BackgroundDrug-Resistant tuberculosis (DR-TB) is estimated to cause about 10% of all TB related deaths. There is dearth of data on determinants of DR-TB mortality in Nigeria. Death among DR-TB treated cohorts in Nigeria from 2010 to 2013 was 30%, 29%, 15% and 13% respectively. Our objective was to identify factors affecting survival among DR-TB patients in northern Nigeria.MethodsDemographic and clinical data of all DR-TB patients enrolled in Kano, Katsina and Bauchi states of Nigeria between 1st February 2015 and 30th November 2016 was used. Survival analysis was done using Kaplan-Meier and multiple regression with Cox proportional hazard modeling.ResultsMean time to death during treatment is 19.2 weeks and 3.9 weeks among those awaiting treatment. Death was recorded among 38 of the 147 DR-TB patients assessed. HIV co-infection significantly increased probability of mortality, with an adjusted hazard ratio (aHR) of 2.35, 95% CI: 1.05–5.29, p = 0.038. Treatment delay showed significant negative association with survival (p = 0.000), not starting treatment significantly reduced probability of survival with an aHR of 7.98, 95% CI: 2.83–22.51, p = 0.000. Adjusted hazard ratios for patients started on treatment more than eight weeks after detection or within two to four weeks after detection, was beneficial though not statistically significant with respective p-values of 0.056 and 0.092. The model of care (facility vs. community-based) did not significantly influence survival.ConclusionBoth HIV co-infected DR-TB patients and DR-TB patients that fail to start treatment immediately after diagnosis are at significant risk of mortality. Our study showed no significant difference in mortality based on models of care. The study highlights the need to address programmatic and operational issues pertaining to treatment delays and strengthening DR-TB/HIV co-management as key strategies to reduce mortality.

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Clerodendrum capitatum (Willd) Schumach and Thonn. (Verbenaceae) is a perennial herb, which grows up to 0.5 m to 2 m high. It is widespread over North-East, East, and South Central Africa. It is known as “bambaro or maashayi” by the Hausas of Northern Nigeria. The leaves are used traditionally to treat intercostal pain, headaches and toothaches. The aim of this study is to evaluate the anti-inflammatory and analgesic activities of the aqueous ethanol extract and fractions of C. capitatum. The anti-inflammatory activity was investigated using carrageenan induced rat paw oedema model, while acetic acid induced mice writhing model was used to evaluate the anti-nociceptive property. The oral median lethal dose values were found to be greater than 5,000 mg/kg for the aqueous ethanol extract, ethyl acetate and n-butanol fractions, while that of dichloromethane fraction was less than 2000 mg/kg using OECD method. The acetic acid induced writhing was significantly (P<0.05-0.001) reduced particularly for the EF and NF fractions at 200 mg/kg (93.12% and 98.79%). DF showed percentage inhibition of 87.59% and 81.75% at 50 and 100 mg/kg respectively. The extracts and fractions also caused a significant (P<0.05-0.001) dose dependent reduction of inflammation induced by carrageenan when compared with the negative control with the maximum inhibitory effect of 43.69% observed in Ethyl acetate fraction at 50 mg/kg dose at the 3rd hour. It can be concluded that the leaf extracts of C. capitatum possess anti-inflammatory and analgesic effects in animal models, which may be mediated through the phytochemical constituents present in the extract and fractions of the plant. Keywords: Clerodendrum capitatum; Anti-inflammatory; Analgesic; OECD

The COVID-19 pandemic has impacted on several aspects of human existence including primary care research activities in resource-limited settings. Opportunities exist for initiating multi-disciplinary collaborative research teams that may examine current controversial areas of the disease such as prevention, diagnosis and treatment; experiences of stakeholders like COVID-19 survivors and frontline health workers; and individuals and community experiences during lockdowns. Challenges associated with initiating new studies and/or sustaining old ones and publication of research outcomes may need to be curtailed through alternative strategies and support from stakeholders.