RESUMEN
Poor adherence is a major challenge to antiretroviral therapy. It is now recommended that patients have 95% adherence in order to maintain sufficient suppression of viral replication and prevent the emergence of resistance. It is therefore of paramount importance device methods to improve patient adherence. The use of mobile phone calls and text messages are being explored in improving adherence. In this study, the effect of counselling plus reminder text messages were determined. A total of 132 patients was allocated into an intervention and control groups. Both groups were given additional adherence counselling at the beginning of the study and at every clinic visit. The intervention group was also sent reminder text messages for a period of 24 weeks. The CD4 count of all patients was recorded at the start of the study, then the final reading after the follow-up period. The difference in the increase in the CD4 counts between the two groups was compared to find out the difference. Additionally, patients’ self-report of adherence was compared between the two groups. Patients with 95% and above adherence were classified as adherent, while those with less than 95% non-adherent. It was found that the patients who received reminder text messages in addition to counselling had significantly higher mean percentage increase in CD4 count (36.7%) compared to the control group (19.12%), which received counselling only (p=0.007) However, using self-report form, there was no statistical significant difference in the level of adherence between intervention group and control group. It was therefore concluded that regular counselling and reminder text messages have improved adherence to antiretroviral therapy.
RESUMEN
Medicinal plants are the primary source of medicines and main ingredients used by traditional medicine practitioners. Byrsocarpus coccineus Schum and Thonn is one of such plants that have been used in Africa to treat different ailments including augmentation of labour. The aim of this study is to determine the acute toxicity and to screen the in vivo uterotonic effects of the ethylacetate leaf extract of Byrsocarpus coccineus in pregnant rat uterus. Leaves of the Byrsocarpus coccineus were collected, air dried, pounded and extracted using ethanol, ethylacetate, N-butanol and water. The extracts obtained were then used for the acute toxicity study, while the ethylacetate extract was used to assess the in vivo activity in pregnant rat uterus. Ethylacetate and aqueous leaf extracts Byrsocarpus coccineus was found to be relatively non toxic, whereas N-butanol was found to be toxic in rats and mice. Ethanol leaf extract was found to be only relatively toxic in mice. Ethylacetate leaf extract of Byrsocarpus coccineus potentiated the delivery of pregnant rats on days 21 of pregnancy. The results of the abortificient effect of the ethyl acetate extract on the pregnant rats showed no significant difference between the treatment groups compared with the control (p>0.05). There was a significant increase in haemoglobin, white blood cell, platelets and aspartate aminotransferase (p<0.05). Ethylacetate leaf extract of Byrsocarpus coccineus is relatively safe and was found to potentiate the delivery of pregnant rats with no significant change in hepatic and renal functions and this supports the traditional use of this plant to induce labour at terms.