Evidence-based universal health coverage interventions delivery in infectious disease of poverty elimination and eradication.

The recent 78th United Natiions General Assembly (UNGA) declaration relaunched a new health priority and political commitment in accelerating Universal Health Coverage (UHC), adopted by the United Nations (UN) in 2015 and are intended to be met by 2030. At mid-way point of UHC implementation, we advocate for the much needed programmatic implementation research, evidence-based interventions (EBIs) policies and strategies leadership and management capacity building to enable robust, resilient and sustainable multi-sectoral partnerships, integrated coordination and governance mechanisms capabilities in accelerating UHC package mainly infectious diseases of poverty elimination and eradication agenda.

Quantitative modelling of Ostracod bioassay: assigning toxicity index to potentially chemical contaminated swimming pools.

One of the primary objectives of any public health programme is to design a protocol that will curtail a population from being predisposed to toxic substances in the environment. Biomarkers help in actualising such an objective by their potential to detect the presence of toxic substances in environmental media such as soil, water and air. The Ostracod Heterocypris incongruens, an already established biomarker for quality evaluation of freshwater, does not quantify toxicity. This work was aimed at modelling Ostracod bioassay as a quantitative whole-water toxicity assay (QWTA) for the determination of potentially chemical contaminated swimming pools. In this modelling approach, a pool water sample was deliberately contaminated with a mixture of Fenton reagent (FR) and Bonny light (BL) crude oil. The mechanism of toxic injury of this mixture is via oxidative stress-mediated superoxide ion and other free radicals. The mortalities and growth factors of the exposed freshly hatched Ostracods to the serial dilutions of the contaminated swimming pool water sample for 6 days were mathematically modelled to toxicity indices (Ti), which were used to construct the toxicity reference curve (TRC). A graph of the "toxic concentrations" of the serially diluted contaminated pool water sample against Ostracod mortality was plotted. The TRC and the linear graph constitute the "Ostracod-linked mathematical model". Against the reference mortality ≤ 20% of the Ostracods, the toxicity index based on the model prediction is ≤ 32.5, and this signifies "no observed toxic effect" for toxicity values below 32.5 units. Using this model, toxicity indices were calculated for 5 randomly selected swimming pools in the study area. The results showed that the outdoor pool SP 5 has a toxic index of 49.0, while outdoor pools SP 2 and SP 3 each has a toxic index of 42.5. The indoor swimming pool (SP 4) and Standard water (control) have zero toxicity, thus suggesting that that the outdoor pools SP 2, SP 3 and SP 5 were possibly contaminated by chemicals from extraneous sources while contamination of SP 1 was very much negligible, hence the "no observed toxic effect".

Predictive factors to access and use of family planning services by rural and semi-urban dwellers in Afikpo North Local Government area, Ebonyi State, Nigeria.

Pregnancy and childbirth are important periods when women of reproductive age frequently come in contact with healthcare facilities and providers. These periods afford them the privilege for discussion and decision on post-partum family planning with healthcare providers. Male partner consent has been shown to have a positive impact on access and uptake of modern contraception. This study was aimed at assessing the availability, uptake and male partner consent for post-partum family planning (PPFP) amongst rural and semi-urban dwellers in Afikpo North local government area of Ebonyi state, Nigeria. The study conducted on 205 postpartum women, 40 health workers at the primary health centres (PHCs) and traditional birth attendants (TBAs) in Afikpo North LGA were selected by a random sampling technique. Information was obtained via 3 categories of interviewer-administered questionnaire for the different categories of individuals involved in the study. Data analyses was done using SPSS version 21.0. The overall findings showed a high prevalence of grand multiparity (51.2%) and child-bearing at extremities of reproductive age (20.5%) despite generally good awareness of modern contraception (92.7%) and availability of family planning services and modern birth control methods in all the PHC facilities. Of note is that a good percentage of the women received antenatal care (38.1%) or had their last delivery at TBAs places (42.4%) despite the fact that only 60% of the TBAs are aware of modern family planning methods and none of them offer family planning services. The prevalence of modern contraceptive usage was 41.5% and the male partner consent was present in 72.9% of modern contraceptive users. Despite high level of awareness and availability of modern family planning services, the TBAs should be more sensitized in order to improve the uptake of PPFP.

Rebuilding transformation strategies in post-Ebola epidemics in Africa.

Rebuilding transformation strategies in post-Ebola epidemics in West Africa requires long-term surveillance and strengthening health system preparedness to disease outbreak. This paper assesses reconstruction efforts from socio-cultural, economic and ecological transformation response approaches and strategies in improving sustainable survivors and affected communities livelihood and wellbeing. A comprehensive approach is required in the recovery and rebuilding processes. Investing in rebuilding transformation requires fostering evidence-based and effective engaging new investors partnership strengthening, financing community-based programmes ownership, novel socio-economic innovations strategies and tools against the evolving and future Ebola epidemics. Thus, there should be improved community partnership, health and economic rebuilding programmes to address mistrust and care underutilization, poverty and care access inequity at all levels. Implementing effective post-Ebola national 'One Health' approach coupled with climate change mitigation and adaptations strategies is urgent public health needs aiming at improving the quality healthcare access, delivery trust and uptake in anticipation of EVD immunization program, productivity and emerging economy.

The effect of aqueous leaf extract of Telfairia occidentalis (Cucurbitaceae) on gentamycin-induced renal damage.

BACKGROUND: Despite the acclaimed beneficial effects of Telfaria occidentalis (TO), it is yet to be established that its aqueous extract is safe in the condition of renal impairment. Thus, the study investigated the effects of TO aqueous leaves extract on gentamycin-induced renal damage. METHODS: The animals were distributed into five groups. Group A (control) was placed on standard rat feed. Groups B and C received 500 mg/kg and 80 mg/kg of TO and gentamicin for 21 days, respectively. Group D received 500 mg/kg of TO 14 days before 7 days administration of 80 mg/kg of gentamycin. Group E received 80 mg/kg of gentamicin for 14 days before 7 days administration of 500 mg/kg TO. Group F received 500 mg/kg of TO and 80mg/kg of gentamycin concurrently for 21 days. Biochemical and histological examinations were analysed by standard methods. RESULTS: The administration of TO for 7 days after 14 days of gentamycin injection and its concomitant administration with gentamicin for 21 days caused significant reduction (p<0.05) on the relative kidney weight, creatinine and uric acid levels compared to groups C and D. There was a significant decrease (p<0.05) in the mean serum potassium level in group C compared to groups A, B, D, and F. The histological reports showed that the combination of the extract and gentamycin (group F) seems to ameliorate the deleterious effect observed when gentamycin was administered alone. CONCLUSIONS: The administration of the extract together with and after the administration of gentamycin reverses renal damage caused by gentamycin.

Fostering prevention and care delivery services capability on HIV pandemic and Ebola outbreak symbiosis in Africa.

Human immunodeficiency virus (HIV) and the re-emerging Ebola virus disease (EVD) are closely intertwined and remain a persistent public health threat and global challenge. Their origin and rapid transmission and spread have similar boundaries and share overlapping impact characteristics, including related symptoms and other interactions. The controversies and global threat of these viruses require rapid response policy and evidence-based implementation findings. The constraints and dual burden inflicted by Ebola and HIV infections are highly characterized by similar socio-demographics, socio-economic and political factors. EVD has similar effects and burdens to HIV infection. This study seeks to understand EVD in the context of HIV epidemic despite the challenges in developing an effective vaccine against HIV and EVD. Our findings show that early understanding, prevention and treatment of these diseases a global health threat mainly in Africa is important and valuable. The lessons learned so far from HIV and Ebola epidemics are crucial in health programming and execution of rapid response interventions and continued vigilance against EVD before it become another worldwide health menace. Therefore, the current regional West Africa EVD requires strengthening healthcare systems and building preparedness and response capacity. Importantly, appropriate community participation, health education and resilience coupled with deployment of effective novel diagnostic approaches in early warning and surveillance of threats and emerging diseases. Therefore, there is an urgent need to develop novel key strategies are crucial in curbing the constant viral resurgence, persistence transmission dynamics and spread, as well in accelerating Ebola vaccines regimen (immunization) development and national implementation plans in achieving sustained control, and eventual elimination.

China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries.

BACKGROUND AND INTRODUCTION: This review paper examines the growing implications of China's engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. METHODS: We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. RESULTS: Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China's significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS: Strengthening China-Africa health development agenda towards collective commitment and investment in quality care delivery, effective programs coverage and efficiency, preparedness and emergency response is needed in transforming African health information systems, and local health governance structures and management in emerging epidemics. Furthermore, innovative evidence of operational joint solutions and strategies are critical in advancing healthcare delivery, and further enhancing Universal Health Care, and Sustainable Development Goals to attain global health improvements and economic prosperity.

Fostering Prevention and Care Delivery Services Capability on HIV Pandemic and Ebola Outbreak Symbiosis in Africa

Human immunodeficiency virus (HIV) and the re-emerging Ebola virus disease (EVD) are closely intertwined and remain a persistent public health threat and global challenge. Their origin and rapid transmission and spread have similar boundaries and share overlapping impact characteristics; including related symptoms and other interactions. The controversies and global threat of these viruses require rapid response policy and evidence-based implementation findings. The constraints and dual burden inflicted by Ebola and HIV infections are highly characterized by similar socio-demographics; socio-economic and political factors. EVD has similar effects and burdens to HIV infection. This study seeks to understand EVD in the context of HIV epidemic despite the challenges in developing an effective vaccine against HIV and EVD. Our findings show that early understanding; prevention and treatment of these diseases a global health threat mainly in Africa is important and valuable. The lessons learned so far from HIV and Ebola epidemics are crucial in health programming and execution of rapid response interventions and continued vigilance against EVD before it become another worldwide health menace. Therefore; the current regional West Africa EVD requires strengthening healthcare systems and building preparedness and response capacity. Importantly; appropriate community participation; health education and resilience coupled with deployment of effective novel diagnostic approaches in early warning and surveillance of threats and emerging diseases. Therefore; there is an urgent need to develop novel key strategies are crucial in curbing the constant viral resurgence; persistence transmission dynamics and spread; as well in accelerating Ebola vaccines regimen (immunization) development and national implementation plans in achieving sustained control; and eventual elimination

Comparative assessment of onion and garlic extracts on endogenous hepatic and renal antioxidant status in rat.

BACKGROUND: Despite growing claims of functional health benefits in folkloric medicine, the safety of chronic/elevated intakes of onion and garlic cannot be assumed. Therefore, this study assesses oral administration of varied doses of onion and garlic on some biomarkers of hepatic and renal functions in rats. METHODS: Animals were divided into five groups: control group received vehicle and extract-treated groups received varied doses of onion or garlic extract (0.5 mL and 1.0 mL/100 g bwt/day) for 6 weeks. RESULTS: Both doses of onion caused marked (p<0.05) increase in hepatic and renal levels of glutathione (GSH), glutathione S-transferase (GST), superoxide dismutase (SOD), catalase (CAT) and marked (p<0.05) decrease in malondialdehyde (MDA). Treatment with low dose of garlic elicited similar trend except in hepatic CAT, renal SOD and GST levels. A high dose of garlic only caused marked (p<0.05) increase in hepatic GST, renal GST, and SOD. Both doses of onion and low dose of garlic significantly (p<0.05) enhanced renal Na+/K+-ATPase activity. Only a high dose of onion caused significant (p<0.05) increase in hepatic aspartate transaminase (AST), alkaline phosphatase (ALP), and decrease in plasma AST activities. CONCLUSIONS: These findings suggest antioxidant enhancing capability for both doses of onion and low dose of garlic, while high dose of garlic elicited pro-oxidant conditions.

Surveillance on the status of immune cells after Echinnococcus granulosus protoscoleces infection in Balb/c mice.

BACKGROUND: Cystic echinococcosis is a global parasitic disease caused by infection with Echinococcus granulosus larvae with potentially life-threatening complications in humans. To date, the status of the immune cells believed to be associated with the pathogenicity of E. granulosus infection has not been demonstrated clearly. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we developed a multiplex flow cytometry assay to investigate the systemic immune status of innate and adaptive immunity at 30, 180, 360 days post-infection (dpi) in mice infected with E. granulousus. At 30 dpi, an increase in the number of CD11b(+) and CD11c(+) antigen-presenting cells (APCs) was observed. This was accompanied by the slight down-regulated expression of the co-stimulatory molecule MHC-II, indicating the impairment of APCs in early infection through the release of secretory-excretory products. In all infected groups, we observed a significant increase in innate immune cells, including APCs and GR-1(+) cells, and a dramatic increase in the myeloid-derived suppressor cells (MDSC) expressing CD11b(+)/GR-1(+). Moreover, the upregulation of the activated markers CD69, CD44, CD40L, and the downregulation of CD62L were observed in the CD4(+) and CD8(+) T cells following infection. Regulatory T cells expressing CD4(+)/CD25(+)/FoxP3 (+) increased significantly over the course of infection. CONCLUSIONS: Our findings demonstrate that the microenvironment in the peripheral immune system after E. granulosus infection changes in subtle but detectably ways, especially during the persistent period of infection. We found that T cells were activated following infection, but observed that the significant increase of immunosuppressive cells such as MDSC and Treg cells could inhibit T cell response to E. granulosus antigens. We suggest these cells may play a neglected but key role in the downregulation of the immune response in long-term parasitic infection. Understanding the basic functions and temporal interactions of these immunosuppressive cells will pave the way for new strategies of parasite vaccine design.

Digging a little Bellow the Surface of the relationship between blood Plessure and Obesity: Dichotomous Correlations in Young-Adult Nigerians

The relationship between blood pressure (BP) and obesity is still controversial; and was studied in a population of young-adult Nigerians. Systolic BP (SBP) and diastolic BP (DBP) were measured using an oscillometric device while relevant anthropometric indices were measured and derived using standard protocol. Body fat (BF) was measured by bioelectrical impedance analysis. The Pearson's correlation coefficients were calculated for the general population and based on BP phenotype; and scatter plots generated (for both sexes). The results show that in the general population; SBP was correlated with BF (males; r = +0.093; P 0.01; females; r 0.05) correlated with either BF or BMI. The BP versus BF or BMI curve shows sex variations; and plateaus once the BP value exceeds 120/80 mmHg. This dichotomous relationship implies that weight management may be useful in hypertension prevention in normotensive subjects; but may not be very useful; as a therapeutic option; in hypertensives

Variations in the prevalence of point (pre)hypertension in a Nigerian school-going adolescent population living in a semi-urban and an urban area.

BACKGROUND: Hypertension has been shown to start in early life and to track into adulthood. Detecting adolescents with hypertension and prehypertension will aid early intervention and reduce morbidity and mortality from the disorders. This study reports the point-prevalence of the two disorders in a semi-urban and an urban population of school-going adolescents in Nigeria. METHODS: A total of 843 adolescents from two places of domicile were studied. Their blood pressures and anthropometric indices were measured using standard protocol. Point-hypertension and point-prehypertension were defined with respect to each subject's gender, age and height. The prevalence of the disorders was calculated and reported age-wise and nutritional status-wise. RESULTS: The prevalence of point-prehypertension in the semi-urban area was 22.2% (20.7% for girls and 23.1% for boys) while it was 25.0% (21.8% for girls and 29.2% for boys) in the urban area. The prevalence of point-hypertension was 4.6% (4.1% for girls and 4.8% for boys) in the semi-urban area and 17.5% (18.0% for girls and 16.9% for boys) in the urban area. Point-prehypertension was not detected among the thin subjects of both places of domicile. The prevalence of point-prehypertension was similar in both the urban and semi-urban areas among the subjects who had normal BMI-for-age, and over-weight/obese subjects respectively. From the semi-urban to the urban area, the prevalence of point-hypertension increased approximately 3-folds among thin and normal BMI-for-age subjects, and 10-folds among overweight/obese subjects. Systolic hypertension was more preponderant in both the semi-urban and urban areas. CONCLUSIONS: The prevalence of both disorders is considerably high in the studied populations. Urgent pediatric public health action is needed to address the situation.