The impact of war on HIV/AIDS service provision: In rural health facilities of Tigray, northern Ethiopia, a cross-sectional study.

BACK GROUND: HIV/AIDS remained among the common public health problems in developing country. Despite the extensive delivery of ART and improved coverage of the service access, still, man-made problems like war have negatively influenced the utilization of antiretroviral treatment services. The war in Tigray Region in the northern Ethiopia broke out in November 2020 and thereby has brought about an extreme damage on most of the infrastructure in Tigray, including the health institutions. The purpose of this study is, therefore, to assess and report the trend of HIV service provision across the war affected rural health facilities in Tigray. METHODS: The study was conducted in 33 rural health facilities during the active war in Tigray. A facility based retrospective cross-sectional study design was conducted among health facilities from July 03 to August 05, 2021. RESULT: A total of 33 health facilities from 25 rural districts were included in the HIV service delivery assessment. A total of 3274 and 3298 HIV patients were seen during pre-war period in September and October 2020, respectively. The number of follow-up patients during the war period in January remained to be only 847(25%) which is significantly reduced with a P value<0.001. A similar trend was observed during the subsequent months until May. The trend of follow-up patients on ART significantly declined from 1940 in September (pre-war) to 331(16.6%) in May (during the war). This study also revealed a 95.5% reduction of laboratory service provision to HIV/AIDS patients during the war in January and with similar trends thereafter (P<0.001). CONCLUSION: The war has led to a significant decline of HIV service provision in the rural health facilities and most part of the region during the first eight months of active war in Tigray.

Medicinal Plants Used for the Treatment of Erectile Dysfunction in Ethiopia: A Systematic Review.

BACKGROUND: Erectile dysfunction has remained as one of the major global health issues. Since the discovery of phosphodiesterase type 5 inhibitors, a significant portion of the patients has solved the issue of erectile dysfunction. However, the wide distribution of phosphodiesterase type 5 enzymes at various sites of the body led phosphodiesterase type 5 inhibitors to cause various unnecessary outcomes. Hence, it is vital to look for and find optional agents that could solve these limitations. The people of Ethiopia depend heavily on medicinal plants to ease their ailments, including erectile dysfunction. Aim of the study. The current study was carried out to systematically review the traditional medicinal plants used for the management of erectile dysfunction in Ethiopia. METHOD: A systematic and manual search was conducted to retrieve relevant articles published from 2000 to August 2020. Electronic databases of PubMed (Medline), Google Scholar, and grey literature were employed to access the studies. Accordingly, fifty-four published articles and thesis papers were finally included in this study. RESULT: Seventy plant species have been reported for the management of erectile dysfunction in Ethiopia. The commonly recorded family was Fabaceae, followed by Asteraceae, Malvaceae, Convolvulaceae, and Solanaceae. The plant species that represented the highest number of citations were Asparagus africanus, succeeded by Ricinus communis and Carissa spinarum. The commonest plant part used was roots. Majority of the medicinal plants were administered orally. The growth forms of the reported species were primarily herbs followed by shrubs. CONCLUSION: The present review compiled medicinal plants utilized by the Ethiopian community to manage erectile dysfunction. The findings will serve as a reference for the selection of plants for further pharmacological, toxicological, and phytochemical investigations in developing new plant-based drugs used for the treatment of erectile dysfunction.

Antibacterial and Antifungal Activities of the Leaf Exudate of Aloe megalacantha Baker.

Infectious diseases caused by fungi and bacteria are among the major causes of illness and death worldwide. This is mainly implicated by the antimicrobial resistance of the current treatment regimens. Since plant products are house stores of bioactive compounds, it is essential to screen plant-based antimicrobials to come up with novel medicines that counter the grave consequences of antimicrobial resistance. In the folk medicine of Ethiopia, Aloe megalacantha is used for the treatment of wound, dandruff, malaria, diabetes, impotence, colon cleansing, amoeba, ascariasis, abdominal pain, urine retention, snake bite, and evil eye. Hence, the present study was aimed to evaluate the antibacterial and antifungal effects of the leaf exudate of Aloe megalacantha. Agar well diffusion was employed to determine the antibacterial and antifungal effects. Six bacterial strains, namely, S. aureus (standard), S. aureus (clinical isolate), E. coli ATCC 25922 (standard), E. coli (clinical isolate), K. pneumoniae (standard), and P. aeruginosa ATCC 27853 (standard), and four fungal strains such as C. albicans, C. glabrata, C. tropicalis, and C. krusei were studied. The leaf exudate showed the highest activity against C. krusei with an average zone diameter of 22.49 ± 0.47 mm at 400 mg/mL. Among the bacterial species, S. aureus ATCC 29213 (standard) was the most sensitive with an average zone of diameter of 16.63 ± 0.12 mm at 200 mg/mL. Thus, the present findings support the folklore use of Aloe megalacantha for the treatment of different microbial infections.

Antimicrobial Evaluation of Latex and TLC Fractions from the Leaves of Aloe adigratana Reynolds.

BACKGROUND: The highest prevalence and emergence of microbial infections coupled with the threat of antimicrobial resistance constitute a global concern, which entails searching for novel antimicrobial agents. Medicinal plants are among the major sources of medicines for novel drug discovery. Aloe adigratana is one of the endemic Aloe species in Ethiopia where the leaf latex of the plant is traditionally used for the treatment of various pathogenic conditions such as wound, dandruff, malaria, and diabetes. In spite of such claims, there was no scientific study done so far. The aim of the current study was, therefore, to evaluate the antimicrobial effect of leaf latex of A. adigratana and its thin layer chromatography (TLC) fractions. METHODS: Thin layer chromatography (TLC) separation was employed for isolation of bioactive compounds. Agar well diffusion and microdilution assay method were used to evaluate the antimicrobial actions of the leaf latex and TLC fractions against six bacterial strains and four Candida species of reference and clinical isolate microbial strains. RESULTS: Three major fractions, AA01, AA02, and AA03, were identified by TLC. Among the tested microbial strains, the reference strain of Staphylococcus aureus ATCC 29213 (MIC = 0.06 mg/mL) and clinical Candida krusei 242/18 (MIC = 0.14 mg/mL) exhibited higher susceptibility towards AA02, while reference strains of Klebsiella pneumoniae ATCC 700603 (MIC = 0.19 mg/mL) revealed the highest susceptibility towards AA01. The leaf latex displayed the highest activity against Staphylococcus aureus ATCC 29213 and clinical Candida krusei 242/18 with a MIC value of 0.19 mg/mL. CONCLUSION: The leaf latex and TLC fractions were found to be active against the tested bacterial and Candida species. Therefore, this finding supports the traditional claim of Aloe adigratana and the need for characterization of the TLC fractions to provide as lead compounds for further comprehensive antibacterial and antifungal activities.