Hypoglycemic and hypolipidemic effects of the aqueous fresh leaves extract of Clerodendrum capitatum in Wistar rats.

Diabetes mellitus, the most common endocrine disorder of carbohydrate metabolism, is treated in the African traditional phytotherapies with the cold water decoction of Clerodendrum capitatum (CC). In the current study, the hypoglycemic and hypolipidemic effects of fresh leaves aqueous extract of CC were studied in four groups of six adult Wistar rats per group and weighting 120-150 g, by administering graded oral doses (100, 400 and 800 mg/kg/day) of the extract for 14 days. On the 15th day, the fasted rats were anesthetized under inhaled halothane and blood samples obtained through cardiac puncture. Phytochemical analysis of CC extract was conducted using standard procedures while the preliminary acute oral toxicity study was also conducted using limit dose test of Up and Down Procedure at a limit dose of 5000 mg/kg body weight/oral route. Results of the study showed CC to cause significant (p<0.05, p<0.001) dose dependent hypoglycemic and hypolipidemic effects but had no effect on the pattern of weight gain in the treated rats. Although no lethal effect was recorded with CC oral administration for up to 5000 mg/kg body weight/oral route, but there was an associated transient somatomotor and behavioral toxicities. Phytochemical results revealed the presence of saponins, flavonoids, alkaloids, tannin, glycosides and reducing sugars in the extract. Thus, the folkloric use of Clerodendrum capitatum in the treatment of suspected type 2 diabetics has a positive correlation with scientific data generated in this study.

Sociocultural aspects of mass delivery of praziquantel in schistosomiasis control: the Abeokuta experience.

BACKGROUND: Schistosomiasis is a public health problem in Nigeria. Although there is an ongoing national program for its control, disease control programs in other countries have shown the need to understand the sociocultural aspects of disease transmission, prevention, and treatment in endemic communities before control efforts are undertaken. OBJECTIVE: To describe sociocultural factors that influence the distribution process of praziquantel for the mass treatment of schistosomiasis infection. METHODS: Data for the study were collected through focus group discussions held separately with adult males and females, male and female adolescents (13-19 years), and male and female children (5-12 years). In-depth interviews were similarly held with the drug distributors of praziquantel for mass treatment and with community/opinion leaders of six hyperendemic communities in Ogun State, Southwest Nigeria on mass treatment using praziquantel. These focus group discussions and in-depth interviews were held both before and following the drug distribution. The data were analyzed using the textual analysis program, Textbase Beta. RESULTS: Following a 3-week period of mass treatment in six communities, we observed an increased awareness of rivers/streams as a source of schistosomiasis. In addition, the communities reported overwhelming support for the mass treatment after receiving treatment. The reasons for this acceptance appear to include the perceived efficacy of praziquantel against the disease and its availability free of charge. The drug's distributors adhered to the originally specified systems-based protocol for mass treatment in only two of the six communities. The systems-based protocol adhered to strict distribution through primary health centers and schools. The four other communities used a community-based approach for mass treatment with praziquantel and attained greater coverage of treatment as a result. CONCLUSION: Obtaining community support and involvement before the implementation of mass treatment of schistosomiasis with praziquantel contributes to an effective treatment strategy for this disease. A detailed assessment of a community's health needs, before the initiation of the control efforts against endemic infections, should be undertaken.

A pilot study to evaluate malaria control strategies in Ogun state, Nigeria.

With limited evidence of decreases in malaria-related mortality and morbidity, and nearly half the time to the 2010 deadline of Roll Back Malaria (RBM) targets now past, we conducted this study to assess the awareness, accessibility and use of malaria control strategies among at-risk groups within the context of RBM in Nigeria. It was a descriptive, cross-sectional pilot study of 34 registered women attending antenatal clinics and 34 mothers of children less than five years old, using a questionnaire in a malaria holo-endemic community of Ogun State, Nigeria. Results showed that 14.7% and 16.2% of all respondents interviewed were aware of the home management of malaria (HMM) program (17.6% of mothers of children under five years vs. 11.8% of pregnant women) and the change in policy on malaria treatment (23.5% of mothers of children under five years vs. 8.8% of pregnant women) respectively. Younger respondents knew more about HMM than older ones (p <.05). Most (63.2%) of the 68 respondents (64.7% of mothers of children under five years vs. 61.8% of pregnant women) interviewed knew about insecticide treated nets (ITNs); however, only 22.1% were using the treated material. Reasons given by those not using ITNs included: they did not know about ITN prior to the interview (43.3%(, they had no money (41.5%) and they did not know where to get it (7.6%). Only 5.8% of mothers of children less than five years old, and none of the pregnant women, had taken the new combination drug. Eight (23.5%) of the 34 pregnant women interviewed knew about intermittent preventive treatment of malaria for pregnant women (IPT), while two (25.0%) of these eight women had received a preventive treatment dose. The results of this pilot study showed that efforts need be intensified to make adequate information and materials relating to the different malaria control strategies more available and accessible at the community level to achieve and sustain the RBM goals, both in Ogun State and in Nigeria in general. However, a larger study is needed to provide more generalized findings.

Height as a substitute for weight for estimating praziquantel dosage.

The study evaluated height and weight measurements of 750 school children from five rural communities in western Nigeria. The measurements were taken by 12 trained community members designated as distributors in determining treatment dose with praziquantel for these children. A very strong correlation value, r=0.97, was obtained for the weight of treated children measured by the distributors and the research team. The distributors obtained a correlation coefficient value of r=0.87 on weight and height measurements, showing that height can be used by community distributors in lieu of weight for correct dose determination.

Willingness to pay for praziquantel treatment in a hyperendemic community of Ogun State, Nigeria.

BACKGROUND: Schistosomiasis is highly endemic in Nigeria. However, very little is known about the usage and social marketing of praziquantel in the control of schistosomiasis in endemic communities and on the persons willingness to pay for the drug to support its extensive use and thus aid control efforts in Nigeria. OBJECTIVE: The study examined the willingness of people in a hyperendemic community, to pay for treatment with praziquantel before and after provision of the drug, with a view to assess the feasibility of achieving widespread coverage. METHODS: Data were collected through focus group discussions among household heads and other adult family members and through the use of a questionnaire to survey household heads in Imala-Odo, a community hyperendemic for schistosomiasis, in southwest Nigeria. The main outcome measure was the respondents' willingness to pay for schistosomiasis treatment. RESULTS: The results showed that in contrast to the 92.3% of respondents who expressed willingness to buy the drug in the preintervention study, only 46.5% actually purchased the drug during intervention for the treatment of their infected household members. The respondents' level of education, occupation, and income influenced their willingness to pay (P<.05). Statistical tests showed that those willing to pay for treatment had a higher income score than those unwilling to do so. Most respondents preferred their community head and reliable persons chosen by the community as convenient outlets for drug distribution. The number of household members respondents were willing to treat increased from 4 to 6 at N320.00 (US $2.52) in the preintervention and postintervention phases, respectively. Gender factor was found to influence the respondents' perceived average treatment cost; the females wanted N300.00 (US $2.36) against N100.00 (US $0.79) among the males. CONCLUSION: Efforts need to be made and sustained to ensure that all families can afford to praziquantel drug to achieve the ultimate goal of controlling the infection in endemic communities of Nigeria.

Hypoglycemic and hypocholesterolemic activities of the aqueous leaf and seed extract of Phyllanthus amarus in mice.

The effect of the aqueous leaf and seed extracts of Phyllanthus amarus at oral dose of 150, 300 and 600 mg/kg was investigated for their antidiabetic and anti-lipidemic potentials. The extract produced a dose-dependent decrease in the fasting plasma glucose and cholesterol, and reduction in weights in treated mice. The results suggest that the extract could be enhancing peripheral utilization of glucose but the mechanisms on how this works remain unclear.

The hypotensive mechanisms for the aqueous stem bark extract of Musanga cecropioides in Sprague-Dawley rats.

The present study was designed to evaluate the hypotensive properties and the mechanisms of action of the stem bark aqueous extract of Musanga cecropioides R.Br. Apud Tedlie (MCW) in anesthetized rats of Sprague-Dawley strain, through an invasive direct blood pressure measuring procedure. Thirty adult rats, weighing 150-230 g, were grouped into five groups of six rats each. The effects of the intravenous graded doses (0.0005-0.05 mg/kg) of the extract on the blood pressure indices were investigated. Its underlying mechanisms were also studied using additional five groups of rats. The results showed that the extract caused a dose dependent fall in the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure and heart rate of the rats. Bilateral carotid artery occlusion (BCO) caused a reflex increase in mean arterial pressure and heart rate which were significantly attenuated by the extract injection. Angiotensin Converting Enzyme (ACE) blockade with 5 mg/kg of Captopril and cholinergic blockade with 0.2 mg/kg of atropine significantly attenuated the hypotensive response to MCW. However, the pattern of MAP fall in rats pretreated with a combination of Promethazine (1 mg/kg) and Cimetidine (15 mg/kg) was not significant. The results of the study was able to demonstrate dose dependent hypotensive effect of MCW and that its vasorelaxant effects may be through inhibition of sympathetic, cholinergic control of the arterial pressure and most significantly through ACE blockade. However, the phytochemical, elemental and toxicological studies of this potential antihypertensive still needed to be investigated.

Willingness to seek HIV testing and counseling among pregnant women attending antenatal clinics in Ogun State, Nigeria.

HIV counseling and testing (CT) is slowly being introduced as one of several key components of the comprehensive package of HIV/AIDS prevention and care in Nigeria, particularly in the prevention of mother-to-child transmission of HIV (PMTCT). A cross-sectional survey of 804 women attending antenatal clinics (ANC) in Ogun State, Nigeria was done using questionnaires to assess their willingness to seek and undergo CT and know the determinants. Focus group discussions were also held in the general community: 84.3% of respondents believed in AIDS reality, while 24.3% thought they were at risk of HIV infection. Only 27% knew about MTCT, while 69.7% of 723 who had heard of HIV/AIDS did not know about CT. Only 71 (8.8%) had thought about CT and 33 (4.5%) mentioned HIV testing as one of antenatal tests. After health education on CT, 89% of the women expressed willingness to be tested. Their willingness for CT was positively associated with education (p < 0.05), ranging from 77% (no education) to 93% (post-secondary). More of those with self-perceived risk expressed willingness to test for HIV (p < 0.05). Those willing to be tested had a higher knowledge score on how HIV spreads than those not willing. Multiple regressions identified four key factors that were associated with willingness for CT: increasing educational level; not fearing a blood test; perception that the clinic offered privacy; and perceptions of higher levels of social support from relatives and peers. Those unwilling or undecided about CT expressed strong fear of social stigma/rejection if tested positive. The results provided insights for planning promotional programs and showed that not only are IEC efforts needed to boost knowledge about HIV/AIDS, but that change in clinic setting and community are imperative in creating supportive environment to encourage uptake of CT services.

An assessment of parent-child communication on sexuality in lagos, Nigeria.

This study is the first phase of a project designed to help parents acquire skills necessary for comfortable and effective communication about adolescents' sexuality. It assessed parent-child communication on sexuality among the in-school adolescents in Lagos, Nigeria. It was observed that a high proportion of the adolescents interviewed receive information on sexuality from friends and the mass media and also communicate more with their friends on sexuality than with their parents.

Limitations to Access and Use of Antiretroviral Therapy (ART) Among HIV Positive Persons in Lagos, Nigeria.

The study was designed to examine the knowledge and perception of HIV positive persons about the antiretroviral therapy (ART) program and to determine their ability to pay for ART and the treatment of other opportunistic infections in Nigeria. This is aimed at identifying factors that may impede effective delivery and utilization of ART in the country. One hundred and twenty-five HIV positive persons seeking ART at the Nigerian Institute of Medical Research (NIMR) clinic, Lagos, were studied using questionnaires. Respondents' average monthly income was N11,253.00 (US$90.00). Almost 26% (25.6%) were unwilling to seek ART at the nearest hospital because of fear of stigmatization. While 9% wanted the therapy for free, the majority was willing to pay N500.00 (US$4.00) per month. The average affordable price based on the subjects' assessment was N905.00 (US$7.24), while the median was N500.00 (US$4.00) per month. Eighty-eight percent believed ART would prolong their lives. The ART drugs need to be affordable and building on the positive perceptions of ART is imperative.

Herbal remedy in the treatment of malaria: cross sectional survey of residents of Lagos State, Nigeria.

Semi structured questionnaires. designed to capture information on the type. composition, method of preparation. dosage, mode of administration. and frequency of use of herbal preparations in malaria treatment, were administered to 1,593 adults of the 3 main ethnic groups and a forth group comprising other smaller ethnic groups designated as "others", all resident in Lagos metropolis in a cross sectional survey. The 1,593 respondents were made up of 892 males and 701 females and their ages ranged from 19 to 60 years. A high percentage in all the ethnic groups especially the Yorubas admitted to the use of herbs in treating malaria [Yoruba (69%), Hausa (47%). others (32%) and Igbo (30%)1. Effectiveness of herbs in treating malaria episodes featured as the major factor for their use. as claimed by the majority (>50%) of the respondents in each of the ethnic groups, while cost consideration was the next most important factor. Other factors mentioned included the absence of side effect in herbal use. to avoid the itchy side effect and ineffectiveness of chloroquine and some other anti-malarials. An appreciable percentage across the ethnic groups had no idea of the constituents of the herbal remedies they use for treating their malaria episodes since they buy these from traditional herbalists. Varied combinations of these herbs in combination with different types of fruits and other substances are claimed to be used, the main ones of which are Azardiracha indica and pineapple. A large majority of respondents in all the ethnic groups claimed to use the same herbs for the treatment and prevention of malaria and great improvement is experienced after use [Hausas (90%). Igbos (83%). Yorubas (77%) and the others (88%)]. There is usually no specific dose or dose regimen. however a high proportion in all the ethnic groups use herbal preparation thrice a day and a few of the respondents take unspecified measures at arbitrary intervals. The lack of standards in the use of these herbal preparations needs to be urgently addressed especially as use continued until the malaria symptoms and signs are deemed to have disappeared. There is also need to standardize the usage of herbs if they are to play a significant role in malaria prevention and treatment.

Effectiveness of different approaches to mass delivery of praziquantel among school-aged children in rural communities in Nigeria.

Schistosomiasis is hyperendemic in Nigeria. The national policy on schistosomiasis control has adopted praziquantel as the main drug of use in the control strategy aimed at reducing morbidity. However, the best delivery channel for praziquantel in schistosomiasis control in Nigeria is yet to be determined. This study assessed different channels for praziquantel delivery in a mass treatment effort. Three groups, each of two communities, were assigned to one of the following three channels: health facility (HF), school, and community for mass delivery of praziquantel to school-aged children. Distributors were trained on all aspects of praziquantel distribution and sufficient praziquantel tablets were provided for the drug distribution within 3 weeks following which an evaluation of the drug distribution by the different treatment channels was conducted. Overall, the community channel of delivery achieved the best coverage of 72.2% (range: 69-73%) compared to 44.3% (range: 39.5-62%) and 28.5% (range: 26.3-74.5%) for the HF and school channels, respectively. Community channel of praziquantel delivery as shown in this study ensures good coverage of both in and out-of-school children.

Treatment of childhood fevers and other illnesses in three rural Nigerian communities.

The seeking of healthcare for childhood illnesses was studied in three rural Nigerian communities of approximately 10,000 population each. The aim was to provide a baseline understanding of illness behaviour on which to build a programme for the promotion of prepackaged chloroquine and cotrimoxazole for early and appropriate treatment of childhood fevers at the community level. A total of 3117 parents of children who had been ill during the 2 weeks prior to interview responded to questions about the nature of the illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illnesses were 'hot body' (43.9 per cent), malaria, known as iba (17.7 per cent), and cough (7.4 per cent). The most common form of first-line treatment was drugs from a patent medicine vendor or drug hawker (49.6 per cent). Only 3.6 per cent did nothing. Most who sought care (77.5 per cent) were satisfied with their first line of action, and did not seek further treatment. The average cost of an illness episode was less than US$2.00 with a median of US$1.00. Specifically, chloroquine tablets cost an average of US 29 cents per course. Analysis found a configuration of signs and symptoms associated with chloroquine use, to include perception of the child having malaria, high temperature and loss of appetite. The configuration positively associated with antibiotic use consisted of cough and difficult breathing. The ability of the child's care-givers, both parental and professional, to make these distinctions in medication use will provide the foundation for health education in the promotion of appropriate early treatment of childhood fevers in the three study sites.