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Patients’Knowledge, Attitude and Practices on Disposal Methods of Expired and Unused Medicines: Implication for Creation of Drug Take-Back Program

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Pharmacology & Pharmacy 2024年第4期15卷 113-128页

作者： Martin Kampamba Zebedy Kalambwa Billy Chabalenge Janipher Zulu Steward Mudenda Tadious Chimombe Webrod Mufwambi Audrey Hamachila Mashebe Innocent Ngula christabel nang’andu hikaambo Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Department of Pharmacy School of Health Sciences Levy Mwanawasa Medical University Lusaka Zambia

Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (EUM). Improper disposal of expired and unused medicines is hazardous both to humans and the environment. Objective: This sought to measure patients’ knowledge, attitude, and practices on disposal methods of EUM. Methods: A cross-sectional study was carried out among 384 patients at three outpatient pharmacies at the University Teaching Hospitals (UTHs). The structured questionnaire was used to collect data and STAT version 15.1 was used to analyse the data. Results: 384 respondents participated in this study and, at some point, had EUM. In this study, 356 (92.7%) of the participants reported that they had never heard of a drug take-back system. Most of the participants 285 (74.2%) and 239 (62.2%) kept and donated their unused medicine, respectively. Additionally, 244 (63.5%), 212 (55.2%), and 176 (44.8%) of the participants disposed of expired medicines in the bin or garbage, flushed them in toilets or sinks, or burned them, respectively. Occupation was significantly associated with unsafe disposal of unused medicine [P-value = 0.019]. Conclusion and Relevance: Knowledge of safe disposal methods for EUM was good amongst most participants. However, used unsafe disposal methods. The majority of the participants exhibited positive attitude concerning safe disposal methods. This study highlights the need for drug-take-back program creation in Zambia.

关键词： Attitude Disposal Methods Expired Medicines Knowledge Practices Unused Medicines

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Roles of Community Pharmacists in Screening and Disseminating of Information about Non-Steroidal Anti-Inflammatory Drugs Risks: Implications for Drug Safety Assessment

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Pharmacology & Pharmacy 2024年第4期15卷 129-145页

作者： Martin Kampamba Progress Mulenga Steward Mudenda Billy Chabalenge Jenipher Zulu Tadius Chimombe Webrod Mufwambi Mashebe Innocent Ngula Audrey Hamachila Jimmy Hangoma christabel nang’andu hikaambo Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Department of Pharmacy School of Health Sciences Levy Mwanawasa Medical University Lusaka Zambia

Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.

关键词： Community Pharmacists Non-Steroidal Anti-Inflammatory Drug Risk Screening

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Phytochemical Analysis of Leaf, Stem Bark, and Root Extracts of Cassia abbreviata Grown in Zambia

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Pharmacology & Pharmacy 2022年第5期13卷 119-128页

作者： Reagan Kabuka Steward Mudenda Martin Kampamba Martha Chulu Tadious Chimombe christabel nang’andu hikaambo Department of Pharmacy School of Health Sciences Levy Mwanawasa Medical University Lusaka Zambia Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia

Background: Plants have for a long time been used as medicines to treat ailments. Cassia abbreviata (C. abbreviata) is one of the plants that has been widely used in the management of a range of ailments, including malaria, diarrhea, and abscesses. Aim: This study was conducted to investigate the phytochemical composition of crude extracts of the roots, leaves, and stem bark of C. abbreviata. Materials and Methods: This was a laboratory-based study in which the fresh leaves, stem bark, and roots of C. abbreviata were collected, thoroughly cleaned, chopped into small pieces, and kept at room temperature until fully dry. The dried plant parts were powdered separately and stored separately in airtight containers for the phytochemical investigation. Ethanol (96% v/v) or distilled water was used for the extraction of components of the coarse powder. The mixtures were separately filtered, and the filtrates were reduced to a concentrated semisolid mass by drying in a water bath at 40?C. Thereafter, phytochemical analysis for flavonoids, phenolics, tannins, saponins, alkaloids, terpenoids, glycosides, carbohydrates, and proteins was done. Results: The phytochemical analysis of the ethanolic extracts revealed the presence of high concentrations of tannins, reducing sugars, and sterols in the stem bark and roots. Flavonoids, phenolics, and proteins were present in high concentrations in the stem bark, while anthraquinone, glycosides, and alkaloids were present in the leaves and roots, respectively. Conclusion: C. abbreviata plant contains a wide range of phytochemical constituents. Depending on the solvent used for extraction, various compositions of phytochemicals are obtained in each part of the tree. However, extraction with ethanol showed a better concentration than with water for most of the phytochemicals.

关键词： Cassia abbreviata Flavonoids Phytochemicals Stem Bark Sterols Tannins

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Antimicrobial Activities of Solanum aculeastrum Fruit Extract against Escherichia coli, Staphylococcus aureus and Candida albicans: Significance of African Traditional Medicine in Combating Infections and Attaining Universal Health Coverage

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Pharmacology & Pharmacy 2023年第5期14卷 176-188页

作者： christabel nang’andu hikaambo Phanuel Chilala Ferdinand Ndubi Godfrey Mayoka Martin Kampamba Reagan Kabuka Billy Chabalenge Steward Mudenda Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Pharmaceutical Chemistry and Pharmaceutics School of Pharmacy Kabarak University Nakuru Kenya Department of Pharmacology and Pharmacognosy School of Pharmacy Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Department of Pharmacy School of Health Sciences Levy Mwanawasa Medical University Lusaka Zambia Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia

Solanum aculeastrum, a member of the Solanum genus, has a rich history of traditional use in various populations throughout tropical and southern Africa for treating different ailments. This study investigated the antimicrobial activities of S. aculeastrum fruit extracts grown in Zambia against Escherichia coli (E. coli) (ATCC 25922), Staphylococcus aureus (S. aureus) (ATCC 25923), and Candida albicans (C. albicans). After being dried in an oven at 50°C for eight days, the fruits of S. aculeastrum were pulverised and subjected to extraction using methanol and distilled water as solvents. The resulting crude extract was then filtered, concentrated using a water bath, and packed into airtight containers separately. The disc diffusion method was employed to evaluate the antimicrobial activity of the extracts. The results showed that both the methanolic and aqueous extracts demonstrated antimicrobial activity against S. aureus and C. albicans, but not against E. coli. The zone of inhibition was greater in S. aureus than in C. albicans. This study highlights the importance of researching plants for their medicinal properties, which can pave the way for discovering natural product-based drugs with potential antimicrobial properties. These findings recommend further studies on plants used in African traditional medicine.

关键词： African Traditional Medicine Solanum aculeastrum Phytochemicals Solanum Berries Antimicrobial Activity

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Availability of Antimalarial Medicines in Community Pharmacies of Lusaka District, Zambia: Implications on Compliance to Malaria Treatment Guidelines

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Pharmacology & Pharmacy 2023年第4期14卷 85-97页

作者： Tadious Chimombe Steward Mudenda Stephen Bwalya Tamara N’gona christabel nang’andu hikaambo Webrod Mufwambi Audrey Hamachila Simon Nkowani Busiku Hamainza Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia National Malaria Elimination Centre Ministry of Health Lusaka Zambia

Background: Malaria remains a major cause of morbidity and mortality in Zambia, affecting all levels of society, with children under the age of five and pregnant women being most at risk of serious illness. The availability of antimalarial medicines is one of the key interventions of malaria management. This study assessed the availability of antimalarial medicines in community pharmacies in Lusaka district, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 210 community pharmacies from September to November 2022 using a well-structured checklist in selected areas of Lusaka district. The availability was verified by a physical check of the product. The checklist contained the medicines listed both in the guidelines for diagnosis and treatment of malaria in Zambia as well as in the World Health Organization (WHO) malaria treatment guidelines. Results: This study found that all antimalarials listed in the local treatment guidelines for malaria were available in community pharmacies, though with the varying distribution. Of the 210 community pharmacies, 209 (99.5%) had artemether/lumefantrine in stock. The lowest available antimalarial was quinine/clindamycin, which was only available in 3 (1.4%) of the outlets. Conversely, 3 out of 16 (18.8%) antimalarials that were available in community pharmacies were not listed in the local treatment guidelines of malaria in Zambia, despite being listed in the WHO malaria treatment guidelines. This translated into a compliance level of 81.2% based on the local malaria treatment guidelines. Conclusion: This study concluded that antimalarials were available for all categories of malaria management in community pharmacies, though with a varying distribution. The presence of antimalarials not listed in the Zambian treatment guidelines is of public health concern which may have an impact on antimicrobial resistance in the future.

关键词： Antimalarials Antimalarial Medicines Availability Community Pharmacies Zambia

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Assessment of Knowledge, Attitude and Practices towards the Disposal of Unused and Expired Medications among Students of Private Medical Universities in Lusaka, Zambia

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Pharmacology & Pharmacy 2022年第2期13卷 49-68页

作者： Martin Kampamba Vewoerd Maingaila Tumelo Muyenga Akapelwa Steward Mudenda Luke Biete Webrod Mufwambi Michelo Banda Margaret Phiri christabel nang’andu hikaambo Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Physiological Sciences School of Medicine and Health Sciences Mulungushi University Livingstone Zambia Department of Clinical Pharmacy and Pharmacy Practice School of Pharmacy Eden University Lusaka Zambia Department of Pharmacy School of Medicine and Health Sciences Mulungushi University Kabwe Zambia

Background: The disposal of unused and expired medications has been a concern in many countries in that, the pharmaceutical waste enters the ecosystem and eventually causes a negative impact on human health and environment. Aim: To assess the knowledge, attitude and disposal practices of unused and expired medicines by students in the private medical universities in Lusaka of Zambia. Method: A cross-sectional survey was conducted over a period of 8 weeks among 391 respondents from three private universities in Lusaka. Respondents were polled using semi structured questions that focused on their knowledge, attitudes, and disposal practices for unused and expired drugs. In order to analyze data, the statistical package for social sciences (SPSS) version 20 was utilized. Results: The mean age of the participants was 23 years (SD: ±3). Out of the 391 participants, 320 (81.8%) knew about medicine waste and 391 (100.0%) responded that unsafe disposal of unused and expired medicine poses a threat to human health and can harm the environment. The drug-take-back system was unknown to a vast percentage of the respondent 371 (94.9%). The majority 274 (70.1%) of respondents had unused medicine stored at home, with antibiotics 215 (56.0%) and analgesia 111 (28.4%) being the most prevalent types of drugs kept in the households. The most commonly used disposal practice for unused 126 (32.2%) and expired medicines 274 (70.1%) was throwing them in household garbage. Only 27 (6.9%) and 30 (7.7%) reported returning unused and expired medicines to the nearest pharmacy respectively. The majority of respondents believed the risk stemmed from the presence of an undesired drug in the home, the potential for harm to children, a lack of proper information on safe disposal practices, and the necessity for a take-back program. Conclusions: The majority of the study participants used unsafe methods to dispose of unused and expired medicine. However, most of the participants acknowledged that unsafe disposal of unused and expired medicines is

关键词： Unused Medications Expired Medications Medicine Disposal Medicine Waste

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Zambia’s Response to the COVID-19 Pandemic: Exploring Lessons, Challenges and Implications for Future Policies and Strategies

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Pharmacology & Pharmacy 2022年第1期13卷 11-33页

作者： Steward Mudenda Misheck Chileshe Moses Mukosha christabel nang’andu hikaambo Michelo Banda Martin Kampamba Kennedy Mwila David Chimbizgani Banda Webrod Mufwambi Victor Daka Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia MaryBegg Health Services Northrise Ndola Zambia Graduate School of Education Peking University Beijing China Department of Nursing Faculty of Health Sciences Chreso University Lusaka Zambia Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia

The coronavirus disease 2019 (COVID-19) pandemic is a global public health problem that has affected the globe in different ways. There is little information published on the challenges and lessons learnt in responding to the COVID-19 epidemic in Zambia. Objective: To establish Zambia’s response, lessons and the challenges experienced in the fight against COVID-19. Results: Since the emergence of COVID-19, Zambia has experienced three waves, with the third wave being the most severe. The Zambian government responded positively and effectively to all three pandemics with the help of cooperating partners. Zambia adopted the World Health Organization (WHO) recommended prevention methods such as hand hygiene, masking up in public, physical distancing, avoiding crowded areas and staying at home to prevent the further spread of the disease. Additionally, surveillance of COVID-19 was strengthened, which led to the early detection of cases. Besides, there has been a strong call for all Zambian adults to receive the COVID-19 vaccine as a way of controlling the epidemic. However, since the launch of the COVID-19 vaccination programs, there has been a high level of vaccine hesitancy, causing Zambia to fall below the 10% of the adult population required to be vacci

关键词： COVID-19 COVID-19 Vaccines Vaccine Hesitancy Pandemic Wave Surveillance Zambia

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Familiarity, Knowledge and Practices of Healthcare Professionals Regarding the Pharmacovigilance of Biological Medicines in Lusaka, Zambia: A Multi-Facility Cross-Sectional Study

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Pharmacology & Pharmacy 2022年第7期13卷 230-251页

作者： Michelo Banda Katia Verhamme Webrod Mufwambi Steward Mudenda Billy Chabalenge Scott Kaba Matafwali Ronald Kampamba Mutati christabel nang’andu hikaambo Martin Kampamba Lavina Prashar Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Medical Informatics Erasmus MC Rotterdam Netherlands Department of Bioanalysis Ghent University Ottergemsesteenweg Ghent Belgium Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Clinical Research Department Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine London UK Department of Physiological Sciences School of Medicine University of Zambia Lusaka Zambia

Background: Pharmacovigilance of biological medicines is crucial because it ensures that medicines meet the World Health Organization (WHO) standards. In Zambia, there is little information on healthcare professionals’ familiarity, knowledge and practices on the pharmacovigilance of biological and biosimilar medicines. Therefore, this study investigated the familiarity, knowledge, and practices related to the pharmacovigilance (PV) of biological and biosimilar medicines at selected hospitals in Lusaka, Zambia. Methods: The study was an analytical questionnaire-based cross-sectional study conducted among healthcare professionals (HCPs) at the Adult hospital, Cancer Diseases hospital, Paediatrics hospital and Women and New Born Hospital in Lusaka. Data were collected over four weeks in May and June 2021 and subsequently analysed using IBM SPSS version 21. The statistical significance was set at a 95% confidence interval. Results: Of 245 participants, only 115 (48.9%) of the HCPs were familiar with biological medicines to a basic understanding. Regarding the term biosimilars, most of the HCPs (40.9%) never heard of this word. The mean score for knowledge regarding the PV considerations of biological medicines was 4.1 out of 8 questions. Most HCPs used non-proprietary names (44.2%) when prescribing, dispensing, or administering biological medicines. Additionally, more than half (57.3%) of HCPs did not record batch numbers when dispensing or administering biological medicines. Conclusion: Healthcare professionals were more familiar with the term biological medicines than biosimilars. Healthcare professionals generally scored poorly when their knowledge regarding the PV considerations of biological medicines was assessed. Thus, there is a need to provide adequate training and continuous professional development among healthcare professionals on the pharmacovigilance of biological and biosimilar medicines.

关键词： Pharmacovigilance Biological Medicines Biosimilars Brand Batch Zambia

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Phytochemical Analysis and Antibacterial Activity of <i>Azadirachta indica</i>Leaf Extracts against <i>Escherichia coli</i>

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Pharmacology & Pharmacy 2022年第1期13卷 1-10页

作者： christabel nang’andu hikaambo Luyando Kaacha Steward Mudenda Mutenta Nsokolo Nyambe Billy Chabalenge Margaret Phiri Luke Lundau Biete Tumelo Muyenga Akapelwa Webrod Mufwambi Martha Chulu Martin Kampamba Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Faculty of Pharmacy Nutrition and Dietetics Lusaka Apex Medical University Lusaka Zambia Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Department of Pharmacy School of Medicine and Health Sciences Mulungushi University Kabwe Zambia Department of Clinical Pharmacy and Pharmacy Practice School of Pharmacy Eden University Lusaka Zambia Department of Physiological Sciences School of Medicine and Health Sciences Mulungushi University Livingstone Zambia Department of Pharmacy School of Health Sciences Levy Mwanawasa Medical University Lusaka Zambia

Background: Traditional medicine has employed Azadirachta indica to treat a variety of ailments. However, there is little information on the use of this plant in Zambia. Objective: To evaluate the phytochemicals and antibacterial activity of Azadirachta indica leaf extracts against Escherichia coli. Materials and Methods: This was a laboratory-based experimental study in which ethanol and water were used for extraction by maceration. Phytochemical analysis was then done on the leaf extract. Using the disc diffusion method, varying concentrations of A. indica aqueous and ethanolic extracts were used to test the antibacterial activity of A. indica against Escherichia coli. The sensitivity of the tested microorganisms to aqueous and ethanoli

关键词： Phytochemicals Antibacterial Activity Escherichia coli Azadirachta indica Neem

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Challenges Affecting African Countries in the Fight against the COVID-19 Pandemic: Implications for Interventional Strategies in Low- and Middle-Income Countries

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Advances in Infectious Diseases 2022年第3期12卷 496-517页

作者： Steward Mudenda Kennedy Mwila christabel nang’andu hikaambo Victor Daka Godfrey Mayoka Maisa Kasanga Michelo Banda Moses Mukosha Ruth Lindizyani Mfune Martin Kampamba Lungwani Tyson Muungo Ronald Kampamba Mutati Webrod Mufwambi Misheck Chileshe Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Graduate School of Education Peking University Beijing China Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia Department of Pharmacology and Pharmacognosy School of Pharmacy Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya College of Public Health Zhengzhou University Zhengzhou China Department of Pathology and Microbiology University Teaching Hospitals Lusaka Zambia Mary Begg Health Services Ndola Zambia

The coronavirus disease 2019 (COVID-19) has caused many global challenges, especially in resource-constrained countries. Africa, a continent with a large number of low-and middle-income countries (LMICs), shares this burden disproportionately compared to developed countries. Here we review some of the major challenges African countries face in the fight against COVID-19 and propose some mitigation measures. Studies have reported low adherence to COVID-19 prevention measures in most African countries. Additionally, there has been a shortage of healthcare workers, inadequate surveillance and diagnostic tools, unavailability of drugs in healthcare facilities, increased wrong beliefs, myths, misinformation and misconceptions about COVID-19 and vaccinations, and an already existing burden of infectious and non-infectious diseases across the African continent. Despite being very challenging to implement across African countries, telehealth is a critical solution to offer healthcare services during disease outbreaks. Many African countries have faced challenges in the fight against COVID-19. The training of healthcare workers (HCWs) must be strengthened to help address the shortage. In addition, African countries should strive to invest in research and capacity-building to be self-reliant regarding diagnostic tests. Thus, there is an urgent need to address the challenges faced by African countries in this fight, which may even include increased collaborations with other countries.

关键词： Africa African Countries Challenges COVID-19 COVID-19 Vaccines Pandemic Telehealth Vaccination

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