-Hip Ratio, Zinc, Copper, CD4+ T Cells Count and Viral Load in Early HIV Infection in ART Naïve HIV Infected Adults in Taita Taveta County, Kenya

During HIV/AIDS micronutrients play a key role in the host defense systems-Micronutrients such as zinc and copper have been implicated to play important roles in immuno-physiologic functions. The aim of the study was to assess the level of zinc and copper among ART naïve HIV positive adults and assess the association with their waist-hip ratio (WHR), body mass index (BMI), viral load and immunity. Descriptive cross-sectional study was conducted in the voluntary counselling and testing centre (VCT) at Comprehensive Care Clinics  in Taita-Taveta County health care services, Coast, Kenya, blood samples obtained from 192 HIV sero-positive individuals, 18 years of age and gender matched healthy controls were analyzed for zinc and copper using atomic absorption spectrophotometer machine. Data were analysed by statistical (SPSS version 21) computer software. The (mean+ SD) of serum copper and zinc were (158.7+51.0µ/dl, 84.3+51.1µ/dl) in patients and (130.5+17.9 µ/dl, 100.3+5.5 µ/dl) in control group, respectively. Serum zinc level was significantly decreased in HIV patients (P value, 0.05) while serum copper level was significantly increased compared to control group. There was significant association between viral load and waist-hip ratio but not body mass index (P &lt; 0.05). Both body mass index and waist-hip ratio were not significantly associated with CD4+T cells in participants at early HIV infection.Serum zinc was significantly associated to waist-hip ratio in participants in early HIV infection. (P &lt; 0.05). This study indicates that zinc and copper levels are altered in patients in early HIV infection with more decreased Zinc level suspected with increased duration of the HIV infection. It also demonstrates that the associated characteristics in early HIV infection are different from studies in late stages. In conclusion, waist-hip ratio has been identified as a more sensitive predictor and nutrition status maker than body mass index in early HIV hence can be a decisive benchmark for monitoring HIV progression.