Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further.Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic.Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation.Results: One hundred and thirty one pharmacists took part building on the earlier studies across Asia. There were increases in the utilisation of principally antimalarials (hydroxychloroquine) and antibiotics (azithromycin) especially in Nigeria and Ghana. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in others through government initiatives. Suggestions in Namibia going forward included better planning and educating patients.Conclusion: Encouraging to see increases in the utilisation of vitamins/immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price rises. Community pharmacists and patient organisations can play key roles in providing evidence-based advice, helping moderate prices through improved stock management, and helping address unintended consequences of the pandemic.

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BackgroundInflammation has been implicated in many disorders, including cancer and available therapies elicit adverse effects. Plants of the family Rubiaceae have shown potency against inflammation. The anti-inflammatory and anti-oxidant potential of Feretia apodanthera was investigated in this study to evaluate its effectiveness.MethodsThe phytochemical, antioxidant and anti-inflammatory potential of root bark (n-Hexane, diethyl ether, ethanol and aqueous) extracts of Feretia apodanthera was investigated in this study. The extracts were subjected to various chemical tests for phytochemical constituents; their antioxidant activity was determined using in-vitro DPPH radical scavenging activity assay and their anti-inflammatory activity was determined using carrageenan induced paw oedema model. FTIR and GCMS analysis was done to determine the compounds present.ResultsPhytochemical screening of extracts revealed the presence of unsaturated steroids, triterpenes, cardiac glycosides, tannins, saponin and alkaloids. Vitamin C had a median inhibitory concentration (IC50) of 0.038 mg/ml which was lower than IC50 of all the extracts. Of all the extracts, ethanol extract had the lowest IC50 (0.044 mg/ml) which is comparable to vitamin C. Anti-inflammatory studies showed that the inflammation inhibition potential of 400 mg/kg body weight of all the extracts was significantly lower (p < 0.05) than the standard ketoprofen (50 mg/kg) at the first three hours but significantly higher (p < 0.05) at the fourth hour. At the fifth hour, the inflammation inhibition potential of diethyl ether, ethanol and aqueous extracts were significantly higher (p < 0.05) than that of the standard. FTIR analysis showed the presence of ketones, amines, alkenes and carboxylic groups. GCMS analysis revealed compounds that are potential anti-inflammatory agents.ConclusionThis study revealed that extracts of Feretia apodanthera possess anti-inflammatory effects against right hind paw oedema of albino rats and can act as an effective antioxidant.

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Background: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers.Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders.Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries.Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production.Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities.

IntroductionBlood transfusions remain a substantial source of HIV in SSA particularly among children and pregnant women. Aims and objectives: This aim of this retrospective study was to investigate the prevalence of p24 antigen among HIV antibody seronegative blood donors in Sokoto, North West Nigeria.MethodsA total of 15,061 HIV antibody negative blood donors with mean age and age range (29.2 ± 8.18 and 18-50 years) were screened for p24 antigen between January 2010 to July 2013 using the Diapro Diagnostic immunoassay kit for P24 antigen (King Hawk Pharmaceuticals Beijing China).ResultsThe overall prevalence of p24 antigen among the HIV antibody negative donors sample was 5.84%. The yearly prevalence was 9.79, 8.12, 2.7 and 2.84% respectively in 2010, 2011, 2012 and 2013. Of the total number of blood donor tested, 14,968 (99.38%) were males while 93 (0.62%) were females. The prevalence of P24 antigen was significantly higher among male blood donors 873 (5.8%) compared to females 7(0.05%), (p= 0.001). P24 positivity was significantly higher among blood group O blood donors compared to A, B and AB donors (494 (3.29%) compared to 184 (1.89%), 196 (1.30%) and 6 (0.04%)) respectively, p = 0.001). The prevalence of P24 antigen was significantly higher among Rhesus positive blood donors compared to Rhesus negative (807 (5.36%) versus 73 (0.48%), p =0.001).ConclusionBlood transfusion in Nigeria is associated with increased risk of HIV transmission. There is the urgent need to optimize the screening of blood donors in Nigeria by the inclusion of p24 antigen testing into the blood donor screening menu. The Nigerian government urgently need to adopt the WHO blood safety strategies to reduce the risk of transmission of HIV through blood transfusion.

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Kware Lake provides life to various forms of aqua flora and fauna, livelihood for fishermen community and food for the local populace. The study was conducted to evaluate nutrient dynamics of the lake's sediment for a period of 12 months (June 2014 to May 2015). Results reveal that some of the variables studied did not show any variation due to space and time but electrical conductivity (EC), phosphate (PO43-), potassium, sodium and clay texture were able to vary according to months, seasons and stations. They recorded range of 101.3-113 µs/cm, 0.97-1.24 g/Kg, 0.29-0.37 g/kg, 0.62-0.77 g/kg, and 13-14 g/kg respectively. Results therefore suggest and confirmed that sediment has a high accumulation of phosphate, due to decomposition on the sediment bed and low nitrate level in sediment than in surface water.