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Formulation and Assessment of the Efficacy and Stability of an Ointment Containing Ocimum americanum ***

Clinical Complementary Medicine and Pharmacology 2023年第1期3卷 62-72页

作者： Nakamwi Akombaetwa lungwani tyson muungo James Nyirenda Sergio Muwowo Aubrey Kalungia Chichonyi Moses Mukosha Chiluba Mwila Department of Pharmacy School of Health SciencesUniversity of ZambiaLusaka 10101Zambia Department of Chemistry School of Natural SciencesUniversity of ZambiaLusaka 10101Zambia Histopathology Department University Teaching HospitalLusaka 10101Zambia

Background:Ocimum americanum *** an annual herbaceous plant used to manage pain and *** of standard dosage forms,and safety and efficacy data potentially exposes users of this medicinal plant to the risk of toxic or sub-therapeutic effects,as well as drug-herb ***:The study developed a standard dosage form containing *** extract and assessed its anti-inflammatory efficacy and ***:The fusion method was used to formulate an ointment comprising acetone extract,beeswax,and *** optimization involved the application of Box-Behnken Design(BBD)to design an exper-iment whose input variables were%beeswax and%soft-paraffin and its melting *** variables were drug release and viscosity which were quantified using a vertical diffusion cell(VDC)and stanhope-seta viscometer,*** albino rats were used in carrageenan-induced rat hind paw edema(n=6/test,positive and negative control)to assess the anti-inflammatory *** studies comprised assessment of spreadability,thin layer chromatograms(TLC),and microbial growth in ointment batches stored at 25±2℃/60±5%RH and 40±2℃/75±5%***:Temperature and%beeswax significantly influenced drug release(P=0.0024).Optimal drug release and viscosity were obtained at 5.4%beeswax,89.6%soft-paraffin melted at 58℃.The predominant drug release mechanism was Higuchi(R^(2)=0.967±0.023),which implied longer contact between formulation and skin favours drug *** of edema by the ointment was comparable to 1%(w/w)diclofenac gel(t=2.1;CI=(-8.29)-1.15),and both differed significantly with negative control(t=11.3 and 13.4;CI=14.5-23.9 and 18.1-27.5 respectively).Insignificant changes in spreadability(P=0.112),absence of new spots on chromatograms,and deficiency of microbial colonies on agar plates implied physical,chemical,and microbial stability,***:A formulated ointment containing *** extract ex

关键词： O.americanum Formulation optimization Anti-inflammatory Stability

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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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Antibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, Zambia

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Pharmacology & Pharmacy 2022年第10期13卷 379-392页

作者： Steward Mudenda Mary Chomba Billy Chabalenge Christabel Nang’andu Hikaambo Michelo Banda Victor Daka Annie Zulu Abraham Mukesela Maxwell Kasonde Peter Lukonde Enock Chikatula Lloyd Matowe Ronald Kampamba Mutati tyson lungwani muungo Tobela Mudenda Shafiq Mohamed Scott Matafwali Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Department of Public Health Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia Bell Pharmacy Kabulonga Centro Mall Lusaka Zambia Ministry of Health Headquarters Ndeke House Lusaka Zambia Department of Pharmacy Levy Mwanawasa University Teaching Hospital Lusaka Zambia Faculty of Pharmacy School of Pharmacy Eden University Lusaka Zambia Department of Pathology Ndola Teaching Hospital Ndola Zambia Remedium Pharmaceuticals Limited Lusaka Zambia Clinical Research Department Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine London UK

Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely;Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.

关键词： Antibiotic Prescribing Antimicrobial Resistance Antimicrobial Stewardship AWaRe Classification Prescribing Patterns Primary Healthcare Surveillance Zambia

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Psychological Impact of COVID-19 on Healthcare Workers in Africa, Associated Factors and Coping Mechanisms: A Systematic Review

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Advances in Infectious Diseases 2022年第3期12卷 518-532页

作者： Steward Mudenda Billy Chabalenge Scott Matafwali Victor Daka Misheck Chileshe Webrod Mufwambi Ruth Lindizyani Mfune Josephine Chali Mukuka Chomba Michelo Banda Racheal Mwaweza Ronald Kampamba Mutati tyson lungwani muungo John Balidawa Christabel Nang’andu Hikaambo James Mwanza Maisa Kasanga Shafiq Mohamed Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia 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 United Kingdom Department of Public Health Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia MaryBegg Health Services Ndola Zambia Faculty of Paediatrics and Child Health Lusaka College of Nursing Lusaka Zambia Unicaf University Kampala Uganda Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia College of Public Health Zhengzhou University Zhengzhou China Department of Pathology and Microbiology University Teaching Hospitals Lusaka Zambia Remedium Pharmaceuticals limited Salama Park Lusaka Zambia

Background: The coronavirus disease 2019 (COVID-19) is a public health problem that has caused harm to the mental health of healthcare workers. In Africa, the COVID-19 pandemic has led healthcare workers to experience mental health disorders such as anxiety, depression, stress, insomnia and burnout. This study aimed to review published studies on the effect of COVID-19 on the mental health of healthcare workers, associated factors and coping strategies that have been employed in Africa. Methods: This was a systematic review that was conducted through searching databases including;PubMed/Medline and Google Scholar. The study included published literature from January 2020 to May 2022 that met the inclusion criteria. The selection of articles was conducted following the 2020 PRISMA guidelines. Results: A total of 39 articles were retrieved, of which only 18 met the inclusion criteria and were used in this study. Our review revealed that healthcare workers experienced mental health disorders such as anxiety, depression, insomnia, stress and burnout that were associated with the COVID-19 pandemic. Coping strategies such as religious practices, support from family members and colleagues and avoiding listening to social media about COVID-19 were used to minimize mental health problems. Conclusion: The COVID-19 pandemic has caused increased mental health disorders among healthcare workers in Africa. Identification of factors associated with mental health problems is cardinal in developing coping mechanisms against the psychological impact of COVID-19. Therefore, there is a need for governments to develop and implement strategies for protecting the mental health of healthcare workers during crises such as the COVID-19 pandemic.

关键词： Africa Coping Mechanisms COVID-19 Factors Healthcare Workers Mental Health Pandemic Psychological Impact

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