Ethnobotanical survey of medicinal plants used in the management of hypertension in the Maritime region of Togo

Background: Hypertension is one of the most common chronic diseases in modern societies and there is evidence that its incidence and severity are increasing. This survey was conducted to investigate the plants used by the Togolese traditional healers to treat the disease.Method: From January to June 2016, an ethnobotanical survey was conducted using a semi-structured questionnaire with traditional healers (TH) in the southern region of Togo. The importance of the plants was assessed by the calculation of the use value (UV).Results: In Total, 128 TH male and female were interviewed and 116 plants species belonging to 46 families were identified as treating hypertension. The most represented families were: Fabaceae with 16 species followed by Euphorbiaceae and Rutaceae contributing with 8 and 6 species respectively. Based on the calculated use values the most important species were Byrsocarpus coccineus Schum. Et thonn. (UV = 0.47); Crateva religiosae G.Forst. (UV = 0.47), Boerhavia diffusa Engelm. &A.Gray L. (UV = 0.47), Xylopia athiopica A. Rich. (UV = 0.42), Mangnifera indica L. (UV = 0.38). The leaves and the roots were the parts of plant predominantly used to prepare the recipes, mainly decoctions administrated by oral route. Clinical manifestations such as dizzy spells, swarming, loss of consciousness, severe headache, severe anxiety and shortness of breath, nosebleed, and fear of heights were used by TH to diagnose the disease.Conclusion: This study showed initial evidence of the use of plant materials by Togolese TH to treat hypertension. These results constitute a database for pharmacological screenings with the aim of developing new therapies.Key words: Hypertension, traditional medicine, ethnobotanical survey, medicinal plants, Togo

Synchronic macrophage response and <i>Plasmodium falciparum</i> malaria

Human Chitotriosidase (CHIT), produced by activated macrophage, is a member of the chitinase family, a group of enzymes with the capability to hydrolyze chitin. Recently plasma CHIT activity was found elevated in children with acute P. falciparum malaria compared with healthy African children, as a consequence of macrophage activation due to the presence of parasites. In this study we recruited at the local Centre Medical Saint Camille (CMSC) of Ouagadougou, the capital of Burkina Faso, 62 African children (30 males and 32 females, aged 2–140 months; median 16.5 months), affected by acute P. falciparum malaria, born and living in Burkina Faso. Control subjects included 140 healthy African children (79 males and 61 females) with age ranging from 10 to 100 months (median 22 months) at evaluation time. They did not show signs of acute infectious disease and their blood smears for P. falciparum were negative. This study was approved by the local Ethical Committees of CMSC. Parents of the participating children in the study were orally informed of the scope of this research. For plasma CHIT assay, 3 ml of EDTA-blood was centrifuged and plasma samples were stored at –40°C determination by fluorimetric method at the Centre for Metabolic Diseases— University of Catania, Italy

Antibacterial activity of alkaloids from Sida acuta

Sida acuta is a shrub indigenous to pantropical regions. The plant is widely used for its various pharmacological properties. Among compounds of pharmacological interest occurring in the plant, are indoloquinoline alkaloids. The aim of the present study was to investigate the antimicrobial activity of alkaloids of S. acuta from Burkina Faso. The alkaloids had a good antimicrobial activity against the test microorganisms. In the agar-well diffusion assay, highest inhibition zone diameters were recorded with Gram-positive bacteria. The broth microdilution assay gave minimal inhibitory concentration values ranging from 16 to 400 μg/ml and minimal bactericidal concentration values ranging from 80 to up to 400 μg/ml. The gas chromatography-mass spectrometry analysis of the same alkaloids led to the identification of cryptolepine and quindoline as the major components.Keywords: Cryptolepine, quindoline, indoloquinolines, antibacterial, Sida acut

Antiretroviral (ARV) Therapy in Resource Poor Countries: What do we Need in Real Life?

Significant progresses have been made in the last 5 years towards the ultimate goal to provide universal access to care for all HIV/AIDS patients needing antiretroviral treatment in resource-poor countries. However, many barriers are still to be overcome, including (●) cost of care for the individual, (●) stigma, (●) lack of qualified human resources and infrastructure, especially in the rural setting, (●) rescue drugs for failing patients and (●) pediatric formulations. Priority actions to be promoted if the fight against HIV/AIDS is to be successful include: (i) promoting access to care in the rural areas, (ii) strengthening of basic health infrastructures, (iii) waiving of users’ fee to get ARV, (iv) a larger variety of drugs, with particular regard to fixed dose combination third line drugs and pediatric formulations, (v) local quality training and (vi) high quality basic and translational research. While the universal access to HIV care is crucial in developing countries, a strong emphasis on prevention should be maintained along

Self-collected vaginal sampling for the detection of genital human papillomavirus (HPV) using careHPV among Ghanaian women.

BACKGROUND: Detection of genital HPV DNA is recommended as an important strategy for modern cervical cancer screening. Challenges include access to services, the reliance on cervical samples taken by clinicians, and patient's preference regarding provider gender. The objective of this research was to determine the acceptability, feasibility and performance of alternative self-collected vaginal samples for HPV detection among Ghanaian women. METHODS: A comparative frequency-matched study was conducted in a systematic (1:5) sample of women attending HIV and outpatient clinics in the Cape Coast Teaching Hospital, Ghana. Participants were instructed on self-collection (SC) of vaginal samples using the careHPV brush and a clinician-collected (CC) cervical sample was obtained using a similar brush. Paired specimens were tested for HPV DNA (14 high-risk types) by careHPV assay (Qiagen) and by HPV genotyping (Anyplex II, Seegene). RESULTS: Overall, 194 women of mean age 44.1 years (SD ± 11.3) were enrolled and 191 paired SC and CC results were analysed. The overall HPV detection concordance was 94.2% (95%CI: 89.9-97.1), Kappa value of 0.88 (p < 0.0001), showing excellent agreement. This agreement was similar between HIV positive (93.8%) and negative (94.7%) women. Sensitivity and specificity of SC compared to CC were 92.6% (95%CI: 85.3-97.0) and 95.9% (95%CI: 89.8-98.8) respectively. The highest sensitivity was among HIV positive women (95.7%, 95%CI: 88.0-99.1) and highest specificity among HIV negative women (98.6%, 95%CI: 92.4-100). Overall, 76.3% women found SC very easy/easy to obtain, 57.7% preferred SC to CC and 61.9% felt SC would increase their likelihood to access cervical cancer screening. CONCLUSIONS: The feasibility, acceptability and performance of SC using careHPV support the use of this alternative form of HPV screening among Ghanaian women. This could be a potential new affordable strategy to improve uptake of the national cervical cancer screening program

Multiparity and Breast Cancer Risk Factor among Women in Burkina Faso

The relative lack of information on breast cancer etiology in Burkina Faso led us to undertake the present work to highlight risk factors. This prospective study was conducted using a questionnaire between January 2015 and February 2016 on women admitted to Yalgado OUEDRAOGO hospital, for consultation or supervision. The characteristics of multiparous breast cancer patients (n = 44) were compared with their non-multiparous counterparts (n = 36). The study found that increased risk of breast cancer among non-multiparous cases was related to body mass index (BMI) (p <0.001), age at menopause (p <0.004) and use of oral contraception (p <0.021) while abortion (p <0.002) was a risk factor among multiparous cases. These results suggest that even if multiparity is associated with a decreased risk in some women, avoidance of abortion during reproductive life should be recommended. The results provide preliminary information, which now need to be supplemented by survey of a larger sample in the national territory.Peer reviewe

Options in human papillomavirus (HPV) detection for cervical cancer screening: comparison between full genotyping and a rapid qualitative HPV-DNA assay in Ghana.

BACKGROUND: Modern cervical cancer screening increasingly relies on the use of molecular techniques detecting high-risk oncogenic human papillomavirus (hr-HPV). A major challenge for developing countries like Ghana has been the unavailability and costs of HPV DNA-based testing. This study compares the performance of careHPV, a semi-rapid and affordable qualitative detection assay for 14 hr-HPV genotypes, with HPV genotyping, for the detection of cytological cervical squamous intraepithelial lesions (SIL). METHODS: A study comparing between frequency matched HIV-1 seropositive and HIV-seronegative women was conducted in the Cape Coast Teaching Hospital, Ghana. A systematic sampling method was used to select women attending clinics in the hospital. Cervical samples were tested for HPV by careHPV and Anyplex-II HPV28 genotyping assay, and by conventional cytology. RESULTS: A total of 175 paired results (94 from HIV-1 seropositive and 81 from HIV-seronegative women) were analyzed based on the ability of both tests to detect the 14 hr-HPV types included in the careHPV assay. The inter-assay concordance was 94.3% (95%CI: 89.7-97.2%, kappa = 0.88), similar by HIV serostatus. The careHPV assay was equally sensitive among HIV-1 seropositive and seronegative women (97.3% vs. 95.7%, p = 0.50) and slightly more specific among HIV-seronegative women (85.0% vs. 93.1%, p = 0.10). careHPV had good sensitivity (87.5%) but low specificity (52.1%) for the detection of low SIL or greater lesions, but its performance was superior to genotyping (87.5 and 38.8%, respectively). Reproducibility of careHPV, tested on 97 samples by the same individual was 82.5% (95%CI: 73.4-89.4%). CONCLUSIONS: The performance characteristics of careHPV compared to genotyping suggest that this simpler and cheaper HPV detection assay could offer a suitable alternative for HPV screening in Ghana

Antibacterial and anti-inflammatory activities of crude extracts of three Togolese medicinal plants against ESBL Klebsiella pneumoniae strains

Background: Pithecellobium dulce (Roxb.) Benth., Securidaca longepedunculata Fresn and Cryptolepis sanguinolenta (Lindl.) Schlt are three plants widely used in the Togolese traditional medicine to treat microbial infections. Some studies reported their antibacterial activity alone but until know there no data concerning their possible interaction with conventional antibiotics. The main objective of this study was to investigate the antibacterial activity of the association of the crude extracts of the three plants with some conventional antibiotics. We further evaluate the antioxidant and the anti-inflammatory activities of the extracts on rat’s model.Materials and methods:The antimicrobial activity was evaluated by the broth microdilution assay and the Fractional inhibitory concentrations (FIC) determined by the checkerboard method. The anti-inflammatory activity was evaluated using the Carrageenan- induced rat paw edema model. The antioxidant activities and the phenol contents were determined by spectrophotometry.Results: The MICs of hydroethanolic extract of plants ranged from 3.125 to 100 mg/mL on Klebsiella pneumoniae strains. Synergistic action was observed only with the combination of Imipenem/P. dulce, imipenem/C. sanguinolenta, amikacin/P. dulce and amikacin/C. sanguinolenta against the ESBL negative Klebsiella pneumoniae strain. Of the 21 associations, 15 were antagonistic on the ESBL-producing strains. The indifference effect was observed with the combination of the extract of Securidaca longepedunculata and the following antibiotics imipenem, amikacin, tetracyclin, ciprofloxacin, Cefotaxim; and Sulfametoxazol+Trimethoprim. The in vitro anti-inflammatory with Lipoxygenase inhibition activity was best with C. sanguinolenta extract while the in vivo paw edema model revealed that S. longepedunculata was the highest reducer of paw edema. In addition white blood cells count and biochemical parameters such as total proteins and immunoglobulins were significantly affected by the administration of plant extracts.Conclusion: This study revealed that the three plants although they may inhibit the bacterial growth by themselves, but there is also a possible synergistic action with the commercial antibiotics. Further investigations are needed to identify the active compounds and their mechanism of action.Keywords: antibiotics, extended-spectrum beta lactamase, plant extract, bacteria, Tog

Methylenetetrahydrofolate Reductase Gene Polymorphisms in Burkina Faso: Impact on Plasma Fasting Homocysteine and after Methionine Loading Test

SUMMARY In Burkina Faso the levels of plasma homocysteine (Hcy) are lower and the methionine loading tests suggest a more effective Hcy metabolism. The polymorphisms of methylenetetrahydrofolate reductase (MTHFR) showed a relevant difference in the allele frequencies of T MTHFR-677 in young and in old subjects, while the allele frequency of C MTHFR-1298C was comparable in young and old subjects. The aim of this paper was to study the impact of the MTHFR polymorphisms on plasma fasting Hcy and after methionine loading in Burkina Faso. The young subjects with CC MTHFR-677 genotype had levels of Hcy significantly lower than CT and TT subjects. The level of Hcy in subjects who had AA, AC and CC MTHFR-1298 genotypes were comparable. The levels of Hcy after the methionine loading test were significantly higher in CT and TT MTHFR-677 genotype. These results suggest that the genetic situation in Burkina Faso is different from that of other Western countries and this guarantees the maintenance of lower plasma levels of Hcy in young and old Africans. The elevated levels of plasma Hcy in old subjects compared to young subjects, against the low prevalence of the T allele in elderly subjects is discussed. (Clin. Lab. 2007;53:XXX-XXX) KEY WORDS Burkina Faso, homocysteine, methionine loading test, MTHFR, C677T, A1298