Light microscopic detection of Plasmodium falciparum in vitro through Pf histidine rich protein 2 (HRP 2) gold conjugate labeling: Rapid diagnosis of cerebral malaria in humans

Plasmodium falciparum (Pf) has been found to be the deadliest of all the known species of the parasite capable of infecting humans; this is because it is capable of causing severe cerebral tissue damage. This study was carried out to demonstrate the parasite in the host blood in vitro through immunogold labeling using antibodies against Plasmodium falciparum histidine rich protein 2 (HRP 2); a major metabolite released during the cause of the parasite infection and feeding in the erythrocyte. 12 known Pf positive samples were obtained from across the six geopolitical zones of Nigeria and were further characterized by Geimsa thick and thin film for parasite identification parasite count expressed as parasites/l of blood. An average of 400 parasites/l of blood was obtained in each of the samples used for this study. Pf-HRP 2 antibody was conjugated to freshly prepared colloidal gold of particle size 40nm. The conjugation process was blocked with bovine serum albumin (BSA) and the conjugate itself preserved by 1% glycerol and 0.01% sodium azide. The parasite count was titrated against the Pf-HRP 2gold conjugate and was analyzed under the light microscope with a fluorescent filter. Reactivity and specificity of Pf-HRP 2 gold conjugate was found to be highly specific and gave direct identification of the erythrocytes infected with the parasite. A good contrast was also obtained between uninfected erythrocytes, parasite and the infected erythrocytes

P53, Bax and Cathepsin D Dysregulation in Neurons Subjected to Cyanide Toxicity and Oxygen Deprivation

Cyanide is a potent neurotoxin capable of potentiation NMDA R1 (N-methyl-D-aspartate receptor 1) a form of glutamate receptor that is calcium gated, thus causing excitotoxicity. It is also well established that the glutamate-glucose exchange is dependent on the activity of the Na + /K + ATPase pump, thus we examine the role of the Na + /K + pump in the metabolism of the neuron during cyanide toxicity. Six separate perfusion set up of the rat brain cortical tissues were made with ACSF (ACSF, ACSF+KCN, ACSF+KCN + pump blocker, ACSF + pump blocker). The tissues were perfused for duration of 180 minutes. The tissues were processed immunohistochemically using antibodies against p53,Bax and Cathepsin D (CD) to demonstrate disregulation of cell cycle proteins associated with the induced DNAbreakage as a result of cyanide toxicity. The pumpblockers (methyldigoxin and promethazine) induced excitotoxicity when used in culture, and amplified cyanide toxicity when combined with KCN. Cell death induced by toxicity of cyanide and the blockade of the Na/K ATPasepump has been seen to be complimentary in driving the toxicity effects that drives the cell into apoptosis.The tumor suppressor/apoptosis inducing factors p53 and Bax were over expressed while cathepsin was suppressed to show that the cells are apoptotic as against an increased cathepsin D level that would have implied senescence

Basic Principles of Fluorescence Microscopy

Fluorescence microscopy is a basic requirement in cell biology , molecular biology and biotechnology . Advancements over the years has helped scientist to trace molecules in live cells and understand the basis of cell metabolism, exchange, mutation and to xicity. In this short communication we seek to explain in simple terms the basic principles of how a fluorescence microscope works. The principles o f excitation and emission focuses on the ability of f luorophores to absorb energy from photons and to emit such absorbed energy. The difference between t he chemical structures of these fluorephores determines how much energy that is required to exci te them and how long a fluorescence signal from a fluorophore will last. The principles of epi-illumi nation on the other hand describe the arrangement a nd function of the various components of a fluorescenc e microscope

Mass administration of medicines in changing contexts: Acceptability, adaptability and community directed approaches in Kaduna and Ogun States, Nigeria

Nigeria has the highest burden of NTDs in sub-Saharan Africa. Commitments to reach the control and elimination of many Neglected Tropical Diseases (NTDs), particularly those amenable to preventive chemotherapy (onchocerciasis, schistosomiasis, soil transmitted helminths, lymphatic filariasis and trachoma) by 2020 are detailed in the London declaration. Strategies to reach targets build on existing approaches, one of which is the use of community directed intervention (CDI) methods to deliver the mass administration of medicines (MAM). However, treatment using this approach has been inconsistent and there are questions about the acceptability and adaptability of these interventions during periods of programmatic, social, and political change. This paper explores the current strengths and weaknesses of CDI approaches in MAM delivery. We consider the acceptability and adaptability of existing MAM approaches to ensure equity in access to essential treatments. Using qualitative methods, we explore implementer perspectives of MAM delivery. We purposively selected programme implementers to ensure good programmatic knowledge and representation from the different levels of health governance in Nigeria. Data collection took place across two States (Kaduna and Ogun). Our results indicate that CDI approaches have underpinned many historic successes in NTD programme acceptance in Nigeria, specifically in Kaduna and Ogun State. However, our results also show that in some contexts, factors that underpin the success of CDI have become disrupted presenting new challenges for programme implementers. Capturing the tacit knowledge of health implementers at varying levels of the health system, we present the current and changing context of MAM delivery in Kaduna and Ogun States and consolidate a platform of evidence to guide future programme delivery and research studies. We situate our findings within the broader NTD literature, specifically, in identifying how our findings align to existing reviews focused on factors that shape individual acceptance of MAM

A holistic approach to well-being and neglected tropical diseases: evaluating the impact of community-led support groups in Nigeria using community-based participatory research

Background: Neglected tropical diseases (NTDs) affect around 1 billion people, many living in the poorest parts of the world. NTDs often lead to serious long-term physical impairments. Stigma, disability, poverty and social isolation interact, resulting in poor quality of life and significant psychosocial impacts. The holistic health and psychosocial needs of persons affected by NTDs are often overlooked in integrated NTD programme design and research. Furthermore, the viewpoints of persons affected are often absent and spaces for empowerment and advocacy are limited. Methods: Using a community-based participatory research design, our study partnered with persons affected and caregivers as co-researchers to address this gap. Through the process, we co-designed and implemented community-based support groups in Kaduna and Kwara, Nigeria, where NTDs are endemic. This paper utilises photovoice with support group facilitators (persons affected); participant observation of group meetings; rapid micronarratives with support group members; and key informant interviews with programme implementers at the state and local government area levels to explore the impact of the support groups from the perspective of people affected by NTDs and other health system actors. Results: Perceived impacts of the support groups included a sense of ownership and empowerment, stigma reduction, improved self-esteem, improved health knowledge and health outcomes and capacity strengthening through vocational training. Conclusions: Support groups, as community spaces of healing, offer a low-cost holistic intervention for chronic disease and disability

Exploring the well-being of people affected by skin NTDs in Kaduna and Kwara States, Nigeria: a photovoice and scoping review study

People affected by skin neglected tropical diseases (NTDs) grapple with both physical and emotional reactions that compromise their health and well-being. Multiple studies with people affected by skin NTDs have shown high levels of poor mental well-being using self-report questionnaires or psychological measures. However, few have provided in-depth documentation of lived experiences from the perspective of affected persons and there is limited consideration of how their viewpoints can be used to shape intervention design. This article draws together findings from an international scoping review and a photovoice study conducted in Kaduna and Kwara States, Nigeria. Our combined analysis, which situates the lived realities of people affected by skin NTDs within the existing evidence base, was used to inform the design of a subsequent well-being intervention. Using Meyer's (2003) minority stress model, we have illustrated that there is a synergistic relationship between mental health, chronic morbidity and disability from skin NTDs. This relationship results from a complex interplay of factors including pain and discomfort and a reduced ability to function and participate in areas such as livelihoods, food provision and education. Stigma and discrimination act as a catalyst for these functional limitations and participation restrictions, resulting in feelings of being useless, broken, shame and sadness. The critical role of participatory methods in our study emphasises how people affected by skin NTDs have multiple coping mechanisms that can be galvanised in the provision of holistic NTD care. We recommend that NTD programmes should strengthen relationships with affected persons to identify pre-existing support platforms that can be used to support the emotional and physical health and well-being of affected persons. Working with affected persons and community actors to strengthen necessary intersectoral approaches is a first step in designing and delivering such holistic care

Guiding principles for quality, equity and sustainability in implementation research: Multicounty learnings from participatory action research to strengthen health systems

Global health gains can be achieved through strengthening health systems to identify and address implementation challenges in low- and middle-income countries. Participatory research, that promotes joint problem and solution finding between communities and different health systems actors, supports policy implementation analysis at all levels. Within the neglected tropical disease programmes in Liberia and Nigeria, we applied participatory action research (PAR) to address programmatic and health system bottlenecks with health systems strengthening embedded. This paper shares learning from 20 interviews with co-researchers, from national and sub-national levels and academic researchers who worked collaboratively to understand challenges, co-create solutions and advocate for policy change. Through analysis and reflections of existing PAR principles, we inductively identified five additional guiding principles for quality, ethical standards and ongoing learning within PAR projects that aim to strengthen health systems. (1) Recognize communities as units of identity and define stakeholder participation to ensure equitable engagement of all actors; (2) enable flexible action planning that builds on existing structures whilst providing opportunities for embedding change; (3) address health systems and research power differentials that can impede co-production of knowledge and solution development; (4) embed relational practices that lead to new political forms of participation and inquiry within health systems and (5) develop structures for ongoing learning at multiple levels of the health system. PAR can strengthen health systems by connecting and co-creating potentially sustainable solutions to implementation challenges. Additional research to explore how these five additional principles can support the attainment of quality and ethical standards within implementation research using a PAR framework for health systems strengthening is needed

Promoting equity through inclusive learning, planning and implementing: lessons from Nigeria's mass drug administration programme for neglected tropical diseases

Background: An inclusive, localised approach to planning and implementing equitable mass drug administration was developed through participatory action research (PAR). This new approach aligns with principles of learning health systems (LHS). Tools were co-developed to support scaling up the new approach across two Nigerian states. Lessons are distilled here to enable learning for other programmes. Methods: Observations and reports by researchers (2019–2021) from 23 meetings and workshops, 8 in-depth interviews and 8 focus group discussions (FGDs) were used. Results: Nine key steps of best practice were identified to promote inclusive LHS for participatory planning and implementing: utilise participatory research methodologies to facilitate community engagement and tailor interventions; develop tools and governance structures to support learning, teamwork and sustainability; strengthen capacity for participation and collaboration with space for dialogue and shared learning; undertake participatory planning to develop action plans; advocate for implementation; monitor action plans; review and act on successes and challenges; apply community evaluation to understand challenges and enablers and disseminate policy and programme changes. Conclusions: PAR in disease programmes can support health systems to embed cyclical and iterative learning to sustainably address localised equity challenges. However, it takes time, resources and political commitment