Evaluation of Wound Healing Activity of 80% Methanol Stem-Bark Extract and Solvent Fractions of Prunus africana (Hook.f.) Kalkman (Rosaceae) in Mice

Sagni Hanbisa,1 Wondmagegn Tamiru Tadesse,2 Teferra Abula2 1Department of Pharmacy, Institute of Health Science, Wallaga University, Nekemte, Ethiopia; 2Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Wondmagegn Tamiru Tadesse, Tel +251 911637599, Email [email protected]; [email protected]: Prunus africana is a well-known plant that is used in Ethiopian traditional medicine for the treatment of wounds and other ailments, although there is no scientific evidence to back up the claims of its wound-healing properties. Thus, the objective of this study is to evaluate the wound-healing potential of P. africana bark extract in mice.Methods: The bark of the plant was extracted by successive maceration using 80% methanol and then fractionated with aqueous, n-butanol, and chloroform. The crude extract and solvent fractions were formulated as an ointment. Wound healing activity was evaluated using excision and incision wound models. Total phenol, flavonoid, and alkaloid contents of the crude extract, aqueous, and n- butanol fractions of the plant were determined.Results: In both models, mice treated with 5% (w/w) and 10% (w/w) crude extract ointment exhibited a significant (p < 0.001) wound healing activity compared with control as evidenced by the increased rate of wound contraction and hydroxyproline content, the reduced epithelialization time, and the higher skin breaking strength. Mice treated with aqueous fraction ointment exhibited a high percentage of wound healing effect among all solvent fractions. The aqueous fraction consisted of higher phenolic (49.71 ± 0.73 mg/g) and flavonoid (39.58 ± 0.27 mg/g) content, while alkaloid (3.89 ± 0.55 mg/g) content was the lowest.Conclusion: Prunus africana stem bark extract demonstrated wound healing activity in mice model which supports the acclaimed use by Ethiopian traditional medicine.Keywords: wound healing, mice, P. africana, extract, fraction, incision, excisio

Tafenoquine and its potential in the treatment and relapse prevention of Plasmodium vivax malaria: the evidence to date

Yehenew A Ebstie,1,* Solomon M Abay,2,* Wondmagegn T Tadesse,3 Dawit A Ejigu4 1Department of Microbiology, Immunology and Parasitology, 2Department of Pharmacology, 3Department of Pharmacology and Clinical Pharmacy, School of Medicine, College of Health Sciences, Addis Ababa University, 4Department of Pharmacology, St Paul&rsquo;s Hospital Millennium Medical College, Addis Ababa, Ethiopia *These authors contributed equally to&nbsp;this work Abstract: Despite declining global malaria incidence, the disease continues to be a threat to people living in endemic regions. In 2015, an estimated 214 million new malaria cases and 438,000 deaths due to malaria were recorded. Plasmodium vivax is the second most common cause of malaria next to Plasmodium falciparum. Vivax malaria is prevalent especially in Southeast Asia and the Horn of Africa, with enormous challenges in controlling the disease. Some of the challenges faced by vivax malaria-endemic countries include limited access to effective drugs treating liver stages of the parasite (schizonts and hypnozoites), emergence/spread of drug resistance, and misperception of vivax malaria as nonlethal. Primaquine, the only 8-aminoquinoline derivative approved by the US Food and Drug Administration, is intended to clear intrahepatic hypnozoites of P. vivax (radical cure). However, poor adherence to a prolonged treatment course, drug-induced hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency, and the emergence of resistance make it imperative to look for alternative drugs. Therefore, this review focuses on data accrued to date on tafenoquine and gives insight on the potential role of the drug in preventing relapse and radical cure of patients with vivax malaria. Keywords: vivax malaria, radical cure, schizonts, hypnozoite, primaquine&nbsp

Magnitude and causes of first-line antiretroviral therapy regimen changes among HIV patients in Ethiopia: a systematic review and meta-analysis

Background: Antiretroviral therapy (ART) has markedly decreased the morbidity and mortality due to HIV/AIDS. ART regimen change is a major challenge for the sustainability of human immunodeficiency virus (HIV) treatment program. This is found to be a major concern among HIV/AIDS patients in a resource-limited setting, where treatment options are limited. Objectives: The aim of this review is to generate the best available evidence regarding the magnitude of first-line antiretroviral therapy regimen change and the causes for regimen change among HIV patients on ART in Ethiopia. Methods: The reviewed studies were accessed through electronic web-based search strategy from PubMed Medline, EMBASE, Hinari, Springer link and Google Scholar. Data were extracted using Microsoft Excel and exported to Stata software version 13 for analyses. The overall pooled estimation of outcomes was calculated using a random-effect model of DerSimonian-Laird method at 95% confidence level. Heterogeneity of studies was determined using I2 statistics. For the magnitude of regimen change, the presence of publication bias was evaluated using the Begg's and Egger's tests. The protocol of this systematic review and meta-analysis was registered in the Prospero database with reference number ID: CRD42018099742. The published methodology is available from: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=99742. Results: A total of 22 studies published between the years 2012 and 2018 were included. Out of 22 articles, 14 articles reported the magnitude of regimen change and consisted of 13,668 HIV patients. The estimated national pooled magnitude of regimen change was 37% (95% CI: 34, 44%; Range: 15.1-63.8%) with degree of heterogeneity (I2), 98.7%; p-value &lt; 0.001. Seventeen articles were used to identify the causes for first-line antiretroviral therapy regimen change. The major causes identified were toxicity, 58% (95% CI: 46, 69%; Range: 14.4-88.5%); TB co-morbidity, 12% (95% CI: 8, 16%; Range: 0.8-31.7%); treatment failure, 7% (95% CI: 5, 9%; Range: 0.4-24.4%); and pregnancy, 5% (95% CI: 4, 7%; Range: 0.6-11.9%). Conclusions: The original first-line regimen was changed in one-third of HIV patients on ART in Ethiopia. Toxicity of the drugs, TB co-morbidity, treatment failure, and pregnancy were the main causes for the change of the first-line regimen among HIV patients on antiretroviral therapy

The burden of transboundary animal diseases and implications for health policy

In Sahelian Africa and connected regions, the burden of transboundary animal diseases is poorly understood. This is due in part to the lack of robust estimates of the distribution and intensity of these diseases within the region. However, the problem is compounded by the complexity of the types of losses attributable to specific diseases, including the impact on human health of zoonotic transboundary diseases such as brucellosis and Rift Valley fever. There is also a balance between disease losses and the cost of our response to the presence or perceived threat of transboundary animal diseases. This chapter presents a framework for measuring the burden of transboundary animal diseases in the Sahel region, explores disease distribution data and collates what information is available on productivity losses and expenditure on disease mitigation, namely surveillance, prevention, control and treatment activities. We highlight the need for standardised data collection processes that capture disease loss estimates as well as expenditure related to our response. Reporting changes in losses and expenditure over time will provide a basis for making informed disease control policies for transboundary animal diseases. The outcome of this will be an evidence-base for mobilising resources in an efficient and effective manner

Adverse Drug Reactions and Clinical Outcomes in Patients Initiated on Antiretroviral Therapy: A Prospective Cohort Study From Ethiopia

© 2015, Springer International Publishing Switzerland.Introduction: In Ethiopia, the use of antiretroviral therapy (ART) has been scaled up for HIV/AIDS over the past decade. Adverse drug reactions (ADRs) associated with ART pose a unique challenge in the treatment of the infection in this resource-limited setting. Objectives: The aims of this study were to examine the incidence and nature of ADRs, identify the risk factors associated with the development of ADRs, and assess their impact on treatment outcomes. Methods: A prospective cohort study was conducted in adult patients (=18 years of age) with HIV/AIDS who commenced ART. All ADRs in the first 12 months of therapy were recorded, and the severity, causality, and preventability assessed. The impact of severe ADRs on self-reported adherence, immunological, and body mass index (BMI) outcomes were assessed. Results: Of the 211 patients included in the analysis, 181 (85.7 %) experienced at least one ADR and 66 (31.3 %) experienced at least one severe ADR within 12 months of commencing ART (incidence rates for any ADR and severe ADR of 14.8 and 3.2 per 100 person-months, respectively). Logistic regression analysis indicated that taking zidovudine-containing regimens (odds ratio [OR] 4.2, 95 % confidence interval [CI] 2.1–8.4) or being unemployed (OR 2.2, 95 % CI 1.1–4.3) were independent predictors of experiencing severe ADRs. Patients who experienced a severe ADR were less likely (OR 0.4, 95 % CI 0.2–0.9) to be =90 % adherent to ART. The mean gain in BMI was significantly lower in patients with severe ADRs after 3 and 12 months of therapy. Conclusions: ADRs were common within the first 3 months in patients initiated on ART. Severe ADRs were negatively associated with self-reported adherence and gain in BMI. Measures need to be implemented to routinely monitor for severe ADRs to improve ART adherence and treatment outcomes