Contribution of Illicit Drug Use to Pharmaceutical Load in the Environment: A Focus on Sub-Saharan Africa

This research article was published by Hindawi, 2022Illicit drug abuse and addiction are universal issues requiring international cooperation and interdisciplinary and multisectoral solutions. ese addictive substances are utilized for recreational purposes worldwide, including in sub-Saharan Africa. On the other hand, conventional wastewater treatment facilities such as waste stabilization ponds lack the design to remove the most recent classes of pollutants such as illicit drug abuse. As a result, e uents from these treatment schemes contaminate the entire ecosystem. Public health o cials are concerned about detecting these pollutants at alarming levels in some countries, with potential undesirable e ects on aquatic species and increased health hazards through exposure to contaminated waters or recycling treated or untreated e uents in agriculture. Contaminants including illicit substances enter the environment by human excreta following illegal intake, spills, or through direct dumping, such as from clandestine laboratories, when their manufacturer does not follow accepted production processes. ese substances, like other pharmaceuticals, have biological activity and range from pseudopersistent to highly persistent compounds; hence, they persist in the environment while causing harm to the ecosystem. e presence of powerful pharmacological agents such as cocaine, morphine, and amphetamine in water as complex combinations can impair aquatic organisms and human health. ese compounds can harm human beings and ecosystem health apart from their low environmental levels. erefore, this article examines the presence and levels of illicit substances in ecological compartments such as wastewater, surface and ground waters in sub-Saharan Africa, and their latent impact on the ecosystem. e information on the occurrences of illicit drugs and their metabolic products in the sub-Saharan Africa environment and their contribution to pharmaceutical load is missing. In this case, it is important to research further the presence, levels, distribution, and environmental risks of exposure to human beings and the entire ecosystem

Relaxed complex scheme and molecular dynamics simulation suggests small molecule inhibitor of human TMPRSS2 for combating COVID-19

This research article was published by Taylor & Francis online in 2021As the coronavirus disease 19 (COVID-19) pandemic continues to pose a health and economic crisis worldwide, the quest for drugs and/or vaccines against the virus continues. The human transmembrane protease serine 2 (TMPRSS2) has attracted attention as a target for drug discovery, as inhibition of its catalytic reaction would result in the inactivation of the proteolytic cleavage of the SARS-CoV-2 S protein. As a result, the inactivation prevents viral cell entry to the host’s cell. In this work, we screened and identified two potent molecules that interact and inhibit the catalytic reaction by using computational approaches. Two docking screening experiments were performed utilizing the crystal structure and holo ensemble structure obtained from molecular dynamics in bound form. There is enhancement and sensitivity of docking results to the holo ensemble as compared to the crystal structure. Compound 1 demonstrated a similar inhibition value to nafamostat by interacting with catalytic triad residues His296 and Ser441, thereby disrupting the already established hydrogen bond interaction. The stability of the ligand–TMPRSS2 complexes was studied by molecular dynamics simulation, and the binding energy was re-scored by using molecular mechanics Poisson-Boltzmann surface area (MM-PBSA) binding free energy. The obtained compounds may serve as an initial point toward the discovery of potent TMPRSS2 inhibitors upon further in vivo validation

A Review on Contaminants of Emerging Concern in the Environment: A Focus on Active Chemicals in Sub-Saharan Africa

This research article published by MDPI, 2021: Active chemicals are among the contaminants of emerging concern that are rarely covered in regulatory documents in sub-Saharan Africa. These substances are neither in the list of routinely monitored substances nor in the guidelines for routine environmental monitoring activities. This has been of concern to public health officials, toxicologists, communities, and governments, hence the need for risk assessment and regulation of these substances. In this review article, the presence of active chemicals in the sub-Saharan African environment was investigated. The results indicate the availability of few studies in some countries, while in other countries no reports of active chemicals were found, hence the need for further research targeting such countries. It was further observed that mixtures of active chemicals from different therapeutic categories—such as antibiotics and analgesics—were reported. The natural environment is increasingly at risk due to the presence of these substances, their metabolites, and their transformation byproducts. These substances are characterized by persistence as a result of their non-biodegradable nature; hence, they circulate from one environmental compartment to another through the food chain, causing harm along the way. Most studies that evaluated the toxicity of these substances considered the effects of a single drug, but observations indicated the presence of drug mixtures, hence the need for further evaluation of the effects of drug–drug interactions—including synergistic and additive effects—for environmental sustainability. The presence of ACs in several environmental compartments at quantifiable quantities was discovered in this investigation, indicating the potential for ecosystem injury as a result of bioaccumulation, bioconcentration, and biomagnification through the food chain. This necessitates further research on the subject in order to ensure a healthier environment

Disparities in Risk Factors Associated with Obesity between Zanzibar and Tanzania Mainland among Women of Reproductive Age Based on the 2010 TDHS

The occurrence of overweight and obesity has serious health implications. The 2010 Tanzania Demographic and Health Survey data set was reanalysed to compare the prevalences of overweight and obesity between Mainland Tanzania and Zanzibar and to determine how demographic factors can predict overweight and obesity across the United Republic of Tanzania. About 7.92% of the Tanzanian women of reproductive age were obese, 15% were overweight, and 11.5% were underweight. Women from Mainland Tanzania (6.56%) were significantly less likely (AOR = 0.66, 95% CI: 0.53–0.82) to be affected by obesity as compared to women from Zanzibar (12.19%). The common predictors of obesity in Mainland Tanzania and Zanzibar were wealth index, marital status, and age. Whereas the place of residence and education level emerged as predictors of obesity in the Mainland Tanzania alone, the number of meals per day did so in Zanzibar. Most importantly, Zanzibar had a greater prevalence of obesity compared to Mainland Tanzania

Data from the batch adsorption of ciprofloxacin and lamivudine from synthetic solution using jamun seed (Syzygium cumini) biochar: Response surface methodology (RSM) optimization

This research article was published by Elsevier, 2023This dataset expresses the experimental data on the batch adsorption of ciprofloxacin and lamivudine from synthetic solution using jamun seed (JS) (Syzygium cumini) biochar. Independent variables including concentration of pollutants (10-500 ppm), contact time (30–300 min), adsorbent dosage (1-1000 mg), pH (1-14) and adsorbent calcination temperature (250,300, 600 and 750 °C) were studied and optimized using Response Surface Methodology (RSM). Empirical models were developed to predict the maximum removal efficiency of ciprofloxacin and lamivudine, and the results were compared with the experimental data. The removal of polutants was more influenced by concentration, followed by adsorbent dosagage, pH, and contact time and the maximum removal reached 90%

Antibiotic-resistant microbial populations in urban receiving waters and wastewaters from Tanzania

This research article was published by Elsevier, 2023Antimicrobial resistance against certain medications in the pathogenic microbial community is globally increasing due to the continual discharge and disposal of pharmaceuticals in the environment. The phenomenon resulted in significant antibiotic resistance among several exposed Enterobacteriaceae species, with wastewater treatment plants (WWTPs) and rivers serving as significant reservoirs. Despite antibiotic resistance being a tragedy, particularly in treating diseases by using antibiotics, local and regional studies indicating the severity, resistant species and the molecular level insight into these pathogens are scarce, thus requiring immediate intervention. This study, therefore, investigated wastewater from wastewater treatment ponds and receiving waters for the presence of resistant pathogens through phenotypical and molecular approach screening of their genes. Among the 57 analyzed samples, 18 (67%, n = 27) isolates of Klebsiella spp.., 4 (80%, n = 5) isolates of Proteus spp., 1 (100%, n = 1) of isolated Pseudomonas aeruginosa and 6 (18%, n = 34) of E. coli found were resistant to at least 1 among the tested antibiotics. E. coli had an 83% higher proportion of multi-drug resistance (MDR) than Klebsiella spp.., which had 68.5%, and no MDR was shown by P. aeruginosa isolates. Among the 20 bacterial isolates of antibiotic-resistant genes, showed that E. coli harboured 39%, followed by 22% of Klebsiella spp. Eleven (11) isolates of these 20 (55%) contained sulphonamides resistant genes: Sul 1 (n = 4) and Sul 2 (n = 7). Ten (10) isolates (50%) contained the tetracycline-resistant genes in which 4 isolates showed the Tet A, Tet B – 1 and 5 isolates contained Tet D. β-lactamases (bla CTX-M and bla SHV) were found in 7 isolates (35%). The existence of these antibiotic-resistant species in the urban receiving and wastewater presents a threat of transmission of diseases to humans and animals that are not cured by the existing medications, jeopardizing public health safety

The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countries

BackgroundEvidence from sub-Saharan Africa (SSA) regarding risky behaviors among adolescents remains scarce, despite the large population (approximately 249 million out of 1.2 billion globally in 2019) of adolescents in the region. We aimed to examine the potential influence of depressive symptoms and school-going status on risky behaviors among adolescents in six SSA countries.MethodsWe used individual cross-sectional data from adolescents aged 10–19 based in eight communities across six SSA countries, participating in the ARISE Network Adolescent Health Study (N = 7,661). Outcomes of interest were cigarette or tobacco use, alcohol use, other substance use, getting into a physical fight, no condom use during last sexual intercourse, and suicidal behavior. We examined the proportion of adolescents reporting these behaviors, and examined potential effects of depressive symptoms [tertiles of 6-item Kutcher Adolescent Depression Scale (KADS-6) score] and school-going status on these behaviors using mixed-effects Poisson regression models. We also assessed effect modification of associations by sex, age, and school-going status.ResultsThe proportion of adolescents reporting risky behaviors was varied, from 2.2% for suicidal behaviors to 26.2% for getting into a physical fight. Being in the higher tertiles of KADS-6 score was associated with increased risk of almost all risky behaviors [adjusted risk ratio (RR) for highest KADS-6 tertile for alcohol use: 1.70, 95% confidence interval (95% CI): 1.48–1.95, p < 0.001; for physical fight: 1.52, 95% CI: 1.36–1.70, p < 0.001; for suicidal behavior: 7.07, 95% CI: 2.69–18.57, p < 0.001]. Being in school was associated with reduced risk of substance use (RR for alcohol use: 0.73, 95% CI: 0.53–1.00, p = 0.047), and not using a condom (RR: 0.81, 95% CI: 0.66–0.99, p = 0.040). There was evidence of modification of the effect of school-going status on risky behaviors by age and sex.ConclusionOur findings reinforce the need for a greater focus on risky behaviors among adolescents in SSA. Addressing depressive symptoms among adolescents, facilitating school attendance and using schools as platforms to improve health may help reduce risky behaviors in this population. Further research is also required to better assess the potential bidirectionality of associations

COVID-19 Preventive Practices, Psychological Distress, and Reported Barriers to Healthcare Access during the Pandemic among Adult Community Members in Sub-Saharan Africa: A Phone Survey

The COVID-19 pandemic has had serious negative health and economic impacts in sub-Saharan Africa. Continuous monitoring of these impacts is crucial to formulate interventions to minimize the consequences of COVID-19. This study surveyed 2,829 adults in urban and rural sites among five sub-Saharan African countries: Burkina Faso, Ethiopia, Nigeria, Tanzania, and Ghana. Participants completed a mobile phone survey that assessed self-reported sociodemographics, COVID-19 preventive practices, psychological distress, and barriers to healthcare access. A modified Poisson regression model was used to estimate adjusted prevalence ratios (aPRs) and 95% CIs to investigate potential factors related to psychological distress and barriers to reduced healthcare access. At least 15.6% of adults reported experiencing any psychological distress in the previous 2 weeks, and 10.5% reported that at least one essential healthcare service was difficult to access 2 years into the pandemic. The majority of participants reported using several COVID-19 preventive methods, with varying proportions across the sites. Participants in the urban site of Ouagadougou, Burkina Faso (aPR: 2.29; 95% CI: 1.74–3.03) and in the rural site of Kintampo, Ghana (aPR: 1.68; 95% CI: 1.21–2.34) had a higher likelihood of experiencing any psychological distress compared with those in the rural area of Nouna, Burkina Faso. Loss of employment due to COVID-19 (aPR: 1.77; 95% CI: 1.47–2.11) was also associated with an increased prevalence of psychological distress. The number of children under 5 years in the household (aPR: 1.23; 95% CI: 1.14–1.33) and participant self-reported psychological distress (aPR: 1.83; 95% CI: 1.48–2.27) were associated with an increased prevalence of reporting barriers to accessing health services, whereas wage employment (aPR: 0.67; 95% CI: 0.49–0.90) was associated with decreased prevalence of reporting barriers to accessing health services. Overall, we found a high prevalence of psychological distress and interruptions in access to healthcare services 2 years into the pandemic across five sub-Saharan African countries. Increased effort and attention should be given to addressing the negative impacts of COVID-19 on psychological distress. An equitable and collaborative approach to new and existing preventive measures for COVID-19 is crucial to limit the consequences of COVID-19 on the health of adults in sub-Saharan Africa

COVID-19 vaccine hesitancy and its determinants among sub-Saharan African adolescents.

COVID-19 vaccine hesitancy among adolescents poses a challenge to the global effort to control the pandemic. This multi-country survey aimed to assess the prevalence and determinants of COVID-19 vaccine hesitancy among adolescents in sub-Saharan Africa between July and December 2021. The survey was conducted using computer-assisted telephone interviewing among adolescents in five sub-Saharan African countries, Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania. A rural area and an urban area were included in each country (except Ghana, which only had a rural area), with approximately 300 adolescents in each area and 2662 in total. Sociodemographic characteristics and perceptions and attitudes on COVID-19 vaccines were measured. Vaccine hesitancy was defined as definitely not getting vaccinated or being undecided on whether to get vaccinated if a COVID-19 vaccine were available. Log-binomial models were used to calculate the adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between potential determinants and COVID-19 vaccine hesitancy. The percentage of COVID-19 vaccine hesitancy was 14% in rural Kersa, 23% in rural Ibadan, 31% in rural Nouna, 32% in urban Ouagadougou, 37% in urban Addis Ababa, 48% in rural Kintampo, 65% in urban Lagos, 76% in urban Dar es Salaam, and 88% in rural Dodoma. Perceived low necessity, concerns about vaccine safety, and concerns about vaccine effectiveness were the leading reasons for hesitancy. Healthcare workers, parents or family members, and schoolteachers had the greatest impacts on vaccine willingness. Perceived lack of safety (aPR: 3.52; 95% CI: 3.00, 4.13) and lack of effectiveness (aPR: 3.46; 95% CI: 2.97, 4.03) were associated with greater vaccine hesitancy. The prevalence of COVID-19 vaccine hesitancy among adolescents is alarmingly high across the five sub-Saharan African countries, especially in Tanzania. COVID-19 vaccination campaigns among sub-Saharan African adolescents should address their concerns and misconceptions about vaccine safety and effectiveness

Continued disruptions in health care services and mental health among health care providers during the COVID-19 pandemic in five sub-Saharan African countries.

BACKGROUND: Continuous monitoring of the pandemic's impact on health service provision and mental health, COVID-19 perceptions, and compliance with prevention measures among health care providers (HCPs) can help with mitigating the pandemic's negative effects. METHODS: A computer-assisted telephone interviewing (CATI) survey was conducted among 1499 HCPs in Burkina Faso (Ouagadougou), Ethiopia (Addis Ababa), Nigeria (Lagos and Ibadan), Tanzania (Dar es Salaam), and Ghana (Kintampo). Self-reported mental health, perceptions of the COVID-19 pandemic, and prevention measures available in the workplace were assessed. HCPs' responses to questions regarding the impact of COVID-19 on nine essential health services were summed into a score; high service disruption was defined as a score higher than the total average score across all sites. Modified Poisson regression was used to identify potential factors related to high service disruption. RESULTS: Overall, 26.9% of HCPs reported high service disruption, with considerable differences across sites (from 1.6% in Dar es Salaam to 45.0% in Addis Ababa). A considerable proportion of HCPs reported experiencing mild psychological distress (9.4%), anxiety (8.0%), and social avoidance or rejection (13.9%) due to their profession. Participants in Addis Ababa (absolute risk ratio (ARR) = 2.10; 95% confidence interval (CI) = 1.59-2.74), Lagos (ARR = 1.65; 95% CI = 1.24-2.17), and Kintampo (ARR = 2.61; 95% CI = 1.94-3.52) had a higher likelihood of reporting high service disruption compared to those in Ouagadougou. Reporting ever-testing for COVID-19 (ARR = 0.82; 95% CI = 0.69-0.97) and the presence of COVID-19 guidelines in the workplace (ARR = 0.63; 95% CI = 0.53-0.77) were both associated with lower reported health service disruption among HCPs. CONCLUSION: The COVID-19 pandemic continues to disrupt essential health services and present a challenge to HCPs' mental health, with important differences across countries and settings; interventions are needed to mitigate these negative effects of the pandemic