Assessment of the Teratogenic Effect of Sulfadoxine-Pyrimethamine on the Chicken Embryo.

Background: The sulfadoxine-pyrimethamine combination is a product used in the intermittent preventive treatment (IPT) of malaria in pregnant women in our country. To date, there is very little data on the teratogenic effect of this product. This study proposed to evaluate the teratogenic effect of sulfadoxine-pyrimethamine on chicken embryos. Methods: The teratogenic effect of the product was evaluated on chicken embryos at a dose of 1.3 mg/g sulfadoxine and 0.06 mg/g pyrimethamine. The product was injected before the start of incubation and on days 12, 14, 16, and 18 of incubation. One batch received a double injection of the product on days 16 and 18 of incubation. The quality of the hatched chicks was evaluated by the Tona Score followed by the determination of hematological and biochemical parameters. Results: From the aforementioned, it appears that the eggs treated with sulfadoxine-pyrimethamine significantly decreased the hatchability rate of the eggs. The chicks obtained were all of very good quality. Apart from a significant decrease in the weight of the chicks of the batch that received the injection twice and a significant increase in the weight of the yolk sac of the chicks of the batch that received the injection on day 16 compared to the control, no variation was obtained. A significant increase in the white blood cell count of the chicks compared to the control was reported in the chicks of the batch injected before incubation and on day 12, as well as a significant increase in the platelet count of the chicks of the batch injected twice. For biochemical parameters, no significant difference was reported in ALT and AST. Conclusion: Sulfadoxine-pyrimethamine decreased egg hatch and caused an increase in embryo and chick mortality as well as a loss in relative chick weight and an increase in relative yolk sac weight. More in-depth studies would be needed on sulfadoxine-pyrimethamine teratogenicity and the benefit/risk ratio of this drug during pregnancy.

Medication Consumption Patterns and Polypharmacy among Community-Dwelling Elderly in Lomé (Togo) in 2017.

BACKGROUND: In the sub-Saharan African, region of the world with a fast growing aging population and where the use of herbal products is very common, there is a paucity of data on medication consumption patterns among elderly people. The objective of this study was to assess the prevalence of polypharmacy and its associated factors among community-dwelling elderly in Lomé, Togo, in 2017. METHODS: A cross-sectional study was conducted from March to June 2017 in Lomé, Togo among people aged 60 years and older. The Respondent Driven Sampling method was used to recruit participants. Data on socio-demographic characteristics and medication consumption patterns, including the use of medicinal plants and dietary supplements, were collected using a standardized questionnaire during a face-to-face interview at participants' home. Descriptive and binary logistic regression analyses were performed. RESULTS: A total of 370 participants with median age 65 years, (IQR: 62-71) were enrolled in the study. Almost three elderly in five (57.6%) were multimorbid (had two or more chronic diseases). Conventional drugs (78.4%), medicinal plants (14.3%) and other dietary supplements (9.5%) were used by participants. The prevalence of polypharmacy was 22.7% (95% CI: 18.5-27.3%). Concurrent use of conventional drugs and medicinal plants or other dietary supplements was observed among 17.0% of participants and 67.3% reported self-medication. Multimorbidity (aOR = 4.55; 95% CI: [2.42-8.54]) and female sex (aOR = 1.86; 95% CI: [1.00-3.47]) were associated with polypharmacy. CONCLUSION: One elderly in five uses five or more medications in Togo. Further studies are needed to assess drug-drug interactions and herb-drug interactions among this population.

Toxicological assessment of the hydroethanolic leaf extract of clerodendrum capitatum in Wistar rats.

INTRODUCTION: Clerodendrum capitatum (Willd) Schumach. & Thonn (Lamiaceae) is used in African traditional medicine for the treatment of malaria, hypertension, obesity, jaundice and diabetes however there is lack of experimental data on its possible toxicity. This study investigated the acute and 28 days sub-chronic toxicity of C. capitatum in Wistar rats. METHODS: In acute toxicity tests, a single administration of the hydroethanolic C. capitatum leaf extract (5 g/kg) was given orally to 5 female rats. The general behavior, adverse effects and mortality were recorded for up to 14 days post treatment. On the 15(th) day, the rats were weighed and euthanized for necropsy. In sub-chronic toxicity tests, the extract (4, 8 and 16 g/kg/day) was given orally to both male and female rats for 28 days. The animal body weight was recorded throughout the experiment, while hematological and biochemical parameters of blood and relative organs weights were evaluated on the 29(th) day. RESULTS: Clerodendrum Capitatum did not cause any death or any hazardous symptoms of acute toxicity, showing an LD50 higher than 5 g/kg. Sub-chronic administration of C. capitatum resulted in no noticeable changes in weight gain and water or food consumption. White blood cells and hemoglobin increased while urea concentration, liver enzymes, total cholesterol and glucose concentrations significantly decreased in treated animals. No changes in macroscopical aspect of organs were observed in the animals. CONCLUSION: These results showed that acute or sub-chronic oral administration of the hydroethanolic leaf extract of Clerodendrum capitatum may be considered as relatively free of toxicity.

Knowledge and adherence to antiretroviral therapy among adult people living with HIV/AIDS treated in the health care centers of the association "Espoir Vie Togo" in Togo, West Africa.

BACKGROUND: The efficiency of antiretroviral therapy (ART) depends on a near perfect level of patients' adherence. The level of adherence of adults HIV-infected patients treated in the HIV/AIDS health care centres of the association "Espoir Vie Togo" in Togo, West Africa is not properly documented. The aim of the present study was to examine by means of self-reports the knowledge, the adherence level and associated factors to antiretroviral therapy (ART) among these patients. METHODS: We conducted a cross-sectional survey among adult people living with HIV/AIDS (PLWHA) through a structured questionnaire. RESULTS: A total of 99 patients were enrolled. Among them, 55.6% knew the name of antiretroviral agents of regimens prescribed. All patients had a good knowledge of treatment schedule. The treatment regimens based on 2 NRTIs + 1 NNRTI were used in 90% of patients. The average adherence rate was 89.8% of the total doses prescribed while 62.62% of patients showed an adherence rate of 95% or above. The treated groups were similar in term of median % of medication doses taken according to PLWHA epidemiological characteristics. However, patients reported forgetting (34.9%), travel (25.6%), cost of treatment (13.9%) and side effects (11.6%) as the main factors of missing at least once a dose intake. CONCLUSION: These results should encourage the association and all the involved actors in the HIV/AIDS's program to strengthen counseling, education and information interventions for HIV-infected patients in order to overcome the potential barriers of poor adherence.

Prescription drugs among pregnant women in Lome, Togo, West Africa.

OBJECTIVE: To assess the trends in prescription drugs and the potential repercussions to newborns among pregnant women who attended prenatal consultations and gave birth in the Department of Gynaecology of Tokoin's University Hospital, Lome (Togo). METHODS: A retrospective study of the registers of prenatal visits and deliveries of the eligible population was performed. RESULTS: In total, 184 different drugs were prescribed to 627 pregnant women attending prenatal consultations. The profile of pharmacotherapeutic groups prescribed was: anti-anaemics (33.33%), antimalarial drugs (24.75%), vitamins +/- mineral salts, amino acids and appetite stimulants (14.96%) and antispasmodics and anti-emetics (7.22%). The median proportion of prescriptions for each pharmacotherapeutic group increased significantly from the first to third trimester (9.72, 25.17 and 64.00 respectively; P < 0.05). The median number of drugs prescribed did not vary significantly (P = 0.051) with the age groups, parity (P = 0.068) or obstetrical-gynaecological history (P = 0.401); it did, however, increase significantly with the medical-surgical history (P < 0.05). There were complications associated with deliveries that had no obvious cause related to drug prescription, including four cases of minor defects, 28 stillborns, 65 cases of low birth weight and 27 hospitalised newborns for neonatal diseases. Some interventions were needed for safeguarding the health of the mother, the foetus and the newborn. CONCLUSION: The trends in obtaining prescription drugs and the consumption of drugs by pregnant women can be assessed using multiple parameters. We limited our study to age groups, gestational age, parity and the medical history of the pregnant woman, profile of pharmacotherapeutic groups, median number of drugs prescribed and the potential risks of the drugs used. The results of our retrospective study were not alarming in terms of neonatal outcomes.