Antiprotozoal Activity of Plants Used in the Management of Sleeping Sickness in Angola and Bioactivity-Guided Fractionation of Brasenia schreberi J.F.Gmel and Nymphaea lotus L. Active against T. b. rhodesiense.

Folk medicine is widely used in Angola, even for human African trypanosomiasis (sleeping sickness) in spite of the fact that the reference treatment is available for free. Aiming to validate herbal remedies in use, we selected nine medicinal plants and assessed their antitrypanosomal activity. A total of 122 extracts were prepared using different plant parts and solvents. A total of 15 extracts from seven different plants exhibited in vitro activity (>70% at 20 µg/mL) against Trypanosoma brucei rhodesiense bloodstream forms. The dichloromethane extract of Nymphaea lotus (leaves and leaflets) and the ethanolic extract of Brasenia schreberi (leaves) had IC50 values ≤ 10 µg/mL. These two aquatic plants are of particular interest. They are being co-applied in the form of a decoction of leaves because they are considered by local healers as male and female of the same species, the ethnotaxon "longa dia simbi". Bioassay-guided fractionation led to the identification of eight active molecules: gallic acid (IC50 0.5 µg/mL), methyl gallate (IC50 1.1 µg/mL), 2,3,4,6-tetragalloyl-glucopyranoside, ethyl gallate (IC50 0.5 µg/mL), 1,2,3,4,6-pentagalloyl-ß-glucopyranoside (IC50 20 µg/mL), gossypetin-7-O-ß-glucopyranoside (IC50 5.5 µg/mL), and hypolaetin-7-O-glucoside (IC50 5.7 µg/mL) in B. schreberi, and 5-[(8Z,11Z,14Z)-heptadeca-8,11,14-trienyl] resorcinol (IC50 5.3 µg/mL) not described to date in N. lotus. Five of these active constituents were detected in the traditional preparation. This work provides the first evidence for the ethnomedicinal use of these plants in the management of sleeping sickness in Angola.

Nutrition supplementation plus standard of care versus standard of care alone or standard of care plus unconditional cash transfer in the prevention of chronic malnutrition in Southern Angola: study protocol for the MuCCUA study, a cluster randomized controlled trial.

BACKGROUND: Chronic malnutrition is a condition associated with negative impacts on physical and cognitive development. It is multi-causal and can start very early in life, already in utero, thus it is especially challenging to find appropriate interventions to tackle it. The government of Angola is implementing a standard of care program with potential to prevent it, and the provision of cash transfers and the supplementation with small quantity lipid-based nutrients (SQ-LNS) are also promising interventions. We aimed to evaluate the impact of the standard of care program alone and of the standard of care plus a cash transfer intervention in the lineal growth of children less than 2 years old and compare it to the effectiveness of a nutrition supplementation plus standard of care program in Southern Angola. METHODS/DESIGN: The three-arm parallel cluster randomised controlled trial is set in four communes of Huila and Cunene provinces. Clusters are villages or neighbourhoods with a population around 1075 people. A total of twelve clusters were selected per arm and forty pregnant women are expected to be recruited in each cluster. Pregnant women receive the standard of care alone, or the standard of care plus unconditional cash transfer or plus nutritional supplementation during the first 1000 days, from pregnancy to the child reaching 24 months. The primary outcome is the prevalence of stunting measured as height-for-age Z-score (HAZ) < -2 in children below 2 years. Impact will be assessed at 3, 6, 12, 18 and 24 months of children's age. Secondary outcomes include mortality, morbidity, caring, hygiene and nutrition behaviours and practices, and women and children's dietary diversity. Quantitative data are also collected on women's empowerment, household food security, expenditure and relevant clinical and social events at baseline, endline and intermediate time points. DISCUSSION: The results will provide valuable information on the impact of the standard of care intervention alone as well as combined with an unconditional cash transfer intervention compared to a nutrition supplementation plus standard of care intervention, carried out during the first 1000 days, in the children´s growth up to 2 years and related outcomes in Southern Angola. TRIAL REGISTRATION: Clinical Trials NCT05571280. Registered 7 October 2022.

Impact of traditional cutaneous scarification on anthrax lesions: A series of cases from Cubal, Angola.

OBJECTIVES: Bacillus anthracis infection is a worldwide zoonosis that affects the most vulnerable population and has a high mortality rate without treatment, especially in non-cutaneous presentations. Cutaneous scarification is still common in some regions of the world for the treatment of certain diseases as part of traditional medicine. We describe a series of cutaneus anthrax from a rural setting in Angola where cutaneus scarification is common. CASE PRESENTATION: This is a retrospective observational study describing a series of cutaneous anthrax cases from Cubal (Angola), many of whom were treated with skin scarification before admission. A total of 26 cases were diagnosed from January 2010 to December 2018. None of the cases were confirmed and eight (30.8%) were probable cases according to the Centers for the Disease Control and Prevention anthrax case definition. The median age was 11 (4.7-30.5) years, 17 (65.4%) had lesions on the head, face, or neck and 15 (57.7%) were treated with cutaneous scarification. Nine (34.6%) patients died. Traditional cutaneous scarification was significantly associated with cutaneous superinfection, respiratory, systemic involvement, and death. CONCLUSION: Our case series points to increased complications and worse outcome of cutaneous anthrax disease if treated with skin scarification.

Nutritional education during rehabilitation of children 6-24 months with acute malnutrition, under unavailability of therapeutic/supplementary foods: a retrospective study in rural Angola.

BACKGROUND: Dietary counseling can play an important role in managing child malnutrition but is often inadequate or absent. Moreover, little emphasis is given to the usefulness of local available foods in the rehabilitation of malnourished children. This study aimed to evaluate the adherence and effectiveness of nutritional education during rehabilitation of children (6-24 months) with acute malnutrition, in a setting of unavailability of therapeutic/supplementary foods. METHODS: Retrospective observational study on the adherence to dietary counseling and the impact on growth in children 6-24 months who were referred for acute malnutrition at the Catholic Mission Hospital of Chiulo (Angola) from August 2018 to January 2019. Main outcome measures were change in dietary habits and growth gain. RESULTS: Sixty-four out of 120 children returned at first follow-up visit (default rate 47%). A change in dietary habits was reported in 32/64 (50%) children. Changing dietary habits was associated with an improved change in weight gain (MD 9.3 g/kg/day, 95%CI 4.2 to 14.3; p = 0.0005) and in weight/height ratio (MD 1.1 SD, 95%CI 0.7 to 1.4; p < 0.0001). CONCLUSIONS: A change in dietary habits after discharge was noted in only half of the patients who returned at first follow up visit, but it provided some advantages in term of weight gain and weight/height ratio. Further studies are needed to identify children at risk of low adherence to follow-up visits and low compliance to the nutritional recommendations, in order to increase the effectiveness of rehabilitation programs.

Classical Biomarker and Quantitative Extended Diamondoid Analysis Fingerprints for Crude Oils from Deepwater Developments in Block 17, Lower Congo Basin, Angola.

The organic geochemistry of six oil samples from the offshore Block 17 (Lower Congo Basin, northwestern Angola) was studied by a combination of classical biomarker and extended diamondoid analyses to elucidate source rock facies, the extent of biodegradation, and thermal maturity. Based on molecular data, oils are interpreted as depicting a mixture of two pulses of hydrocarbon generation probably from the Bucomazi and Malembo formations. Geochemical results also gave evidence of mixing of a lacustrine siliciclastic-sourced oil charge and a second more terrestrially derived oil type in the samples analyzed. A single genetic oil family was identified through hierarchical cluster analysis; however, two groups of oils were identified on the basis of their biodegradation levels using the Peters/Moldowan scale. Lower and upper Malembo oils have a slight depletion and a notable absence of n-alkanes, suggesting PM levels of 1 and 2, respectively. Most molecular maturity parameters of the oil samples suggest a maturity level equivalent to the onset of the peak of the oil generative window.

Plants, food and treatments used by BaKongo tribes in Uíge (northern Angola) to affect the quality and quantity of human breast milk.

BACKGROUND: Angola has one of the highest annual under-five mortality rates in in the world and malnutrition poses a severe problem in the country. This study is the first to focus on the traditional knowledge of plants, foods, and treatments used by the local population in the province of Uíge to affect the quality and quantity of human breast milk, since decades of independence and civil war impeded ethnobotanical studies in this area. METHODS: This study was conducted in eight municipalities in the province of Uíge, Northern Angola in February and March 2018. In 265 semi-structured interviews, 360 informants in 40 rural villages were asked about plants, food, and treatments used to affect the quality and quantity of human breast milk. Additionally, information on child mortality and the duration of breastfeeding were collected. Whenever possible, plant specimens were collected for later identification. To determine the local importance of the collected plants, food, and treatments, the Relative Frequency of Citations was calculated. RESULTS: Most women reported to have no problems with their breast milk production. The duration of breastfeeding meets the recommendations of the World Health Organization (WHO). Across all use categories, 69 plants from 36 plant families, and 21 other foods and treatments could be identified. CONCLUSIONS: The study shows an overview of a variety of plants, foods, and treatments used by mothers as galactagogues, to "clean" or to reduce their breast milk and those which they avoided to use during the lactation period. There is great potential for further research into this traditional knowledge. Also, further analysis of some of the plants could be of interest.

Stories told by plants on graveyards in Northern Angola.

BACKGROUND: Worldwide, different traditions of symbolic statements in graveyards can be found. However, studies on sub-Saharan Africa are rare. For BaKongo cemeteries, it is only known that they traditionally do not exhibit plants for decoration purposes. Our study wanted to inspect the influence of Portuguese culture due to the long shared colonial past. METHODS: During 2015 and 2019, plant use in 87 graveyards in 13 municipalities of the province Uíge was documented. Five expert interviews with the village eldest in five municipalities completed the data collection. RESULTS: While 24% of the graveyards didn´t have any planting, 27 plant species were found in the remaining ones, including a high percentage of alien species (59%), mainly from the Americas. The most abundant plant species are Euphorbia tirucalli (23%) and Agave sisalana (22%). With increasing distance from the city Uíge (especially towards the Democratic Republic of the Congo), the utilization of living plants in cemeteries is decreasing except along the road. In most of the cases, just one plant species per gravesite was found. CONCLUSIONS: This unexpected high number of plants might be interpreted as a strong evidence of outside influence. Cultural symbols of the BaKongo cosmology and Christianism appear to coexist or coalesce. Furthermore, plants are used as a marker for graveyards. Modern influences like the use of concrete in proximity to urban areas indicate a certain wealth.

Julbernardia paniculata and Pterocarpus angolensis: From Ethnobotanical Surveys to Phytochemical Characterization and Bioactivities Evaluation.

Julbernardia paniculata and Pterocarpus angolensis are two plant species with important application in African traditional medicine, particularly in Angola, in the treatment of several diseases. However, scientific studies concerning these species are scarce. The goal of this work was to know better which medicinal approaches are used by the Huíla population in Angola by means of ethnobotanical surveys. Furthermore, extracts of both plants were phytochemically characterized. Antioxidant, anti-inflammatory, wound-healing activities, and potential cytotoxicity were also studied. With this study it was possible to verify that 67% of the individuals that use medicinal plants are women, and their main therapeutic uses are the treatment of problems of the digestive system and skin disorders. Barks of J. paniculata and leaves of P. angolensis are the most often used plant parts. Through high-performance liquid chromatography coupled to diode-array detector (HPLC-DAD) and GC-MS it was possible to characterize the chemical composition of the two species, which are rich in phenolic compounds, terpenes, terpenoids, sesquiterpenoids and fatty acids. Both plants showed to possess antioxidant, anti-inflammatory proprieties, and wound-healing activity. To the best of our knowledge, this is the most comprehensive study of these two species and the first ethnobotanical and ethnopharmacological study of medicinal plants from this region of Angola.

Schistosomiasis and soil-transmitted helminthiasis preventive chemotherapy: Adverse events in children from 2 to 15 years in Bengo province, Angola.

Preventive chemotherapy campaigns with praziquantel and albendazole are being implemented in Angola, as a high priority public health intervention. However, there are no published data regarding adverse events associated with these medications. In this context, we analysed adverse events due to co-administration of praziquantel and albendazole in endemic areas of schistosomiasis and soil-transmitted helminths in Bengo, Angola. In the context of a targeted drug administration, between December 2012 and September 2013, we conducted two surveys after co-administrating single oral doses of praziquantel and albendazole tablets to children 2 to 15 years of age. About 24 hours after each treatment, participants answered a questionnaire about adverse events. At baseline, 605 children (55.0% male; mean age: 9.7 years) were treated; 460 were interviewed and 257 (55.9%) reported at least one adverse event, 62.3% (160/257) of children being infected with schistosoma haematobium. After six months of treatment, among 339 children surveyed, 184 (54.3%) reported adverse events, with 49.5% (91/184) of infected children. Adverse events were most common in preschool-aged children, with no significant difference between genders. The most frequent adverse events in the two surveys were abdominal pain (18.5%, 25.7%), headache (20.9%, 23.0%) and dizziness (15.7%, 19.8%). Children aged 12 to 15 years (adjusted OR = 0.40, p = 0.040) and those with mixed infection (adjusted OR = 0.04, p = 0.011) had lower odds of adverse events. After the second treatment, those with heavy infection (adjusted OR = 2.72, p = 0.018) and aged 9-11 years (adjusted OR = 2.01, p = 0.049) had significantly fewer adverse events. About 2.0% of children experienced severe adverse events. This study adds evidence that preventive chemotherapy for schistosomiasis and soil-transmitted helminths control is safe, but cases of adverse events are expected. Standardized methodologies to discriminate drug-related adverse events from the clinical manifestations of the infections are needed.

Medicinal plants used by 'root doctors', local traditional healers in Bié province, Angola.

ETHNOPHARMACOLOGICAL RELEVANCE: This study is one of the first post-civil war efforts to document traditional botanical knowledge in Bié province, central Angola, in a first step to bring more studies on the use of medicinal plant resources in this area so as to bring new insights into Angolan bio-cultural diversity. AIM OF THE STUDY: Examine the variety of plant species used for medical purposes, as well as characterize their social and cultural values. Also, it is aimed to compare their uses in the studied region with those in Sub-Saharan Africa and report new ethnomedicinal uses. MATERIALS AND METHODS: We documented traditional medicinal plant knowledge among professional herbalists in two areas in Bié province through participatory observation, semi-structured interviews and transect walks. Ethnobotanical information was quantified based on Use Reports to (1) rate traditional knowledge; and (2) determine most useful taxa. RESULTS: In total, 10 traditional healers shared information on their knowledge. A total of 87 plant species distributed among 57 genera and 36 botanical families were documented with Fabaceae being the best-represented family with 18 species, followed by Phyllanthaceae (6), Apocynaceae (5), Asteraceae (5), Rubiaceae (5), Lamiaceae (4), and Ochnaceae (3). Most medicinal plants are usually gathered at a distance from human settlements because of the belief in the higher efficacy of 'wild' plants shared by all herbalists. Roots are the most common plant part used (79%), explaining why the consulted herbalists call themselves 'root doctors'. CONCLUSIONS: The culturally most important medicinal species identified in this study, i.e. Securidaca longepedunculata, Garcinia huillensis, Annona stenophylla, Afzelia quanzensis and Strychnos cocculoides, were previously reported for the same use in neighbouring countries and elsewhere in Africa. Our study also indicates that there are several locally valuable species that have not yet been studied for their medical potential, to name a few: Alvesia rosmarinifolia, Diplorhynchus condylocarpon, Eriosema affine, Paropsia brazzaeana, Rhus squalida, Sclerocroton cornutus or Xylopia tomentosa. Moreover, the ethnomedicinal use of 26 species was reported for the first time to sub-Saharan Africa. CLASSIFICATION: Ethnopharmacological field studies.

Chemical Composition and Antibacterial Activity of Lippia multiflora Moldenke Essential Oil from Different Regions of Angola.

The purpose of the study was to determine the chemical composition and antibacterial activity of Lippia multiflora Moldenke essential oils (EOs) collected in different regions of Angola. Antibacterial activity was evaluated using the agar wells technique and vapour phase test. Analysis of the oils by GC/MS identified thirty-five components representing 67.5 to 100% of the total oils. Monoterpene hydrocarbons were the most prevalent compounds, followed by oxygenated monoterpenes. The content of the compounds varied according to the samples. The main components were Limonene, Piperitenone, Neral, Citral, Elemol, p-cymene, Transtagetone, and Artemisia ketone. Only one of the eleven samples contained Verbenone as the majority compound. In the vapour phase test, a single oil was the most effective against all the pathogens studied. The principal component analysis (PCA) and hierarchical cluster analysis (HCA) of components of the selected EOs and inhibition zone diameter values of agar wells technique allowed us to identify a variability between the plants from the two provinces, but also intraspecific variability between sub-groups within a population. Each group of essential oils constituted a chemotype responsible for their bacterial inhibition capacity. The results presented here suggest that Angolan Lippia multiflora Moldenke has antibacterial properties and could be a potential source of antimicrobial agents for the pharmaceutical and food industry.

Use of herbal remedies in the management of sleeping sickness in four northern provinces of Angola.

ETHNOPHARMACOLOGICAL RELEVANCE: This study reports for the first time on the use of folk medicine to treat sleeping sickness and its symptoms in four endemic provinces in northern Angola. By interviewing both traditional practitioners and confirmed patients, it highlights reasons to recourse to folk medicine, the plant species used for this affection as well as arises awareness about the use of particular plants showing potential risks. AIM OF THE STUDY: The aims of this explorative study were three-fold. Firstly, it informed on access to, and use of plant-based medicine as first-choice treatment by infected persons. Secondly, it aimed at collecting comprehensive data from patients and traditional healers on herbal remedies in order to identify plant species used in the management of the disease. Thirdly, it served as contribution for primary indication of potential risk of use associated with the studied plants and their preparation. MATERIALS AND METHODS: The study was conducted in 4 endemic provinces of Angola, namely Bengo, Zaire, Kwanza Norte and Uíge. We explored the use of herbal remedies by conducting structured and semi-structured interviews within two distinct study populations. The first group comprises 30 patients who had been diagnosed for trypanosomiasis and treated by the reference treatment. The second group included 9 traditional practitioners who had already treated sleeping sickness. The plants that were cited during the interviews were collected during field walks under supervision of a traditional healer, then authenticated and deposited at the National Herbarium in Luanda. RESULTS: Of the 30 included patients, 12 (40%) had turned to folk medicine in the management of trypanosomiasis and related symptoms. 7 medicinal plants were reported by this group. Considering the key motivation to consult a traditional practitioner, two main factors accounted for half of the cases: "past experience with folk medicine" and "family habit". Out of 9 traditional practitioners' interviewees, 26 medicinal plants were cited. Roots and leaves were the most used plant parts, and decoction was the common mode of preparation. Evidence for antitrypanosomal activity in the scientific literature was found for 56% (17 of 30) of the identified plant species. The most cited plant was Crossopteryx febrifuga (UR = 6). Some of the cited plants, as for example Aristolochia gigantea, raised concern about potential toxicity. CONCLUSIONS: With 40% of infected persons having turned first to folk medicine before consulting a medical doctor, this explorative study points out that plant-based medicines play an important role in local dynamics of health care. It highlights the need for primary assessment of potential risk of use related to the herbal recipes, and for reporting it to the concerned population. This first ethnobotanical study on trypanosomiasis in endemic provinces of Angola provides information on 30 plants, of which some had been identified as promising for further pharmacological research. Our results provide a first step towards the validation and valorization of Angolan herbal remedies for sleeping sickness.

An Overview on the Properties of Ximenia Oil Used as Cosmetic in Angola.

Ximenia (Ximeniaamericana L.) is a shrub, or small tree, native from Africa and spread across different continents. In Angola, the seeds oil is used by local populations, to prevent sunburn, to smooth and hydrate the skin, and to give it a pleasant color and elasticity, to prevent stretch marks, in pregnant woman, and also as hair conditioner. Herein, an oil sold in the region (LPO), and two others extracted in laboratory, from seeds collected in the same region, were investigated in terms of their composition, chemical properties, UV transmission. The three oils are similar although the LPO is more acidic, 0.48 mg KOH/g. GC-MS analysis indicated that the major components are the fatty acids, oleic (31.82%), nervonic (11.09%), ximenic (10.22%), and hexacosa-17,20,23-trienoic acids (14.59%). Long chain fatty acids, n ≥ 20, accounted for 51.1% of the total fatty acids. A thin film of the oil showed a reduction in transmittance from 200 to 300 nm. Viscosity studies of the LPO indicated that at normal temperature of skin, the oil can be spread over the skin as a thin film. At concentrations up to 10 µg/mL, the LPO is not toxic to human keratinocytes, suggesting the safety of this oil.

First large-scale ethnobotanical survey in the province of Uíge, northern Angola.

BACKGROUND: Angola suffered a long-lasting military conflict. Therefore, traditional knowledge of plant usage is still an important part of cultural heritage, especially concerning the still very poor health care system in the country. Our study documents for the first time traditional knowledge of plant use of local Bakongo communities in the northern province of Uíge on a large scale with a focus on medicinal plants and puts data in context to different parameters of age, gender and distance to the provincial capital. METHODS: Field work was carried out during nine field trips in 13 municipalities between October 2013 and October 2016. In 62 groups, 162 informants were interviewed. Herbarium specimens were taken for later identification. Database was analysed using Relative Frequency of Citations, Cultural Importance Index, and Informant Consensus Factor. Furthermore, significances of influence of age, gender and distance were calculated. RESULTS: Our study presents 2390 use-reports, listing 358 species in 96 plant families, while just three out of 358 mentioned species are endemic to Angola about one-fifth are neophytes. The larger the distance, the higher the number of use citations of medical plants. Although women represent just a fifth of all citations (22%), their contribution to medicinal plants was proportionally even higher (83%) than those of men (74%). Fifty percent of all plants mentioned in the study were just listed by men, 12% just by women. We made some new discoveries, for example. Gardenia ternifolia seems to be promising for treatment of measles, and Annona stenophylla subsp. cuneata has never been ethnobotanically nor phytochemically investigated. CONCLUSIONS: While the study area is large, no significant influence of the distance in regard to species composition in traditional healer's concepts of the respective village was pointed out. Although several plants were just mentioned by women or men, respectively, no significant restriction to gender-specific illnesses in medical plant use could be found. Merely concerning the age of informants, a slight shift could be detected. Visual representation of the ethnobotanical study in Uíge, northern Angola.

Medicinal plants of northern Angola and their anti-inflammatory properties.

ETHNOPHARMACOLOGICAL RELEVANCE: 32 plants, from which 30 are used in local traditional medicine - identified by interviews with the resident population - in the province of Uíge in northern Angola for the treatment of inflammation related disorders, were screened on different anti-inflammatory parameters. Three extracts were selected for a detailed ethnobotanical, pharmacological and phytochemical investigation based on their in vitro activity. AIM OF THE STUDY: We aimed to assess the in vitro anti-inflammatory activity of these plants and highlight the active principles of the three most promising candidates. MATERIALS AND METHODS: Plant material was collected in northern Angola during eight field trips from 2013 to 2015 based on data documented in 61 interviews with 142 local informants. 36 methanol (MeOH) extracts were prepared and tested at different concentrations (100, 50, 10µg/mL) to evaluate their inhibition on cyclooxygenase (COX)-2 expression and on nitric oxide (NO) release in lipopolysaccharide (LPS)-stimulated J774A.1 macrophages. Five selected extracts were additionally tested at the lower concentrations of 5, 2.5, and 1.25µg/mL and for their potential on inhibition of tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) release. The major compounds of three of those five extracts were either identified by HPLC coupled with (tandem) mass spectrometry and comparison with data from literature or isolated from the respective extracts and confirmed by NMR experiments (one and two dimensional). RESULTS: 30 plant species with in total 161 citations were mentioned by the informants to have anti-inflammatory properties. The predominantly used plant part is the leaf (39%), followed by underground organs like roots and rhizomes (25%), bark (18%) as well as fruits and seeds with 15%. With 47%, decoction is the most frequent preparation form. A large number of the MeOH extracts showed promising activities in our preliminary screening for the inhibition of COX-2 expression and NO release. Five extracts with high activities in both assays showed also concentration dependent inhibition at lower concentrations and a decreased release of two additional pro-inflammatory mediators (IL-6 and TNF-α) vs. LPS. Three leaf extracts where chosen for a detailed investigation, which lead to the identification of several constituents: verbascoside and isoverbascoside (Acanthus montanus), geraniin, chebulagic acid and a large flavonoid fraction (Alchornea cordifolia) as well as the four flavonoids astilbin, isovitexin, isoorientin and swertisin (Chaetocarpus africanus). Their implication in the observed biological activity was proved by comparison with published data of these compounds in identical or similar pharmacological models. CONCLUSIONS: The indigenous use of these plants against inflammation related ailments could be - at least partly - verified by our in vitro models for many of the investigated extracts. Acanthus montanus and Alchornea cordifolia particularly stood out with their high activity in all four performed assays, which was in accordance with pharmacological studies of their major constituents in literature. In addition, this study was the first phytochemical investigation of Chaetocarpus africanus and first description of the occurrence of the ellagitannins geraniin and chebulagic acid in Alchornea cordifolia. These results support the traditional use and should encourage further investigations of medicinal plants of northern Angola.

[Health as a right in Colombia's post-conflict period]. / La salud como derecho en el postconflicto colombiano.

OBJECTIVE: To explore the elements that should be considered in post-conflict zones to guarantee the right to health of populations immersed or living in areas near the concentrations of former combatants. MATERIALS AND METHODS: A retrospective study was carried out by searching databases, obtaining 26 relevant articles. RESULTS: The literature review made evident that not only the legal or normative framework is important, but also the needs and interests of the people of the community, of both the civilian population and the victims of war. The right to health in these areas also involves the exercise of power, of dialogue of knowledge, forgiveness, non-repetition and respect. In addition, health promotion and disease prevention services, treatment and rehabilitation based on the primary care strategy should be offered, that is, they should be adapted to the cultural realities, the environments and the interests of the communities. CONCLUSIONS: The challenge lies in the way how these goals can be achieved within a context of a weak health system, in financial, administrative and technical terms. Basic multidimensional elements in the field of primary health care are proposed to face this challenge for the Colombian public health.

OBJETIVO: Explorar los elementos que se deben considerar en las zonas de post-conflicto para garantizar el derecho a la salud de las poblaciones inmersas o vecinas a las zonas de concentración de los excombatientes. MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo, mediante búsqueda en bases de datos, obteniendo 26 artículos pertinentes. RESULTADOS: Mediante la revisión documental se evidenció que no solo es importante el marco legal o normativo, se deben incluir las necesidades e intereses de las personas de la comunidad, tanto de la población civil como de las víctimas de la guerra, el derecho a la salud en estas zonas implica también ejercicios de poder, de dialogo de saberes, de perdón, no repetición y de respeto, se debe ofertar servicios de promoción de la salud y prevención de la enfermedad, tratamiento y rehabilitación basados en la estrategia de atención primaria en salud, es decir adaptados a las realidades culturales, los entornos y los quereres de las comunidades. CONCLUSIONES: El reto es cómo dentro de un débil sistema de salud tanto en lo financiero, administrativo y técnico eso pueda ser posible. Se proponen los elementos básicos multidimensionales en el ámbito de la atención primaria en salud, para afrontar este reto de la salud pública colombiana.

Fluoroquinolone-Resistant Alcaligenes faecalis Related to Chronic Suppurative Otitis Media, Angola.

We found that 20 (10.6%) of 188 patients with chronic suppurative otitis media in Angola were co-colonized with fluoroquinolone-resistant Alcaligenes faecalis, commonly found in birds. A likely explanation for our findings was the use of bird feces by residents as a traditional remedy to prevent ear secretions caused by primary ear infection.

Antimalarial drugs available in the city Cabinda (Angola) in 2016.

Antimalarial drug offerings in the city of Cabinda (Angola) were assessed during the fourth quarter of 2016. Combinations of artemisinin with other effective antimalarial drugs were available free of charge in public health centres, theoretically after a biological validation of the diagnosis of a malaria attack. Private pharmacies offered many products without medical prescription, most of them being ACT (Artemisinin Combined Therapy) but some being Artemisia derivatives alone. The cost of treatment for a presumptive attack varied from 14 to 44 €. The diversity of antimalarial drugs and of their dosages makes it difficult for sellers to provide appropriate recommendations for their use. In the informal sector, sellers offered the same products at similar prices as the formal sector but with the option of purchasing only a part of the treatment. Analgesics and herbal medicine not validated as antimalarial drugs were also available.

International cooperation and shortage of doctors: an analysis of the interaction between Brazil, Angola and Cuba. / Cooperação internacional e escassez de médicos: análise da interação entre Brasil, Angola e Cuba.

The shortage of doctors, especially in remote areas, is a critical issue for the development of national health systems and has thus been the focus of a number of international cooperation projects. An exploratory and qualitative study was conducted to examine cooperation between Brazil, Angola and Cuba. A nonsystematic literature review was conducted of selected open access articles and official documents addressing relevant health cooperation initiatives. Previously selected characteristics of actions designed to redress the shortage of doctors were compared. It was concluded that the interactions between the three countries were fruitful and potentially beneficial for the health of the population of these countries. South-South cooperation between these countries showed positive results in the educational and regulatory dimensions and adopted a non-dependence perspective that seeks to strengthen endogenous capacity, which are important factors for evaluating the structural components of health systems.

Adaptação e validação discriminante do instrumento Mini Exame do Estado Mental (MEEM) para avaliação neuropsicológica em adultos angolanos com diagnóstico clínico de acidente vascular cerebral (AVC) e epilepsia / Adaptation and discriminant validation of the instrument Mini Mental State Examination (MMSE) for neuropsychological assessment in Angolan adults with a clinical diagnosis of stroke (CVA) and epilepsy

Doenças como AVC e Epilepsia estão constantemente associadas à manifestação de comprometimentos cognitivos e demência, tendo como característica principal os déficits de memória. Atualmente,o instrumento Mini Exame do Estado Mental (MEEM) é o teste de rastreio de comprometimento cognitivo mais utilizado no mundo, individualmente ou como parte integrante em baterias de avaliação neuropsicológica. Devido afalta de instrumentos específicos pararastreiode comprometimento cognitivo de indivíduos com sintomas de demênciavítimas de AVC e/ou Epilepsia em Angola, África, fez se necessária aadaptação evalidação de instrumentos confiáveis.O presente estudoteve por objetivo a avaliação clínicada versão brasileira do instrumento MEEM adaptado por Brucki, para uso na população adulta de Angola.Trata-se de um estudo clínico comparado, envolvendo três populações. Foram incluídos neste estudo 85 indivíduos acometidos por AVC, 40 por Epilepsia e como grupo de comparação, 87 indivíduos de 20 a 65 anos de idade, supostamente saudáveis. A escolaridade mínima para inclusão do estudo foi definida em 4 anos de ensino formal. O presente estudo foi desenvolvido em parceria com o Serviço de Neurologia do Hospital Américo Boavida e com a Faculdade de Medicina da Universidade Agostinho Neto (FMUAN), ambos localizados ao norte da cidade de Luanda, capital de Angola, África.Toda a amostra foi submetida à coleta de dados sócio demográficos e avaliação neuropsicológica, através do instrumento MEEM. O instrumento consistiu no rastreio de comprometimento cognitivo, contemplando funções como orientação temporal e espacial, memória, cálculo, linguagem e capacidade construtivavisual.No presente estudo, encontramos dados que apontam um desempenho significativamente pior das funções cognitivas em pacientes acometidos por AVC quando comparados a pacientes com Epilepsia e grupo dossaudáveis. Esses achados confirmam a validade do instrumento MEEM, em função das características apresentadas pela doença, sendo possível discriminar com clareza os grupos AVC, Epilepsia e Controles Saudáveis. Os dados obtidos indicam uma boa qualidade da versão na língua portuguesa angolana, sendo a consistência interna da versão adaptada com ? de Cronbach = 0,736, semelhante aos dados de referência. Este estudo pioneiro preenche uma importante lacuna na produção de conhecimento em Angola, abrindo um leque de possibilidades para outros trabalhos científicos no país, facilitando a aplicação dos resultados tanto na área acadêmica-científica, quanto na clínica. É necessário aos profissionais de saúde que se apropriem de mais conhecimentos, para que possam propor intervenções adequadas, que auxiliam nos direitos de saúde e bem-estarda população angolana

Diseases such as stroke and epilepsy are constantly associated with the manifestation of cognitive impairment and dementia, having as main feature the memory deficits (Caramelli & Castro, 2005). Currently, the instrument Mini Mental State Examination (MMSE) is the screening test of cognitive impairment most used in the world, individually or as an integrated part in neuropsychological assessment battery (Melo & Barbosa, 2015). Due to the lack of specific instruments for screening cognitive impairment of individuals with dementia symptoms victims of stroke and / or epilepsy in Angola, Africa, it was necessary to adapt and validate reliable instruments. The presentestudy had as objective the clinical evaluationof the brazilian version of the MMSE instrument adapted by Brucki et al. (2003), for use in the adult population of Angola, Africa. It is a comparative clinical study involving three populations. This studyincluded 85 individuals affected by stroke, 40 by Epilepsy, and as a comparison group, 87 individuals, 20 to 65 years of age, who were supposed to be healthy. The minimum schooling for inclusion of the study was defined in 4 years of formal education. Thepresent study was developed in partnership with the Neurology Service of the Américo Boavida Hospital and the Faculty of Medicine of the Agostinho Neto University (FMUAN), both located north of the city of Luanda, the capital of Angola, Africa. All the sample was submitted to the collection of sociodemographic data and neuropsychological evaluation, through the MMSE instrument. The instrument consisted in the screening of cognitive impairment, including functions such as temporal and spatial orientation, memory, calculus, language and visual constructive capacity.In the presente study, we found data that indicate a significantly worse performance of cognitive functions in patients with stroke when compared to patients with epilepsy and healthy group. These findings confirm the validity of theinstrument MMSE in, due to the characteristics of the disease, being possible to discriminate with clarity the groups Stroke, Epilepsy and Healthy Controls. The data obtained indicate a good quality of the Angolan Portuguese language version, being the internal consistency of the adapted versionwhit the Cronbach's alpha = 0.736, similar to the reference data.This pioneering study fills animportant gap in knowledge production in Angola, opening up a range of possibilities for other scientific papers in the country, facilitating the application of the results both in the academic and scientific area, as at the clinic. It is necessary that health professional take ownership of more knowledge, so that they can propose appropriate interventions that assist in health and welfare rights of the Angolan population