HIV and STI Prevalence among Female Sex Workers in Côte d'Ivoire: Why Targeted Prevention Programs Should Be Continued and Strengthened

Objective: To assess condom use and prevalence of STIs and HIV among female sex workers (FSWs), as part of a comprehensive monitoring and evaluation plan of a nationwide sex worker prevention project in Côte d’Ivoire. Design and Methods: Cross sectional surveys were conducted among FSWs attending five project clinics in Abidjan and San Pedro (2007), and in Yamoussoukro and Gagnoa (2009). A standardized questionnaire was administered in a face-toface interview, which included questions on socio-demographic characteristics, sexual behaviour and condom use. After the interview, the participants were asked to provide samples for STI and HIV testing. Results: A total of 1110 FSWs participated in the surveys. There were large differences in socio-demographic and behavioural characteristics between FSW coming for the first time as compared to FSW coming on a routine visit. The prevalence of N. gonorrhoeae or C.trachomatis was 9.1%, 11.8 % among first vs. 6.9 % routine attendees (p = 0.004). The overall HIV prevalence was 26.6%, it was lower among first time attendees (17.5 % as compared to 33.9 % for routine attendees, p,0.001). The HIV prevalence among first attendees was also lower than the proportion of HIV positive tests from routine testing and counselling services in the same clinics. Conclusions: The results show a relatively high STI and HIV prevalence among FSWs in different cities in Côte d’Ivoire. In th

Self-assembled biotransesterified cyclodextrins as potential Artemisinin nanocarriers. II: In vitro behavior toward the immune system and in vivo biodistribution assessment of unloaded nanoparticles.

In a previous study, we reported on the formulation of Artemisinin-loaded surface-decorated nanoparticles (nanospheres and nanoreservoirs) by co-nanoprecipitation of PEG derivatives (PEG1500 and PEG4000-stearate, polysorbate 80) and biosynthesized γ-CD fatty esters. In the present study, the co-nanoprecipitation was extended to the use of a PEGylated phospholipid, namely DMPE-PEG2000. As our goal was to prepare long-circulating nanocarriers for further systemic delivery of Artemisinin (ART), here, we have investigated, on the one hand, the in vitro behavior of these surface-modified γ-CD-C10 particles toward the immune system (complement activation and macrophage uptake assays) and, on the other hand, their biodistribution features in mice. These experiments showed that the in vitro plasma protein adsorption and phagocytosis by macrophage cells triggered by γ-CD-C10 nanoparticles were significantly reduced when their surface was decorated with amphiphilic PEGylated molecules, in particular PEG1500-stearate, DMPE-mPEG2000 or polysorbate 80. The prolonged blood circulation time assessed by fluorescence imaging was demonstrated for unloaded γ-CD-C10-based nanospheres and nanoreservoir particles containing DMPE-PEG2000 and polysorbate80, respectively. These nanoparticles also proved to be non-hemolytic at the concentration range used in vivo. Within the limits of the conducted experiments, the co-nanoprecipitation technique may be considered as an alternative for surface modification of amphiphilic CD-based drug delivery systems and may be applied to the systemic delivery of ART

A Trial of Early Antiretrovirals and Isoniazid Preventive Therapy in Africa

BACKGROUND: In sub-Saharan Africa, the burden of human immunodeficiency virus (HIV)-associated tuberculosis is high. We conducted a trial with a 2-by-2 factorial design to assess the benefits of early antiretroviral therapy (ART), 6-month isoniazid preventive therapy (IPT), or both among HIV-infected adults with high CD4+ cell counts in Ivory Coast. METHODS: We included participants who had HIV type 1 infection and a CD4+ count of less than 800 cells per cubic millimeter and who met no criteria for starting ART according to World Health Organization (WHO) guidelines. Participants were randomly assigned to one of four treatment groups: deferred ART (ART initiation according to WHO criteria), deferred ART plus IPT, early ART (immediate ART initiation), or early ART plus IPT. The primary end point was a composite of diseases included in the case definition of the acquired immunodeficiency syndrome (AIDS), non-AIDS-defining cancer, non-AIDS-defining invasive bacterial disease, or death from any cause at 30 months. We used Cox proportional models to compare outcomes between the deferred-ART and early-ART strategies and between the IPT and no-IPT strategies. RESULTS: A total of 2056 patients (41% with a baseline CD4+ count of ≥500 cells per cubic millimeter) were followed for 4757 patient-years. A total of 204 primary end-point events were observed (3.8 events per 100 person-years; 95% confidence interval [CI], 3.3 to 4.4), including 68 in patients with a baseline CD4+ count of at least 500 cells per cubic millimeter (3.2 events per 100 person-years; 95% CI, 2.4 to 4.0). Tuberculosis and invasive bacterial diseases accounted for 42% and 27% of primary end-point events, respectively. The risk of death or severe HIV-related illness was lower with early ART than with deferred ART (adjusted hazard ratio, 0.56; 95% CI, 0.41 to 0.76; adjusted hazard ratio among patients with a baseline CD4+ count of ≥500 cells per cubic millimeter, 0.56; 95% CI, 0.33 to 0.94) and lower with IPT than with no IPT (adjusted hazard ratio, 0.65; 95% CI, 0.48 to 0.88; adjusted hazard ratio among patients with a baseline CD4+ count of ≥500 cells per cubic millimeter, 0.61; 95% CI, 0.36 to 1.01). The 30-month probability of grade 3 or 4 adverse events did not differ significantly among the strategies. CONCLUSIONS: In this African country, immediate ART and 6 months of IPT independently led to lower rates of severe illness than did deferred ART and no IPT, both overall and among patients with CD4+ counts of at least 500 cells per cubic millimeter. (Funded by the French National Agency for Research on AIDS and Viral Hepatitis; TEMPRANO ANRS 12136 ClinicalTrials.gov number, NCT00495651.)

Étude des conditions de préparation des médicaments issus de la pharmacopée traditionnelle au Bénin et au Burkina Faso

Introduction: Traditional medicine has become an important component in the care system of African populations. Many products derived from it are increasingly used in the therapeutic arsenal. This work is an inventory of the production of these drugs in two countries of West Africa, Burkina Faso and Benin. Methods: A cross-sectional descriptive study that listed the drug manufacturing units producing medicines derived from the traditional pharmacopoeia (MDTP) identified by the health ministries in the two countries was carried out. Results: Thirty-three production facilities, including 10 in Burkina Faso and 23 in Benin, were surveyed. Seven units surveyed in Burkina Faso and 16 in Benin were illegally installed. Only 16 of the 33 units obtain their raw materials from botanical gardens. The rest obtain theirs through picking which is not favorable to the perpetuation of the plant resource. In addition, among the 1041 MDTPs manufactured by the units surveyed, only 1.44% are registered. Finally, shortcomings in applying good practices for harvesting raw materials and manufacturing finished products were noticed. Conclusion: Management and capacity building efforts of MDTPs production facilities by political authorities are still needed to optimize the contribution of traditional medicine to the health care of African populations

In vitro Biocompatibility and Genotoxicity Assessment of a Gentamicin-Loaded Monoolein Gel Intended to Treat of Chronic Osteomyelitis

The aim of the study was to assess in vitro the biocompatibility and the genotoxicity of a gentamicin-loaded monoolein gel intended to treat of chronic osteomyelitis. Indeed, we are developing biodegradable implants based on monoolein and gentamicin. The results of formulations, physico-chemical characterization of the formulated implants and in vitro release kinetic of gentamicin from implants were encouraging. As biocompatibility and absence of genotoxicity are the prerequisites for safe use of implants, we performed in vitro hemolysis, cytotoxicity and, genotoxicity tests. Hemolysis was evaluated by incubating human erythrocytes in direct contact with the implant whereas cytotoxicity was evaluated by 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide (MTT) assay using fibroblasts and macrophages. Alkaline comet Assay was used to evaluate genotoxic potential of the implants. From these in vitro assays, the implant based on monoolein and gentamicin showed no genotoxic potential and has satisfactory biocompatibility

In vivo Biocompatibility and Toxicity Assessment of a Gentamicin-Loaded Monoolein Gel Intended to Treat Chronic Osteomyelitis

Biocompatibility and preliminary toxicity of a novel gentamicin-loaded monoolein gel (implant) intended for the local treatment of chronic osteomyelitis were investigated in mice. The mice, randomly allotted in 3 groups of 10, received respectively a single dose (0.05 mL) of normal saline, monoolein and the gel by subplantar injection. Clinical monitoring and assessment of induced oedema were carried out during 52 days after implantation. A histologic examination of the implantation site was performed at the end of the experiment. Renal and hepatic functions of the implant were also assessed on 52 days post-implantation by using biochemical and histological methods. In mice, no adverse reaction occurred after implantation. Only, a transitional foreign body reaction was observed in mice implanted by the monoolein and the implant. The paw volume of the mice increased within 3 h post-implantation and returned to baseline by 52 days. The liver and kidneys histology at light microscopy and biochemical parameters were similar for all mice. Further investigation is undertaken to detect eventual early damages which could have been resolved with time. Nevertheless, the novel gel is biocompatible and doesn`t show sub-chronic toxicity

PHYSICOCHEMICAL QUALITY AND LYODISPONIBILITY OF FIXED-DOSE ARTEMETHER-LUMEFANTRINE COMBINATIONS DISPENSED IN BURKINA FASO

peer reviewedThe purpose of this study was to evaluate the pharmaceutical quality and lyodisponibility of fixed-dose combinations of artemether-lumefantrinere found on the market in Burkina Faso. For this purpose, 122 samples were collected from dispensing sites in public and private health facilities and routine physico-chemical parameters were evaluated. Routine physicochemical parameters were evaluated. The in vitro comparative dissolution test was used to assess the lyodisponsibility of the samples in comparison to the originator drugs

Contrôle qualité et étude de comprimabilité des poudres de feuille de Moringa oleifera (lam) et de pulpe du fruit de Adansonia digitata

Moringa oleifera (LAM), arbre tropical à usages multiples, constitue de nos jours une nouvelle ressource alimentaire et économique pour les pays du Sud. Ces feuilles sont faciles d’accès et très riches en protéines, en vitamines et en minéraux. Elles sont de plus en plus utilisées dans des projets luttant contre la malnutrition. Cependant, le goût, la présentation et la qualité de ces produits demeurent une préoccupation majeure nécessitant des adaptations innovantes. L’objectif de cette étude était d’étudier la comprimabilité des poudres de feuilles de Moringa oleifera en améliorant le goût avec des matières premières locales et facilement accessibles comme la poudre de pulpe de Andansonia digitata. Les propriétés physico-chimiques et les tests pharmacotechniques ont permis de contrôler la qualité des poudres, des comprimés et orienter le choix du procédé de fabrication. Cinq (5) types de formulations (F1 à F5) ont été réalisés et les comprimés ont été fabriqués par compression après granulation par la voie sèche. Les comprimés des formulations F4 et F5 ont donné de meilleures propriétés pharmacotechniques selon les recommandations de la pharmacopée Européenne 6.0. L’association des deux poudres offre une alternative pour la fabrication de comprimés à croquer avec un goût acceptable.Mots-clés : Moringa oleifera, Adansonia digitata, poudre, comprimé, contrôle qualité

Pectin Matrix as Oral Drug Delivery Vehicle for Colon Cancer Treatment

Colon cancer is the fourth most common cancer globally with 639,000 deaths reported annually. Typical chemotherapy is provided by injection route to reduce tumor growth and metastasis. Recent research investigates the oral delivery profiles of chemotherapeutic agents. In comparison to injection, oral administration of drugs in the form of a colon-specific delivery system is expected to increase drug bioavailability at target site, reduce drug dose and systemic adverse effects. Pectin is suitable for use as colon-specific drug delivery vehicle as it is selectively digested by colonic microflora to release drug with minimal degradation in upper gastrointestinal tract. The present review examines the physicochemical attributes of formulation needed to retard drug release of pectin matrix prior to its arrival at colon, and evaluate the therapeutic value of pectin matrix in association with colon cancer. The review suggests that multi-particulate calcium pectinate matrix is an ideal carrier to orally deliver drugs for site-specific treatment of colon cancer as (1) crosslinking of pectin by calcium ions in a matrix negates drug release in upper gastrointestinal tract, (2) multi-particulate carrier has a slower transit and a higher contact time for drug action in colon than single-unit dosage form, and (3) both pectin and calcium have an indication to reduce the severity of colon cancer from the implication of diet and molecular biology studies. Pectin matrix demonstrates dual advantages as drug carrier and therapeutic for use in treatment of colon cancer