ABSTRACT
BACKGROUND: We report the results of a phase IIB study investigating the safety and effectiveness of atorvastatin use with standard anti-TB drugs.METHODS: In this multicentre, open-labelled study, we recruited treatment-naÏve patients with uncomplicated pulmonary TB aged at least 18 years. Participants were randomly assigned to standard-of-care or standard-of-care plus oral dose of atorvastatin (40 mg) daily for 2 months. Primary end points were safety measured by the number of participants with severe adverse events and effectiveness measured by the number of participants with negative sputum culture. Secondary endpoint was chest X-ray (CXR) severity score.RESULTS: Of the 185 participants screened, 150 were enrolled and equally assigned to the standard-of-care and atorvastatin groups. Adverse event severity was similar in the two groups. There was increased frequency of muscle pain in the trial group (12/75, 16% vs. 4/75, 5%). For efficacy analysis, respectively 64 (97%) and 57 (85.1%) patients in the trial and control groups had culture-negative results (P = 0.02) and experienced a reduction in CXR severity score of respectively 37% and 22%, with a mean difference of 1.4-4.9%.CONCLUSION: Atorvastatin is safe and associated with improved microbiological and radiological outcomes in TB.
Subject(s)
Sputum , Tuberculosis, Pulmonary , Humans , Adolescent , Adult , Atorvastatin/adverse effects , Sputum/microbiology , X-Rays , Treatment OutcomeABSTRACT
BACKGROUND: Human Immunodeficiency Virus (HIV) post-exposure prophylaxis (PEP) has been documented to be effective in preventing HIV in exposed individuals. World Health Organization (WHO) recommends that every individual exposed should be treated within 72hours. We aimed to assess the utilization of PEP among clients in a tertiary facility in Northwest, Nigeria. METHODS: A retrospective study was conducted in Barau Dikko Teaching Hospital (BDTH), a tertiary hospital in Kaduna, Nigeria involving all clients who assessed HIV PEP between January 2016 - December 2019. Data collection sheet was used to document the sociodemographic parameters of clients, sources/circumstances of infection, client HIV status, source HIV status and the interval between exposure and commencement of PEP. Analysis of data was done using IBM SPSS version 23. RESULTS: Analysis of 136 complete records was done, mean age was 31.97± 10.24 years, 77 (56.6%) were females, 102 (75%) were due to occupational exposures involving mostly nurses and medical and nursing students while 26 (76.5%) of non-occupational exposures were attributed to rape. The PEP service was assessed by 119 (87.5%) under 72hours but 120 (88.2%) never returned for follow-up. Source of exposure and HIV status of source were significantly associated with the time of assessing PEP. Statistical significance is determined by a p value of < 0.05. CONCLUSION: A major proportion of those that assessed PEP did so in less than 72 hours which is the recommended time by WHO but follow-up and rescreening was poor. There is need for active follow-up of clients that assess the service and increased public health enlightenment on availability and effect of PEP when assessed at the appropriate time.
CONTEXTE: La prophylaxie post-exposition (PPE) du virus de l'immunodéficience humaine (VIH) s'est avérée efficace pour prévenir le VIH chez les personnes exposées. L'Organisation mondiale de la santé (OMS) recommande que chaque individu exposé soit traité dans les 72 heures. Nous avons cherché à évaluer l'utilisation de la PEP dans un établissement tertiaire du Nord-Ouest du Nigeria en examinant les caractéristiques sociodémographiques, le type d'exposition, le moment de l'évaluation des soins et du suivi. MÉTHODES: Il s'agit d'une étude rétrospective menée au Barau Dikko Teaching Hospital (BDTH), un hôpital tertiaire à Kaduna, au Nigeria, impliquant tous les clients qui ont évalué la PEP du VIH entre janvier 2016 et décembre 2019. La feuille de collecte de données a été utilisée pour recueillir les paramètres sociodémographiques des clients, les sources/circonstances de l'infection, le statut VIH du client et de la source et l'intervalle entre l'exposition et le début de la PEP. L'analyse des données a été réalisée à l'aide d'IBM SPSS version 23. RÉSULTATS: 136 dossiers complets ont été analysés. L'âge moyen était de 31,97± 10,24 ans, 77 (56,6%) étaient des femmes. 102 (75%) étaient dus à des expositions professionnelles impliquant principalement des infirmières et des étudiants en médecine et en soins infirmiers, tandis que 26 (76,5%) des expositions non professionnelles étaient attribuées à des viols. 119 (87,5%) ont évalué la PEP sous 72 heures mais 120 (88,2%) ne sont jamais revenus pour un suivi. La source d'exposition et le statut VIH de la source étaient significativement associés au délai d'évaluation de la PEP (p ≤0,05). CONCLUSION: Un nombre significatif de ceux qui ont évalué la PEP étaient des professionnels plus jeunes dans le délai recommandé par l'OMS, mais le suivi et le redépistage étaient faibles. Il faut un suivi actif des clients qui évaluent le service et une éducation accrue sur la disponibilité et l'effet de la PPE lorsqu'elle est évaluée au moment opportun. MOTS CLÉS: Virus de l'immunodéficience humaine (VIH), prophylaxie post-exposition (PPE), médicaments antirétroviraux (ARV), expositions professionnelles et non professionnelles.
Subject(s)
Anti-HIV Agents , HIV Infections , Occupational Exposure , Adult , Anti-HIV Agents/therapeutic use , Female , HIV Infections/drug therapy , Humans , Infectious Disease Transmission, Patient-to-Professional , Nigeria , Post-Exposure Prophylaxis , Retrospective Studies , Tertiary Care Centers , Young AdultABSTRACT
BACKGROUND: Massularia acuminata is a small tree or shrub of tropical rainforest. The leaves are used in Nigerian ethno-medicine for the treatment of microbial infections and pharmacological report suggested the leaf extract as possessing antioxidant activity. This study was therefore carried out to determine the most antioxidant and antimicrobial active fraction(s) of Massularia acuminata leaf and the constituent(s) responsible for the activities. MATHERIALS AND METHODS: The leaf of Massularia acuminata was investigated for in vitro antioxidant and antimicrobial activities, using a 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay and agar dilution method respectively. RESULTS: The ethyl acetate fraction demonstrated the best activities among the partitioned fractions tested. Bioassay guided purification of the most active ethyl acetate fraction led to isolation of a new thiophenolic glycoside, characterized as 4-(3',3'-dihydroxy-1-mercaptopropyl)phenyl glycosylpyranoside. CONCLUSION: The isolated compound from the leaf of Massularia acuminata demonstrated antioxidant and antimicrobial activities and may be responsible for the activities of leaf extract and its ethyl acetate fraction, hence this may justify its ethnomedicinal use.