A survey of chloroquine use for prevention and treatment of COVID-19 in Nigeria

Background: Rampant chloroquine/hydroxychloroquine poisoning in Nigerian hospitals following suggestions of its possible efficacy in the treatment and prevention of the newly emerged COVID-19 disease informed this survey. Objective(s): The aim of this study was to assess the knowledge, attitude and perception of the Nigerian populace on the use of chloroquine in the COVID-19 pandemic. Method(s): This cross-sectional study was done by administering an electronic questionnaire created using Google Docs, through social media cascade methods including the WhatsApp application software to capture data on chloroquine use between April 20 and June 20, 2020. Result(s): Six hundred and twenty-eight people responded to the questionnaire (response rate 99.2%, mean age 41.05 +/- 12.3) from the six geopolitical zones in Nigeria with 556 (88.5%) having tertiary level education. Only 21 (3.3%) of the respondents took chloroquine for treatment or prevention. Respondents from the North-west geopolitical zones used chloroquine 5.8 (95% CI: 1.55, 21.52, p=0.02) more times than other zones while the age group 20-29 were 8.8 times more likely to use chloroquine than any other age group (95% CI: 3.53, 21.70, p = 0.00). Female respondents were 2.3 times more likely to use chloroquine than the males (OR 2.26 95% CI: 0.90-5.68;p=0.08) and those in the income bracket of N75,000-99,000, 2.5 times more than other income groups. Conclusion(s): Young adults, North-western geopolitical zone, and female gender should be target groups for education on rational chloroquine use. The danger of chloroquine overdose should be communicated to the general population in Nigeria.Copyright © 2023 Olukosi AY et al. Licensee African Health Sciences.

Measuringthe Knowledge and Behaviors of University Students Toward Rational Use of Herbal Supplement Products in the COVID-19 Pandemic

Objective: This study was planned to measure the knowledge and behavior of university students toward the rational use of herbal supplements during the COVID-19 pandemic. Methods: It was carried out with students from uskudar University Faculty of Health Sciences and Health Services Vocational School. The study used a descriptive design and was completed with 640 students who volunteered to participate in the study. The data were collected by using a questionnaire including questions about students' rational use of herbal supplements according to their gender, faculty, the status of having had COVID-19 viral infection, and the status of having received education on pharmacology and medicinal plant products. Counts, mean scores, and percentage values were used in the evaluation of the data. Results: It was found that 15.5% of the participants were from the Faculty of Health Sciences and their mean age was 20.8 +/- 2.84 years and that 84.5% were from the Health Vocational School and their mean age was 21.42 +/- 3.87 years. The rate of having had COVID-19 viral infection among students was 22.7%, having received pharmacology education was 75.5%, and having received education on medicinal plant products was 46.3%. Conclusion: It was found that the pharmacology and medicinal plant products education received by the students studying health significantly affected the rational use of herbal supplements and that students should be given more education on phytotherapy.

Traditional medicine users in a treated chronic disease population: a cross-sectional study in Indonesia.

BACKGROUND: Traditional medicine (TM) is commonly used as a treatment in Indonesia. This raises the need for an analysis of its potential development and irrational use. Therefore, we analyze the proportion of TM users among chronic disease patients and its associated characteristics to optimize the use of TM in Indonesia. METHODS: A cross-sectional study of treated adult chronic disease patients was conducted using the fifth Indonesian Family Life Survey (IFLS-5) database. Descriptive analysis was used to identify the proportion of TM users, while a multivariate logistic regression was used to analyze their characteristics. RESULTS: This study included 4901 subjects and identified 27.1% as TM users. The highest TM use was in subjects with cancer (43.9%), liver issues (38.3%), cholesterol issues (34.3%), diabetes (33.6%), and stroke (31.7%). Characteristics associated with TM users were a perception of one's current health as unhealthy (OR 2.59, 95% CI 1.76-3.81), low medication adherence (OR 2.49, 95% CI 2.17-2.85), age above 65 years (OR 2.17, 95% CI 1.63-2.90), having higher education (OR 1.64, 95% CI 1.17-2.29), and residence outside of Java (OR 1.27, 95% CI 1.11-1.45). CONCLUSIONS: Low medication adherence among TM users highlights the potentially irrational use of treatment in chronic diseases. Nevertheless, the longstanding use of TM users indicates the potential for its development. Further studies and interventions are needed to optimize TM use in Indonesia.

Pharmacokinetics and Metabolism of Traditional Chinese Medicine in the Treatment of COVID-19.

BACKGROUND: The outbreak of coronavirus disease 19 (COVID-19) has caused great concern to public health. Convincing clinical experiences showed that traditional Chinese medicine (TCM) has exhibited remarkable efficacy in the prevention, treatment and rehabilitation of COVID-19. The research on the treatment of COVID-19 disease with TCM mainly focused on the pharmacological effects and mechanistic analysis. However, the TCM's pharmacokinetics and potential herb-drug interaction in the treatment of COVID-19 are currently unclear. METHODS: This review summarizes the pharmacokinetics and characteristics of cytochrome P450 enzyme (CYP450) metabolism of TCM recommended in the Guidelines for diagnosis and treatment of coronavirus disease 2019 (trial version eighth), and meanwhile analyzes the potential interactions between TCM and western medicine. RESULTS: The pharmacokinetics of TCM mainly focused on preclinical pharmacokinetics, and fewer clinical pharmacokinetics research was reported. When TCM and western are both metabolized by CYP450 and coadministered, a potential herb-drug interaction might occur. CONCLUSION: Knowledge of the pharmacokinetics and metabolism of TCM is key to understanding rational TCM use of COVID-19 and developing antiviral TCM.

Rationality analysis of blood-activating TCM injections in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from 2019 to 2020

Objective To analyze and summarize the use and rationality of blood-activating TCM injections in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from 2019 to 2020, so as to provide reference for rational drug use in clinic. Methods The hospital information system and Excel software were used to analyze the use of TCM injections for promoting blood circulation from January 2019 to December 2020. Results In 2020 the application of blood-activating Chinese medicine injections in our hospital decreased by 20.68% compared with 2019, but the proportion of total Chinese patent medicine was basically the same. Xueshuantong (freeze-dried) for injection is the blood activating traditional Chinese medicine injection with the highest sales amount and use frequency in 2019 and 2020. The average daily cost of blood-activating TCM injections in 2020 decreased as a whole, and the synchronization was more reasonable. Although the use of blood-activating TCM injections has been affected by COVID-19, medical policies have a greater impact on the application of traditional Chinese medicine injections. Conclusion Blood-activating traditional Chinese medicine injection is an important part of hospital medication, and its application is relatively reasonable, and continue to improve the level of rational drug use, so that it can play a greater role in clinical practice. © 2022 Tianjin Press of Chinese Herbal Medicines. All rights reserved.

Antibiotic Use in China's Public Healthcare Institutions During the COVID-19 Pandemic: An Analysis of Nationwide Procurement Data, 2018-2020.

Background: The overuse of antibiotics is a serious public health problem and a major challenge in China, and China lacks up-to-date evidence on the nationwide antibiotic use in different healthcare settings. The changes of China's antibiotic use under the COVID-19 pandemic are still unknown. Objective: This study aimed to investigate the use of antibiotics in China's public medical institutions based on a three-year nationwide surveillance and to examine the impact of the COVID-19 pandemic on China's antibiotic consumption. Methods: This study used nationwide drug procurement data from the China Drug Supply Information Platform (CDSIP). We retrospectively analyzed antibiotic procurement data of 9,176 hospitals and 39,029 primary healthcare centers (PHCs) from 31 provinces in mainland China from January 2018 to December 2020. Antibiotic utilization was measured by defined daily doses (DDDs) and DDD per 1,000 inhabitants per day (DID). Generalized linear regression models were established to quantify the impact of the COVID-19 pandemic on antibiotic use. Results: The total antibiotic consumption among all healthcare settings increased from 12.94 DID in 2018 to 14.45 DID in 2019, and then dropped to 10.51 DID in 2020. More than half of antibiotics were consumed in PHCs, especially in central regions (59%-68%). The use of penicillins (J01C) and cephalosporins (J01D) accounted for 32.02% and 28.86% of total antibiotic consumption in 2020. During 2018-2020, parenteral antibiotics accounted for 31%-36% of total antibiotic consumption; the proportion is more prominent in central and western regions and the setting of hospitals. Access category antibiotics comprised 40%-42% of the total utilization. Affected by COVID-19, the antibiotic consumption was significantly dropped both in hospitals (ß = -.11, p < .001) and PHCs (ß = -.17, p < .001), as well as in total (ß = -.14, p < .001). Significant increments were observed in the proportion of total antibiotics (ß = .02, p = .024) consumed in hospitals (against the consumption in all healthcare settings), as well as parenteral antibiotics (ß = 1.73, p = .001). Conclusion: The consistent preferred use of penicillin and cephalosporin, as well as injections, among China's public healthcare institutions should draw concern. China's antibiotic consumption significantly declined during the COVID-19 pandemic, which brings opportunities for antibiotic use management in China.