Anti-diabetic drugs in the private and public sector in Dar es Salaam, Tanzania

Objectives: To compare availability, cost, affordability and sources of anti-diabetic drugs 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 staff working in the diabetic clinics. Semi-structured questionnaires and a checklist were used to collect the information. Results: Oral hypoglycaemic agents were available in all seven private and three public facilities that were studied. Private facilities stocked more types of oral hypoglycaemic agents than public facilities, which stocked only chlorpropamide and tolbutamide, based on the National Essential Drugs List. The cost of chlorpropamide was five times higher in private facilities compared to public facilities. Insulin was also available in all the facilities. The price of animal insulin in private health facilities was ten times that in public health facilities. Human insulin, which is generally more expensive than animal insulin, was only available in private facilities. Although prices were much lower in public facilities, affordability emerged as a common issue in both private and public facilities. Conclusions: Urban private health facilities offer a wider choice for the needs of diabetic patients but this advantage is compromised by higher prices as compared to public facilities as well as inconsistent supply across facilities. Public health facilities offer only a limited selection of essential oral hypoglycaemics and insulin but at a lower price and across all facilities. Twenty six per cent and 10% of patients in public and private facilities respectively are unable to afford anti-diabetic drugs. The need for intervention to increase affordability of anti-diabetic drugs is evident. Financing and cost of drugs needs to be addressed, either by means of health insurance or other mechanisms, in this era of increasing prevalence of diabetes mellitus among developing countries

Evaluation of the potential of the marine sponges of the Zanzibar Island to yield antimalarial and antimicrobial active compounds

Emergence of new and re-emergence of old infections continue to elude prospects of reducing morbidity and mortality caused by microbial infections. Trends of resistance to currently in use antimicrobials and antimalarials threaten to increase mortality caused by these infections. This study explores the potential of marine invertebrates as a source for new antimicrobials and antimalarials. The lactate dehydrogenase method was used to assay marine sponges for activity against Plasmodium falciparum, while the disc diffusion method was used to assay the extracts for antibacterial and antifungal activity. Extracts of some marine sponges from the Zanzibar Island exhibited both antiplasmodial and antimicrobial activities. Among the 55 marine sponge extracts that were tested 23 (41.8%) inhibited Plasmodium falciparum W2 strain by more than 50% at both 250 and 50 μg/ml concentrations. Moderate polar extracts were more active against Plasmodium falciparum W2 strain than polar and non-polar extracts. None of the 12 extracts that were tested on Plasmodium falciparum strain D6 exhibited inhibitory activity reaching 50%. Among 18 marine sponge extracts that were tested for antimicrobial activity 12 (66.7%) showed activity against one or more of the bacteria and fungi used ranging from weak to strong on an arbitrary criterion. The ethyl acetate extracts of Agelas mauritania and Oceanopia sp. exhibited high activity against the fungi Candida albicans and Cryptococcus neoformans . The best antibacterial profile was exhibited by ethyl acetate extracts of Aplysinopsis sp., Halichondrida sp. 1 and Oceanopia sp. In conclusion, these results support the need for intensified efforts to search for active antimalarial and antimicrobial compounds from the Zanzibar marine sponges

Brine shrimp toxicity of some plants used as traditional medicines in Kagera Region, north western Tanzania

Dichloromethane and/or ethanol extracts of 30 plants used as traditional medicines in Bukoba district, northwestern Tanzania were evaluated for brine shrimp toxicity. Among the 50 extracts tested, 32 extracts (64%) showed very low toxicity with LC50 values above 100 μg/ml. Among these 12 (24%) which had LC50 >500 μg /ml can be categorized as being practically non-toxic. Among the remaining extracts 19 (38%) which showed LC50 >100 < 500 μg /ml are also considered to be non-toxic. Extracts that showed LC50 results between 30-100 μg/ml have been categorized as mildly toxic; these include ethanol extracts of Lantana trifolia (LC50 32.3 μg/ml), Vernonia bradycalyx (LC50 33.9 μg/ml), Antiaris toxicaria (LC50 38.2 μg /ml) and Rubus rigidus (LC50 41.7 μg /ml) and the dichloromethane extracts of Gynura scandens (LC50 36.5 μg /ml) and Bridelia micrantha (LC50 32.0 μg /ml). The dichloromethane extracts of Picralima nitida (LC50 18.3 μg/ml) and Rubus rigidus (LC50 19.8 μg /ml), were only moderately toxic. Picralima nitida and Rubus rigidus extracts are only 1.1 and 1.2 less toxic than the standard drug, cyclophosphamide (LC50 16.3 μg /ml). In conclusion, the results indicate that among the 30 plants used as traditional medicines, 28 are safe for short term use. Picralima nitida and Rubus rigidus extracts are mildly toxic, but by comparison have a remote possibility to yield active anticancer compounds

Antimicrobial and brine shrimp activity of Acanthus pubescens root extracts

The root dichloromethane and ethyl acetate extracts of Acanthus pubescens (Oliv.) Engl (ACANTHACEAE) exhibited weak antibacterial activity against Staphylococcus aureus, Bacillus subtilis, Bacillus anthracis, Salmonella typhi, Streptococcus faecalis, Streptococcus agalactiae and Pseudomonas aeruginosa, with MIC values ranging from 1.6-6.25 mg/ml. The two extracts also exhibited weak antifungal activity against Candida albicans (MIC 6.25 mg/ml). Using the brine shrimps lethality test ethanol, ethyl acetate and aqueous extracts were virtually non-toxic to brine shrimp larvae, but the dichloromethane extract (LC50 38.9 μg/ml) was mildly toxic. These results support the use of the plant in traditional medicine to treat gonorrhea, syphilis, gastroenteritis and pneumonia. Since the plant is used in combination with other plants it is difficult to make any final conclusions regarding safety and efficacy. Further work is needed to evaluate the activity of an extract made from a combination of the six plants