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SCREENING OF TRADITIONAL MEDICINAL PLANTS FROM ZIMBABWE FOR PHYTOCHEMISTRY, ANTIOXIDANT, ANTIMICROBIAL, ANTIVIRAL AND TOXICOLOGICAL ACTIVITIES
No full textFourteen indigenous medicinal plants used by traditional medical practitioners in treating sexually transmitted diseases including HIV/AIDS and opportunistic infections were selected after an ethno-botanical pilot survey of five districts from Zimbabwe. The plant materials were collected and extracted separately with methanol. The 28 extracts were lyophilized and screened for phytochemical groups, and biological: antioxidant, antiviral, antibacterial, antifungal and toxicological activities. The phytochemical screening was carried out using Thin Layer Chromatography and UV detection, followed by standard confirmatory tests. The results indicated that seven (25.9%) extracts were positive for alkaloids, ten (35.7%) for anthraquinones, thirteen (46.4%) for coumarins, seventeen (60.7%) for flavonoids, twenty-three (82.1%) for saponins and twenty-five (89.3%) for tannins. Flavonoids, saponins and tannins were the most frequent phytochemical groups found. All extracts contained at least three of the chemical groups. In order to determine the antioxidant activity, the plants were screened for Radical Scavenging Activity using DPPH (2,2-diphenyl-picrylhydrazyl) with β-carotene as reference and their Total Phenolic Contents were measured by the Folin-Ciocalteu reagent using gallic acid as reference. Eight extracts exhibited antioxidant activity with percentages higher than 90% (Rhus chirindensis leaves & roots-both 96.9%; Khaya anthotheca bark-96.1%) and the lowest result was 27.4% for Dichrostachys cinerea roots. Their TPCs ranged from 0.596mg/mg GAE for Khaya anthotheca bark to 0.105mg/mg GAE for Dichrostachys cinerea roots. The phenolic compounds in the extracts correlate with their antiradical activity (r2=0.57), confirming that the phenolics are likely to cause the radical scavenging activity. The antiviral activity was examined using End Point Titration Technique (EPTT) and Neutralisation Test (NT) after calculating the cytotoxicity of the plant extracts on VERO cells. The HSV-2 virus titre was calculated using the Reed and Muench method (TCID50 = 10-8.5 per 0.1ml). The reduction factor (RF) was calculated and it was considered a promising antiviral result if the RF was ≥ 103. Out of 26 extracts, 13 (50%) showed considerable antiviral activity against the HSV-2 virus. The best results were obtained from the extracts of Dichrostachys cinerea leaves (RF 104), Kigelia africana fruit (RF 104) and Hypoxis rooperi tuber (RF 103) with concentrations ranging from 10.41μg/ml (Dichrostachys cinerea leaves) to 125.0μg/ml (Flacourtia indica roots). The reference acyclovir was active at 1.50μg/ml. Their cytotoxicity could also be beneficiary in developing new anti-tumour drugs. The antibacterial and antifungal activities of the plant extracts (10mg/ml) were investigated by the agar well assay. The chosen microorganisms were Staphylococcus aureus, Streptococcus group A, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, and Aspergillus niger. The best results were Terminalia sericea roots, Warburgia salutaris roots, Gymnosporia senegalensis roots and Kigelia africana bark which were active against all micro-organisms. T. sericea roots inhibited the growth of S. aureus with inhibition zone of 7.88±0.48mm where the reference amoxicillin (10μg) gave a zone of 9.00±0.41mm and against P. aeruginosa, gave a larger zone of inhibition, 10.00±0.82mm, than the reference gentamicin (10μg), 7.00±0.40mm. W. salutaris roots were active against both fungal strains with inhibition zones of 10.00±0.82mm for C. albicans and 8.25±0.50mm for A. niger which were even bigger than the zones of the reference amphotericin B (10μg) 6.35±0.50mm and 6.75±0.58mm respectively. The toxicity tests were conducted using the Brine Shrimp (Artemia salina) Lethality Test (BSLT). Five of the extracts showed significant toxicity levels of LC50< 300μg/ml. The lowest readings of LC50, Terminalia sericea leaves (66.7ppm) and Kigelia africana fruit (117.4ppm) were even lower than the positive control, Nerium oleander leaves (141.7ppm) which is a plant with well-established anti-tumour activity. These results confirm the ethno-botanical claims by traditional medical practitioners treating viral, bacterial and fungal infections caused by HIV/AIDS, cancer and cardiovascular diseases with traditional medicinal plants due to the rich phytochemistry, their high levels of antioxidant activity as well as bioactivity of the plants. They should be preserved and harvested with caution not only because of their medicinal value but also the role they play in the rich African heritage
An investigation of the factors influencing the choice of infant feeding methods among urban Zimbabwean women in the context of HIV transmission
No full textObjective: To determine the socio-economic and cultural factors influencing the choice of infant feeding methods in urban Zimbabwe women in the context of HIV transmission. Study Design: A prospective survey. Setting: Clinics in Harare and Chitungwiza, Zimbabwe. Subjects: A total ol 200 women attending eight baby clinics, with babies aged up to two years. Main Outcome Measures: Infant feeding methods used by mothers, number of women who had undergone HIV testing, those who knew the link between HIV and breast feeding, and those who were afraid to breast feed. The most common reasons for breast feeding and formula feeding. Results: Husbands had a greater influence on feeding practices than nurses, implying that social influences have a higher influence than the advice of medical personnel when choosing a method of feeding (58% and 42% respectively). Thirty three percent and 77% of women in Harare and Chitungwiza respectively knew the link between HIV and breast milk. Thirteen percent and 36% of the women were afraid to breast feed in Harare and Chitungwiza respectively. Conclusion: The level of education and employment status as well as the opinions of family members and health care personnel are the major factors that influence the choice of method of infant feeding. The multiplicity of factors complicate the decision making process, considering the benefits of breast feeding, which have to be weighed against the risk of transmitting HIV to the infant
An autopsy study of splenic injuries seen in patients with blunt abdominal trauma at Parirenyatwa Group of Hospitals in Harare: Prevalence of missed splenic injuries
No full textThe spleen is one of the most commonly injured organs following blunt
abdominal trauma1. Significant evolution has occurred in the
management of splenic injuries, with a paradigm shift, from splenectomy
to non-operative management.2 In low resource centres, absent
management protocols and the lack of expertise and equipment, have
resulted in a significant number of splenic injuries being missed.3
1.2 OBJECTIVES
(i) To determine the frequency of missed splenic injuries related to
blunt abdominal trauma at the Parirenyatwa Group of Hospitals at
autopsy.
(ii) To evaluate the initial diagnostic modalities being utilised in
screening for splenic injuries.
(iii) To identify other injuries associated with missed splenic injuries at
autopsy.
1.3 STUDY DESIGN
Retrospective Descriptive autopsy study
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1.4 MATERIALS AND METHODS
Records of autopsies done over the period January 2008-December
2011were analysed in conjunction with those from casualty at the
Parirenyatwa Group of Hospitals. All autopsies performed for blunt
trauma were included in the study. Analysis was done using Stata version
10.0.
1.5 RESULTS
A total of 2171 autopsies were conducted for blunt trauma during the period
January 2008 and December 2011. Of these, 136 cases were identified as
having a missed splenic injury, giving a prevalence of 6% (p=0.001). Data
for analysis was available in 87 cases. The remaining cases (n=49) were
excluded from the study. Median age was 33 years (Q1=27, Q3=40). Male:
female ratio was 4.2:1.Road traffic accidents accounted for 86% of all
injuries. In 83% of cases, the initial attending clinician was the casualty
officer. None of the initial attending clinicians had Advanced Trauma Life
Support(ATLS® )training. Sixty per cent of cases presented with a GCS
of 3-8. Head injuries were the most common association in 46% of cases.
None of the cases had an ultrasound scan done. At autopsy, the median
volume of haemoperitoneum was 1000ml; (Q1=713 Q3=1069). The
commonest cause of death was hypovolemic shock in 60% of cases.
Combined splenic and liver injuries accounted for 40% and isolated
splenic injuries accounted for 33% of these cases.
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1.6 CONCLUSION
The study confirms that a significant number of splenic injuries were
missed by the attending clinician. A low Glasgow Coma Scale and the
presence of serious injuries were the commonest associations. The lack of
training in ATLS®, absence of protocols of managing trauma patients
and inadequate diagnostic equipment and expertise were the other
contributory factors associated with the missed splenic injuries. Early
detection and appropriate management of these cases could significantly
reduce the mortality of these polytrauma patients
Prevalance and associated risk factors of multi-drug resistant tuberculosis in adult( 18years and above) HIV positive patients registered at Mpilo OI clinic
No full textObjectives: To determine prevalence of multidrug-resistant tuberculosis (MDR-TB) and
associated risk factors among adult (=18 years) HIV positive patients registered at Mpilo
Opportunistic Infection (OI) clinic. To assess the association of CD4 count and MDR-TB.
Background: Tuberculosis (TB) is a major public health disease, affecting one third of the world’s population and killing approximately two million people yearly. The
emergence of resistance to anti -tuberculosis drugs, particularly MDR-TB has become a global threat .Its association with HIV positivity has been reported. It is estimated that
approximately 3.6% of all incident TB cases are MDR-TB. In Zimbabwe there are no clear
guidelines for MDR-TB case finding in new TB patients. This may lead to mis-treatment as all new TB cases are initiated on first line drugs. Of late Zimbabwe has undergone serious economic hardships which together with its very high burden of HIV could have a negative impact on MDR-TB. Despite the high risk of MDR-TB in HIV positive patients, little has been done to investigate the burden of MDR-TB in these patients. This study determined prevalence of MDR-TB in adult HIV positive patients
Methods:A health facility based cross-sectional study was carried out at Mpilo OI Clinic
between 01March and 31July 2012. Convenience sampling was used to recruit 275 adult HIV positive patients into the study on a daily basis. A single sample for MDR-TB was collected from each one of these participants. A total of 275 sputum and aspirate(Bone marrow, Aspirates, pus Cerebrospinal fluid) samples were collected and cultured for MDR-TB using both the Liquid using BACTEC Mycobacterium Growth Indicator Tube 960 (MGIT) and the Conventional Solid Lowenstein Jensen (LJ )culture methods. Whole blood for CD4 count was collected from each participant and tested
using BD FACS Calibur Flow Cytometry CD4 count machine. Logistic regression was used to determine predictors of MDR-TB prevalence.
Results: The prevalence of MDR-TB was 2.6% among adult HIV patients registered at Mpilo OI Clinic and attended the clinic between 01 March and 31July 2012.In the multivariate analysis, MDR-TB prevalence was associated with CD4 count (OR 0.14 p=0.043)
Conclusion: A prevalence of 2.6% of MDR-TB among HIV positive patients was found. This is very high considering this high MDR-TB risk group. A CD4 count of >200 cells/ul was found to be protective of high MDR-TB prevalence. Targeted interventions of MDR
-TB are necessary to reduce incident MDR-TB cases among HIV positive patients.Increased MDR-TB case finding through culture and Drug Susceptibility testing
before initiation of First line drugs is necessary to reduce mistreatment. Infection control
measures need to be put in place to reduce transmission of MDR-TB
Effect of irbesartan on blood glucose levels in a mice model of type 2 diabetes mellitus
No full textAngiotensin receptor blockers (ARBs) have been reported to affect glycaemic control in both animals and humans. A few studies have evaluated the effects of irbesartan on blood glucose levels. However, only one study evaluated the effect of irbesartan on insulin resistance and glucose tolerance.
Objective: To evaluate the effect of irbesartan on blood glucose levels and glucose tolerance in diabetic and non-diabetic mice
Method: A total of 48 mice were divided into 8 groups (n=6) where group 1-4were fed on
standard diet and group 5-8were fed on high fat diet. Diabetes was induced in mice fed on high fat diet using alloxan monohydrate 150mg/kg via the intra-peritoneal route. Group 1, 2 and 3 were non-diabetic and received irbesartan at 20mg/kg, 50mg/kg and 75mg/kg for 13 days, respectively. Group 4 acted as the non-diabetic control and received water. After induction of diabetes, group 5, 6 and 7 received irbesartan 20mg/kg, 50mg/kg and 75mg/kg for 13 days, respectively, whilst group 8 acted as the diabetic control and received distilled water. Drug administration was done via oral gavage. Blood glucose levels were measured on selected days. Oral glucose tolerance test was carried out on day 14 after the commencing of drug dosing via administration of 1g/kg body weight to all the mice and measuring the blood glucose levels at 15, 30, 60 and 120 minutes.
Results: Irbesartan at the dose of 20mg/kg and 75mg/kg significantly lowered (-39%, and 40%, respectively; p<0.05) blood glucose levels in diabetic mice. Irbesartan 20mg/kg, 50mg/kg and 75mg/kg did not significantly change blood glucose levels (-15%, -3% and 9%) in non-diabetic mice. In diabetic mice, irbesartan 20mg/kg and 75mg/kg improved glucose tolerance (Area under the curve [AUC] = 55.35mmol/Lmins and 45.54mmol/Lmins, respectively). However, the improvements were not statistically significant compared to the diabetic control group (AUC=63.53mmol/Lmins; p<0.05). Unlike in the diabetic mice, all the doses of irbesartan had no effect on glucose tolerance in non-diabetic mice (p<0.05)
Conclusion: Low and high dose irbesartan had significant hypoglycaemic effects and
improved glucose tolerance in diabetic mice. However, all doses of irbesartan had no
significant effects on blood glucose levels and glucose tolerance in non-diabetic mice
Factors associated with defaulting among women initiated on option B+ in urban clinics- 2015
No full textIntroduction: We carried out this study to describe the demographic characteristics of the mothers on Option B+ at Budiriro, Mabvuku, Rutsanana and Kuwadzana poly-clinics. To determine the patient level factors, the service related factors, the provider-patient relationship factors, the environmental, socio- cultural factors and the drug related factors associated with defaulting among women initiated on Option B+ at the four poly-clinics, 2015.
Methods: A 1:2 unmatched case control study was conducted. A total of 195 participants were recruited, 65 cases and 130 controls. The study was carried out at four polyclinics, Rutsanana, Mabvuku, Kuwadzana and Budiriro. Simple random sampling technique was used to select study participants from the Option B+ registers. A case was an HIV positive pregnant or lactating woman registered and initiated for Option B+ at any one of the four sites from January to April 2015 but missed at least one resupply visit or medicine pick up appointment for ART. A control was an HIV positive pregnant or lactating woman registered and initiated on Option B+ at any one of the four sites from January to April 2015 and attended all resupply visits or medicine pick up appointments for ART. Data were collected using interviewer administered questionnaires, in depth interviews, focus group discussions and key informant interviews. Quantitative data were analysed using Epi infoTM 7 to generate tables and graphs. Qualitative data were analysed manually using themes. The median age for cases was 27 years (Q1 = 23.5, Q3 = 32 years) while that of controls was 30 years (Q1 = 26.5, Q3 = 35.5 years).
Results: Non-disclosure of HIV status and having experienced stigma because of HIV status were significant patient level factors that were associated with defaulting with OR 16.6 and 14.3 respectively, (p<0.05). Running short of medication at some point and having experienced drug side effects were significant drug related factors associated with defaulting with OR 52 and 4.0 respectively, (p<0.05). Receiving inadequate information during counselling and not having attended individual counselling sessions were significant service related factors associated with defaulting with OR 9.4 and 3.7 respectively, (p<0.05).
Conclusions: Factors associated with defaulting among women initiated on Option B+ vary. Some of the factors have to do with the patient while some are related to the service that they receive and their relationship with the health care provider. Some are however related to the availability and the effects of the drugs themselves. We recommend providing adequate information on all the factors that might affect the women, encouraging disclosure of status so that they get support from others and strengthening of follow up mechanisms
Infection control among dental therapists in Zimbabwe
No full textObjectives: To assess the general infection control practices with special reference to the prevention of transmission ofHIV/AIDS infection among dental therapists in Zimbabwe.
Setting: Dental therapists practising in Zimbabwe Government Oral Health Clinics.
Methods: A descriptive cross sectional study using a self-administered questionnaire. Questions dealt with infection control practices in the procedure rooms, including barriers to transmission of infection, the practice of disinfection of working surfaces, the use of autoclave, and sterilization of the handpiece. The questionnaire also covered issues of personal protection through the use of protective wear, vaccination against hepatitis B as well as knowledge of one's HIV status.
Results: There was a 68% (24/35) response rate. The therapists were predominantly male and they were evenly distributed in the provinces of Zimbabwe. All were trained in Zimbabwe; 91.7% had not been vaccinated against hepatitis B and only 20% (n=7) had undergone previous HIV testing. Use ot gloves was universal; 92% used face masks; 66.7% used protective eyewear; 87.5% wore protective garments; 95% autoclavcd/chemoclavcd high speed handpieces; 83.3% autoclavcd/chemoclavcd slow speed handpieces. Barriers to infection control ranged from 22.7% to 40.9% and was attributed to non-availability of gloves and disinfectants.
Conclusion: The dental therapists seem to practise acceptable infection control methods. There is need to improve upon handpiece sterilization, the use of eyewear and improvement upon supplies for disinfection. Vaccination against hepatitis B virus needs to be encouraged
Factors associated with chronic malnutrition in Mazowe district, Mashonaland Central province, 2012
No full textIntroduction: The rate of stunting in Zimbabwe was recorded as 35% in 2012. Mashonaland Central Province recorded 2168 cases of malnutrition and 964(44%) were from Mazowe District, despite the fact that the district has the best in terms of food security. The objective was to determine the factors associated with chronic malnutrition in Mazowe District in 2012.
Methods: A 1:1 unmatched case control study was carried out in health facilities in Mazowe District to determine the factors associated with chronic malnutrition. A case was defined as a mother or caregiver of any child <5years in Mazowe district who is chronically malnourished registered in the malnutrition register at the health facility and is stunted (children whose height for age z score is below -2 standard deviation from the median of the reference population) during the period January 2012 and December 2012. A control was defined as mother or caregiver of any child less than five (5) years who was suffering from conditions other than malnutrition and was not stunted, during the period January 2012 to December 2012 in Mazowe District. Interviewer administered questionnaires were used to collect data from both cases and controls and Epi Info 3.5.1 statistical software was used to analyze data.
Results: A total of 78 cases and 78 controls were enrolled into the study. Factors independently associated with chronic malnutrition were; a child who had diarrhea in the last three months (adjusted OR=6.33, CI 2.8-14.00) and failing to breastfeed because of pressure of work (adjusted OR=3.37, CI 1.1-10.00). Fever was a significant risk factor (adjusted OR=3.57, CI 1.84-6.90).
Conclusion: Chronic malnutrition was associated with diarrhea, failure to breastfeed and fever in Mazowe District. We recommend early treatment of diarrhea, childhood illness and promotion of breastfeeding in Mazowe district. Mothers were given health education on breastfeeding