In vivo Antimalarial, Antioxidant Activities and Safety of Carapa procera DC. (Meliaceae).

Background and Objectives: Carapa procera is a popular herb used by traditional healers in the western part of Burkina Faso. In a previous study, Carapa procera showed interesting antiplasmodial activity in vitro against P. falciparum. The present study aimed to evaluate its in vivo potential against malaria parasites and its safety in mice. Materials and Methods: The antimalarial activity of the ethanolic extract was evaluated on Plasmodium berghei Anka in the Naval Medical Research Institute (NMRI) mice using the Peters 4-day suppressive test. The acute toxicity was performed according to the Lorke method and sub-acute toxicity following the Seewaboon method. The polyphenols and flavonoids were determined by colorimetric methods. The antioxidant activity of the extract was evaluated in vitro by Ferric Reducing Antioxidant Power (FRAPP) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) methods. Results: Carapa procera had a good antiplasmodial activity at a dose of 250 mg kg¹ b.wt. Phytochemical screening revealed the presence of polyphenols and flavonoids in the extracts. Soxhlet ethanolic extracts had the highest content in polyphenols and flavonoids. The antioxidant activity of Soxhlet ethanolic extracts was better than macerated extract by DPPH method and FRAP method. Besides, no mortality in mice was recorded with the soxhlet ethanolic extract. No toxic signs were observed in animals in the sub-acute toxicity test. Conclusion: Carapa procera soxhlet ethanolic stem bark extract had a good in vivo antimalarial activity against Plasmodium berghei infection in mice and the extract was relatively safe when administered orally in mice.

[Wholesale distribution and delivery of plant-based medicinal products through the pharmaceutical system of Burkina Faso]. / Distribution en gros et délivrance des médicaments à base de plantes à travers le circuit pharmaceutique du Burkina Faso.

OBJECTIVE: In order to improve the contribution of medicines from traditional pharmacopoeia to health care, African countries like Burkina Faso have adopted for several years, policies and regulations organizing their distribution. This study aims to analyze the situation of the wholesale and retail sale of herbal medicines imported by the official pharmaceutical facilities. METHOD: This is a retrospective study involving all 18 drug wholesalers and 115 pharmacies in the city of Ouagadougou (Burkina Faso). It consisted of a collection of sales data of herbal medicines from 2013 to 2016 and interviews of the pharmacists responsible for the facilities surveyed. RESULTS: All the pharmacies surveyed obtain their supplies from national wholesalers, but eleven of them do so directly from manufacturers or non-wholesalers. Only 40% (44/111) of herbal medicines distributed by wholesalers and pharmacies had valid marketing authorizations. Also, although the average growth rates of annual sales by wholesalers and private pharmacies, respectively 23.67% and 11.94%, are significant, the turnover generated from their sale remains low. CONCLUSION: Supporting local producers with appropriate funding and adequate promotion of herbal medicines is still needed to boost the share of the national herbal medicines market.

In vitro antioxidant, xanthine oxidase and acetylcholinesterase inhibitory activities of Balanites aegyptiaca (L.) Del. (Balanitaceae).

The present study aimed to test the validity of Balanites aegyptiaca remedies used for the treatment of rheumatisms and mental disorders by examining the antioxidant, xanthine oxidase and acetylcholinesterase inhibitory activities of galls and leaves extracts and fractions. The total phenolics and flavonoids were measured using Folin-Ciocalteu and AlCl3 reagents, respectively. Two methods i.e., FRAP and ABTS were used to estimate the total antioxidant capacity of the plant materials. The FRAP and ABTS antioxidant activities showed that among all extracts and fractions tested, the best antioxidant activities were found with the galls dichloromethane and the leaves ethyl acetate fractions. The antioxidant activities did correlated significantly with the total phenolic and flavonoid contents. The study also showed that B. aegyptiaca galls and leaves fractions exhibited a moderate xanthine oxidase inhibitory activity comparatively to the acetylcholinesterase which was weakly inhibited by the tested extracts and fractions.

[Cataract in Burkina Faso: factors of choice between modern and traditional surgical procedures]. / Cataracte au Burkina Faso: facteurs de choix entre chirurgie moderne ou traditionnelle.

Despite advances in cataract surgery, many peoples in the Sub-Saharan region are still treated by the traditional lens couching technique. The purpose of this study is to investigate the factors leading to the choice of lens couching for cataract treatment. A total 34 patients (40 eyes) from the northern Burkina Faso who underwent lens couching were examined and interviewed. Most patients (56%) did not understand the etiology of cataracts and attributed the disease to fate. Nor did they know of any other cataract treatment than lens couching. Only 13 patients (38.2%) would recommend modern cataract treatment and 52% suggested that health workers should come out into the villages and operate as traditional healers do. In spite of its potentially dramatic complications, lens couching is still the only method of cataract treatment known in some communities of Burkina Faso. Public information campaigns are needed to put an end to the ancestral practice of lens couching.

Anaemia during pregnancy in Burkina Faso, west Africa, 1995-96: prevalence and associated factors. DITRAME Study Group.

We report the results of a cross-sectional study carried out in 1995-96 on anaemia in pregnant women who were attending two antenatal clinics in Bobo-Dioulasso, Burkina Faso, as part of a research programme including a clinical trial of zidovudine (ZDV) in pregnancy (ANRS 049 Clinical Trial). For women infected with human immunodeficiency virus (HIV) in Africa, anaemia is of particular concern when considering the use of ZDV to decrease mother-to-child transmission of HIV. The objectives were to determine the prevalence of and risk factors for maternal anaemia in the study population, and the effect of HIV infection on the severity of maternal anaemia. HIV counselling and testing were offered to all women, and haemograms were determined for those women who consented to serological testing. Haemoglobin (Hb) levels were available for 2308 of the 2667 women who accepted HIV testing. The prevalence of HIV infection was 9.7% (95% confidence interval (CI): 8.6-10.8%). The overall prevalence of anaemia during pregnancy (Hb level < 11 g/dl) was 66% (95% CI: 64-68%). The prevalence of mild (10 g/dl < or = Hb < 11 g/dl), moderate (7 g/dl < or = Hb < 10 g/dl) and severe (Hb < 7 g/dl) anaemia was 30.8%, 33.5% and 1.7%, respectively. The prevalence of anaemia was 78.4% in HIV-infected women versus 64.7% in HIV-seronegative women (P < 0.001). Although the relative risk of HIV-seropositivity increased with the severity of anaemia, no significant association was found between degree of anaemia and HIV serostatus among the study women with anaemia. Logistic regression analysis showed that anaemia was significantly and independently related to HIV infection, advanced gestational age, and low socioeconomic status. This study confirms the high prevalence of anaemia during pregnancy in Burkina Faso. Antenatal care in this population must include iron supplementation. Although HIV-infected women had a higher prevalence of anaemia, severe anaemia was infrequent, possibly because few women were in the advanced stage of HIV disease. A short course regimen of ZDV should be well tolerated in this population.

Low and stable HIV infection rates in Senegal: natural course of the epidemic or evidence for success of prevention?

OBJECTIVES: To document the level of HIV infection in Senegal and also to review evidence of the impact of efforts in prevention, developed by the National AIDS Control Programme and the Civil Society, on the level of the HIV epidemic. METHODS: Research, compilation and critical review of all relevant data on HIV and sexually transmission diseases (STDs) epidemiology, sexual behaviour, and the efforts in prevention developed in Senegal. RESULTS: From 1989 to 1996, the levels of HIV infection estimated in four sentinel urban regions remained stable at around 1.2% in the population of pregnant women, and at 3% in male STD patients. It had increased to 19% in female sex workers. A strong political and community commitment led to an early response to the HIV/AIDS epidemic that has been extended since 1986. Blood transfusion safety was established at the start of the HIV epidemic. The level of knowledge of preventive practices relating to HIV/AIDS among the general population exceeded 90% in the early 1990s. From 1991 to 1996, a 30% to 66% decrease of the STD prevalence rates was observed in pregnant women and sex workers in Dakar. In 1997, 33% of men aged 15-49 years in Dakar reported having had sex with non-regular partners. Among them 67% reported condom use. CONCLUSIONS: It is not possible to know what the course of the HIV epidemic in Senegal would have taken in the absence of efforts at prevention. Certainly, several factors that pre-dated the occurrence of AIDS in Senegal laid the groundwork for a positive response. However, data from a number of sources do reveal the successfulness of efforts in prevention. From available data, Senegal can rightfully claim to have contained the spread of HIV by intervening early and comprehensively to increase knowledge and awareness of HIV/AIDS and to promote safe sexual behaviour.

[The reduction of mother-child transmission of HIV infection in developing countries: potential intervention strategies, obstacles to implementation and perspectives. The Reduction of Mother-Child Transmission of HIV Infection in Africa Group]. / Réduction de la transmission mère-enfant du VIH dans les pays en développement: stratégies d'intervention disponsibles, obstacles à leur mise en oeuvre et perspectives. Groupe DITRAME.

Mother to child transmission (MCT) of Human Immunodeficiency Virus (HIV) is the main cause of the spread of the HIV epidemic in the pediatric population. It is estimated that to date, three million children worldwide have been infected by HIV. The epidemic burden in developing countries is dramatic. Ninety-five percent of the world's HIV-infected women are living in developing countries. In industrialized countries, antiretroviral treatment of pregnant women and newborns with azidothymidine (AZT, ACTG 076 regimen) and discouraging breast feeding by HIV-infected mothers are effectively reducing MCT of HIV. However, there are three major obstacles to the systematic application of these strategies in developing countries: (a) difficulties in implementing the complex AZT administration and its corollary the avoidance of breast feeding; (b) the complexity of the logistics of the ACTG 076 regimen; (c) cost. Indeed, in developing countries the socioeconomic situation of the populations are precarious and health structures and services are underdeveloped. In addition, the anxiety and the reluctance of general population in the face of the HIV problem and the high prevalence of maternal anemia reduce the acceptability and safety of AZT treatment for pregnant women in developing regions. Only interventions that are applicable, acceptable, safe, affordable, of low cost and integrated into health system will be able to reduce HIV MCT. We now know that MCT occurs mostly during the perinatal period and the maternal viral load in blood, in cervical secretions and in breast milk appears to be the main determinant of transmission. Maternal vitamin A deficiency may also favor MCT of HIV. It is however possible that this association is confounded by the relationship between advanced maternal HIV disease (a known risk factor for transmission) and vitamin A deficiency. In spite of these uncertainties concerning determinants of MCT of HIV, several interventions have been designed. The first involves treating the mother with antiretroviral drugs for the perinatal period. The second is vaginal disinfection by application of virucidal antiseptics during the perinatal period. The third is to give vitamin A supplements to pregnant women and children. Finally, passive immunotherapy with anti-HIV antibodies applied to pregnant women and/or new born, may be beneficial. The feasibility, safety and efficacy of these potential interventions have not yet been demonstrated in developing countries. In view of the dramatic spread of HIV infection in these countries, the evaluation of these interventions is of utmost priority. These trials are necessary because of the public health emergency but should be performed in strict respect of human rights and medical ethics.

Anaemia among women of reproductive age in Burkina Faso.

The control of anaemia among women of reproductive age (15-49 years) is one of the priorities of the Safe Motherhood initiative. This article presents the results of a study that was carried out to provide some of the information needed for an effective and sustainable programme to control anaemia in women of this age group in Burkina Faso.

PIP: The control of anemia in women of childbearing age is essential to prevent low birth weight and perinatal and maternal mortality. To help identify appropriate intervention strategies for the control of iron deficiency anemia in Burkina Faso, cluster sampling of women 15-49 years of age was conducted in Bobo-Dioulasso. Of the 251 women selected, 56 were pregnant and 123 were breast feeding. Chronic nutritional deficiency (defined as a body mass index under 19 kg/m2) was present in 18% of women. The overall prevalence of anemia was 58.6% (71.4% among pregnant women, 64.2% among breast-feeding women, and 38.9% among non-pregnant/non-lactating women). Although health service utilization was high (91% for prenatal care and 72% for delivery) in this sample, only 11% had taken iron tablets. Ignorance about the benefits of iron supplements, the black color of feces associated with use of the tablets, and the tablets' unpleasant odor were the main reasons for non-compliance. When health workers addressed these concerns, women were compliant. Examination of conjunctival pallor had low sensitivity (16%) as a screening mechanism for anemia, while the portable hemoglobinometer was both acceptable and accurate. Recommended are programs to prevent malaria and malnutrition--the two main causes of anemia in Burkina Faso.