Prevalence of cryptococcosis among HIV-infected patients in Yaounde, Cameroon.

BACKGROUND: Cryptococcus neoformans is encapsulated yeast which causes life-threatening infections in up to 40% of AIDS patients in Africa. OBJECTIVE: To investigate the prevalence of cryptococcosis among HIV infected patients in Yaounde. METHODS: In a hospital-based surveillance study of cryptococcosis, the colonization of Cerebrospinal Fluid (CSF), urine and blood sample by C. neoformans was evaluated by direct microscopic examination and culture techniques. Data obtained were then analyzed based on the medical records of the patients. RESULTS: Among the 105 patients sampled for the study, the CD4 counts varied between 31 and 304 lymphocytes/mm(3). Direct specimens examination (n= 294) in India ink preparations revealed polysaccharide capsule in 25 (8.5%) of the samples. Upon culture, 29 (9.86 %) samples were positive of C. neoformans (23 from the CSFs and 6 from the urine). All the positive samples were obtained from patients who were not on Antiretroviral Therapy (ART). Meningo-encephalitis symptoms were observed in 13 patients with C. neoformans in CSFs. CONCLUSION: This study reveals that cryptococcosis is rife in AIDS patients in Yaounde. Therefore, to minimize the death toll, we recommend that its routine check should be integrated in the management of HIV/AIDS patients.

Phytotoxic, antifungal activities and acute toxicity studies of the crude extract and compounds from Diospyros canaliculata.

In vitro biological activities including phytotoxic, antifungal activities as well as acute toxicity of the methanol extract, fractions and/or isolated compounds from the stem bark of Diospyros canaliculata were investigated. Well agar diffusion and macrodilution assays were used for investigating the antifungal activity. A phytotoxicity assay was performed against Lemna minor while an acute toxicity assay was performed in mice via oral administration. As a result, plumbagin (5-hydroxy-2-methyl-1,4-naphtoquinone) and two known pentacyclic triterpenes (lupeol and lupenone) were isolated from the extract. With regards the antifungal activities, the inhibition zones varied from 16.51 to 24.86 mm and from 20.50 to 25.10 mm for the extract and plumbagin, respectively. The minimum inhibitory concentrations of the extract and plumbagin ranged between 12.5-25 and 0.78-1.56 µg mL(-1), respectively. At 50 µg mL(-1), the hexane fraction showed phytotoxic activities similar to paraquat, the standard phytotoxic inhibitor. The extract was found to be non-toxic to mice after administration per os. Based on the current findings, we can conclude that this extract is non toxic, with significant phytotoxic and antifungal properties due to the presence of plumbagin.

In vitro antifungal activity of extract and plumbagin from the stem bark of Diospyros crassiflora Hiern (Ebenaceae).

In this study the methanol/dichloromethane (1:1) extract and plumbagin isolated from extract of stem barks of Diospyros crassiflora were tested for their antifungal activity against 12 strains of yeast pathogens and filamentous fungi: Candida albicans, Candida glabrata, Candida krusei, Candida tropicalis, Cryptococcus neoformans, Aspergillus niger, Aspergillus flavus, Alternaria sp., Cladosporium sp., Geotrichum candidum, Fusarium sp. and Penicillium sp. The growth of all fungi strains tested was inhibited by the extract and plumbagin. The diameter of inhibition zones varied from 12 to 18 mm and from 21 to 35 mm for the extract and plumbagin, respectively. The MIC values ranged from 12.5 to 25 mg/mL for the extract and 0.78-3.12 microg/mL for plumbagin. It is therefore suggested that extracts from the stem bark of Diospyros crassiflora could be used traditionally in the treatment of fungal infections. Compared with ketoconazole used as a standard antifungal, plumbagin could be considered as a promising antifungal agent.