Background Global HIV funding cutbacks have been accompanied by the adoption of user fees to address funding gaps in treatment programs. Our objective was to assess the impact of user fees on HIV care utilization and medication adherence in Nigeria. Methods We conducted a retrospective analysis of patients enrolled in care before (October 2012-September 2013) and after (October 2014-September 2015) the introduction of user fees in a Nigerian clinic. We assessed pre-vs. post-user fee patient characteristics and enrollment trends, and determined risk of care interruption, loss to follow-up, and optimal medication adherence. Results After fees were instituted, there was a 66% decline in patient enrollment and 75% decline in number of ART doses dispensed. There was no difference in the proportion of female clients (64% vs 63%, p = 0.46), average age (36 vs. 37 years, p = 0.15), or median baseline CD4 (220/ul vs. 222/uL, p = 0.24) in pre-and post-fee cohorts. There was an increase in clients employed and/or had tertiary education (24% vs. 32%, p<0.001). Compared to pre-fee
Alchornea cordifolia Müll. Arg. (commonly known as Christmas Bush) has been used traditionally in Africa to treat sickle cell anaemia (a recessive disease, arising from the S haemoglobin (Hb) allele), but the active compounds are yet to be identified. Herein, we describe the use of sequential fractionation coupled with in vitro anti-sickling assays to purify the active component. Sickling was induced in HbSS genotype blood samples using sodium metabisulphite (Na2S2O5) or through incubation in 100% N2. Methanol extracts of A. cordifolia leaves and its sub-fractions showed >70% suppression of HbSS erythrocyte sickling. The purified compound demonstrated a 87.2 ± 2.39% significant anti-sickling activity and 93.1 ± 2.69% erythrocyte sickling-inhibition at 0.4 mg/mL. Nuclear magnetic resonance (NMR) spectra and high-resolution mass spectroscopy identified it as quercitrin (quercetin 3-rhamnoside). Purified quercitrin also inhibited the polymerisation of isolated HbS and stabilized sickle erythrocytes membranes. Metabolomic comparisons of blood samples using flow-infusion electrospray-high resolution mass spectrometry indicated that quercitrin could convert HbSS erythrocyte metabolomes to be like HbAA. Sickling was associated with changes in antioxidants, anaerobic bioenergy, and arachidonic acid metabolism, all of which were reversed by quercitrin. The findings described could inform efforts directed to the development of an anti-sickling drug or quality control assessments of A. cordifolia preparations.
The antibacterial activities of the clove essential oil (C), turmeric essential oil (T) as well as clove and turmeric (CT) essential oil were analysed against some bacterial pathogens implicated in periodontal diseases using agar well diffusion. The bacteria include Klebsiella oxytoca, Bacillus subtilis, Pseudomonas flourescens, Pseudomonas aeruginosa, Klebsiella oxytoca, Enterobacter sp., Proteus mirabilis and Escherichia coli. At 15% concentration of the essential oils, both clove essential oil and the essential oil of clove and turmeric (CT) exhibited pronounced and varying degrees of growth inhibition zones against the bacteria (8.3+/-0.33-22.6+/-1.53 and 7.3+/-0.33-22.3+/-1.45). The MIC value for clove essential oil, tumeric essential oil and clove and turmeric (CT) essential oils ranges from 0.9-7.5%, respectively. The result shows that in general, clove essential oil has significantly greater zone of inhibition (mean) than tumeric essential oil. The bactericidal rate of clove essential oil against Klebsiella oxytoca and Bacillus subtilis was also determined. From our study, we can conclude that clove essential oil has more prevailing and sustainable antibacterial properties than turmeric essential oil even at a considerable low percentage. We recommend that clove essential oil not only has very promising potential for a broad-spectrum antibiotic drug against periodontal pathogenic bacteria. In addition, it can be used as an effective source of natural herbal antibiotics.
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