Background Many people are used to administering their drugs with food, beverages or herbs. These substances may contain chemicals that interfere with the prescribed drugs and could potentially lead to changes in their efficacy or safety, and could result in alterations in their pharmacokinetic properties. Objective To assess the extent of the perception and consumption of food, beverages and herbs alongside conventional drugs, along with their potential interactions, specifically in Jordanian society. Methods A descriptive cross‐sectional survey was conducted in Jordan (20 April ‐ 5 May 2020). The survey was developed using Google Forms, then validated and distributed via social media platforms. Data were analysed using Statistical Package for Social Sciences‐24. Main outcome measure Use and perception of food, beverages, herbs and how they interact with drugs among Jordanians. Results Of all the participants (n = 789), 77.8% were females, 46.2% were 50‐year‐olds, 69.7% were married, 70.8% were medically insured, and 51.1% had bachelor's degrees. 70% of the study participants reported use of medicinal plants. About 66% of participants agreed that medicinal plants or herbs could treat diseases and 58.6% thought that medications could interact with drugs. In general, the participants’ knowledge about food/beverage/herb–drug interactions was considered poor. However, a linear regression analysis showed that the level of knowledge was significantly affected (P < .05) by gender, marital status, social status, educational level and employment sector. Conclusion Jordanians have a positive perception towards herbs and their ability to treat diseases. However, their knowledge about food/beverage–drug interactions was poor. There is therefore a need to enhance the community awareness of food/beverage/herb–drug interactions.
Artemether-lumefantrine is often coadministered with efavirenz-based antiretroviral therapy for malaria treatment in HIV-infected women during pregnancy. Previous studies showed changes in lumefantrine pharmacokinetics due to interaction with efavirenz in nonpregnant adults. The influence of pregnancy on this interaction has not been reported. This pharmacokinetic study involved 35 pregnant and 34 nonpregnant HIV-malaria-coinfected women receiving efavirenz-based antiretroviral therapy and was conducted in four health facilities in Nigeria. Participants received a 3-day standard regimen of artemether-lumefantrine for malaria treatment, and intensive pharmacokinetic sampling was conducted from 0.5 to 96 h after the last dose. Plasma efavirenz, lumefantrine, and desbutyl-lumefantrine were quantified using validated assays, and pharmacokinetic parameters were derived using noncompartmental analysis. The median middose plasma concentrations of efavirenz were significantly lower in pregnant women ( = 32) than in nonpregnant women ( = 32) at 1,820 ng/ml (interquartile range, 1,300 to 2,610 ng/ml) versus 2,760 ng/ml (interquartile range, 2,020 to 5,640 ng/ml), respectively ( = 0.006). The lumefantrine area under the concentration-time curve from 0 to 96 h was significantly higher in pregnant women ( = 27) at 155,832 ng · h/ml (interquartile range, 102,400 to 214,011 ng · h/ml) than nonpregnant women at 90,594 ng · h/ml (interquartile range, 58,869 to 149,775 ng · h/ml) ( = 0.03). A similar trend was observed for the lumefantrine concentration at 12 h after the last dose of lumefantrine, which was 2,870 ng/ml (interquartile range, 2,180 to 4,880 ng/ml) versus 2,080 ng/ml (interquartile range, 1,190 to 2,970 ng/ml) in pregnant and nonpregnant women, respectively ( = 0.02). The lumefantrine-to-desbutyl-lumefantrine ratio also tended to be lower in pregnant women than in nonpregnant women ( = 0.076). Overall, pregnancy tempered the extent of efavirenz-lumefantrine interactions, resulting in increased lumefantrine exposure. However, any consideration of dosage adjustment for artemether-lumefantrine to enhance exposure in this population needs to be based on data from a prospective study with safety and efficacy endpoints.
Ebola virus disease (EVD) is a rare but highly contagious and lethal disease that occurs predominantly in African countries, with a case-fatality rate of 30–90%. The causative viral pathogens of EVD are within the genus Ebolavirus in the family Filoviridae. The primary route of human-to-human transmission is through direct contact with blood, bodily fluids and secretions from infected individuals. Direct contact with virally contaminated objects and sexual transmission have also been reported. Management of EVD is aggressive supportive care with possibly new therapeutic options. On 20 September 2022, an EVD outbreak was declared in Uganda, caused by Sudan ebolavirus. As of 7 November 2022, a total of 136 confirmed cases, 53 confirmed deaths have been reported, including 18 cases with seven deaths among healthcare workers. In the Democratic Republic of Congo (DRC), an EVD outbreak was also declared on 22 August 2022 (which ended on 27 September 2022); with only one case, a middle-aged woman. At the time when most countries in the world have been occupied with the coronavirus disease 2019 (COVID-19) pandemic and the recent human monkeypox outbreak, these two outbreaks of EVD have the potential to significantly add to the burden on global health. Authorities need to augment their multi-faceted response, including stringent contact tracing and border control, to avoid the catastrophe of the 2014–2016 EVD epidemic.
Background Human trafficking is considered a hidden global crime with unsubstantiated numbers. Despite the challenges in counting or measuring this crime, reports revealed the presence of around 40.3 million victims worldwide. Human trafficking results in severe detrimental impacts on both mental and physical health. Given the sensitivity and negative consequences of human trafficking on the global system and victims, and considering the scarce research in this area, our current study aimed at describing the (i) Sociodemographic profiles of anonymized victims, (ii) Means of control, and (iii) Purpose of trafficking, utilizing the largest anonymized and publicly available dataset on victims of human trafficking. Methods This is a retrospective secondary analysis of the Counter-Trafficking Data Collaborative (CTDC) data pool in the period from 2010 to 2020. The utilized dataset is called the k-anonymized global victim of trafficking dataset, and it is considered the largest global dataset on victims of human trafficking. Data from the k-anonymized data pool were extracted and exported to Statistical Package for Social Sciences, SPSS® version 27.0 for Windows (IBM Corp. Version 27.0. Armonk, NY) for quality check and analysis using descriptive statistics. Results A total of 87003 victims of human trafficking were identified in the period from 2010 to 2020. The most age category encountered among victims was 9–17 years with 10326 victims (11.9%), followed by 30–38 years with 8562 victims (9.8%). Females comprised 70% of the sample with 60938 victims. The United States (n = 51611), Russia (n = 4570), and the Philippines (n = 1988) comprised the most countries of exploitation/trafficking. Additionally, the year 2019 witnessed the greatest number of victims registered for assistance by anti-trafficking agencies with around 21312 victims (24.5%). Concerning means of control, threats, psychological abuse, restriction of the victim’s movement, taking the victim’s earnings, and physical abuse were the most reported means. 42685 victims (49.1%) reported sexual exploitation as the purpose of their trafficking, followed by forced labor with 18176 victims (20.9%). Conclusion Various means and methods can be used by traffickers to control the victims to be trafficked for many purposes, with sexual exploitation and forced labor being the most common ones. Global anti-trafficking efforts should be brought together in solidarity through utilizing the paradigm of protection of victims, prosecution of traffickers, prevention of trafficking, and inter-sectoral partnerships. Despite being a global concern with various reports that tried to capture the number of trafficked victims worldwide, human trafficking still has many unseen aspects that impose a significant challenge and adds to the global burden in combatting this threat.
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