Establishing high temperature gas chromatographic profiles of non-polar metabolites for quality assessment of African traditional herbal medicinal products.

The quality assessment of African traditional herbal medicinal products is a difficult challenge since they are complex mixtures of several herbal drug or herbal drug preparations. The plant source is also often unknown and/or highly variable. Plant metabolites chromatographic profiling is therefore an important tool for quality control of such herbal products. The objective of this work is to propose a protocol for sample preparation and gas chromatographic profiling of non-polar metabolites for quality control of African traditional herbal medicinal products. The methodology is based on the chemometric assessment of chromatographic profiles of non-polar metabolites issued from several batches of leaves of Combretum micranthum and Mitracarpus scaber by high temperature gas chromatography coupled to mass spectrometry, performed on extracts obtained in refluxed dichloromethane, after removal of chlorophyll pigments. The method using high temperature gas chromatography after dichloromethane extraction allows detection of most non-polar bioactive and non-bioactive metabolites already identified in leaves of both species. Chemometric data analysis using Principal Component Analysis and Partial Least Squares after Orthogonal Signal Correction applied to chromatographic profiles of leaves of Combretum micranthum and Mitracarpus scaber showed slight batch to batch differences, and allowed clear differentiation of the two herbal extracts.

Determinants of glycaemic control in type 2 diabetes African patients monitored by physicians from 1991 to 2004 in Cote d'Ivoire.

The aim of this study was to propose determinants of glycaemic control which are useful to adequately manage the healthcare of type 2 diabetes patients attending an out-patient clinic. A retrospective, descriptive research design was implemented at the Centre AntiDiabétique d'Abidjan in 2399 African patients. Glycaemic control was calculated from the average of at least 12 fasting plasma glucose levels measured during at least three years. Logistic and multiple linear regressions were performed at the limit of the glycaemia average of 6.7mmol/l (120mg/dl). The determinants of poor glycaemic control were: long duration of monitoring (odds ratio (OR)=1.66, then 2.68), annual frequency of visits outside the 2-3 per year interval (OR=3.25) and insulin treatment (OR=4.66) in 'non-obese men'; the aforementioned frequency of visits (OR=3.69) and insulin treatment (OR=3.72) in 'non-obese women'; the duration of monitoring reaching the 10-14 year interval (OR=3.48), the aforementioned frequency of visits (OR=2.51), insulin treatment (OR=26.16) and housewife status (OR=1.94) in 'obese women'. In 'obese men', insulin treatment was the sole determinant (r(2)=0.24). Healthcare parameters (treatment, frequency of visits, and duration of monitoring) seemed to be predominant as effective predictors of glycaemic control in our study context. These findings reveal the urgent need for both more concern and further research in diabetes management to improve the quality of care and tackle this health challenge.