Enumeration of CD4 and CD8 T-cells in HIV infection in Zimbabwe using a manual immunocytochemical method

A CAJM article on HIV infection

"Practical Knowledge" and Perceptions of Antibiotics and Antibiotic Resistance Among Drugsellers in Tanzanian Private Drugstores.

Studies indicate that antibiotics are sold against regulation and without prescription in private drugstores in rural Tanzania. The objective of the study was to explore and describe antibiotics sale and dispensing practices and link it to drugseller knowledge and perceptions of antibiotics and antibiotic resistance. Exit customers of private drugstores in eight districts were interviewed about the drugstore encounter and drugs bought. Drugsellers filled in a questionnaire with closed- and open-ended questions about antibiotics and resistance. Data were analyzed using mixed quantitative and qualitative methods. Of 350 interviewed exit customers, 24% had bought antibiotics. Thirty percent had seen a health worker before coming and almost all of these had a prescription. Antibiotics were dispensed mainly for cough, stomachache, genital complaints and diarrhea but not for malaria or headache. Dispensed drugs were assessed as relevant for the symptoms or disease presented in 83% of all cases and 51% for antibiotics specifically. Non-prescribed drugs were assessed as more relevant than the prescribed. The knowledge level of the drugseller was ranked as high or very high by 75% of the respondents. Seventy-five drugsellers from three districts participated. Seventy-nine percent stated that diseases caused by bacteria can be treated with antibiotics but 24% of these also said that antibiotics can be used for treating viral disease. Most (85%) said that STI can be treated with antibiotics while 1% said the same about headache, 4% general weakness and 3% 'all diseases'. Seventy-two percent had heard of antibiotic resistance. When describing what an antibiotic is, the respondents used six different kinds of keywords. Descriptions of what antibiotic resistance is and how it occurs were quite rational from a biomedical point of view with some exceptions. They gave rise to five categories and one theme: Perceiving antibiotic resistance based on practical experience. The drugsellers have considerable "practical knowledge" of antibiotics and a perception of antibiotic resistance based on practical experience. In the process of upgrading private drugstores and formalizing the sale of antibiotics from these outlets in resource-constrained settings, their "practical knowledge" as well as their perceptions must be taken into account in order to attain rational dispensing practices

Zinc status and growth of Korean infants fed human milk, casein-based, or soy-based formula: three-year longitudinal study

To evaluate the effect of feeding methods on growth and zinc nutritional status of infants early in life, we monitored from birth to 36 months in 51 infants who were exclusively fed human milk (HM, n = 20), casein-based formula (CBF, n = 12), or soy-based formula (SBF, n = 19) during the first five months of life. Zinc status was assessed by analyzing serum zinc concentrations and zinc intakes. Zinc contents in HM and formulas were measured. Zinc intake was estimated by weighing infants before and after feeding in the HM group and by collecting formula-intake records in the CBF and SBF groups. After solid foods were introduced, all foods consumed were also included to estimate zinc intake. The growth of infants in all groups was similar to that established for normal Korean infants. Human milk zinc concentrations declined as lactation progressed. Zinc concentrations in all formulas tested in this study were higher than HM and were also higher than those claimed by the manufacturers. During the first twelve months, mean serum zinc concentrations of infants were similar in all groups, although infants in the HM group consistently had the lowest zinc intake among the groups, and the overall zinc intake in infants fed SBF was highest. This finding could be explained by the different zinc bioavailability of HM and formulas. In conclusion, infants fed HM, CBF or SBF has normal growth up to three years of age, although HM contained the lowest zinc concentration followed by CBF, then SBF

Malaria treatment in the retail sector: Knowledge and practices of drug sellers in rural Tanzania

<p>Abstract</p> <p>Background</p> <p>Throughout Africa, the private retail sector has been recognised as an important source of antimalarial treatment, complementing formal health services. However, the quality of advice and treatment at private outlets is a widespread concern, especially with the introduction of artemisinin-based combination therapies (ACTs). As a result, ACTs are often deployed exclusively through public health facilities, potentially leading to poorer access among parts of the population. This research aimed at assessing the performance of the retail sector in rural Tanzania. Such information is urgently required to improve and broaden delivery channels for life-saving drugs.</p> <p>Methods</p> <p>During a comprehensive shop census in the districts of Kilombero and Ulanga, Tanzania, we interviewed 489 shopkeepers about their knowledge of malaria and malaria treatment. A complementary mystery shoppers study was conducted in 118 retail outlets in order to assess the vendors' drug selling practices. Both studies included drug stores as well as general shops.</p> <p>Results</p> <p>Shopkeepers in drug stores were able to name more malaria symptoms and were more knowledgeable about malaria treatment than their peers in general shops. In drug stores, 52% mentioned the correct child-dosage of sulphadoxine-pyrimethamine (SP) compared to only 3% in general shops. In drug stores, mystery shoppers were more likely to receive an appropriate treatment (OR = 9.6), but at an approximately seven times higher price. Overall, adults were more often sold an antimalarial than children (OR = 11.3). On the other hand, general shopkeepers were often ready to refer especially children to a higher level if they felt unable to manage the case.</p> <p>Conclusion</p> <p>The quality of malaria case-management in the retail sector is not satisfactory. Drug stores should be supported and empowered to provide correct malaria-treatment with drugs they are allowed to dispense. At the same time, the role of general shops as first contact points for malaria patients needs to be re-considered. Interventions to improve availability of ACTs in the retail sector are urgently required within the given legal framework.</p

Indigenous use and bio-efficacy of medicinal plants in the Rasuwa District, Central Nepal

<p>Abstract</p> <p>Background</p> <p>By revealing historical and present plant use, ethnobotany contributes to drug discovery and socioeconomic development. Nepal is a natural storehouse of medicinal plants. Although several ethnobotanical studies were conducted in the country, many areas remain unexplored. Furthermore, few studies have compared indigenous plant use with reported phytochemical and pharmacological properties.</p> <p>Methods</p> <p>Ethnopharmacological data was collected in the Rasuwa district of Central Nepal by conducting interviews and focus group discussions with local people. The informant consensus factor (F_IC) was calculated in order to estimate use variability of medicinal plants. Bio-efficacy was assessed by comparing indigenous plant use with phytochemical and pharmacological properties determined from a review of the available literature. Criteria were used to identify high priority medicinal plant species.</p> <p>Results</p> <p>A total of 60 medicinal formulations from 56 plant species were documented. Medicinal plants were used to treat various diseases and disorders, with the highest number of species being used for gastro-intestinal problems, followed by fever and headache. Herbs were the primary source of medicinal plants (57% of the species), followed by trees (23%). The average F_IC value for all ailment categories was 0.82, indicating a high level of informant agreement compared to similar studies conducted elsewhere. High F_ICvalues were obtained for ophthalmological problems, tooth ache, kidney problems, and menstrual disorders, indicating that the species traditionally used to treat these ailments are worth searching for bioactive compounds: <it>Astilbe rivularis</it>, <it>Berberis asiatica</it>, <it>Hippophae salicifolia, Juniperus recurva</it>, and <it>Swertia multicaulis</it>. A 90% correspondence was found between local plant use and reported plant chemical composition and pharmacological properties for the 30 species for which information was available. Sixteen medicinal plants were ranked as priority species, 13 of which having also been prioritized in a country-wide governmental classification.</p> <p>Conclusions</p> <p>The <it>Tamang </it>people possess rich ethnopharmacological knowledge. This study allowed to identify many high value and high priority medicinal plant species, indicating high potential for economic development through sustainable collection and trade.</p

Developing an empowerment framework for broad-based black economic empowerment in the hotel industry in South Africa

Thesis (PhD)--Stellenbosch University, 2013.This study investigated the implementation of broad-based black economic empowerment (BBBEE) policy in the hotel industry of South Africa. BBBEE aims to accelerate the inclusion of black people into the economy through company ownership, human resource, and enterprise and community development. Although black people represent 91 per cent of South Africa’s population, the economy is controlled by a small white population. Studies have shown slow adoption and resistance to the BBBEE policy by the private sector, including in the hotel industry. Therefore, the research problem was the nature of compliance with, and the implementation of, black empowerment policy in the hotel industry. The main objective of the study was to investigate whether a framework for the effective implementation of black empowerment policy could be developed, given the centrality of hotels in the tourism value chain. The specific objectives were to determine the nature of the disconnect on BBBEE, to identify factors which facilitated or inhibited implementation, and to explore solutions for enhancing BBBEE implementation in the hotels. A quantitative investigation of 611 hotel general managers constituted the core of the dissertation’s content and contribution. Data from 178 respondents was analysed using descriptive and correlational statistical methods. The development of the quantitative research instrument was substantiated by the preliminary qualitative study of five hotel group executives. The mixed methods approach was appropriate for investigating the dual structure (group and unit) of the hotel industry. The results indicated that hotels were recording progress on human resource development although compliance levels did not meet the required BBBEE targets. On enterprise development, the hotels’ engagement with small black enterprises was low both quantitatively and qualitatively. Furthermore, hotel group leaders indicated that the tourism-specific BBBEE charter presented bureaucratic challenges, as tourism straddles several industries which required different BBBEE certification. The study has developed an empowerment framework of solutions for achieving success in BBBEE in hotels. The primary factors determining success are the provision of performance targets and incentives for general managers, and if the hotel manager supports BBBEE policy. Furthermore, exogenous factors such as the star rating and location of a hotel also impact on BBBEE implementation. A quantitative investigation of 611 hotel general managers constituted the core of the dissertation’s content and contribution. Data from 178 respondents was analysed using descriptive and correlational statistical methods. The development of the quantitative research instrument was substantiated by the preliminary qualitative study of five hotel group executives. The mixed methods approach was appropriate for investigating the dual structure (group and unit) of the hotel industry. The results indicated that hotels were recording progress on human resource development although compliance levels did not meet the required BBBEE targets. On enterprise development, the hotels’ engagement with small black enterprises was low both quantitatively and qualitatively. Furthermore, hotel group leaders indicated that the tourism-specific BBBEE charter presented bureaucratic challenges, as tourism straddles several industries which required different BBBEE certification. The study has developed an empowerment framework of solutions for achieving success in BBBEE in hotels. The primary factors determining success are the provision of performance targets and incentives for general managers, and if the hotel manager supports BBBEE policy. Furthermore, exogenous factors such as the star rating and location of a hotel also impact on BBBEE implementation. This study builds on, and adds value to previous studies by moving beyond the investigative mode to identifying practical policy options for successful transformation of the hotel industry. The proposed framework acknowledges the diverse nature of the tourism product, and provides potential solutions to enhance the hotel managers’ ability to anticipate and incorporate factors impacting on BBBEE implementation. The framework adds theoretical value to affirmative action discourse by suggesting a conceptual shift from a race-based approach to an alternative one which would incorporate sustainable tourism and ethical governance concerns. Such an approach would maximise BBBEE potential in the hotel industry of South Africa for beneficiaries and communities. Additional research is recommended to substantiate the hypothesis with a broader sample as the study was limited to hotel managers

Book Review: Doctors and the State: the struggle for professional control in Zimbabwe

No Abstract. Central African Journal of Medicine Vol. 45 (12) 1999: pp. 33