Infection with Onchocerca volvulus was recently reported to increase the risk for epilepsy in Cameroonian children. We investigated whether infection with O. volvulus may alter the cognitive function of children who may or may not develop epilepsy later in their lifetime. Using rapid diagnostic tests, we determined the presence of Ov16 antibodies in 209 school-aged children without epilepsy recruited from three Cameroonian villages, as a proxy for onchocerciasis exposure. In addition, the neurocognitive performance of these children was assessed using a battery of validated tools. Participants were aged 6–16 years, and 46.4% were Ov16 seropositive. Upon standardizing age-specific neurocognitive scores and investigating predictors of neurocognitive performance using multiple linear regression models (adjusted for gender, education level, previous ivermectin use, and anthropometric parameters), we found that being Ov16-positive was significantly associated with reduced semantic verbal fluency (estimate –0.38; 95% confidence interval –0.65 to –0.11; p = 0.006) and lower scores on the International HIV Dementia Scale (estimate –0.31; confidence interval –0.56 to –0.04; p = 0.025). Furthermore, an increasing frequency of past ivermectin use was associated with increased neurocognitive scores. Our findings suggest that exposure to O. volvulus may affect neurocognitive performance of children.
Recently, there were anecdotal reports of a high number of persons with epilepsy, including children with nodding seizures in the Landja Mboko area located about 9 km from the capital city Bangui, Central African Republic. We suspected the area to be endemic for onchocerciasis, and that the alleged increase in the number of epilepsy cases was due to ongoing Onchocerca volvulus transmission. However, ivermectin mass drug distribution (MDA) had never been implemented in the area. Therefore we performed an Ov16 antibody prevalence study among children, aged 6–9 years, using the biplex rapid diagnostic test (SD Bioline Oncho/LF biplex IgG4 RDT). The overall Ov16 seroprevalence was 8.9%, and that of lymphatic filariasis (LF) was 1.9%. Ov16 seropositivity was highest in Kodjo (20.0%), a village close to rapids on the river. Our study shows that there is ongoing O. volvulus transmission in the Landja Mboko area. We recommend that the extent of this onchocerciasis focus should be mapped, and the introduction of ivermectin MDA should be considered in these communities.
Introduction: Improved Traditional Medicines (ITMs), a recent concept by the World Health Organization (WHO) was introduced to promote the rational use of herbal medicine for primary health care in developing countries. The ITM by WHO andAIPO have categorized into 4 categories with respect to the quality of the active ingredient. However, this category needs more research in finding a greater variety of acceptable dosage forms. There is a need to account for formulation and process variables in these dosage forms to maintain product properties hence performance of plant extract, ensuring consistent quality. One of the methods to account for formulation and process variables is by using the Design of Experiments (DoE) approach. Objective: The main objective of this work was to optimize the formulation of a category 2 Improved Traditional Medicine containing Mangifera indica L. stem bark aqueous extract using Design of Experiments. Methods: Mangifera indica L. stem bark was collected and identified at the National herbarium. It was dried, ground and the powder used for extraction using digestion method using water as solvent (at 70°C). Phytochemical screening was done on the extract. The extract then proceeded unto pharmaceutical development. The formulation optimization of Mangifera indica aqueous stem bark extract (MIABE) started with the definition of the Quality Target Product Profile (QTPP) that was expected for the final product; which is an orodispersible tablet that will facilitate patient compliance and promote a rapid disintegration. These QTPPs formed the basis of the Critical Quality Attributes (CQAs) which were identified (as hardness, disintegration time and mass uniformity) and used for all experiments. The experimental part was divided into 2 main manufacturing processes; direct compression and wet granulation techniques. Each process was investigated for drug product optimization. A risk assessment was undertaken to identify the formulation variables that impact product quality. For direct compression, a 32 full factorial Design of Experiment (DoE) was used to investigate the effect of superdisintegrant (25%) and lubricant level (0.25-5%) on powder flow characteristics. For wet granulation, a 22 full factorial DoE was used to investigate the effect of superdisintegrant (2-5%) and binder (5-10%) on flow properties and tablet properties. Results: The design and evaluation of the formulations in this study resulted in successful formulation optimization of an Improved Traditional Medicine. DoE proved to be an excellent method to optimize formulations of ITMs, providing several tools that increase a much better understanding of the formulation and manufacturing process. Further studies on this formulation DoE are needed to evaluate the effect of more process variables (compression force and speed) and more formulation variables such as palatability. Conclusion: Optimization models were developed for the various responses (disintegration time, wetting time and hardness) showing the influence of formulation variables on these responses. Therefore, the formulation optimization of a category 2 ITM containing Mangifera indica L. stem extract using Design of Experiment is a suitable approach to save time, money and improve drug product understanding.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.