Poisoning cases and their management in Amhara National Regional State, Ethiopia: Hospital-based prospective study.

BACKGROUND: Poisoning is a significant public health problem globally. Ethiopia is a low-income country undergoing technological and social change that may increase access to drugs and chemicals, potentially increasing the incidence of poisoning. This study describes the epidemiology of hospital admissions due to poisoning in a region of Ethiopia. METHODS: An institution based prospective observational study was employed, as a study design, in selected hospitals of the region from January to December 2018. RESULTS: Of 442 poisoning cases, 78 (17.6%) died. Almost all poisoning cases were intentional self-poisonings. The most frequent poisonings were organophosphate compounds, 145 (32.8%), and metal phosphides (majorly aluminum phosphide), 115 (26.0%). The ingested poison was most frequently accessed from the patients' homes, 243 (55.0%), followed by purchases from local shops, 159 (36%). The median duration of admission was 24 hours. Of all the cases, 23 (5.2%) were admitted to intensive care units (ICU) requiring mechanical ventilation. Most of the cases admitted to the ICU were aluminum phosphide-poisoned patients. The majority of deaths (43 of 78) were due to metal phosphides. From the multivariate logistic regression analysis, altered level of consciousness on hospital arrival, metal phosphide poisoning, and no laboratory result as a part of the diagnosis process or investigation of the extent of toxicity were found to be significantly associated with the likelihood of poor treatment outcome. CONCLUSION: The majority of the poisoning cases were females. The most common reasons for the intent of self-poisoning were dispute-related, mainly family disharmonies, followed by psychiatric conditions. The poisoning agents were mostly obtained from households. Organophosphate compounds and metal phosphides were the first and the second most frequently encountered poisoning agents, respectively, and it was noted that the later ones were responsible for most of the fatal cases. Of the pharmacologic interventions, atropine was the only agent regarded as an antidote. The most commonly employed agent for supportive treatment was cimetidine followed by maintenance fluids, while gastric lavage was the only GI decontamination method used among others. The fatality rate of poisoning in this study was found to be much higher than in other similar studies. Impaired consciousness upon hospital arrival, metal phosphide poisoning, and no involvement of laboratory investigation were found to significantly associate with the likelihood of death. Generally, the results dictate the need for the design and implementation of strategies to create awareness, prevent, and manage poisoning incidences in the community.

Anti-Diabetic Activities of Hydro-Methanolic Crude Extract and Solvent Fractions of Heteromorpha arborescens (Apiaceae) Leaves in Mice.

Background: Heteromorpha arborescens has been used to treat diabetes traditionally. There was no in vivo study to support the claim. This study aimed to confirm anti-diabetic activity of 80% methanol in water extract and solvent fractions of H. arborescens leaves in mice. Methods: H. arborescens leaves were macerated and extracted in 80% methanol in water. Hydro-methanol extract of H. arborescens leaves were tested in mice models. Overnight fasted mice were randomly divided into five groups for normoglycemic and glucose-loaded models as a negative control, positive control, and three tested groups, whereas, in streptozotocin-induced diabetic models, the mice were grouped into six groups each comprised six mice: diabetic negative control and normal negative control groups treated with 10 mL/kg distilled water, diabetic positive control group treated with Glibenclamide 5 mg/kg and three diabetic tested groups treated with extract at 100, 200, and 400 mg/kg doses. A one-way ANOVA was performed to analyze the data, and the post hoc Tukey's test was utilized for multiple comparisons. The P-value <0.05 was considered statistically significant. Results: Hydro-methanol extract of H. arborescens leaves at 400 mg/kg in normoglycemic mice significantly lowered blood glucose levels (BGLs) (P< 0.01). Mice with oral glucose-loaded test lowered BGLs at dosages of 200 mg/kg (P < 0.05) and 400 mg/kg (P < 0.01) respectively. Single-dose of ethyl acetate, n-hexane fractions and hydro-methanol extract at 100 mg/kg, 400 mg/kg and 200 mg/kg reduced BGLs (P < 0.05, P < 0.001, and P < 0.01) respectively. BGL drops in diabetic mice given daily repeated doses of 200 mg/kg of hydro-methanol extract and 400 mg/kg of ethyl acetate fraction (P < 0.001). Diabetic mice gained weight at a 400 mg/kg hydro-methanol extract and ethyl acetate fraction (P < 0.05 and P < 0.01) respectively. Hydro-methanol extract and ethyl acetate fraction and at 200 mg/kg decreased total cholesterol, triglycerides, and low-density lipoprotein and increased high-density lipoprotein (P < 0.001). Conclusion: 80% methanol in water extract and solvent fractions of H. arborescens leaves showed anti-diabetic effects and significantly reduced hyperlipidemia in diabetics, this study supported the traditional usage of H. arborescens for treating diabetes; however, species variation could also limit such a straightforward extrapolation of the findings of this study in humans.

Antimalarial activity of solvent fractions of a leaf of Eucalyptus globulus labill against Plasmodium berghei infected mice.

INTRODUCTION: The leaf of Eucalyptus globulus is commonly used in the traditional management of malaria. However, the efficacy of solvent fractions are didn't study yet scientifically. Thus, this study aimed to investigate the antimalarial efficacy of the solvent fractions of the leaf of Eucalyptus globulus in mice against P.berghei. METHODS: The antimalarial activity of the fractions was tested in a 4-day suppressive test, Rane's test, and prophylactic test models within P.berghei infected mice. The results were analyzed using a one-way analysis of variance (ANOVA) followed by a post hoc Tukey's test in version 20 SPSS. RESULTS: All fractions at all test doses in the three test models suppressed parasitemia (p < 0.001) compared to the negative controls. In addition, the CF and EA at all three test doses and the AF at 400 mg/kg in three antimalarial test models showed 50% and above parasitemia suppression. In compliance with this, all fractions at all test doses in all test models prolonged the mean survival time of the mice greater than 12 days, except the AF at a lower dose. All fractions at 400 mg/kg in the three test models prevented (p < 0.001) loss of body weight and rectal temperature compared to the negative controls. Furthermore, all fractions in all test models and doses prevented packed cell volume reduction (p < 0.05 to p < 0.001) compared to the negative controls.. CONCLUSION: The findings of this study showed that CF and EAF had greater antimalarial activity compared to AF. This could be attributed to the presence of few phytochemicals in the AF in contrast to the CF and EAF. Overall, the results of this study further support the in vitro antimalarial activity study and the traditional use of the leaf in the management of malaria.

Efficacy of Praziquantel Treatment and Schistosoma Mansoni Infection among Primary School Children in Kemisse Town, Northeast Ethiopia.

Background: Schistosoma mansoni infection is endemic in Ethiopia. The epidemiology of S. mansoni and the efficacy of praziquantel among schoolchildren have not been well documented in different parts of the country including our study area. Therefore, this study aimed to determine the status of S. mansoni infection and evaluate the therapeutic efficacy of praziquantel among school children in northeast Ethiopia. Methods: A comparative cross-sectional study was conducted among 499 children of two preschool children. Stool specimens were collected and microscopically examined using Kato-Katz (41.7 gram) methods. Positive children were treated with a single oral dose of praziquantel at 40 mg/kg body weight. Egg reduction and cure rates were assessed 4 weeks post-treatment to evaluate the therapeutic efficacy of praziquantel against S. mansoni infection. Results: The overall prevalence of S. mansoni infection among the schoolchildren was 52.1% with a mean intensity of 546 eggs per gram of stool. Majorities of the S. mansoni infections were moderate to heavy intensity, with only 5.0% light infections. Praziquantel administered at a single oral dose of 40 mg/kg achieved a cure rate of 91.7% and reduced the egg rate by 86.8%. Twenty-one schoolchildren remained infected at 4 weeks post-treatment, among which 6 and 15 children had moderate and light infections, respectively. Conclusions: S. mansoni prevalence among primary school children in Northeast Ethiopia was high, highlighting the need to implement school-based chemotherapy with annual frequency. The efficacy of praziquantel at 40 mg/kg is sufficient to permit continued use in treating S. mansoni-infected schoolchildren.

Evaluation of the antidiarrheal activity of 80% methanol extract and solvent fractions of the leaf of Bersama abyssinica fresen (Melianthaceae) in mice.

INTRODUCTION: The use of traditional medicinal plants in the management of diarrhea has long been practiced in Ethiopia. B. abyssinica fresen is one of the plants traditionally used to treat diarrhea whereas an in vivo study had not yet been conducted. Thus, this study aimed to evaluate the antidiarrheal activity of crude extract and solvent fractions of the leaf of B. abyssinica in mice. METHODS: Cold maceration within 80% methanol was used to extract the leaf powder and extract of the leaf was fractionated using n-hexane, chloroform, and distilled water. The in vivo antidiarrheal activity of crude extracts and solvent fractions were tested in experimental models of castor oil-induced diarrhea, enteropooling, and antimotility test. Five groups each with 6 mice were used under the three antidiarrheal models. Positive controls were treated with loperamide 3 mg/kg and atropine 5 mg/kg and 2% tween 80 was used in the treatment of negative controls. The extract and solvent fractions were administered at doses of 100, 200, and 400 mg/kg. Time of onset of diarrhea, number and weight of total and wet feces, the percent reduction in the number of wet feces, weight and volume of intestinal contents, and percent inhibition of intestinal motility were recorded. Data were analyzed using SPSS version 20. RESULT: Defecation of castor oil-induced diarrheal or loose stools was inhibited (p < 0.01 to p < 0.001) at 200 mg/kg and 400 mg/kg of crude extract and aqueous fraction. The crude extract and the aqueous fraction at three doses (p < 0.01 to p < 0.001), the chloroform fraction at 200 mg/kg and 400 mg/kg (p < 0.01 to p < 0.001), and the n-hexane fraction at 400 mg/kg (p < 0.05) reduced intraluminal fluid accumulation compared with the negative control. Castor oil-induced intestinal motility was significantly suppressed with the three-doses of aqueous fraction (p < 0.05 to p < 0.001), 200 mg/kg and 400 mg/kg of crude extract (p < 0.05 to p < 0.01), 400 mg/kg of chloroform and n-hexane (p < 0.01 to p < 0.001) compared with negative control. CONCLUSION: The crude extract, aqueous, and chloroform fractions of B. abyyssinica leaves have promising anti-diarrheal effects, supporting the plant's traditional use to treat diarrhea.

A Review: Matrix Metallopeptidase-9 Nanoparticles Targeted for the Treatment of Diabetic Foot Ulcers.

Diabetes foot ulcers are a leading cause of death in diabetic individuals. There are very few medicines and treatments that have received regulatory clearance for this indication, and numerous compounds from various pharmacological classes are now in various stages of clinical studies for diabetic foot ulcers treatment. Multiple risk factors contribute to diabetic foot ulcers, including neuropathy, peripheral artery disease, infection, gender, cigarette smoking, and age. The present difficulties in diabetic foot ulcers treatment are related to bacterial resistance to currently utilized antibiotics. Inhibition of the quorum sensing (QS) system and targeting matrix metallopeptidase-9 (MMP-9) are promising. This study focuses on the difficulties of existing treatment, current treatment technique, and novel pharmacological targets for diabetic foot ulcer. The electronic data base search diabetic for literature on foot ulcers treatment was carried out using Science Direct, PubMed, Google-Scholar, Springer Link, Scopus, and Wiley up to 2021. Becaplermin, a medication that targets MMP-9, glyceryl trinitrate, which inhibits the bacterial quorum sensing system, probiotic therapy, and nano technological solutions are just a few of the novel pharmaceuticals being developed for diabetic foot ulcers treatment. A combination of therapies, rather than one particular agent, will be the best option for treatment of Diabetes foot ulcer since it is multifactorial factors that render occurs of diabetic foot ulcer.

In vivo evaluation of 80% methanolic leaves crude extract and solvent fractions of buddleja polystachya fresen (buddlejaceae) for wound healing activity in normal and diabetic mice.

In diabetes mellitus, the wound healing process is impaired and delayed. Plants are actively investigated for safe, effective, and well-tolerated treatment options for wound. The plant Buddleja polystachya has a traditional claim for the treatment of wound. Fresh leaves are crushed and given for topical application. The objective of this study was to evaluate the wound healing activity of hydro-alcoholic extract and solvent fractions of leaves of B. polystachya fresen (Buddlejaceae) in normal and diabetic mice. METHOD: B. polystachya leaves were extracted using 80% methanol and further fractionated using chloroform, ethyl acetate, and water. The wound healing activity was tested using excision, incision, and diabetic wound models. Area of wound contraction, time of epithelialization, and wound breaking strength were determined. RESULT: Treatment with 5% w/w (P < 0 0.05) and 10% w/w (P < 0.001) crude extract of B. polystachya significantly lowered wound area as compared to simple ointment. Treatment of excision wound with 5% w/w and 10% w/w of chloroform, ethyl acetate, and aqueous fractions of B. polystachya significantly lowered wound area and epithelization period (P < 0.05). The 10% w/w extract of B. polystachya showed a significant area of diabetic wound contraction compared to 5% w/w extract and simple ointment. The 10% w/w and 5% w/w extracts of B. polystachya significantly increased wound breaking strength compared to untreated and simple ointment groups (P < 0.05). CONCLUSION: The crude and the solvent fractions of B. Polystachya leaves possess wound healing activities as evidenced by an increase in tensile strength and wound contraction rate and decrease in the epithelialization period. This finding supports the traditional claims of B. polystachya for the healing of wounds.

Methanolic Crude Extract of Hagenia abyssinica Possesses Significant Antidiarrheal Effect: Evidence for In Vivo Antidiarrheal Activity.

BACKGROUND: Hagenia abyssinica is one of the most commonly used medicinal plants for the treatment of diarrhea in Ethiopia. Therefore, this study aimed to evaluate the antidiarrheal effect of methanol crude extract of H. abyssinica leaves in mice. METHODS: Acute toxicity testing was conducted using Organization for Economic Cooperation and Development guidelines. The antidiarrheal activity of the crude extract of H. abyssinica was investigated using three animal models such as small intestine transit, enteropooling, and castor oil-induced diarrhea models. The extract was administered at three different doses (100, 200, and 400 mg/kg) to the test groups, while the positive control group received 3 mg/kg of loperamide and the negative control group received 10 ml/kg of vehicle (distilled water). RESULTS: The crude extract of H. abyssinica did not exhibit death at the limit dose (2 g/kg) throughout the observation period. In the castor oil-induced model, the crude extract at a dose of 200 and 400 mg/kg exhibited a significant (P < 0.05) antimotility effect as compared to the negative control. The crude extract revealed a significant reduction in the volume and weight of intestinal contents at 200 and 400 mg/kg doses of the extract. Moreover, the highest antidiarrheal index (ADI) was obtained with the dose of 400 mg/kg of crude extract, which was comparable to the standard drug. CONCLUSION: The crude extract of Hagenia abyssinica possesses antidiarrheal activity and supports the traditional use of H. abyssinica for the management of diarrhea.

Evaluation of In Vivo Antiulcer Activity of Hydro-Methanol Extract and Solvent Fractions of the Stem Bark of Ficus thonningii (Moraceae) on Rodent Models.

INTRODUCTION: The stem bark of Ficus thonningii is used by Ethiopian traditional healers and the community for the treatment of peptic ulcer disease. Thus, the current study was aimed at evaluating the antiulcer effect of hydro-methanol extract and solvent fractions of F. thonningii. METHODS: The stem bark of F. thonningii was collected and shed dried. Then, the stem bark was extracted by 80% hydro-methanol solvents and dried. The part of the dried hydro-methanol extract was further fractionated with n-hexane, chloroform, and distilled water. Dose-dependent pylorus ligation, curative indomethacin-induced, and time-dependent ethanol-induced ulcer models were evaluated for the hydro-methanol extract and solvent fractions. Statistical analysis was done by using the Statistical Package for the Social Sciences (SPSS) version 24. The analyses were carried out using one-way analysis of variance (ANOVA), followed by Tukey's multiple comparison tests. The result was considered significant when p < 0.05. RESULTS: The extract of F. thonningii showed a significant (p < 0.001) reduction in total acidity at all the tested doses (100, 200, and 400 mg/kg). All the tested doses of the hydro-methanol extract significantly reduced the gastric volume as compared to the vehicle (NC) (p < 0.01). The gastric pH was significantly (p < 0.05) increased by 200 and 400 mg/kg. Similarly, 200 mg/kg and 400 mg/kg significantly (p < 0.05) lowered gastric ulceration as compared to the NC. The hydro-methanol extract and aqueous fractions of F. thonningii at 200 mg/kg showed significant (p < 0.05) reduction in the ulcer index on a repeated dose of the hydro-methanol and solvent fractions. Ulcer healing effect on indomethacin-induced ulcer was not significant (p > 0.05) for all tested doses of the hydro-methanol extract. CONCLUSION: The study demonstrated that the stem bark of F. thonningii has a potential antiulcer activity that might be due to antisecretory or cytoprotective effects.

Assessment of exposure risks to COVID-19 among frontline health care workers in Amhara Region, Ethiopia: A cross-sectional survey.

BACKGROUND: The burden to fight with Corona Virus Disease-19 (COVID-19) pandemic has lied to frontline health care workers that are putting themselves at a higher risk in the battle against the disease. This study aimed to assess the exposure health risks of COVID-19 among frontline healthcare workers in the Amhara region, Ethiopia. METHOD: A web-based cross-sectional study was conducted on public health workers from May to August 2020. Data were collected using a structured questionnaire via email and telegram services. Both descriptive statistics and bivariate followed by multivariable logistic regression analyses were conducted to identify distribution patterns and factors associated with exposure risks to COVID-19. Odds ratio with 95% Confidence Interval (CI), and a P-value of <0.05 was used to determine statistical significance. RESULT: A total of 418 health care workers participated in the study with a response rate of 99.1%. The majority of the study participants 310(74.2%), were males, and 163(39%) were nurses/ midwives respectively. More than half of the respondents 237(56.7%), had reported that they didn`t have face-to-face contact with a confirmed COVID-19 patient. Among the respondents, 173(41.4%), 147(35.2%), 63(15.1%), and 65(15.6%) of the health professionals had always used gloves, medical masks, face shield, or goggles/protective glasses, and disposable gown, respectively. In this study, age between 25-34 years (AOR = 0.20), age between 35-44 years (AOR = 0.13), family size of >6 (AOR = 3.77), work experience of 21-30 years (AOR = 0.01), and good handwashing habit (AOR = 0.44) were the protective factors against COVID-19. On the other hand, perception of non-exposure to COVD 19 (AOR = 9.56), and poor habit of decontamination of high touch areas (AOR = 2.52) were the risk factors associated with confirmed COVID 19 cases among health care workers. CONCLUSION: Poor adherence to personal protective equipment use and aseptic practices during and after health care interactions with patients were identified. Strategies should be implemented to institute effective and sustainable infection control measures that protect the health care workers from COVID-19 infection.

Pesticide Residue Analysis of Khat Leaves and Health Risks among Khat Chewers in the Amhara Region, Northwestern Ethiopia.

Introduction: Farmers use a large number of pesticides to increase the productivity of Khat cultivation. Since Khat is consumed by many Ethiopians as a habit, there may be a significant concentration of pesticide residues in Khat leaves which result in adverse effects among the exposed population. Excess use of pesticides in Khat causes cancer, genotoxicity, and endocrine disturbances. The current study aimed to determine the concentration of selected pesticide residues on Khat leaves samples and to estimate the possible health risk on consumers. Methods: Thirty Khat samples were collected from Khat cultivators in the Amhara region, Ethiopia. Pesticide residue extraction and cleanup of Khat samples were performed using the QuEChERS method. Data were also collected about personal variables and Khat consumption habits. The pesticide concentrations were determined and the health risks were estimated. Results: Profenofos, dimethoate, and chlorpyrifos were detected in 6 (20%), 24 (80%), and 28 (93.3%) Khat samples, respectively. However, diazinon was detected in two samples and endosulfan I was not detected. The average concentration of chlorpyrifos, dimethoate, profenofos, and diazinon in Khat samples was 75.39 ± 20.26, 130 ± 48.94, 242.45 ± 119.79, and 81.5 ± 21.0 µg/kg, respectively. The HQ for diazinon was greater than 1 which shows the chronic health risks associated with intake of diazinon among Khat chewers. The acute health risks associated with intake of profenofos and diazinon were minimal. Discussion. Pesticide residue exposure is a risk factor for cardiac complications, reduction in antioxidant defense system, and developing neurological symptoms. All the pesticides were higher than the European Union Maximum Residue Levels (EU-MRL). Diazinon has the potential to cause higher chronic health risks. Chronic Khat chewers in the region may face potential health risks from pesticide residues. Awareness creation among people in the study area is necessary to avoid the adverse health effects of pesticide residues.

Evaluation of In Vivo Antidiarrheal Activity of Solvent Fractions of Hagenia abyssinica (Rosaceae) in Swiss Albino Mice.

BACKGROUND: Ethiopia has several medicinal plants that have been used for their antidiarrheal activity. Hagenia abyssinica is the most commonly used medicinal plant for the management of diarrhea in Ethiopia. Thus, this study's aim is to investigate the antidiarrheal effect of solvent fractions of H. abyssinica. METHODS: Antidiarrheal activity of extract fractions obtained from different solvents was evaluated by using small intestine transit, enteropooling, and castor oil-induced diarrhea animal models. In all animal models, the solvent fractions treated groups were treated with three different doses (100 mg/kg, 200 mg/kg, and 400 mg/kg) of the solvent fractions, while the negative control group was treated with a vehicle (distilled water), and positive control group was treated with loperamide. RESULTS: The acute toxicity test revealed that the LD50 of H. abyssinica is > 2000 mg/kg. In castor oil-induced, the solvent fractions of H. abyssinica (at 200 mg/kg and 400 mg/kg) significantly (P < 0.05-0.001) prolonged the stool frequency, reduced the weight of feces, and delayed diarrheal onset time as compared with the negative control group. The fractions produced a significant (P < 0.05) antimotility effect at the doses of 200 mg/kg and 400 mg/kg as compared to the negative control. All solvent fractions at the middle and higher doses showed a statistically significant dose-dependent reduction in the volume of intestinal contents and weight of the feces. However, the solvent fractions of H. abyssinica at a dose of 100 mg/kg failed to produce a statistically significant activity in all parameters (number of wet feces, the onset of diarrhea, and number of total feces) when compared with the negative control group. CONCLUSION: The extract fractions obtained from different solvents have shown significant antidiarrheal activity. Thus, this finding supports the claimed traditional use of H. abyssinica leaves for the treatment of diarrhea.

Anti-Oxidant Potential and Antimalarial Effects of Acanthus polystachyus Delile (Acanthaceae) Against Plasmodium berghei: Evidence for in vivo Antimalarial Activity.

BACKGROUND: Malaria is among the most devastating and widespread tropical parasitic diseases which is more prevalent in developing countries. Acanthus polystachyus (Acanthaceae) leaves are traditionally used for the treatment of malaria in Ethiopia. This study aimed to investigate the in vivo antimalarial and in vitro antioxidant activity of the leaves extract of Acanthus polystachyus. MATERIALS AND METHODS: The leaves part of A. polystachyus were extracted using 80% methanol. The antioxidant effect of Acanthus polystachyus extract was evaluated by using (DPPH) diphenyl-2-picrylhydrazyl assay model. To evaluate the antimalarial effect of the A. polystachyus extract, Plasmodium berghei ANKA strain (chloroquine sensitive) was used to infect the mice in three different experimental protocol: suppressive, curative, and prophylactic test models. RESULTS: The leaves extract of Acanthus polystachyus significantly (P<0.05-0.0001) suppressed the parasitemia in all experimental protocol. The extract exhibited a chemosupression of 27.64%, 33.67% and 49.25% in 4-day suppressive test; 33.76%, 39.24% and 53.59% in curative test, and 25%, 32.84% and 50% in prophylactic tests at dose of 100, 200, and 400mg/kg, respectively. The extract also extended the mean survival time, prevented the bodyweight loss and body temperature drop, and packed cell volume significantly (P<0.05) as compared to the negative control. Dose-dependent antioxidant activity was shown by the leaf extract of A. polystachyus with an IC50 value of 9.37µg/mL. CONCLUSION: The current finding showed that the leaves extract of Acanthus polystachyus has revealed promising antimalarial effects. Thus, this finding supports the traditional use of A. polystachyus for the treatment of malaria.

Antimalarial Drug Resistance and Novel Targets for Antimalarial Drug Discovery.

Malaria is among the most devastating and widespread tropical parasitic diseases in which most prevalent in developing countries. Antimalarial drug resistance is the ability of a parasite strain to survive and/or to multiply despite the administration and absorption of medicine given in doses equal to or higher than those usually recommended. Among the factors which facilitate the emergence of resistance to existing antimalarial drugs: the parasite mutation rate, the overall parasite load, the strength of drug selected, the treatment compliance, poor adherence to malaria treatment guideline, improper dosing, poor pharmacokinetic properties, fake drugs lead to inadequate drug exposure on parasites, and poor-quality antimalarial may aid and abet resistance. Malaria vaccines can be categorized into three categories: pre-erythrocytic, blood-stage, and transmission-blocking vaccines. Molecular markers of antimalarial drug resistance are used to screen for the emergence of resistance and assess its spread. It provides information about the parasite genetics associated with resistance, either single nucleotide polymorphisms or gene copy number variations which are associated with decreased susceptibility of parasites to antimalarial drugs. Glucose transporter PfHT1, kinases (Plasmodium kinome), food vacuole, apicoplast, cysteine proteases, and aminopeptidases are the novel targets for the development of new antimalarial drugs. Therefore, this review summarizes the antimalarial drug resistance and novel targets of antimalarial drugs.

Depression, Anxiety, Stress, and Associated Factors among Khat Chewers in Amhara Region, Northwest Ethiopia.

Individuals with substance use disorder are prone to develop different psychiatric disorders. Substance abuse and associated problems are of current global concern that leads to mental health disorders which contributed about 14% of the global burden of the disease. It has become an epidemic in some parts of the African region with adolescents being the main victims of the ill health and social effects of substance use. This study is aimed at assessing the prevalence of depression, anxiety, and stress and associated factors among khat chewers in the Amhara region, 2019. A community-based cross-sectional study was done from February 14 to April 15, 2019. A purposive sampling technique was used to enroll the subjects. Data was collected using the face-to-face interview technique using the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Descriptive statistics and bivariate and multivariate logistic regression were used to summarize the results. p value < 0.05 was considered statistically significant. A total of 478 participants were enrolled in the study with a response rate of 94.1%. The overall prevalence of depression, anxiety, and stress was 27.4%, 40.6%, and 18.8%, respectively. Around 43% of the respondents develop dependency from khat chewing. Working in a private sector, being self-employed, being jobless, spending 90 to 180 minutes and more, chewing 51-100 g and more, and chewing khat more than once per week were positively associated with stress. On the other hand, being a private sector worker, being jobless, completing secondary education, earning 1001-5000 ETB per month, chewing khat more than once per week, being khat dependent, and the presence of chronic illness were positively associated with anxiety. History of chronic illness and being khat dependent were positively associated with depression. The prevalence of depression, anxiety, and stress was high among khat chewers in the Amhara region. Special attention has to be given to khat chewers since khat chewing will double the burden of mental illness. Proper awareness and evaluation activities will reduce the impact of the problem.

Hypoglycemic, Anti-Hyperglycemic and Anti-Hyperlipidemic Effects of Bersama abyssinica Fresen (Melianthaceae) Leaves' Solvent Fractions in Normoglycemic and Streptozotocin-Induced Diabetic Mice.

BACKGROUND: The leaves of Bersama abyssinica are used by traditional healers and the community for the treatment of diabetes mellitus. Thus, the current study intended to evaluate the hypoglycemic, anti-diabetic, and anti-hyperlipidemic effects of Bersama abyssinica. METHODS: The solvent fractions of Bersama abyssinica leaves were prepared. A total of 132 healthy, male Swiss albino mice weighing 20-28 grams (age of 6-10 weeks) were used. The antidiabetic activity of all the doses (100, 200, and 400 mg/kg) of Bersama abyssinica solvent fractions was evaluated by animal models: normoglycemic mice, oral glucose loaded mice, and diabetic mice. Diabetes was induced by a single intraperitoneal injection of streptozotocin (150mg/kg body weight). The effect of the plant extract on body weight and serum lipid levels were measured in diabetic mice. Statistical analysis was performed by using statistical package for social sciences version 24. The analyses were carried out using one-way ANOVA, followed by Tukey's multiple comparison tests. The result was considered significant when p <0.05. RESULTS: The solvent fractions of B. abyssinica at all tested doses (100, 200, and 400 mg/kg) exhibited significant (P<0.05-0.001) BGL reduction in all animal models. In hypoglycemic activity, the percentage reduction of baseline BGL was 25.90%, 26.36%, 38.43%, 30.96% and 49.42% for EAF200mg/kg, AQF200mg/kg, EAF400mg/kg, AQF400mg/kg, and GLC 5mg/kg, respectively. B. abyssinica at the dose of AQF 200 mg/kg (p<0.05), AQF 400mg/kg (p<0.001), EAF 200mg/kg (p<0.01), and GLC 5mg/kg (p<0.001) significantly reduced the BGL following 1-hour post-treatment as compared to the negative control. Likewise, the higher doses of the solvent fractions (400mg/kg) significantly (p<0.001) reduced the BGL following 2- and 3-hours post-treatment as compared to the negative control. Daily administration of aqueous fraction of B. abyssinica caused a maximum reduction in fasting BGL at the fourteenth day of administration by 33.29%, 38.59%, 52.71%, and 59.66%, respectively, for AQF100, AQF200, AQF400, and GLC 5mg/kg. The aqueous fraction of B. abyssinica and the glibenclamide significantly (p<0.05) prevent loss of body weight and showed improvement in serum lipid levels. CONCLUSION: The solvent fractions of Bersama abyssinica exhibit noticeable antidiabetic activity in all animal models (normoglycemic mice, oral glucose loaded mice, and diabetic mice) and showed improvement in body weight and serum lipid profile levels, which rationalizes the claimed use of the B. abyssinica in the treatment of diabetes mellitus.

Evaluation of in vitro and in vivo Anti-Diabetic, Anti-Hyperlipidemic and Anti-Oxidant Activity of Flower Crude Extract and Solvent Fractions of Hagenia Abyssinica (Rosaceae).

BACKGROUND: The flower of Hagenia abyssinica (Rosaceae) has been used in traditional health systems to treat diabetes mellitus in Ethiopia and Tanzania. However, the antidiabetic activity of this medicinal plant is not scientifically validated and authenticated. The present study aimed to investigate the in vitro and in vivo anti-diabetic activity of flower crude extract and solvent fractions of Hagenia abyssinica. METHODS: The in vitro α-amylase inhibition and antioxidant activity of the crude extract and solvent fractions of Hagenia abyssinica were evaluated by using 3,5-dinitrosalicylic acid (DNSA) and diphenyl-2-picrylhydrazyl (DPPH) assay model, respectively. Blood glucose lowering activity of 80% methanolic flower crude extract and solvent fraction was studied in four animal models: normoglycemic mice model, oral glucose loaded mice model, single dose-treated streptozotocin-induced diabetic mice model, and repeated dose-treated streptozotocin-induced diabetic mice model. The effect of the crude extract and solvent fraction of Hagenia abyssinica on diabetic lipid profile and body weight was also studied. RESULTS: The acute toxicity study of Hagenia abyssinica flower extract did not show mortality in the animals at the limit dose of 2g/kg during the observation period. The result of α-amylase enzyme inhibition activity was found in a dose-dependent manner, the strongest activity was shown by ethyl acetate fraction (54.23% inhibition at 800 µg/mL) compared to the standard acarbose having 91.87% inhibition at 800 µg/mL. Among these extracts, the crude extract had the highest antioxidant activity (58.38% inhibition at 500 µg/mL). The crude extract of H. abyssinica showed significant blood glucose-lowering effect on normoglycemic mice and oral glucose loaded mice. In streptozotocin-induced diabetic mice model, the crude extract and ethyl acetate fraction significantly decreased the fasting blood glucose level after 14 days of treatment. There were significant reductions in serum total cholesterol, serum triglycerides, very low-density lipoprotein, and low-density lipoprotein. However, there were significant increments in body weight and high-density lipoprotein as compared to untreated diabetic mice. CONCLUSION: The result demonstrated the beneficial biochemical effects of Hagenia abyssinica extract by inhibiting α-amylase, scavenging diphenyl-2-picrylhydrazyl (DPPH) and improving serum lipid profile levels. The flower crude extract and solvent fractions of Hagenia abyssinica are effective in lowering blood glucose levels in diabetic and normoglycemic mice. The claimed traditional use as antidiabetic has scientific ground.