Combating Lassa Fever in West African Sub-Region: Progress, Challenges, and Future Perspectives.

Lassa fever (LF) is a rodent-borne disease that threatens human health in the sub-region of West Africa where the zoonotic host of Lassa virus (LASV) is predominant. Currently, treatment options for LF are limited and since no preventive vaccine is approved for its infectivity, there is a high mortality rate in endemic areas. This narrative review explores the transmission, pathogenicity of LASV, advances, and challenges of different treatment options. Our findings indicate that genetic diversity among the different strains of LASV and their ability to circumvent the immune system poses a critical challenge to the development of LASV vaccines/therapeutics. Thus, understanding the biochemistry, physiology and genetic polymorphism of LASV, mechanism of evading host immunity are essential for development of effective LASV vaccines/therapeutics to combat this lethal viral disease. The LASV nucleoprotein (NP) is a novel target for therapeutics as it functions significantly in several aspects of the viral life cycle. Consequently, LASV NP inhibitors could be employed as effective therapeutics as they will potentially inhibit LASV replication. Effective preventive control measures, vaccine development, target validation, and repurposing of existing drugs, such as ribavirin, using activity or in silico-based and computational bioinformatics, would aid in the development of novel drugs for LF management.

Assessment of the Antimalarial Treatment Failure in Ebonyi State, Southeast Nigeria.

The fight against malaria is a continuum as the epidemic is not abating. For proper deployment of tools in the fight against malaria, an assessment of the situation is necessary. This work assessed the level of antimalarial drug treatment failure in Ebonyi State, Nigeria. Both survey and in vitro analyses were adopted. The survey was used to obtain qualitative information from both the malaria subjects and the pharmacies where antimalarial drugs are sourced. The results from the survey were complemented by an in vitro assay of the level of active pharmaceutical ingredients (APIs) in the commonly used artemisinin combination in Nigeria; artemether/lumefantrine. Results from the survey revealed that artemisinin combination therapies (ACTs) remain the mainstay in the treatment of malaria, even though other non-artemisinin drugs are still used. It also revealed that many patients still self-medicate, although, this may not be connected to the treatment failure seen among some malaria subjects. The in vitro assay showed that ACT contains the right quantity of APIs. Further surveillance is, therefore, necessary to understand the real cause of treatment failure among malaria subjects in Nigeria.

Data on prevalence and management practices of malaria-typhoid co-infection in Unwana South East Nigeria.

Using a descriptive survey design, the prevalence and management practices of malaria and malaria- typhoid co-infection in Unwana South East Nigeria was determined. Two hundred and thirty-six (236) febrile volunteers comprising 104 males and 132 females attending the Medical Centre of Akanu Ibiam Federal polytechnic Unwana, Afikpo Ebonyi state Nigeria participated in this study. Using thick film microscopy and Widal antigen-based agglutination test, one hundred and thirty-seven participants were diagnosed with malaria mono infection while ninety-nine were diagnosed with malaria-typhoid co-infection. Structured questionnaire was used to obtain data on the management practices and attitudes that constitute risk factors to increased incidence of treatment failure of malaria and malaria- typhoid co-infection. The dataset [1] is relevant as a baseline and reference for further research related to factors associated with increased risk of treatment failure and emergence of drug resistance of malaria and malaria-typhoid co-infection in resource poor setting.

Current Advances in the Management of Diabetes Mellitus.

Diabetes mellitus (DM) underscores a rising epidemic orchestrating critical socio-economic burden on countries globally. Different treatment options for the management of DM are evolving rapidly because the usual methods of treatment have not completely tackled the primary causes of the disease and are laden with critical adverse effects. Thus, this narrative review explores different treatment regimens in DM management and the associated challenges. A literature search for published articles on recent advances in DM management was completed with search engines including Web of Science, Pubmed/Medline, Scopus, using keywords such as DM, management of DM, and gene therapy. Our findings indicate that substantial progress has been made in DM management with promising results using different treatment regimens, including nanotechnology, gene therapy, stem cell, medical nutrition therapy, and lifestyle modification. However, a lot of challenges have been encountered using these techniques, including their optimization to ensure optimal glycemic, lipid, and blood pressure modulation to minimize complications, improvement of patients' compliance to lifestyle and pharmacologic interventions, safety, ethical issues, as well as an effective delivery system among others. In conclusion, lifestyle management alongside pharmacological approaches and the optimization of these techniques is critical for an effective and safe clinical treatment plan.

Impact of Drug Pressure versus Limited Access to Drug in Malaria Control: The Dilemma.

Malaria burden has severe impact on the world. Several arsenals, including the use of antimalarials, are in place to curb the malaria burden. However, the application of these antimalarials has two extremes, limited access to drug and drug pressure, which may have similar impact on malaria control, leading to treatment failure through divergent mechanisms. Limited access to drugs ensures that patients do not get the right doses of the antimalarials in order to have an effective plasma concentration to kill the malaria parasites, which leads to treatment failure and overall reduction in malaria control via increased transmission rate. On the other hand, drug pressure can lead to the selection of drug resistance phenotypes in a subpopulation of the malaria parasites as they mutate in order to adapt. This also leads to a reduction in malaria control. Addressing these extremes in antimalarial application can be essential in maintaining the relevance of the conventional antimalarials in winning the war against malaria.

A world free of malaria: It is time for Africa to actively champion and take leadership of elimination and eradication strategies.

The global burden of malaria seems unabated. Africa carries the greatest burden accounting for over 95% of the annual cases of malaria. For the vision of a world free of malaria by Global Technical Strategy to be achieved, Africa must take up the stakeholder's role. It is therefore imperative that Africa rises up to the challenge of malaria and champion the fight against it. The fight against malaria may just be a futile or mere academic venture if Africans are not directly and fully involved. This work reviews the roles playable by Africans in order to curb the malaria in Africa and the world at large.

Antihyperglycemic, antihyperlipidemic and hepatoprotective effects of Ficus ottoniifolia (Miq.) Miq. supplementation in alloxan-induced diabetic rats.

OBJECTIVE: Medicinal plants provide better and cheaper alternative therapy for management of several diseases compared to orthodox medicines. This study evaluated the effects of feed formulated with Ficus ottoniifolia (Miq.) Miq. (FFFO) leaves in the management of alloxan-induced diabetes mellitus (DM) in rats. MATERIALS AND METHODS: DM was induced in overnight-fasted rats by administration of alloxan monohydrate intraperitoneally. DM rats in Groups 1-3 were fed with graded FFFO while group 4 (diabetic control) and group 5 (normal control) were fed with commercial feeds (Vital-Feeds), daily for 21 days. Changes in body weight and some biochemical parameters were thereafter determined. RESULTS: Results showed significant decreases (p<0.05) in serum high-density lipoprotein (HDL) but significant increases (p<0.05) in blood glucose, serum low-density lipoprotein (LDL), triglyceride (TG), total cholesterol (TC) and alanine aminotransferase (ALT) activities in DM-induced rats compared to the normal control group. Feeding with FFFO significantly increased (p<0.05) the body weight and HDL, decreased the blood glucose, serum LDL, TG and TC and attenuated ALT activities in FFFO-fed DM rats compared to the diabetic control group. CONCLUSION: This study revealed that FFFO-diet may mitigate hyperglycemia, dyslipidemia and liver-damage associated with DM.

Studies on Ethanol Extracts of Olax subscorpioidea Against Carbon Tetrachloride-Induced Hepatotoxicity in Rats.

<b>Background and Objective:</b> Liver disease orchestrated by noxious chemicals are serious health problems the world over. Traditionally, there are claims that ethanol extracts of leaves and stem barks of <i>Olax subscorpioidea</i> are used in the treatment of hepatic disorders. Thus, it investigated the impacts of ethanol extract of leaves and stem bark of <i>Olax subscorpioidea</i> against carbon tetrachloride (CCl₄)-induced liver damage in rats. <b>Materials and Methods:</b> Liver toxicity was induced by intraperitoneal injection of 2.5 mg kg¹ b.wt., of CCl₄ in experimental rats. Rats were treated with 200, 400 and 800 mg kg¹ dose ethanol leaves and stem bark of <i>Olax subscorpioidea</i>, respectively after induction of liver damage. <b>Results:</b> Obtained results showed a significant rise in the serum levels of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP), Malondialdehyde (MDA) and bilirubin as well as decreased Albumin (ALB), Superoxide Dismutase (SOD), Catalase (CAT), reduced Glutathione (GSH) in CCl₄-challenged rats. Treatment with the extracts attenuated serum levels of AST, ALT, ALP, MDA and bilirubin in addition to increased activities of SOD, CAT and the levels of ALB and GSH when compared to the CCl₄ group. Histopathological studies demonstrated that the extracts ameliorated liver necrosis and inflammation due to CCl₄ insult. <b>Conclusion:</b> These results concluded that ethanol extract of leaves and stem bark of <i>Olax subscorpioidea </i>may reduce hepatic oxidative injury caused by CCl₄ by its antioxidant potentials.

Data on pilot assessment of efficacy of artemether lumefantrine when co-administered with ciprofloxacin in malaria-typhoid co-infected patients.

Malaria -typhoid co-infection is associated with poverty and underdevelopment with significant morbidity and mortality with similarities in clinical features of the two diseases that often result in misdiagnosis and mistreatment of the febrile patients. The Co-administration of artemether lumefantrine (AL) with ciprofloxacin as treatment for malaria-typhoid co-infection is common in Nigeria and this increases risk of pharmacokinetic drug-drug interaction since ciprofloxacin is an inhibitor of CYP3A4 that metabolizes AL. In an open-label prospective three arm design with registration pactr201909811770922, one hundred and nineteen (119) febrile volunteers comprising 55 males and 64 females were distributed into three oral treatment regimen groups. Group 1 consist of sixty-five participants presenting malaria mono infection treated with AL only and fifty-four participants presenting malaria-typhoid co-infection randomly assigned to Group 2 treated with AL and ciprofloxacin concomitantly and Group 3 whose doses were staggered at 2 hours interval. Blood samples were collected from participants in the three groups on 3 different days: day 0 (before commencement of treatment); day 3 (after completion of AL); and day 7 (after completion of ciprofloxacin), The collected blood sample were used to determine parasite density, serum liver and kidney function parameters, haematological indices, and day 7 lumefantrine concentration. The data in this article provides the changes in PCR-uncorrected Early Treatment Failure (ETA), Late Clinical Failure (LCF), Late Parasitological Failure (LPF), Day 7 serum lumefantrine concentration, liver and kidney function parameters, axillary body temperature and PCV/Hb associated with the different treatment regimen. The dataset [1] as a baseline, will stimulate the need for a randomized clinical assessment of the efficacy of AL when co-administered with ciprofloxacin in the treatment regimen of Malaria-typhoid co-infection in endemic areas. Such findings are capable of influencing national treatment policy on the management of malaria-typhoid co-infection.

Risk Assessment of Metal(Loid)s Exposed to Infants via Consumption of Weaning Foods from Different Supermarkets in Sheffield, UK.

Infant complementary foods are readily available in the UK markets and nowadays, weaning mothers prefer feeding their babies with these products due to modern lifestyles. However, there is a dearth of research with respect to the health risk assessment of trace essential and potentially toxic elements in these products. Hence, this research investigated the health risks of trace essential and potentially toxic elements exposed to infants via consumption of these complementary foods during the first 4 to 12 months of life. Levels of trace essential and potentially toxic elements were determined using inductively coupled plasma mass spectrometer, daily intakes were estimated using the Food Agricultural Organization/World Health Organization and manufacturer food consumption regime while the US Environmental Protection Agency guideline was used to estimate target hazard quotient and carcinogenic health risk indices. The levels of the elements in the foods varied and were within the safe limits recommended by food standard agencies. The results also showed that the estimated daily intakes of these elements were below the reference doses stipulated by food regulatory agencies. The target hazard quotients and the total carcinogenic risks of the elements in the infant foods were less than 1 and 1.0E-04, respectively, signifying that the target groups may not experience adverse non-carcinogenic and carcinogenic health effects because of these foods. This study will be quite helpful for weaning mothers, infant food production and processing companies and government officials in taking protective measures for reducing elemental contamination in infants' complementary foods.

Elemental Composition and Associated Health Risk of Honey Obtained from Apiary Farms in Southeast Nigeria.

ABSTRACT: This study investigated the levels of lead, selenium, arsenic, iron, manganese, copper, zinc, chromium, cadmium, and nickel in honey and their potential health risks to consumers, using standard protocols. The honey samples were obtained from apiary farms at nine different locations in southeast Nigeria. They were digested at optimal conditions and analyzed using a flame atomic absorption spectrophotometer. Levels of the studied elements in the honey were found to vary relative to the sample source; however, all were below European Commission maximum permissible limits, with the exception of lead, whose level in some samples exceeded the recommended set limit. Estimated daily intakes of the elements via ingestion of the honey were all below the maximum permissible limit set by the European Food Safety Authority, with the exception of arsenic, whose values in some samples slightly exceeded the set limit. For all samples, estimated health risk values for the elements quantified were higher in children than in adults. The hazard quotient for arsenic, hence, the hazard index for the elements, indicated a significant risk (>1) for children for some of the honey samples studied. Arsenic was the major contributor to incremental lifetime cancer risk; its estimated value for children in all the honey samples exceeded the U.S. Environmental Protection Agency (EPA) threshold limit (>1.0 × 10-4); hence, the total cancer risk values for the carcinogenic elements indicated an absolute unacceptable risk level for children based on EPA threshold limit.

Mineral compositions of infant complementary foods in relation to dietary daily intake and synergistic/antagonistic interrelationships.

This study investigated the levels of selected essential elements in a brand of industrially prepared complementary foods in the UK for infants aged 4+, 7+, and 10+ months in order to ascertain their nutritional standards relative to the mineral reference daily intakes and interrelationships. Estimated daily intake of minerals was calculated from elemental contribution from the complementary foods and breast milk. The results showed remarkable significant differences (p < .05) in the concentration levels of the elements in the complementary foods. There were no significant differences (p > .05) between the estimated daily intakes compared to the standard values stipulated by the regulatory bodies. Although, the results showed that specific interrelationships were generally justified by the elemental contents, there were few differences with respect to the overall elemental profile. The results of the study support the recommendation of the use of semi-pureed meals by infants as complementary foods. However, the results of mineral interrelationships implicated imbalances and thus recommend fortification of the infants' complementary foods with iron, calcium, and zinc.

Effect of ethanol and aqueous extracts of seed pod of Copaifera salikounda (Heckel) on complete Freund's adjuvant-induced rheumatoid arthritis in rats.

The antirheumatoid arthritis potential of ethanol and aqueous extracts of seed pod of Copaifera salikounda (SPCS) was evaluated using the chicken collagen/complete Freund's adjuvant-induced arthritic rats model. Adjuvat-induced rats were treated with varied doses of the extracts (400, 600, and 800 mg/kg body weight) and with reference drug, indomethacin for 21 days. Antiarthritic evaluation was done through measurement of body weight, paw size, inflammatory makers, hematological parameters, cytokines, antioxidant enzymes, reduced glutathione, lipid peroxidation as well as histopathological examinations. Treatment with the ethanol and aqueous extracts of SPCS markedly inhibited the paw size and caused weight gain. The extracts considerably modulated the hematological as well as the antioxidant parameters. Likewise, the extract restored the altered lipid peroxidation, pro-inflammatory mediators, and inflammatory factors which further accentuate the implication in adjuvant-induced arthritis. Thus, the ethanol and aqueous extracts of SPCS showed a significant antiarthritic activity that was statistically analogous to that of indomethacin. Practical applications Copaifera salikounda (Heckel) has been used in treatment of different ailments including rheumatoid arthritis in folklore medicine. This is the first reported proof of the antiarthritic potential of the seed pod. Oxidative stress has been implicated in rheumatoid arthritis. Ethanol extract of SPCS has been shown to be predominantly rich in phenols, terpenoids, alkaloids, and flavonoids which are natural antioxidant. The present study has demonstrated that ethanol and aqueous extracts of SPCS can exert antioxidative and antiinflammatory effects, thus strengthening its antiarthritic potentials.