Anti-Diabetic Drugs In The Private And Public Sector In Dar Es Salaam, Tanzania

Objectives: To compare availability, cost, affordability and sources of anti-diabeticdrugs between private and public health facilities in Dar es Salaam, Tanzania.Design: Cross sectional descriptive study.Setting: Diabetic clinics in private and public health facilities in Dar es Salaam,Tanzania.Subjects: Eighty patients randomly selected and 45 health facility personnel staffworking in the diabetic clinics. Semi-structured questionnaires and a checklist wereused to collect the information.Results: Oral hypoglycaemic agents were available in all seven private and three publicfacilities that were studied. Private facilities stocked more types of oral hypoglycaemicagents than public facilities, which stocked only chlorpropamide and tolbutamide,based on the National Essential Drugs List. The cost of chlorpropamide was five timeshigher in private facilities compared to public facilities. Insulin was also available inall the facilities. The price of animal insulin in private health facilities was ten timesthat in public health facilities. Human insulin, which is generally more expensive thananimal insulin, was only available in private facilities. Although prices were muchlower in public facilities, affordability emerged as a common issue in both privateand public facilities.Conclusions: Urban private health facilities offer a wider choice for the needs ofdiabetic patients but this advantage is compromised by higher prices as compared topublic facilities as well as inconsistent supply across facilities. Public health facilitiesoffer only a limited selection of essential oral hypoglycaemics and insulin but at alower price and across all facilities. Twenty six per cent and 10% of patients in publicand private facilities respectively are unable to afford anti-diabetic drugs. The needfor intervention to increase affordability of anti-diabetic drugs is evident. Financingand cost of drugs needs to be addressed, either by means of health insurance orother mechanisms, in this era of increasing prevalence of diabetes mellitus amongdeveloping countries

EVALUATION OF ETHNOMEDICAL CLAIMS AND BRINE SHRIMP TOXICITY OF SOME PLANTS USED IN TANZANIA AS TRADITIONAL MEDICINES.

Using information from the literature it has been demonstrated that twenty one (21) plants out of 60 (35%) which are used in traditional medicine, in Tabora region (Western Tanzania), are used elsewhere for the treatment of similar conditions or their claims have proven biological results. Ethanol extracts of some of the plants exhibited low, some intermediate, and some high toxicity against brine shrimps. The brine shrimp assay results for Psorospermum febrifugum Spach (Guttiferae) [LC50 12.7µg/ml], agreed with previous reports of established anticancer activity, while for Phyllanthus engleri Pax. (Euphorbiaceae) [LC50 0.47µg/ml] they supported literature reports that it is toxic to rabbits and fish. Despite the therapeutic claims, literature reports, and brine shrimp assay results, more rigorous studies are needed to confirm the therapeutic utility of the plants