Bypassing shortages of personal protective equipment in low-income settings using local production and open source tools

Free and open-source hardware, 3D printing, and the use of locally sourced materials can be valuable tools for local problem solving, as proven by the production of more than 400 reusable face shields and masks in a Nigerian community to bypass PPE shortages during the COVID-19 pandemic

Exposure to anti-malarial drugs and monitoring of adverse drug reactions using toll-free mobile phone calls in private retail sector in Sagamu, Nigeria: implications for pharmacovigilance

<p>Abstract</p> <p>Background</p> <p>Adverse drug reactions (ADRs) contribute to ill-health or life-threatening outcomes of therapy during management of infectious diseases. The exposure to anti-malarial and use of mobile phone technology to report ADRs following drug exposures were investigated in Sagamu - a peri-urban community in Southwest Nigeria.</p> <p>Methods</p> <p>Purchase of medicines was actively monitored for 28 days in three Community Pharmacies (CP) and four Patent and Proprietary Medicine Stores (PPMS) in the community. Information on experience of ADRs was obtained by telephone from 100 volunteers who purchased anti-malarials during the 28-day period.</p> <p>Results and Discussion</p> <p>A total of 12,093 purchases were recorded during the period. Antibiotics, analgesics, vitamins and anti-malarials were the most frequently purchased medicines. A total of 1,500 complete courses of anti-malarials were purchased (12.4% of total purchases); of this number, purchases of sulphadoxine-pyrimethamine (SP) and chloroquine (CQ) were highest (39.3 and 25.2% respectiuvely). Other anti-malarials purchased were artesunate monotherapy (AS) - 16.1%, artemether-lumefantrine (AL) 10.0%, amodiaquine (AQ) - 6.6%, quinine (QNN) - 1.9%, halofantrine (HF) - 0.2% and proguanil (PR) - 0.2%. CQ was the cheapest (USD 0.3) and halofantrine the most expensive (USD 7.7). AL was 15.6 times ($4.68) more expensive than CQ. The response to mobile phone monitoring of ADRs was 57% in the first 24 hours (day 1) after purchase and decreased to 33% by day 4. Participants in this monitoring exercise were mostly with low level of education (54%).</p> <p>Conclusion</p> <p>The findings from this study indicate that ineffective anti-malaria medicines including monotherapies remain widely available and are frequently purchased in the study area. Cost may be a factor in the continued use of ineffective monotherapies. Availability of a toll-free telephone line may facilitate pharmacovigilance and follow up of response to medicines in a resource-poor setting.</p

Inter-relationship of plasma markers of oxidative stress and thyroid hormones in schizophrenics

<p>Abstract</p> <p>Background</p> <p>The relationship of oxidative stress to thyroid hormones has not been studied in the schizophrenics. The present study determined the status and interrelationship of plasma markers of oxidative stress, nitric oxide and thyroid hormones in thirty (17 males and 13 females) newly diagnosed patients with acute schizophrenia before initiation of chemotherapy. Twenty five (13 males and 12 females) mentally healthy individuals served as controls. Patients and controls with history of hard drugs (including alcohol and cigarette), pre-diagnosis medications (e.g. antiparkinsonian/antipsychotic drugs), chronic infections, liver disease and diabetes mellitus were excluded from the study. Plasma levels of total antioxidant potential (TAP), total plasma peroxides (TPP), nitric oxide (NO), malondialdehyde (MDA), thyroxine (T4), tri-iodothyronine (T3) and thyroid stimulating hormone (TSH) were determined in all participants using spectrophotometric and enzyme linked immunosorbent assay (ELISA) methods respectively. Oxidative stress index (OSI) was calculated as the percent ratio of total plasma peroxides and total antioxidant potential.</p> <p>Findings</p> <p>Significantly higher plasma levels of MDA (p < 0.01), TPP (p < 0.01), OSI (p < 0.01), T3 (p < 0.01) and T4 (p < 0.05) were observed in schizophrenics when compared with the controls. The mean levels of TAP, NO and TSH were significantly lower in schizophrenics (p < 0.01) when compared with the controls. The result shows that T3 values correlate significantly with MDA (p < 0.05) and TPP (p < 0.01) in schizophrenics.</p> <p>Conclusions</p> <p>Higher level of TPP may enhance thyroid hormogenesis in schizophrenics. Adjuvant antioxidant therapy may be a novel approach in the treatment of schizophrenic patients.</p

Effects of Nutritional Status and Supplementation on Resumption of Menstruation Amongst Parturient Nigerian Women

Context: Breastfeeding patterns, ethnic variation and nutrition have been shown to influence the return of menstruation after childbirth, but the role played by nutritional status requires further elucidation, particularly in a place like Nigeria where undernutrition is common. Objectives: To determine the effects of nutrition and breastfeeding pattern on the duration of lactational amenorrhoea in Nigerian women. Subjects and Methods: Marginally malnourished mothers (162) were randomised into two groups [A & B] for comparison with a third group [C] of well-nourished mothers. Mothers in Group A (83 subjects) received supplements in the form of specially formulated biscuits while those in Group B (79 women) & Group C (85 women) received none. The subjects were visited 3 times a week to ensure compliance with the supplements and to collect information on breastfeeding pattern and duration of lactational amenorrhoea. Results: There were no significant differences in the duration of postpartum amenorrhoea in the three groups of mothers, being 270, 220 and 234 days for Groups A, B and C respectively. Wide individual variations were observed in the duration of amenorrhoea in each group of mothers despite the fact that they generally had similar patterns of breastfeeding. The energy expenditure patterns in the supplemented and unsupplemented mothers were similar. Conclusion: Nutritional status and supplementation do not seem to influence the duration of lactational amenorrhoea in this group of Nigerian women. Subtle physiological differences between individual women may account for the wide individual variations observed in the time of resumption of menstruation after childbirth in the subjects. Key Words: Breastfeeding, Lactational Amenorrhoea, Nutritional Status, Menstruation. [Trop J Obstet Gynaecol, 2002, 19: 39-43]