ABSTRACT
Background: Monitoring of HIV-infected individuals on antiretroviral treatment requires periodic viral load(VL) measurements to ascertain adequate response to treatment. While plasmaVL is widely available in health facilities, it is difficult for use among key populations(KPs) due to their high mobility and sophisticated sample storage and transport requirements, which are not available for community VL sample collection. Use of Dried Blood Spot(DBS) VL measurement has shown promise as an alternative to plasma specimens for KPs. Studies to investigate the performance of DBSVL quantification against the standard plasma VL assay has proven to be within acceptable range. DBSVL was introduced for sample collection among KPs when it became difficult to safely and appropriately collect, store and transport samples during COVID-19 lockdown. This study assessed the usefulness of the use of DBSVL deployed by USAID to ensure access to HIV VL services among KPs in 7 states of Nigeria during COVID-19 lockdown Methods: To mitigate the impact of COVID-19 lockdown, virtual trainings were conducted for one-stop-shops and community VL champions of USAID partners providing KPs services in seven states of Nigeria on DBS sample collection, storage and transportation and remote test ordering was activated for service providers. Standard operating procedures and job aids were deployed to points of service and laboratory equipment were verified for DBSVL testing. VL sample collection rate(SCR), VL coverage(VLC), VL suppression(VLS), turnaround time (TAT) and cost savings for the program between March2019 and February2021 were compared using the two-sample independent t test pre-COVID (March2019- February2020) and during-COVID lockdown (March2020 -February2021) at 95 confidence interval and < 0.05 level of significance. Result(s): There was a significant increase (p< 0.05) in SCR from 73% to 94%, VLC 44% to 85%, and VLS 78% to 95% pre-COVID to during-COVID respectively despite increase in number of clients eligible for VL. However, the median TAT remained unchanged at 29 days. There was a 60% cost savings for the program due to reduction in consumables needed for sample collection and processing and convenience in sampling among KP clients. Conclusion(s): Implementation of DBSVL resulted in increases in both VLC and VLS with an improved TAT for KPs clients in seven states of Nigeria. KPs Program implementers should consider introduction of DBSVL sampling among KPs for a better VL access and clinical outcome.
ABSTRACT
Fused pyrimidines gain an increasing interest as being a precursor for biologically active new compounds. The fused pyrimidine derivatives (1-5) were prepared by condensation of the 1,8-diamine naphthalene with some medical compounds in the presence of ammonium chloride as a dehydration agent for the water molecule and toluene as a solvent. Mannich base compounds (6-10) were prepared by reacting pyrimidines (1-5) with formaldehyde and 4-methoxyaniline. A microwave method was used in preparing the compounds. The prepared compounds were characterized by physical methods, through melting points and color, as well as by spectroscopic methods such as FT-IR and 1H-NMR. The purity of the prepared compounds was evaluated using TLC. The bioactivity of these compounds was tested against two types of bacteria, i.e. Escherichia coli and Staphylococcus aureus. The results of bioactivity showed an antibacterial activity compared to the standard drugs Cephalexin and Amoxicillin. The stability of selected compounds was evaluated by laser irradiation for (10, 20, 30, 40) seconds, and was found to be stable and did not decompose with a 30 seconds exposure. On the other hand, their color was changed at 40 seconds of exposure. Molecular docking studies were conducted to examine how some of the synthesized compounds bind to the putative target, SARS COV2 RNA-dependent RNA polymerase. The study concluded that some of the prepared compounds showed promising antibacterial and antiviral bioactivities. Further in vitro and in vivo toxicological and pharmacological studies are required to evaluate the possibility of using these compounds as a medicine.