Medicinal plants used for management of diabetes and hypertension in Ghana.

Diabetes and hypertension have been declared as a global health menace of the 21st Century. Thus, the search for potential therapeutic agents from medicinal plants for the management of diabetes and hypertension is important. This study was undertaken to investigate medicinal plants being used in the management of diabetes and hypertension by herbalists in Ghana. Data were obtained from 36 herbalists through questionnaire interviews and conversations. Botanical specimens were collected, processed and identified following standard ethnobotanical methods. Data were analyzed using Fidelity Level (FL) and Informant Consensus Factor (ICF). A total of 39 species of plants belonging to 31 families were reported being used for management of diabetes and hypertension. Eighteen of these plants are used for the treatment of hypertension, 12 species for diabetes, and 9 species for management of both diseases. Informant consensus factor was highest for plants used to treat both diseases (IFC = 0.82) followed by hypertension (ICF = 0.31) and then diabetes (IFC = 0.24). FL values were high for Carica papaya L. Moringa oleifera Lam. and Khaya senegalensis A. Juss. for the management of both diabetes and hypertension. Of the 14 species used for hypertension, Tetrapleura tetraptera (Schum. ex. Thonn.) recorded the highest FL value whiles Momordica charantia L. recorded the highest FL value for antidiabetic plants. Baphia nitida G. Lodd, Luffa aegyptiaca Mill. and Tapinanthus banguwensis (Engl. & k. Krause) Dancing are being mentioned for the first time in the management of hypertension. Herbal medicines for treatments of both diabetes and hypertension were usually prepared from multiple plant prescriptions by boiling the plant parts, and the decoctions drunk for treatments. The results show that there is substantial preclinical evidence to support the usefulness of some of these herbs as an important choice for patients with diabetes and hypertension. However, clinical studies are important to confirm the efficacy and safety of the herbal medicines prescribed by herbalists.

Standardization and Quality Control of the Herbal Medicine Mist Nibima, Employed to Treat Malaria and COVID-19, Using Physicochemical and Organoleptic Parameters and Quantification of Chemical Markers via UHPLC-MS/MS.

Mist Nibima is an essential herbal medicine used to treat malaria, bacterial, yeast, and COVID-19 infections. However, the drug has not been standardized and its active chemical ingredients are also not known. This study employed physicochemical, organoleptic, qualitative, and quantitate phytochemical analysis to established standards for Mist Nibima. Additionally, UHPLC was used to quantify the alkaloid cryptolepine in the drug using calibration curve. The chemical ingredients in Mist Nibima were thereafter characterized using UHPLC-MS. Organoleptic evaluation shows that Mist Nibima is a very bitter, cloudy, broom yellow decoction with the following physicochemical parameters: pH = 6.10 ± 0.08 (at 28.3°C), total solid residue = 5.34 ± 0.27%w/v, and specific gravity = 1.0099 ± 0.0000. The total alkaloid (23.71 ± 1.311%) content of the drug is 3 times its total saponins (7.993 ± 0.067%) content. Methyl cryptolepinoate (37.10%), cryptolepine (33.56%), quindoline (20.78%), 11-isopropylcryptolepine (5.16%), and hydroxycryptolepine (3.14%) were the active chemical ingredients in the drug with the concentrations of 18.64 ± 0.255, 16.85 ± 0.231, 10.42 ± 0.143, 2.56 ± 0.034, and 1.70 ± 0.023 µg/mL, respectively. Administration of a single oral therapeutic dose (30 mL) of Mist Nibima corresponds to ingestion of 559.2 ± 7.662, 505.5 ± 6.930, 312.6 ± 4.285, 76.8 ± 1.028, and 51.0 ± 0.699 µg of methyl cryptolepinoate, cryptolepine, quindoline, 11-isopropylcryptolepine, and hydroxycryptolepine, respectively. This translates into a corresponding daily dose of 1677.6 ± 22.986, 1516.5 ± 20.790, 937.8 ± 12.855, 230.4 ± 3.084, and 153.0 ± 2.097 µg of methyl cryptolepinoate, cryptolepine, quindoline, 11-isopropylcryptolepine, and hydroxycryptolepine. These results could now serve as tools for authentication, standardization, and quality control of Mist Nibima to ensure its chemical and pharmacological consistency and safety.

COVID-19 in sub-Saharan Africa: impacts on vulnerable populations and sustaining home-grown solutions.

This commentary draws on sub-Saharan African health researchers' accounts of their countries' responses to control the spread of COVID-19, including social and health impacts, home-grown solutions, and gaps in knowledge. Limited human and material resources for infection control and lack of understanding or appreciation by the government of the realities of vulnerable populations have contributed to failed interventions to curb transmission, and further deepened inequalities. Some governments have adapted or limited lockdowns due to the negative impacts on livelihoods and taken specific measures to minimize the impact on the most vulnerable citizens. However, these measures may not reach the majority of the poor. Yet, African countries' responses to COVID-19 have also included a range of innovations, including diversification of local businesses to produce personal protective equipment, disinfectants, test kits, etc., which may expand domestic manufacturing capabilities and deepen self-reliance. African and high-income governments, donors, non-governmental organizations, and businesses should work to strengthen existing health system capacity and back African-led business. Social scientific understandings of public perceptions, their interactions with COVID-19 control measures, and studies on promising clinical interventions are needed. However, a decolonizing response to COVID-19 must include explicit and meaningful commitments to sharing the power-the authority and resources-to study and endorse solutions.

Ghana's National Health Insurance Scheme: insights from members, administrators and health care providers.

The Ghana National Health Insurance Scheme (NHIS) was established as part of a poverty reduction strategy to make health care more affordable to Ghanaians. It is envisaged that it will eventually replace the existing cash-and-carry system. This paper examines the views of NHIS administrators, members/enrollees, and health care providers on how the Scheme operates in practice. It is part of a larger evaluation project on Ghana's NHIS, sponsored by the Bill and Melinda Gates Foundation and the Global Development Network as part of a two-year global research. We rely primarily on qualitative data from focus group discussion in the Brong Ahafo and the Upper East regions respectively. Our findings suggest that the NHIS has improved access to affordable health care services and prescription drugs to many people in Ghana. However, there are concerns about fraud and corruption that must be addressed if the Scheme is to be financially viable.

Traditional beliefs and knowledge base about epilepsy among university students in Ghana.

INTRODUCTION: Epilepsy is a brain disorder characterized by abnormal neuronal electrical signal activity, which results in an array of clinical symptoms. These clinical symptoms may include unusual sensations, movements, emotions, and behavior changes. Sometimes full convulsions or partial muscle spasms may occur, as may loss of consciousness, depending on the nature and type of seizure activity. In Africa, persons with epilepsy are shunned and discriminated against in education, employment and marriage because epilepsy is often perceived as a shameful disease in the eyes of the general public. Epilepsy is also traditionally looked on as a curse by the ancestral spirits or attributed to possession by evil spirits. It is also thought to be due to witchcraft and "poisoning," and often thought to be highly contagious. OBJECTIVES: The main objective of our study was to investigate the current psychosocial beliefs and knowledge about epilepsy among university students in Ghana. METHODS: The Antonak and Rankin's (1982) Scale of Attitudes Toward Persons with Epilepsy (ATPE-Form S) was administered to a voluntarily participating sample of 173 healthy Ghanaian university students without a history of seizure disorder or epilepsy. RESULTS: Pearson product-moment correlation analyses revealed a moderate relationship between the participants' knowledge about, and attitudes toward, persons with epilepsy. Results indicated a restricted knowledge about epilepsy as well as what appears to be a growing trend toward relatively favorable attitudes toward individuals with the disorder. CONCLUSIONS: A trend toward more favorable attitudes was demonstrated in this study. Findings are therefore consistent with the view that attitudes about epilepsy among Ghanaian university students are changing.

Traditional healers as service providers in Ghana's National Health Insurance Scheme: the wrong way forward?

Concerned with the negative impacts of user fees on healthcare access and utilisation, following the enactment of a law in 2003, the Ghanaian government replaced the 'cash-and-carry' system with a National Health Insurance Scheme (NHIS). Even though many Ghanaians rely on traditional medicine (TRM) for reasons of culture, cost and personal preference, the incipient NHIS does not cover the services of TRM practitioners. Consultations with health policy-makers suggest that, in as much as the government recognises the invaluable contributions of TRM practitioners and would like to incorporate them in the incipient scheme, the provision of TRM in the country is still too disorganised, with few if any formal protocols and codes of conduct. Consequently, the inclusion of TRM practitioners in the NHIS is premature. This scholarly review seeks to bring TRM and its practitioners into the mainstream of healthcare provision in Ghana. Possibilities for medical pluralism in Ghana will be discussed with reference to best practices in countries such as China, India and Vietnam. This paper promotes medical pluralism in the form of Active Collaboration Between Fully Recognised Health Systems where there will be equity, mutual respect and understanding among traditional healers and physicians.