34 research outputs found
Ebola virus disease epidemic in West Africa: Lessons learned and issues arising from West African countries
© Royal College of Physicians 2015. All rights reserved.The current Ebola virus disease (EVD) outbreak ravaging three nations in West Africa has affected more than 14,000 persons and killed over 5,000. It is the longest and most widely spread Ebola epidemic ever seen. At the time of this overview (written November 2014), having affected eight different nations, Nigeria and Senegal were able to control and eliminate the virus within a record time. Ghana has successfully, to date, kept the virus away from the country, despite economic and social relationships with affected nations. What lessons can we learn from Nigeria, Senegal and Ghana in the current epidemic? How can the world improve the health systems in low- and middle-income countries to effectively manage future outbreaks? Recently, the Royal College of Physicians launched a new partnership with the West African College of Physicians to curtail the effects of HIV/AIDS, malaria and tuberculosis in the region. We believe that strengthened health systems, skilled human resources for health and national ownership of problems are key to effective management of outbreaks such as EVD
Seismic refraction investigation of the subsurface structure at the southern part of Niger State College of Education, Minna, Nigeria
This paper discussed the seismic refraction survey conducted at the southern part of Niger State College of Education Minna, in which a three-channel seismograph was used for the survey. The profiles were marked at 100m intervals, while the profiles lines traversed 1000m (1km). The exact site surveyed covers a total area of about 500,000m2. From the data collected, time – distance curves for each shot points were drawn, the velocities of the underlying layers for each points were obtained and the depths to the refractor layer were computed. The results obtained gave an overview of the lateral variation in the lithological changes of the subsurface earth materials in the surveyed area. The basement surface varied in depth, from depths as shallow as 2.05m to a maximum of 10.13m. The rock materials identified in the surveyed area are chiefly sand, saturated clay, gravel, and granite.
Keyword: Basement, aquifer, Seismograph, time-distance curve, and velocity
Identification of cryptolepine metabolites in rat and human hepatocytes and metabolism and pharmacokinetics of cryptolepine in Sprague Dawley rats
YesBackground: This study aims at characterizing the in vitro metabolism of cryptolepine using human and rat
hepatocytes, identifying metabolites in rat plasma and urine after a single cryptolepine dose, and evaluating the
single-dose oral and intravenous pharmacokinetics of cryptolepine in male Sprague Dawley (SD) rats.
Methods: The in vitro metabolic profiles of cryptolepine were determined by LC-MS/MS following incubation with
rat and human hepatocytes. The in vivo metabolic profile of cryptolepine was determined in plasma and urine
samples from Sprague Dawley rats following single-dose oral administration of cryptolepine. Pharmacokinetic
parameters of cryptolepine were determined in plasma and urine from Sprague Dawley rats after single-dose
intravenous and oral administration.
Results: Nine metabolites were identified in human and rat hepatocytes, resulting from metabolic pathways
involving oxidation (M2-M9) and glucuronidation (M1, M2, M4, M8, M9). All human metabolites were found in rat
hepatocyte incubations except glucuronide M1. Several metabolites (M2, M6, M9) were also identified in the urine
and plasma of rats following oral administration of cryptolepine. Unchanged cryptolepine detected in urine was
negligible. The Pharmacokinetic profile of cryptolepine showed a very high plasma clearance and volume of
distribution (Vss) resulting in a moderate average plasma half-life of 4.5 h. Oral absorption was fast and plasma
exposure and oral bioavailability were low.
Conclusions: Cryptolepine metabolism is similar in rat and human in vitro with the exception of direct glucuronidation
in human. Clearance in rat and human is likely to include a significant metabolic contribution, with proposed primary
human metabolism pathways hydroxylation, dihydrodiol formation and glucuronidation. Cryptolepine showed extensive
distribution with a moderate half-life.Funded by Novartis Pharma under the Next Generation Scientist Program
Quality of anti-malarial drugs provided by public and private healthcare providers in south-east Nigeria
BACKGROUND: There is little existing knowledge about actual quality of drugs provided by different providers in Nigeria and in many sub-Saharan African countries. Such information is important for improving malaria treatment that will help in the development and implementation of actions designed to improve the quality of treatment. The objective of the study was to determine the quality of drugs used for the treatment of malaria in a broad spectrum of public and private healthcare providers. METHODS: The study was undertaken in six towns (three urban and three rural) in Anambra state, south-east Nigeria. Anti-malarials (225 samples), which included artesunate, dihydroartemisinin, sulphadoxine-pyrimethamine (SP), quinine, and chloroquine, were either purchased or collected from randomly selected providers. The quality of these drugs was assessed by laboratory analysis of the dissolution profile using published pharmacopoeial monograms and measuring the amount of active ingredient using high performance liquid chromatography (HPLC). FINDINGS: It was found that 60 (37%) of the anti-malarials tested did not meet the United States Pharmacopoeia (USP) specifications for the amount of active ingredients, with the suspect drugs either lacking the active ingredients or containing suboptimal quantities of the active ingredients. Quinine (46%) and SP formulations (39%) were among drugs that did not satisfy the tolerance limits published in USP monograms. A total of 78% of the suspect drugs were from private facilities, mostly low-level providers, such as patent medicine dealers (vendors). CONCLUSION: This study found that there was a high prevalence of poor quality drugs. The findings provide areas for public intervention to improve the quality of malaria treatment services. There should be enforced checks and regulation of drug supply management as well as stiffer penalties for people stocking substandard and counterfeit drugs
In vitro anti-malarial interaction and gametocytocidal activity of cryptolepine
YesBackground: Discovery of novel gametocytocidal molecules is a major pharmacological strategy in the elimination
and eradication of malaria. The high patronage of the aqueous root extract of the popular West African anti-malarial
plant Cryptolepis sanguinolenta (Periplocaceae) in traditional and hospital settings in Ghana has directed this study
investigating the gametocytocidal activity of the plant and its major alkaloid, cryptolepine. This study also investigates
the anti-malarial interaction of cryptolepine with standard anti-malarials, as the search for new anti-malarial combinations
continues.
Methods: The resazurin-based assay was employed in evaluating the gametocytocidal properties of C. sanguinolenta
and cryptolepine against the late stage (IV/V) gametocytes of Plasmodium falciparum (NF54). A fixed ratio method
based on the SYBR Green I fluorescence-based assay was used to build isobolograms from a combination of cryptolepine
with four standard anti-malarial drugs in vitro using the chloroquine sensitive strain 3D7.
Results: Cryptolepis sanguinolenta (
IC50 = 49.65 nM) and its major alkaloid, cryptolepine (
IC50 = 1965 nM), showed
high inhibitory activity against the late stage gametocytes of P. falciparum (NF54). In the interaction assays in asexual
stage, cryptolepine showed an additive effect with both lumefantrine and chloroquine with mean ΣFIC50s of
1.017 ± 0.06 and 1.465 ± 0.17, respectively. Cryptolepine combination with amodiaquine at therapeutically relevant
concentration ratios showed a synergistic effect (mean ΣFIC50 = 0.287 ± 0.10) whereas an antagonistic activity (mean
ΣFIC50 = 4.182 ± 0.99) was seen with mefloquine.
Conclusions: The findings of this study shed light on the high gametocytocidal properties of C. sanguinolenta and
cryptolepine attributing their potent anti-malarial activity mainly to their effect on both the sexual and asexual stages
of the parasite. Amodiaquine is a potential drug partner for cryptolepine in the development of novel fixed dose
combinations
Pseudoneoplastic lesions of the testis and paratesticular structures
Pseudotumors or tumor-like proliferations (non-neoplastic masses) and benign mimickers (non-neoplastic cellular proliferations) are rare in the testis and paratesticular structures. Clinically, these lesions (cysts, ectopic tissues, and vascular, inflammatory, or hyperplastic lesions) are of great interest for the reason that, because of the topography, they may be relevant as differential diagnoses. The purpose of this paper is to present an overview of the pseudoneoplasic entities arising in the testis and paratesticular structures; emphasis is placed on how the practicing pathologist may distinguish benign mimickers and pseudotumors from true neoplasia. These lesions can be classified as macroscopic or microscopic mimickers of neoplasia
Improving access to health care for malaria in Africa: a review of literature on what attracts patients
BACKGROUND: Increasing access to health care services is considered central to improving the health of populations. Existing reviews to understand factors affecting access to health care have focused on attributes of patients and their communities that act as 'barriers' to access, such as education level, financial and cultural factors. This review addresses the need to learn about provider characteristics that encourage patients to attend their health services. METHODS: This literature review aims to describe research that has identified characteristics that clients are looking for in the providers they approach for their health care needs, specifically for malaria in Africa. Keywords of 'malaria' and 'treatment seek*' or 'health seek*' and 'Africa' were searched for in the following databases: Web of Science, IBSS and Medline. Reviews of each paper were undertaken by two members of the team. Factors attracting patients according to each paper were listed and the strength of evidence was assessed by evaluating the methods used and the richness of descriptions of findings. RESULTS: A total of 97 papers fulfilled the inclusion criteria and were included in the review. The review of these papers identified several characteristics that were reported to attract patients to providers of all types, including lower cost of services, close proximity to patients, positive manner of providers, medicines that patients believe will cure them, and timeliness of services. Additional categories of factors were noted to attract patients to either higher or lower-level providers. The strength of evidence reviewed varied, with limitations observed in the use of methods utilizing pre-defined questions and the uncritical use of concepts such as 'quality', 'costs' and 'access'. Although most papers (90%) were published since the year 2000, most categories of attributes had been described in earlier papers. CONCLUSION: This paper argues that improving access to services requires attention to factors that will attract patients, and recommends that public services are improved in the specific aspects identified in this review. It also argues that research into access should expand its lens to consider provider characteristics more broadly, especially using methods that enable open responses. Access must be reconceptualized beyond the notion of barriers to consider attributes of attraction if patients are to receive quality care quickly
Two dimentional modeling of subsurface structure over upper Benue trough and Bornu basin in North eastern Nigeria
A two dimensional modelling of the subsurface structures of parts of Benue Trough and Bornu Basin, northeast Nigeria, using aeromagnetic data was carried out in this study. The area under investigation is bounded by latitude 9.50 N to 12.00 N and longitude 9.50 E to 12.00 E. It is covered by 25 aeromagnetic maps. The data obtained were subjected to filtering process using polyfit. Residual data obtained were subjected to 2D subsurface modelling. The study area was covered by seven profiles labelling, AA1, BB1, CC1, DD1, EE1, FF1 and GG1. The depth to magnetic sources results obtained from the Source Parameter Imaging (SPI) was used as depth constraint for modelling the residual magnetic field anomalies. The results of the 2D modelling showed that the sedimentary thicknesses ranged from 0.0 km to a maximum depth of about 5.40 km. The highest sedimentary thicknesses were found around Gombe, Ako Gombe, Bulkachuwa and Damaturu areas, with a value of about 3.80 km to 5.40 km. The highest sedimentary thicknesses obtained, which range between 3.80 km to about 5.40 km is adequate for the hosting of hydrocarbons. The least sedimentary thicknesses obtained from this study could be found around Bauchi axis in the basement complex region, Kaltungo and volcanic area at the eastern part of the survey area. The results of this study also indicated that Borno Basin is separated from the Upper Benue Trough at about latitude 11.00 N to 11.20 N, which corresponds to “Dulbulwa-Bage High”. This separation could have been aided by the paleostructure called St Paul that passes through the area at that latitude. The subsurface lithology obtained from 2D modelling of the residual field showed the presence of two lithological units. The sedimentary rock unit underlined by the basement rock consists of shales, sandstones, limestones, siltstones, clay and non-marine facies. The Basement rock units were composed of pegmatite, granite gneiss and migmatites.Keywords: Aeromagnetic data, 2D modelling, Sedimentary thickness, Source Parameter Imaging and Subsurface litholog
Public private partnership in in-service training of physicians: the millennium development goal 6-partnership for African clinical training (M-PACT) approach
Introduction: in-service training of healthcare workers is essential for improving healthcare services and outcome. Methods: the Millennium Development Goal (MDG) 6 Partnership for African Clinical Training (M-PACT) program was an innovative in-service training approach designed and implemented by the Royal College of Physicians (RCP) and West African College of Physicians (WACP) with funding from Eco Bank Foundation. The goal was to develop sustainable capacity to tackle MDG 6 targets in West Africa through better postgraduate medical education. Five training centres were establised: Nigeria (Abuja, Ibadan), Ghana (Accra), Senegal (Dakar) and Sierra Leone (Freetown) for training 681 physicians from across West Africa. A curriculum jointly designed by the RCP-WACP team was used to deliver biannual 5-day training courses over a 3-year period. Results: of 602 trained in clinical medicine, 358 (59.5%) were males and 535 (88.9%) were from hosting countries. 472 (78.4%) of participants received travel bursaries to participate, while 318 (52.8%) were residents in Internal Medicine in the respective institutions. Accra had the highest number of participants (29.7%) followed by Ibadan, (28.7%), Dakar, (24.9%), Abuja, (11.0%) and Freetown, (5.6%). Pre-course clinical knowledge scores ranged from 35.1% in the Freetown Course to 63.8% in Accra Course 1; whereas post-course scores ranged from 50.5% in the Freetown course to 73.8% in Accra course 1. Conclusion: M-PACT made a positive impact to quality and outcome of healthcare services in the region and is a model for continued improvement for healthcare outcomes, e.g malaria, HIV and TB incidence and mortality in West Africa