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The dipeptidyl peptidase-IV (DPP-IV) inhibitory activity of Khaya senegalensis extracts was evaluated. The DPP-IV from a rat kidney was purified to a purification fold of 2.3. Among extracts from K.â senegalensis, the hexane extract had the best DPP-IV inhibitory activity, with IC50 value of 1.56±0.61â µg/mL and was fractionated to eleven fractions (A-K). Fraction I had the best DPP-IV inhibition via uncompetitive pattern. GC-MS analysis of fraction I showed that the major bioactive compounds were 3-amino-3-hydroxyimino-N-phenylpropanamide (1) and 11-(2-cyclopenten-1-yl)undecanoic acid (2), with good binding affinities toward DPP-IV, based on molecular docking,. They were then subjected to molecular dynamic simulation using WEBGRO and utilizing a GROMACS system for 100â ns. The 3-amino-3-hydroxyimino-N-phenylpropanamide-DPP-IV complex was more stable and compact than the other complex. K.â senegalensis contains compounds like 1 that might be used for the design of new DPP-IV inhibitors.
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Inibidores da Dipeptidil Peptidase IV , Simulação de Dinâmica Molecular , Simulação de Acoplamento Molecular , Inibidores da Dipeptidil Peptidase IV/química , Inibidores da Dipeptidil Peptidase IV/metabolismo , Inibidores da Dipeptidil Peptidase IV/farmacologiaRESUMO
Diterpenes are a diverse group of structurally complex natural products with a wide spectrum of biological activities, including antidiabetic potential. In the last 25 years, numerous diterpenes have been investigated for antidiabetic activity, with some of them reaching the stage of clinical trials. However, these studies have not been comprehensively reviewed in any previous publication. Herein, we critically discussed the literature on the potential of diterpenes as antidiabetic agents, published from 1995 to September, 2021. In the period under review, 427 diterpenes were reported to have varying degrees of antidiabetic activity. Steviol glycosides, stevioside (1) and rebaudioside A (2), were the most investigated diterpenes with promising antidiabetic property using in vitro and in vivo models, as well as human subjects. All the tested pimaranes consistently showed good activity in preclinical evaluations against diabetes. Inhibitions of α-glucosidase and protein tyrosine phosphatase 1B (PTP 1B) activities and peroxisome proliferator-activated receptors gamma (PPAR-γ) agonistic property, were the most frequently used models for studying the antidiabetic activity of diterpenes. The molecular mechanisms of action of the diterpenes include increased GLUT4 translocation, and activation of phosphoinositide 3-kinase (PI3K) and AMP-activated protein kinase (AMPK)-dependent signaling pathways. This review revealed that diterpenes hold promising antidiabetic potential while stevioside (1) and rebaudioside A (2) are the only diterpenes that were advanced to the clinical trial stage of the drug discovery pipeline. Diterpenes belonging to the abietane, labdane, pimarane and kaurane classes have shown promising activity in in vitro and in vivo models of diabetes and should be further investigated.
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Diabetes Mellitus , Diterpenos do Tipo Caurano , Diterpenos , Proteínas Quinases Ativadas por AMP , Diabetes Mellitus/tratamento farmacológico , Diterpenos/farmacologia , Diterpenos/uso terapêutico , Diterpenos do Tipo Caurano/farmacologia , Diterpenos do Tipo Caurano/uso terapêutico , Humanos , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Fosfatidilinositol 3-QuinasesRESUMO
The article offers a qualitative examination of compounded precarity in creative work during the Covid-19 pandemic. Drawing on repeated in-depth interviews with twelve creative workers operating in the creative industries in Ghana, we examine one of the most prevalent practices for navigating, coping with, and managing compounded precarity: that of hustling. We empirically identify and discuss three interrelated practices of hustling in creative work: digitalization, diversification, and social engagement. We present a new way of conceptualizing creative work in precarious geographies by theorizing hustling, and the associated worker resourcefulness, improvisation, savviness, hopefulness, and caring not merely as an individualized survival strategy, but rather as an agentic and ethical effort to turn the vicissitudes of life into situated advantages and opportunities, and even social change.
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The present study was designed to review the antidiabetic potential of anthraquinones (AQs) with emphasis on the extent of blood glucose reduction, the half maximal inhibitory concentration values (in vitro studies), the proposed mechanisms of action, and the structure activity relationship studies. We sourced relevant data from the major scientific databases (Pubmed, Science Direct, Medline, and Google Scholar). According to our search, 25 AQs have shown variable antidiabetic potential, whereas one AQ (morindone-6-O-ß-D-primeveroside) showed no blood glucose-lowering ability. Emodin and rhein showed the most promising antidiabetic potential in various models. The proposed mechanisms of antidiabetic action include upregulation of insulin receptor substrates-1, phosphoinositide-3-kinase, and Akt-ser473 expression and elevation of glucagon-like peptide-1 level in diabetic animal models linked to the potent protein tyrosine phosphatase 1B and dipeptidyl peptidase-4 inhibitions. In addition, activation of peroxisome proliferator-activated receptors gamma and inhibition of α-glucosidase activity are other possible targets proposed as the mechanism of AQs antidiabetic action. The position and the number of hydroxyl group showed great influence on the overall antidiabetic potential of AQs. AQs hold promising antidiabetic activity despite scanty information. We hope that the present study will serve as a template to further explore the antidiabetic potential of AQs and subsequent antidiabetic drug development.
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Antraquinonas/farmacologia , Diabetes Mellitus/tratamento farmacológico , Emodina/farmacologia , Hipoglicemiantes/farmacologia , Animais , Antraquinonas/química , Glicemia/efeitos dos fármacos , Inibidores da Dipeptidil Peptidase IV/química , Inibidores da Dipeptidil Peptidase IV/farmacologia , Emodina/química , Humanos , Hipoglicemiantes/química , Proteína Tirosina Fosfatase não Receptora Tipo 1/antagonistas & inibidoresRESUMO
OBJECTIVES: The epidemiology and clinical significance of disaccharidase deficiencies have not been thoroughly characterized. Recent work suggests at least genetic sucrase-isomaltase deficiency is more prevalent than previously believed. Because lactase deficiency (LD) is well described, the present study focuses on the clinical characteristics of children with disaccharidase deficiencies determined by esophagogastroduodenoscopy. METHODS: Endoscopic records were reviewed from patients undergoing esophagogastroduodenoscopies with biopsies assayed for disaccharidase activity performed by 13 pediatric gastroenterologists during 5 years (2010-2014). Presenting symptoms, clinical and histological diagnosis, treatment, disaccharidase results, and demographic variables were obtained from medical and endoscopic records of those with maltase and sucrase deficiency (SD). RESULTS: Among 963 patients undergoing intestinal disaccharidase testing, 73 (7.6%) had SD on biopsy (enzyme activity <25âµmolâ·âminâ·âg). Thirty-four (34/73; 47%) had normal duodenal histology and are the focus of this report. Four patients had SD without LD. Pan-disaccharidase deficiency was observed in 24 patients when maltase and palatinase assays were obtained (nâ=â646), and 11 had SDâ+âLD when just those 2 enzymes were analyzed (nâ=â317). Those with SD without LD were younger 4.6â±â6.1 versus 14.1â±â3.6 years and uniformly presented with diarrhea. Patients with pan-disaccharidase deficiency or SDâ+âLD primarily reported abdominal pain (33/35; 94%), diarrhea (16/35; 46%), nausea (14/35; 40%); and poor weight gain/weight loss (10/35; 29%); constipation, flatulence, and bloating were also noted. Maltase deficiency is less common (8/963; 0.8%), presenting with similar symptoms. CONCLUSIONS: Genetic sucrase-isomaltase deficiency often occurs together with lactase or pan-disaccharide deficiency. Disaccharidase deficiency should be considered a potential cause of abdominal pain and/or diarrhea in children and adolescents.
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Dissacaridases/deficiência , Duodeno/enzimologia , Síndromes de Malabsorção/diagnóstico , Adolescente , Criança , Pré-Escolar , Dissacaridases/análise , Endoscopia do Sistema Digestório/métodos , Feminino , Humanos , Lactente , Síndromes de Malabsorção/epidemiologia , Masculino , Prevalência , Estudos RetrospectivosRESUMO
CONTEXT: The use of Aframomum melegueta K. Schum. (Zingiberaceae) fruit for treatment of diabetes has recently been established in Nigeria. However, compounds responsible for the antidiabetic action have not been identified. OBJECTIVE: The present study carried out the bioassay-guided isolation of possible bioactive compounds responsible for the antidiabetic action of A. melegueta fruit. MATERIALS AND METHODS: The A. melegueta fruit was sequentially extracted using ethyl acetate (EtOAc), ethanol and water, and the most active extract (EtOAc) was subjected to column chromatography on a silica gel column using solvent gradient systems of hexane (HEX):EtOAc and EtOAc:MeOH and the isolation of compounds was guided by α-glycosidase and α-amylase inhibitory activities at various concentrations (30-240 µg/mL). RESULTS: According to the results, 3 arylalkanes, 6-paradol (1), 6-shogaol (2) and 6-gingerol (3) and a pentacyclic triterpene, oleanolic acid (4) were isolated from A. melegueta fruit. All the compounds exhibited inhibitory effects against α-amylase and α-glucosidase. 6-Gingerol (3) and oleanolic acid (4) showed higher inhibitory activity against α-amylase (IC50: 6-gingerol: 81.78 ± 7.79 µM; oleanolic acid: 91.72 ± 1.63 µM) and α-glucosidase (IC50: 6-gingerol: 21.55 ± 0.45 µM; oleanolic acid: 17.35 ± 0.88 µM) compared to the standard drug, acarbose and other isolated compounds. The kinetics of the enzyme action of the compounds showed a noncompetitive mode of inhibition. CONCLUSION: The data of this study suggest that the 6-gingerol (3) and oleanolic acid (4) showed higher α-amylase and α-glucosidase inhibitory action and therefore could be responsible for the antidiabetic activity of A. melegueta fruit.
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Diabetes Mellitus Tipo 2/tratamento farmacológico , Frutas/química , Inibidores de Glicosídeo Hidrolases/farmacologia , Hipoglicemiantes/farmacologia , Pâncreas/efeitos dos fármacos , Extratos Vegetais/farmacologia , Zingiberaceae/química , alfa-Amilases/antagonistas & inibidores , Acarbose/farmacologia , Bioensaio , Catecóis/isolamento & purificação , Catecóis/farmacologia , Diabetes Mellitus Tipo 2/enzimologia , Relação Dose-Resposta a Droga , Álcoois Graxos/isolamento & purificação , Álcoois Graxos/farmacologia , Inibidores de Glicosídeo Hidrolases/isolamento & purificação , Hipoglicemiantes/isolamento & purificação , Cinética , Ácido Oleanólico/isolamento & purificação , Ácido Oleanólico/farmacologia , Pâncreas/enzimologia , Fitoterapia , Extratos Vegetais/isolamento & purificação , Plantas Medicinais , Solventes/química , alfa-Amilases/metabolismoRESUMO
Parasitic infections are among the leading global public health problems with very high economic and mortality burdens. Unfortunately, the available treatment drugs are beset with side effects and continuous parasite drug resistance is being reported. However, new findings reveal more promising compounds especially of plant origin. Among the promising leads are the pentacyclic triterpenes (PTs) made up of the oleanane, ursane, taraxastane, lupane and hopane types. This paper reviews the literature published from 1985 to date on the in vitro and in vivo anti-parasitic potency of this class of phytochemicals. Of the 191 natural and synthetic PT reported, 85 have shown high anti-parasitic activity against various species belonging to the genera of Plasmodium, Leishmania, Trypanosoma, as well as various genera of Nematoda. Moreover, structural modification especially at carbon 3 (C3) and C27 of the parent backbone of PT has led to improved anti-parasitic activity in some cases and loss of activity in others. The potential of this group of compounds as future alternatives in the treatment of parasitic diseases is discussed. It is hoped that the information presented herein will contribute to the full exploration of this promising group of compounds as possible drugs for parasitic diseases.
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Doenças Parasitárias/tratamento farmacológico , Triterpenos Pentacíclicos/farmacologia , Triterpenos Pentacíclicos/uso terapêutico , Animais , Humanos , Leishmania/efeitos dos fármacos , Leishmaniose/tratamento farmacológico , Malária/tratamento farmacológico , Camundongos , Infecções por Nematoides/tratamento farmacológico , Doenças Parasitárias/parasitologia , Triterpenos Pentacíclicos/efeitos adversos , Triterpenos Pentacíclicos/química , Plasmodium/efeitos dos fármacos , Clima Tropical , Trypanosoma/efeitos dos fármacos , Tripanossomíase/tratamento farmacológicoRESUMO
This study investigated and compared the antioxidative, antidiabetic effects and possible active compounds present in various solvent extracts of fruit, leaf and stem of Aframomum melegueta (Rosc.) K. Schum. Samples were sequentially extracted using solvents of increasing polarity. They were investigated for 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity, ferric reducing power, inhibition of hemoglobin glycosylation, α-amylase and α-glucosidase activities as markers of in vitro antidiabetic effects at various doses (30-240 µg/mL). Possible compounds were analyzed using gas chromatography-mass spectrometry (GC-MS) analysis. From the results, fruit ethanolic (EtOH) extract showed higher total polyphenol (12.52 ± 0.13 mg/g GAE) and flavonoid (4.92 ± 0.12 mg/g QE) contents compared to other extracts. Similarly, for all the in vitro models used in this study, fruit EtOH extract exhibited lower IC50 values compared to other extracts, comparable to standards used in this study (DPPH 0.04 ± 0.01 mg/mL; ascorbic acid: 0.03 ± 0.02 mg/mL; gallic acid: 0.05 ± 0.01 mg/mL; hemoglobin glycosylation: 0.7 2 ± 0.03 mg/mL; gallic acid: 0.20 ± 0.01 mg/mL; α-amylase: 0.62 ± 0.01 mg/mL; acarbose: 4.91 ± 0.80 mg/mL; α-glucosidase: 0.06 ± 0.01 mg/mL; acarbose: 0.34 ± 0.02 mg/mL). Additionally, EtOH extract of the fruit demonstrated significantly (p < 0.05) higher reducing potentials of Fe3+ to Fe2+ compared to other solvent extracts. The GC-MS analysis of fruit and leaf EtOH extracts revealed the presence of some phenolics and other fatty acids derivatives as possible compounds present. Conclusively, fruit EtOH extract exhibited higher antioxidative and antidiabetic effects compared to other solvent extracts in vitro and thus require further work to fully validate these effects in vivo.
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Antioxidantes/farmacologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Inibidores Enzimáticos/farmacologia , Hipoglicemiantes/farmacologia , Extratos Vegetais/farmacologia , Zingiberaceae , Antioxidantes/química , Antioxidantes/isolamento & purificação , Compostos de Bifenilo/química , Diabetes Mellitus Tipo 2/enzimologia , Relação Dose-Resposta a Droga , Inibidores Enzimáticos/química , Inibidores Enzimáticos/isolamento & purificação , Etanol/química , Frutas , Cromatografia Gasosa-Espectrometria de Massas , Hemoglobinas Glicadas/metabolismo , Inibidores de Glicosídeo Hidrolases/farmacologia , Glicosilação/efeitos dos fármacos , Hipoglicemiantes/química , Hipoglicemiantes/isolamento & purificação , Fitoterapia , Picratos/química , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Folhas de Planta , Caules de Planta , Plantas Medicinais , Solventes/química , Zingiberaceae/química , alfa-Amilases/antagonistas & inibidores , alfa-Amilases/metabolismoRESUMO
Diabetes mellitus is one of the major health problems in Africa. The conventional oral synthetic antidiabetic drugs available to manage the disease are costly and not readily affordable to the majority of the affected population. Interestingly, the continent is endowed with a tremendous number of medicinal plants that have been explored for their folkloric treatment of diabetes mellitus. Scientific investigations have validated the antidiabetic potentials of a number of these medicinal plants but there is no repository with information on these scientifically investigated plants as a guide for future research. In this review article, all of the in vivo antidiabetic studies conducted between January 2000 and July 2013 on African plants are systematically compiled with a closer look at some relevant plants from the continent's subregions. Plants of the Asteraceae and Lamiaceae families are the most investigated, and West Africa has the highest number of investigated plants. Although promising results were reported in many cases, unfortunately, only a few studies reported the partial characterization of bioactive principles and/or mechanisms of action. It is hoped that government agencies, pharmaceutical industries, and the scientific community will have a look at some of these plants for future research and, if possible, subsequent commercialization.
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Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/prevenção & controle , Hipoglicemiantes/farmacologia , Medicinas Tradicionais Africanas , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Diabetes Mellitus/fisiopatologia , HumanosRESUMO
OBJECTIVE: The aim of this study was to investigate the prevalence of indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care (ANC) at public health facilities in Dire Dawa, Ethiopia. DESIGN: A facility-based cross-sectional study design. SETTING: The study was conducted in seven public health facilities (one referral hospital, three urban and three rural health centres) in Dire Dawa, Ethiopia, from October to November 2022. PARTICIPANTS: 628 pregnant women of any gestational age who had been on ANC follow-up at selected public health facilities were included. MAIN OUTCOME MEASURES: Prevalence of indigenous herbal medicine (users vs non-users) and associated factors. RESULTS: The study revealed that 47.8% (95% CI 43.8% to 51.6%) of pregnant women used herbal medicines. Lack of formal education (adjusted OR, AOR 5.47, 95% CI 2.40 to 12.46), primary level (AOR 4.74, 95% CI 2.15 to 10.44), housewives (AOR 4.15, 95% CI 1.83 to 9.37), number of ANC visits (AOR 2.58, 95% CI 1.27 to 5.25), insufficient knowledge (AOR 4.58, 95% CI 3.02 to 6.77) and favourable perception (AOR 2.54, 95% CI 1.71 to 3.77) were factors significantly associated with herbal medicine use. The most commonly used herbs were garden cress (Lepidium sativum) (32%), bitter leaf (Vernonia amygdalina) (25.2%), moringa (Moringa oleifera) (24.5%). Common indications were related to gastrointestinal problems, blood pressure and sugar. CONCLUSION: The prevalence of herbal medicine use is high (one in two pregnant women) and significantly associated with education level, occupation, ANC visits, knowledge and perceptions. The study's findings are helpful in advancing comprehension of herbal medicines using status, types and enforcing factors. It is essential that health facilities provide herbal counselling during ANC visits, and health regulatory bodies ought to raise awareness and implement interventions to lower the risks from over-the-counter herbal medicine use by pregnant women.
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Cuidado Pré-Natal , Humanos , Feminino , Etiópia/epidemiologia , Estudos Transversais , Gravidez , Adulto , Cuidado Pré-Natal/estatística & dados numéricos , Adulto Jovem , Adolescente , Medicina Herbária/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Fitoterapia/estatística & dados numéricos , Instalações de Saúde/estatística & dados numéricos , Medicinas Tradicionais Africanas/estatística & dados numéricosRESUMO
Background: Flexible naso-pharyngo-laryngoscopy (NPL) has become an essential clinic tool for evaluating patients with upper airway disorders in otorhinolaryngology. It has been established to be a simple, cost-effective, and minimally invasive technique with good diagnostic yields. This study aimed to audit the procedure of flexible NPL done in our clinic over 2 years and analyse the technique, indications, and findings of the procedure. Methodology: A retrospective cross-sectional study among all the patients who presented to our ENT clinic in ABUTH Zaria, from July 2021 to June 2023 with upper airway symptoms or neck swelling who had flexible NPL done in the clinic. The records of these patients were reviewed, and information extracted including age, sex, use of anaesthesia, indications and findings of the procedure were entered in SPSS and analysed. Results: Flexible NPL was done in 266 patients aged 4 months to 85 years. Only 3% of the patients required local anaesthesia. The commonest indications were for preoperative evaluation of goitre (26.7%), suspected adenoid hypertrophy (18.4%), complaints of hoarseness (18.8%), and foreign body sensation (12%). The commonest diagnoses made were adenoid hypertrophy (19.9%), laryngeal tumour (5.3%), nasopharyngeal tumour (4.9%), vocal cord palsy (4.9%), rhinitis (4.5%) and pharyngitis (4.1%), laryngitis (3.0%), laryngopharyngeal reflux disease (3.0%) and vocal cord nodule (2.3%). Conclusions: Office flexible NPL was done commonly for preoperative evaluation of goitre, suspected adenoid hypertrophy, hoarseness, and foreign body sensation. The commonest pathologies were adenoid hypertrophy, laryngeal tumour, nasopharyngeal tumour, vocal cord palsy, rhinitis, pharyngitis, and laryngitis.
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Background: Compassionate and respectful maternity care during childbirth has been identified as a potential strategy to prevent and reduce maternal mortality and morbidity. Despite its importance, there is a paucity of information on the level of disrespect and abuse meted out to mothers in eastern Ethiopia. This study assesses the level of disrespect and abuse suffered by women during childbirth, and the associated factors, in public health facilities in the rural East Hararghe Zone in eastern Ethiopia. Methods: A cross-sectional study was conducted among 530 women who gave birth in 20 public health facilities in the East Hararghe Zone during the period between 1 April and 30 April 2020. Data were collected using a validated questionnaire. Bivariable and multivariable binary logistic regression analyses were employed to identify the factors associated with disrespect and abuse during childbirth. Adjusted odds ratio (AOR) (95% CI) was used to report this association, and statistical significance was set at P < 0.05. Results: Overall, 77% (95% CI: 73%-81%) of women reported at least one type of disrespect and abuse during childbirth in the East Hararghe Zone public health facilities. In this study, factors such as households having an average monthly income of below 57.22 USD (AOR = 2.29, 95% CI: 1.41-3.71), mothers residing at more than 30â min away from a nearby health facility (AOR = 2.10, 95% CI: 1.30-3.39), those not receiving antenatal care (AOR = 4.29, 95% CI: 2.17-8.52), and those giving birth during nighttime (AOR = 2.16, 95% CI: 1.37-3.41) were associated with at least one type of disrespect and abuse during childbirth. Conclusion: More than three in every four women who gave birth in the East Hararghe Zone public health facilities were disrespected and abused during childbirth. Encouraging all pregnant women to pay attention to antenatal care visits and improving the quality of healthcare service during nighttime in all health facilities will be essential for preventing and reducing disrespect and abuse and its negative consequences.
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Background: The short birth interval is a common public health issue that affects women's and children's health in sub-Saharan Africa. Despite a higher burden of short birth intervals reported in Ethiopia, there is limited evidence to indicate the primary risk factors, particularly in rural eastern Ethiopia. Therefore, this study assessed the determinants of the short birth interval among married multiparous women in Chinaksen district, Eastern Ethiopia. Methods: A community-based case-control study was conducted among randomly selected 210 cases and 210 controls from April 01 to June 30, 2019. The total sample size (219 cases and 219 controls) were calculated using Epi-Info software version 7.2. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27, and multivariable logistic regression analyses conducted to identify the determinants of short birth intervals. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the strength of association and statistical significance declared at p-value < 0.05. Results: The women in the young age group (AOR = 2.33, 95% CI: 1.03, 5.26), missed their antenatal care visits (AOR = 2.23, 95% CI: 1.18, 4.21), failed to utilize postpartum contraceptives (AOR = 5.98, 95% CI: 3.62, 9.89), did not attend postnatal care visit (AOR = 1.86, 95% CI: 1.13, 3.05), nonexclusive breastfed (AOR = 4.05, 95% CI: 2.18, 7.52), short and medium period of breastfeeding (AOR = 4.00, 95% CI: 1.34, 12.10) and (AOR = 3.56, 95% CI: 1.62, 7.82), respectively and female sex of preceding child (AOR = 1.92, 95% CI: 1.18, 3.12) were the important risk factors of short birth interval. Conclusions: Women's age, antenatal care visits, postnatal care attendance, utilization of postpartum contraceptives, exclusive breastfeeding practice, duration of breastfeeding, and sex of the preceding child were the primary predictors of short birth intervals. Improving the utilization of maternal healthcare services in health facilities would be imperative to prevent and reduce short birth intervals, and its negative consequences.
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OBJECTIVE: This study aimed to determine the level of adherence to foot care recommendations and associated factors among people with diabetes on follow-up in public hospitals in Eastern Ethiopia. SETTING: An institutional-based cross-sectional study was conducted in public hospitals found in Eastern Ethiopia from 25 February to 25 March 2022. PARTICIPANTS: A total of 419 patients with chronic diabetes who visited diabetic clinics in public hospitals in Eastern Ethiopia for follow-up were included. MAIN OUTCOME MEASURE: The level of adherence to diabetic foot care recommendations and associated factors. RESULTS: The findings indicated that 44.3% (95% CI: 39.3, 49.0) of people with diabetes had inadequate adherence to diabetic foot care recommendations. Age between 28-37 (adjusted OR (AOR)=1.10; 95% CI: 1.27, 5.63) and 38-47 years (AOR=2.19; 95% CI: 2.74, 8.89), rural residence (AOR=1.71; 95% CI: 1.15, 2.57), absence of comorbidity (AOR=2.22; 95% CI:1.34, 5.14), obesity (AOR=1.43; 95% CI: 1.10, 5.05) and inadequate foot care knowledge (AOR=2.10; 95% CI: 1.52, 4.35) were factors significantly associated with inadequate adherence to diabetic foot care recommendations. CONCLUSION: More than two-fifths of people with diabetes had inadequate adherence to diabetic foot care recommendations. Younger age, rural residence, absence of comorbidity, obesity and inadequate foot care knowledge were significantly associated with inadequate adherence to diabetic foot care recommendations. It is very essential to educate people with diabetes about the importance of foot care recommendations in preventing and delaying the risks of foot-related problems and complications.
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Diabetes Mellitus , Pé Diabético , Humanos , Adulto , Estudos Transversais , Pé Diabético/epidemiologia , Pé Diabético/prevenção & controle , Etiópia/epidemiologia , Comorbidade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/terapia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapiaRESUMO
Background: Cultural practices are any experiences or beliefs that are socially shared views and behaviors practiced in a certain society at a certain time. Cultural malpractices are defined as socially shared views and traditionally accepted behaviors experienced in a certain society that harm maternal health. Worldwide, the period of pregnancy, labor, and delivery is embedded with different beliefs, customs, and rituals in different societies that contribute a lot to maternal death. They are responsible for the annual deaths of 303,000 mothers and 2.7 million newborns globally. In developing countries, it accounts for approximately 5%-15% of maternal deaths. In Ethiopia, approximately 18% of infant deaths occur due to cultural malpractice, and 52% of pregnant mothers give birth at home following cultural customs in Dire Dawa city. The objective of this study was to assess cultural malpractices during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa City in 2021. Methods: Community-based mixed study was conducted. A total of 624 study participants were selected through a systematic random sampling technique, and a purposive sampling method was used for qualitative data. The study was conducted in the randomly selected Kebeles of Dire Dawa City, Eastern Ethiopia, from November 1 to December 30, 2021. Data were entered into Epi Data version 4.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate analyses were done, and the degree of association was measured by using the odds ratio with 95% CI and significance was declared at a p-value of <0.05. The qualitative data were analyzed thematically using ATLAS-ti version 7. Results: The overall prevalence of cultural malpractice during pregnancy, childbirth, and the postnatal period was 74.6% [95% CI: 70.59%, 77.49%]. Women over the age of 35 were two times more likely [AOR 2.61, 95% CI, 1.45-4.72] to commit cultural malpractice than women aged 15-24 and 25-34. Those with no antenatal care (ANC) follow-up were three times more likely to commit cultural malpractice [AOR 3.57, 95% CI, 1.72-7.40], those who were absent from health education were nearly two times more likely to commit cultural malpractice [AOR 1.83, 95%CI, 1.25-2.67], and women whose culture allows harmful traditional practices were nearly two times more likely to commit cultural malpractices than their counterparts [AOR 1.69, 95%CI, 1.29-2.54]. Conclusion: In this study, nearly three-fourths of participants were involved in cultural malpractices. Therefore, strengthening community education and behavioral change messages on the importance of ANC and avoiding unhealthy care during pregnancy, childbirth, postnatal and neonatal periods, especially with pregnancy at old age (age > 35), may help to reduce cultural malpractices.
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The Nigeria Polio Emergency Operations Centre (EOC) was established in October 2012 to strengthen coordination, provide strategic direction based on real-time data analysis, and manage all operational aspects of the polio eradication program. The establishment of seven state-level polio EOCs followed. With success achieved in the interruption of wild poliovirus (WPV) transmission as certified in 2020, the future direction of the polio EOC is under consideration. This paper describes the role of the polio EOC in other emergencies and perspectives on future disease control initiatives. A description of the functionality and operations of the polio EOC and a review of documentation of non-polio activities supported by the EOC was done. Key informant insights of national and state-level stakeholders were collected through an electronic questionnaire to determine their perspectives on the polio EOC's contributions and its future role in other public health interventions. The polio EOC structure is based on an incident management system with clear terms of reference and accountability and with full partner coordination. A decline in WPV1 cases was observed from 122 cases in 2012 to 0 in 2015; previously undetected transmission of WPV1 was confirmed in 2016 and all transmission was interrupted under the coordination of the EOCs at national and state levels. During 2014-2019, the polio EOC infrastructure and staff expertise were used to investigate and respond to outbreaks of Ebola, measles, yellow fever, and meningitis and to oversee maternal and neonatal tetanus elimination campaigns. The EOC structure at the national and state levels has contributed to the positive achievements in the polio eradication program in Nigeria and further in the coordination of other disease control and emergency response activities. The transition of the polio EOCs and their capacities to support other non-polio programs will contribute to harnessing the country's capacity for effective coordination of public health initiatives and disease outbreaks.
Assuntos
Poliomielite , Poliovirus , Recém-Nascido , Humanos , Nigéria/epidemiologia , Programas de Imunização , Vigilância da População , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Surtos de Doenças/prevenção & controle , Erradicação de DoençasRESUMO
In 2011, a dedicated consortium of experts commenced work on the development of the novel oral poliovirus vaccine type 2 (nOPV2). After careful and rigorous analysis of data to enable early, targeted use of the vaccine, World Health Organization´s (WHO´s) Strategic Advisory Group of Experts on Immunization (SAGE) reviewed data from accelerated clinical development of nOPV2 and endorsed entering assessment under WHO´s Emergency Use Listing (EUL) procedure. In November 2020, nOPV2 received an interim recommendation for use under EUL to enable rapid field availability and potential wider rollout of the vaccine. In December 2020, Nigeria initiated preparation to meet all criteria for initial use of nOPV2 in the country and the documentation process to verify meeting them. The process entailed addressing the status of meeting 25 readiness criteria in nine categories for nOPV2 use in Nigeria for response efforts to ongoing cVDPV2 outbreaks. During January-February 2021, Nigeria submitted the required documentation for all required indicators for nOPV2 initial use. In February 2021, the country obtained approval from the GPEI nOPV2 Readiness Verification Team to introduce nOPV2 and in March 2021, rolled out the novel vaccine in mass vaccination campaigns for outbreak response in Bayelsa, Delta, Niger, Sokoto and Zamfara states, and one area council in the Federal Capital Territory (FCT). The lessons learned from this rollout experience in Nigeria are being applied as the country streamlines and strengthens the nOPV2 rollout process across the remaining states.
Assuntos
Poliomielite , Poliovirus , Humanos , Vacina Antipólio Oral , Poliomielite/prevenção & controle , Poliomielite/epidemiologia , Nigéria/epidemiologia , Saúde Global , Surtos de Doenças/prevenção & controleRESUMO
BACKGROUND: Sub-clinical mastitis limits milk production and represents an important barrier to profitable livestock economics worldwide. Milk production from cows in Nigeria is not at optimum levels in view of many factors including sub-clinical mastitis. RESULTS: The overall herd-level prevalence rate for SCM was 85.33% (256/300 heads of cows) while the quarter-level prevalence rate of SCM was 43.25% (519/1,200 quarters). The prevalence of SCM was 50.67%, 43.67%, 39.67% and 39.13% for the left fore-quarter, right hind-quarter, left hind-quarter and right fore-quarter, respectively. The Rahaji breed had the highest prevalence of SCM with 65.91% (29/44), while the White Fulani breed had the least with 32.39% (57/176). A total of 32.33% (97/300) had only one mammary quarter affected, 30.33% (91/300) had two quarters affected, 16.00% (48/300) had three quarters affected while 6.67% (20/300) had all the four quarters affected. A total of 53.00% had SCM in multiple quarters (159/300). The risk of SCM decreased significantly among young lactating cows compared to older animals (OR = 0.283; P < 0.001; 95%CI = 0.155; 0.516). The Rahaji breed had significantly higher risk compared with the White Fulani breed (OR = 8.205; P = 0.013; 95% CI = 1.557; 43.226). Improved sanitation (washing hands before milking) will decrease the risk of SCM (OR = 0.173; P = 0.003; 95% CI = 0.054; 0.554). CONCLUSION: SCM is prevalent among lactating cows in the Nigerian Savannah; and this is associated with both animal characteristics (age, breed and individual milk quarters) and milking practices (hand washing).Good knowledge of the environment and careful management of the identified risk factors with improved sanitation should assist farm managers and veterinarians in implementing preventative programmes to reduce the incidence of SCM.
Assuntos
Lactação/fisiologia , Mastite Bovina/epidemiologia , Criação de Animais Domésticos , Animais , Bovinos , Feminino , Mastite Bovina/patologia , Nigéria/epidemiologia , Razão de Chances , Prevalência , Proteínas de Protozoários , Fatores de RiscoRESUMO
Tiger nut and date fruit are chewy with sweet taste and are popularly consumed as food either alone, mixed or paired with other fruits, seeds and vegetables. They are locally used to treat diabetes and were separately reported to attenuate hyperglycemia in various animal models of diabetes. However, effect of tiger nut and date fruit mixture on key diabetes related parameters has not yet been reported. Therefore, we investigated the antidiabetic and antioxidant effects of the tiger nut and date blend (TDB) using in vitro and in vivo models. The TDB was prepared in equal ratio (1:1). For the in vivo study, mixture was included in the diet at 5% and 10% and feed the type 2 diabetic rats for 4 weeks. The diabetic untreated rats showed significant (p < .05) hyperglycemia, hyperlipidemia, insulin resistance and oxidative stress. Consumption of the TDB blend, significantly (p < .05) reduced fasting blood glucose by 71% and 52% in the groups treated with high and low doses respectively. In addition, intake of TBD blend demonstrated significant (p < .05) antihyperlipidemic, ameliorated insulin resistance and oxidative stress in the treated groups. The effects were more prominent in group supplemented with the 10% of the TDB and attributed to some promising ingredients detected. In conclusion, dietary supplementation of TDB exhibited antidiabetic action and could be due to the phytochemicals assessed. PRACTICAL APPLICATIONS: Inclusion of functional foods such as tiger nut and date fruit in daily diet is proved to be highly beneficial in controlling type-2 diabetes and its associated complications. Our results show that tiger nut and date fruit blend can effectively reduce hyperglycemia and oxidative damage, improve insulin sensitivity in type-2 diabetes rat model. Hence, the data shows the potential of tiger nut and date fruit blend to promote scientific basis of the dietary application of tiger nut and date fruit blend as a functional food for the remedy of diabetes and its associated complications.
Assuntos
Cyperus , Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 2 , Hiperglicemia , Resistência à Insulina , Phoeniceae , Ratos , Animais , Frutas , Diabetes Mellitus Experimental/tratamento farmacológico , Hiperglicemia/tratamento farmacológico , Estresse Oxidativo , Diabetes Mellitus Tipo 2/tratamento farmacológico , HipoglicemiantesRESUMO
BACKGROUND: In Ethiopia, the number of homeless girls and women is increasing, and the government has yet to devise a strategy to address the issue of teenage homelessness. They are influenced by numerous dimensions of health, including physical health, mental health, and social isolation. At all stages of homelessness, the stakeholders and homeless people must work together to address the issue. As a result, this study will be helpful to generate relevant data that may guide policymakers in designing solutions for this underserved group of people. OBJECTIVES: To explore coping mechanisms and suggestions to stakeholders among women experiencing homelessness in Dire Dawa city, eastern Ethiopia, 2021. DESIGN: A community-based phenomenological qualitative study was conducted at Dire Dawa city. METHODS: Data were collected from women experiencing homelessness and key informants through focus group discussion and in-depth interviews using a semi-structured tool. A total of 31 women experiencing homelessness (13 in-depth interviews and 3 focus group discussion with 6 participants in each) and 2 key informants participated in this study. Data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti 7. The thematic analysis follows six steps: familiarization, coding, generating themes, reviewing themes, naming themes, and writing up. RESULTS: Two major themes were driven: coping mechanisms and suggestions to stakeholders. There are three subthemes under the coping mechanism (begging, survival sex, and child prostitution) while there are a total of seven subthemes under suggestions to stakeholders (integration and collaboration, special attention to children, family education, shelter and job, schooling, sexual education, and addiction rehabilitation). CONCLUSION: Child prostitution and survival sex are a very common coping mechanism which is practiced by women experiencing homelessness. Changing society's mindset and paying special attention to children is critical. Furthermore, the government and various stakeholders should work together to develop a rehabilitation program for street children who have been exposed to substance use.