Hyperlactatemia in a group of HIV patients living in Yaounde-Cameroon.

BACKGROUND AND AIM: Prolonged exposure to highly active antiretroviral therapy (HAART) is associated with adverse effects such as hyperlactatemia. We determined the prevalence and risk factors for developing hyperlactatemia among human immunodeficiency virus (HIV)-infected cameroonians on antiretroviral therapy (ART). METHODS: We conducted a cross-sectional study from January to April 2012 involving 91 HIV-infected patients receiving ART for at least 12 months and 30 HIV-infected patients who have never received ART (ART-naïve patients). Plasma lactate levels were determined after at least 12 hours of overnight fasting and hyperlactatemia defined as lactate concentrations ≥ 3 mmol/L. The prevalence of hyperlactatemia was determined and the risk factors were analyzed by a multivariate logistic regression model. RESULTS: The mean lactataemia was significantly higher in the group of HIV patients currently taking ART than in the ART-naïve one (2.3 ± 1.3 and 1.7 ± 0.7 mmol/L respectively, p = 0.002). Patients on first line ART regimens had significantly higher lactatemia than those on second line regimens (2.5 ± 1.5 and 1.9 ± 0.7 mmol/L respectively, p = 0.014). The prevalence of hyperlactatemia in HIV patients receiving ART and in ART-naïve HIV patients was respectively 18.7 and 6.7% (p = 0.095). ART-exposure (adjusted odds ratio (aOR) 5.44, 95% confidence interval (CI) 1.06 - 27.84; p = 0.042) and being on a first line regimen (aOR 16.22, 95% CI 1.57 - 167.91; p = 0.019) were independent strong predictors of hyperlactatemia. CONCLUSION: Hyperlactatemia was not rare in our study population. Being on a first line regimen constitutes an important risk factor for developing hyperlactatemia. Measurement of plasma lactate may be useful in optimizing the management of HIV-positive persons on ART.

Antihyperglycaemic potential of the water-ethanol extract of Kalanchoe crenata (Crassulaceae).

Kalanchoe crenata is a vegetable widely used in Cameroon and largely efficient in the treatment of diabetes mellitus. The effect of the water-ethanol extract of this plant (WEKC) on blood glucose levels was investigated in fasting normal and diet-induced diabetic rats (MACAPOS 1) after a short- and medium-term treatment. Diabetes was induced by submitting Wistar rats to a hypercaloric sucrose diet over 4 months. Six hours after a single oral administration of WEKC, 135 and 200 mg kg(-1) body weight extracts significantly (P < 0.01) reduced the blood glucose levels both in normal and diabetic rats without real dose-dependent effect. During the medium-term treatment, 200 mg kg(-1) WEKC administered daily for 4 weeks significantly reduced blood glucose levels within week 1 (P < 0.05), with a maximum effect at week 4 (-52%, P < 0.01), while maintaining glycaemia within the normal range. All the WEKC-treated diabetic rats exhibited significant (P < 0.01) increase in insulin sensitivity index (K (ITT)) compared with the initial time and to the untreated diabetic animals. Animals treated for 4 weeks exhibited a slight resistance in body-weight gain and decrease in food and water intake. The WEKC activities on all parameters assessed were comparable with the glibenclamide effects. Qualitative phytochemical screening revealed that K. crenata contains terpenoids, tannins, polysaccharids, saponins, flavonoids and alkaloids. The data suggest that K. crenata might contain important chemical components that could induce significant improvement in glucose clearance and/or uptake and resistance to body-weight gain and insulin sensitivity, and could be a potent alternative or complementary therapeutic substance in the control of type 2 diabetes and other insulin-resistant conditions.

Youth of west-Cameroon are at high risk of developing IDD due to low dietary iodine and high dietary thiocyanate.

BACKGROUND: Hypothyroidism in utero leading to mental retardation is highly prevalent in developing countries where iodine deficiency and thiocyanate overload are combined. OBJECTIVE: To explore prevalence of IDD in Bamougoum, a mountain region of western Cameroon, by studying urinary iodine and thiocyanate excretion levels in children. METHODS: Bamougoum district in western Cameroon was selected for closer study due to its geographic location predisposing to iodine deficiency disorders (IDD). A comprehensive sampling strategy included 24-h urine samples collected over three days from 120 school-aged children. Urinary iodine and thiocyanate levels were measured by colorimetric methods. RESULTS: Twenty one percent of boys between the ages 3 and 19 were classified as iodine deficient. The prevalence of thiocyanate overload in the same population was found to be 20%. CONCLUSION: Presence of endemic iodine deficiency and excessive thiocyanate in the population indicates that the region is at risk of iodine deficiency disorder. A multifactorial approach that includes improvement of diet, increasing iodine and minimizing goitrogen substances intake, soil and crop improvement and an iodine supplementation program may help alleviate IDD in the affected area studied.

Antifolate screening using yeast expressing Plasmodium vivax dihydrofolate reductase and in vitro drug susceptibility assay for Plasmodium falciparum.

The presence of homologous point mutations in the dhfr gene in Plasmodium vivax and Plasmodium falciparum is associated with resistance to antifolate drugs. The spread of antifolate resistance encouraged research for novel antifolate drugs active against both wild-type and dhfr-mutant strains of malaria parasites. Because P. vivax cannot be easily maintained in culture, we transformed a Saccharomyces cerevisiae DHFR-deleted mutant to express wild-type P. vivax dhfr gene and its mutant forms. Twenty-five dicyclic and tricyclic 2,4-diaminopyrimidine derivatives were screened. Six quinazoline compounds showed selective inhibition of yeast transformants expressing P. vivax dhfr genes. The 50% inhibitory concentration (IC(50)) of these six compounds was determined against field isolates of P. falciparum. Our results suggest that a close relationship between the yeast assay based on expression of P. vivax dhfr genes and the in vitro test using P. falciparum parasites in culture is a promising initial step for drug screening.

Cameroon local diet-induced glucose intolerance and dyslipidemia in adult Wistar rat.

It has been hypothesised that glucose intolerance or diabetes can be induced in rodents by a hypercaloric-fat diet or a hypercaloric-sucrose diet. This study was designed to examine the effects of a high-fat diet (HFD: carbohydrates 35-40% kcal, fat 50-55% kcal, protein 10-15% kcal) and a high-sucrose diet (HSD: carbohydrates 65-70% kcal, fat 25-30% kcal, protein 10-15% kcal) compared to a normal or standard diet (ND: carbohydrates 50-55% kcal, fat 15-20% kcal, protein 25-30% kcal) on fasting plasma glucose, glucose tolerance test, plasma triglycerides, plasma cholesterol, body weight, food and water consumption in male Wistar rats. After 4 months, weight gain, plasma triglycerides level, fasting plasma glucose and water intake were significantly elevated (p<0.05) in all test groups when compared to the control group. Total HDL and LDL cholesterol levels were significantly elevated (p<0.05) in the HFD group, whereas the HDL level was significantly lower in the HSD group associated with an atherogenic index significantly elevated (p<0.05) when compared to the control group. After 16 weeks of dietary treatment, an oral glucose tolerance test (OGTT) showed a significant increase in plasma glucose levels after 2-4 h of glucose challenge in all test groups. During the experiment, it was noticed that important weight gain observed in all dietary test groups was associated with a significant low (p<0.05) food consumption. The above results suggest that dietary nutrients contained in these hypercaloric diets might have an effect on insulin action and therefore, might contribute to the development of glucose intolerance and type 2 diabetes. These results also suggest that, in addition to their diabetogenic effect, these hypercaloric diets might probably have an atherogenic effect and could be use in a long-term study to induce type 2 (non-insulino-dependant) diabetes mellitus.

[Iodized salt in Cameroon]. / Problématique du sel iodé consommé au Cameroun.

The WHO program to combat iodine deficiency disorders (IDD) adopted in 1992 required countries producing cooking and table salt to add 50-100 ppm of iodine to salt. This program was adopted in Cameroon, but problems remain in ensuring adequate conditioning of the iodized salt at the factories to maintain the iodine levels so that consumers take in the required quantity. This study collected and analyzed five groups of salt samples from three provinces of Cameroon. Each group included a specimen from its factory, wholesalers, retailers, and households. Iodine content was measured by the volumetric method. The results showed that iodine levels in salt decreased substantially between the factory and the consumer; percentages of iodine loss in these samples varied from 44.8% to 82.3%. Iodine levels were highest in fine-grained salt. Iodine concentration also decreases after storage, perhaps as a function of the type and duration of the storage, temperature, packaging material and presence of impurities in salt. This study shows that even salt with an initial high iodine concentration may reach consumers with insufficient levels for daily needs.