Antitumor Mechanism of the Essential Oils from Two Succulent Plants in Multidrug Resistance Leukemia Cell

Drug resistance remains a major challenge in the treatment of cancer. The multiplicity of the drug resistance determinants raises the question about the optimal strategies to deal with them. Essential oils showed to inhibit the growth of different tumor cell types. Essential oils contain several chemical classes of compounds whose heterogeneity of active moieties can help prevent the development of drug resistance. In the present paper, we analyzed, by gas chromatography-mass spectrometry the chemical composition of the essential oil of the leaves of Kalanchoe beharensis obtained by hydrodistillation and compared the chemical composition of its essential oil with that of Cyphostemma juttae. Our results demonstrated the anticancer and proapoptotic activities of both species against acute myeloid leukemia on an in vitro model and its multidrug resistant variant involving NF-κB pathway. The essential oils of both species produced a significant decrease in many targets of NF-κB both at mRNA and protein levels. The results corroborate the idea that essential oils may be a good alternative to traditional drugs in the treatment of cancer, especially in drug resistant cancer

Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries

BACKGROUND: Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from ACTwatch outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia. METHODS: Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly. RESULTS: 28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets) as compared to first-line quality-assured ACT (< 25%). In the public/not-for-profit sector, first-line quality-assured ACT was available for free in all countries except Benin and the DRC (US$1.29 [Inter Quartile Range (IQR):$1.29-$1.29] and$0.52[IQR: $0.00-$1.29] per adult equivalent dose respectively). In the private sector, first-line quality-assured ACT was 5-24 times more expensive than non-artemisinin therapies. The exception was Madagascar where, due to national social marketing of subsidized ACT, the price of first-line quality-assured ACT ($0.14 [IQR:$0.10, $0.57]) was significantly lower than the most popular treatment (chloroquine,$0.36 [IQR: $0.36,$0.36]). Quality-assured ACT accounted for less than 25% of total anti-malarial volumes; private-sector quality-assured ACT volumes represented less than 6% of the total market share. Most anti-malarials were distributed through the private sector, but often comprised non-artemisinin therapies, and in the DRC and Nigeria, oral artemisinin monotherapies. Provider knowledge of the first-line treatment was significantly lower in the private sector than in the public/not-for-profit sector. CONCLUSIONS: These standardized, nationally representative results demonstrate the typically low availability, low market share and high prices of ACT, in the private sector where most anti-malarials are accessed, with some exceptions. The results confirm that there is substantial room to improve availability and affordability of ACT treatment in the surveyed countries. The data will also be useful for monitoring the impact of interventions such as the Affordable Medicines Facility for malaria

Monitoring fever treatment behaviour and equitable access to effective medicines in the context of initiatives to improve ACT access: baseline results and implications for programming in six African countries

BACKGROUND: Access to artemisinin-based combination therapy (ACT) remains limited in high malaria-burden countries, and there are concerns that the poorest people are particularly disadvantaged. This paper presents new evidence on household treatment-seeking behaviour in six African countries. These data provide a baseline for monitoring interventions to increase ACT coverage, such as the Affordable Medicines Facility for malaria (AMFm). METHODS: Nationally representative household surveys were conducted in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia between 2008 and 2010. Caregivers responded to questions about management of recent fevers in children under five. Treatment indicators were tabulated across countries, and differences in case management provided by the public versus private sector were examined using chi-square tests. Logistic regression was used to test for association between socioeconomic status and 1) malaria blood testing, and 2) ACT treatment. RESULTS: Fever treatment with an ACT is low in Benin (10%), the DRC (5%), Madagascar (3%) and Nigeria (5%), but higher in Uganda (21%) and Zambia (21%). The wealthiest children are significantly more likely to receive ACT compared to the poorest children in Benin (OR = 2.68, 95% CI = 1.12-6.42); the DRC (OR = 2.18, 95% CI = 1.12-4.24); Madagascar (OR = 5.37, 95% CI = 1.58-18.24); and Nigeria (OR = 6.59, 95% CI = 2.73-15.89). Most caregivers seek treatment outside of the home, and private sector outlets are commonly the sole external source of treatment (except in Zambia). However, children treated in the public sector are significantly more likely to receive ACT treatment than those treated in the private sector (except in Madagascar). Nonetheless, levels of testing and ACT treatment in the public sector are low. Few caregivers name the national first-line drug as most effective for treating malaria in Madagascar (2%), the DRC (2%), Nigeria (4%) and Benin (10%). Awareness is higher in Zambia (49%) and Uganda (33%). CONCLUSIONS: Levels of effective fever treatment are low and inequitable in many contexts. The private sector is frequently accessed however case management practices are relatively poor in comparison with the public sector. Supporting interventions to inform caregiver demand for ACT and to improve provider behaviour in both the public and private sectors are needed to achieve maximum gains in the context of improved access to effective treatment

Morphological and molecular differentiation in a recent monophyletic group of aphyllous Vanilla species from the South West Indian ocean region: Implications for species delimitation in Madagascar

International audienc

Genetic structuring of aphyllous Vanilla species from the southwest Indian Ocean region

International audienc

Antitumor Mechanism of the Essential Oils from Two Succulent Plants in Multidrug Resistance Leukemia Cell

Drug resistance remains a major challenge in the treatment of cancer. The multiplicityof the drug resistance determinants raises the question about the optimal strategies to deal withthem. Essential oils showed to inhibit the growth of different tumor cell types. Essential oils containseveral chemical classes of compounds whose heterogeneity of active moieties can help prevent thedevelopment of drug resistance. In the present paper, we analyzed, by gas chromatography-massspectrometry the chemical composition of the essential oil of the leaves of Kalanchoe beharensisobtained by hydrodistillation and compared the chemical composition of its essential oil with thatof Cyphostemma juttae. Our results demonstrated the anticancer and proapoptotic activities of bothspecies against acute myeloid leukemia on an in vitro model and its multidrug resistant variantinvolving NF-κB pathway. The essential oils of both species produced a significant decrease in manytargets of NF-κB both at mRNA and protein levels. The results corroborate the idea that essentialoils may be a good alternative to traditional drugs in the treatment of cancer, especially in drugresistant cancer

Limited role of climate change in extreme low rainfall associated with southern Madagascar food insecurity, 2019-21

Southern Madagascar recently experienced a severe food security crisis, made significantly worse by well below average rainfall from July 2019 to June 2021. This exceptional drought has affected a region with high pre-existing levels of vulnerability to food insecurity (subsistence agriculture and pastoralism in the region is rain-fed only), while impacts have been compounded further by COVID-19 restrictions and pest infestations. The rainy seasons of both 2019/20 and 2020/21 saw just 60% of normal rainfall across the Grand South region and was estimated as a 1-in-135 year dry event, only surpassed in severity by the devastating drought of 1990–92. Based on a combination of observations and climate modelling, the likelihood of experiencing such poor rains in the region was not significantly increased due to human-caused climate change: while the observations and models combine to indicate a small shift toward more droughts like the 2019–2021 event as a consequence of climate change, these trends remain overwhelmed by natural variability. This result is consistent with previous research, with the Intergovernmental Panel on Climate Change (IPCC)'s Sixth Assessment Report concluding that any perceptible changes in drought will only emerge in this region if global mean temperatures exceed 2 °C above pre-industrial levels.publishedVersio