Preliminary Study on Open Labelled Randomized Controlled Trial of the Safety and Efficacy of Hydroxychloroquine and Chloroquine Phosphate for the Treatment of Persons Infected with 2019 Coronavirus Disease in Nigeria

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a causative agent of COVID-19 is a leading cause of ill-health and deaths worldwide. Currently, COVID-19 has no known widely approved therapeutics. Thus, the need for effective treatment.

OBJECTIVES

We investigated the safety and efficacy of two (2) therapeutic agents; chloroquine phosphate (CQ), 2- hydroxychloroquine (HCQ) and a control (standard supportive therapy) among hospitalized adults with COVID-19.

METHODS

The clinical trial was done in accordance to the World Health Organization master protocol for investigational therapeutics for COVID-19. Atotal of 40 participants with laboratory-confirmed positive COVID-19 were enrolled. Blood samples and oropharyngeal (OP) swabs were obtained on days 1,3,15 and 29 for safety and efficacy assessments.

RESULTS

The baseline demographics showed that the median ages in years (range) were 45 (31-57) in CQ, 45 (36.5-60.5) in HCQ, 43 (39.5-67.0) and 44.5 (25.3-51.3) in the control (P<0.042).At randomization, seven (7) participants were asymptomatic, thirty-three (33) had mild symptoms, eight (8) had moderate symptoms while three (3) had severe symptoms. The average day of conversion to negative COVID-19 was 15.5 days for CQ, 16 days for HCQ and 18 days for the control(P=0.036).

CONCLUSION

The safety assessment revealed no adverse effect of the drugs in COVID-19 patients after treatment. These findings proved that chloroquine and hydroxychloroquine are effective for the treatment of COVID-19 among hospitalized adults. It also confirmed that they are safe.

Efficacy of Hexetidine, Thymol and Hydrogen Peroxide-Containing Oral Antiseptics in Reducing Sars-Cov-2 Virus in the Oral Cavity: A Pilot Study

BACKGROUND

Studies have demonstrated the role of sputum as a site of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2) transmission. However, there is limited literature on the virucidal efficacy of oral antiseptics against SARS-CoV-2 virus. This study investigated the virucidal efficacy of three oral-antiseptics compared to a placebo-control in the sputum of SARS-CoV-2 infected individuals.

METHODOLOGY

A pilot study of adults with SARS-CoV-2 positive results, as determined by reverse transcription-polymerase chain reaction (RT-PCR) of <7 days. The oral antiseptics investigated were: Hexetidine (0.1% w/v); Thymol (0.063% w/v) and H2O2(1.5%) compared to de-mineralized sterile water (Placebo-control). The primary outcome measure was the proportion of negative RT-PCR results at 15-mins, 30-mins, 1-hour, 2-hours and 4-hours After Oral antiseptics Interventions (AOI) compared to the placebo-control. Statistical analysis was done using STATA 15.0 software with p-values of <0.05 considered statistically significant.

RESULTS

Data from a total of 66 participants that were RT-PCR SARS-CoV-2 positive at baseline (0-min) was analysed. At 15-mins AOI, the highest proportion of negativation from sputum samples was observed in the Hexedine group, with 69.2% of the baseline PCR positive cases converting to negative compared to 46.7% in the placebo-control group. In addition, H2O2 demonstrated efficacy at 2-hours AOI compared to placebo-control (62.5% vs 37.5% respectively) and other oral-antiseptics. Across all time-points, the oral-antiseptic groups compared to the placebo-control group, there was no statistically significant difference in the proportion of sputum samples which converted to a negative status (p>0.05).

CONCLUSION

The findings in this study suggest there was no significant difference in the proportion of participants who converted to a negative sputum status across the treatment groups at various time points. Future studies could compare the cycle threshold (ct) viral titre values of sputum samples to determine quantitative differences.

Implementation of a modified drive-through sampling strategy for SARS-CoV-2-the Nigerian experience

Introduction:

effective and safe means of sample collection is a crucial component of testing for Covid-19. Uptake of testing is key to containing and controlling the spread of the virus. Scientists have been working on various strategies that will increase the uptake of testing for COVID-19. One such method involves the use of the drive-through sampling strategy.

Methods:

data was collected by both qualitative and quantitative methods. An eligibility form was filled online. While in-depth interviews were conducted for the qualitative aspect of the study.

Results:

2,600 visits were recorded at the website, 2300 (88.46%) participants successfully registered for the test. 57.4% were found eligible of which 78.0% presented for the test. This Consisted of 78.0% drive-through and 22.0% walk-in. The average time for transiting through the drive-through site was 19.2 ± 4.6minutes while that of the walk-in was 28 ± 9.2min. This difference was statistically significant (p<0.001). In the qualitative component, respondents opined that maximum safety measures were deployed to protect both participants and health workers. Most said that the turnaround time for the sampling process was short.

Conclusion:

the sampling strategy although largely successful, is largely dependent on Internet penetrability, thus this sampling modality will be best utilized as an adjunct to established models of sample collection.

A possible case of renal oxalate deposit reported in an African fruit bat (Epomops franqueti)

We report a possible spontaneous case of oxalate nephrosis in an African fruit bat (Epomops franqueti), incidentally observed in Ibadan, South-West Nigeria, in an anatomical and serological survey of the species. Wild caught bats underwent sedation, intracardial perfusion, necropsy and histopathology. All 15 wild-caught African fruit bats were apparently healthy. However, light microscopy revealed mild oligofocal tubulonephrosis with intraluminal deposition of polarizing crystals interpreted as subclinical oxalate nephrosis in one case. In summary, we suggest a dietary aetiology, based on seasonal availability of high ascorbic acid or oxalate containing fruits. However, exposure to anthropogenic contaminants cannot be completely ruled out.

Age related Histology and Immunohistochemistry of some intermediate filaments in the Testis of the African Catfish (Clarias gariepinus)

The African Catfish (Clarias gariepinus) are important source of protein for local consumers in developing countries in Africa and have also been reported to have enormous commercial potential. Several works have been done on plethora of general histological, biochemical and hormone changes which accompany puberty in African Catfish. Other studies have touched the effects of ecotoxins on the histological and reproductive parameters of the mature African Catfish. This study is an attempt to use immunohistochemical and basic histology to elucidate the baseline information on the general structural differences between the testes of immature and post-pubertal catfish with respect to some intermediate filaments arrangement within the testicular tissue. Ten (10) each of mature male catfish (4-5 months old) and immature male catfish (3 months old) were used in the study. The fish were subjected to cold shock and decapitated before the testes were harvested from both groups. These tissues were fixed in Bouins fluid for 24 hours and subsequently transferred into 70% Ethanol. Testicular tissues from both groups were processed for paraffin embedding for routine staining. Another set of tissues were fixed in Neutral Buffered Formalin for testicular immunostaining techniques for expression of Vimentin, Desmin, Cytokeratin and Smooth Muscle Actin. There is an increase in seminiferous luminal area in the mature catfish testis with the presence of mature spermatozoa in the lumen when compared with immature catfish testis which has small size of lumen with absence of mature spermatozoa. Testicular interstitium thickness remain relatively unchanged. SMA was markedly expressed in the cytoplasm of interstitial Leydig cells in the immature catfish testis whereas it was weak in its expression in the mature catfish. However, SMA was not expressed in the connective tissue proper in the testicular interstitium. Cytokeratin expression was also marked in the testicular capsule of immature catfish but was weak to absent in the mature catfish, however, both mature and immature catfish had moderate cytokeratin expression in their seminiferous tubule basement membrane. Desmin was strongly expressed in cytoplasm of immature germinal cells in the immature catfish testis but was moderate in its expression in the mature catfish testis. Vimentin expression was marked in the cytoplasm of immature germinal cells in both immature and mature catfish testis but weak in its expression in the Sertoli cell cytoplasm of both groups. This study infers that ultra-structural and protein changes can be related to age changes alone apart from the contribution of seasonality and external interference by ecotoxins. The age-related changes seen in this study could set ``baseline information. The extent of contribution of season and other external factors will be better understood. Though the age-related difference might be peculiar to the species of current interest, the differences elucidated are a sound background for relational studies, especially on the effect of ecologic toxins on immature testis, as separate from the mature testis.

A barcode of multilocus nuclear DNA identifies genetic relatedness in pre- and post-Artemether/Lumefantrine treated Plasmodium falciparum in Nigeria

BACKGROUND

The decline in the efficacy of artemisinin-based combination treatment (ACT) in some endemic regions threatens the progress towards global elimination of malaria. Molecular surveillance of drug resistance in malaria-endemic regions is vital to detect the emergence and spread of mutant strains.

METHODS

We observed 89 malaria patients for the efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum infections in Lagos, Nigeria and determined the prevalence of drug resistant strains in the population. Parasite clearance rates were determined by microscopy and the highly sensitive var gene acidic terminal sequence (varATS) polymerase chain reaction for 65 patients with samples on days 0, 1, 3, 7, 14, 21 and 28 after commencement of treatment. The genomic finger print of parasite DNA from pre- and post-treatment samples were determined using 24 nuclear single nucleotide polymorphisms (SNP) barcode for P. falciparum. Drug resistance associated alleles in chloroquine resistance transporter gene (crt-76), multidrug resistance genes (mdr1-86 and mdr1-184), dihydropteroate synthase (dhps-540), dihydrofolate reductase (dhfr-108) and kelch domain (K-13580) were genotyped by high resolution melt analysis of polymerase chain reaction (PCR) fragments.

RESULTS

By varATS qPCR, 12 (18.5%) of the participants had detectable parasite DNA in their blood three days after treatment, while eight (12.3%) individuals presented with genotypable day 28 parasitaemia. Complexity of infection (CoI) was 1.30 on day 0 and 1.34 on day 28, the mean expected heterozygosity (HE) values across all barcodes were 0.50 ± 0.05 and 0.56 ± 0.05 on days 0 and 28 respectively. Barcode (π) pairwise comparisons showed high genetic relatedness of day 0 and day 28 parasite isolates in three (37.5%) of the eight individuals who presented with re-appearing infections. Crt-76 mutant allele was present in 38 (58.5%) isolates. The mdr1-86 mutant allele was found in 56 (86.2%) isolates. No mutation in the K-13580 was observed.

CONCLUSIONS

Persistence of DNA-detectable parasitaemia in more than 18% of cases after treatment and indications of genetic relatedness between pre- and post-treatment infections warrants further investigation of a larger population for signs of reduced ACT efficacy in Nigeria.

Oxidative stress and micronutrient therapy in malaria: an in vivo study in Plasmodium berghei infected mice

Free radical production from oxidative stress induced by malaria infection plays a major role in the pathogenesis of malaria. However, the use of agents with antioxidant activity may interfere with malaria progression. The study involves an in vivo evaluation of the role of some antioxidant micronutrients in the modulation of malaria infection. Rodent malaria model using Plasmodium berghei NK-65 strain (chloroquine sensitive) was used for the study. Forty five mice of either sex weighing 20.05 +/- 0.02 g were procured for the study. Forty mice were inoculated intraperitoneally with 1 x 10(7) million Plasmodium berghei infected erythrocyte and were administered with 0.2 mL of distilled water, 0.2 mL of vehicle; Tween 80 (control and vehicle group), chloroquine 25 mg kg(-1) and artesunate 4 mg kg(-1) (standard drug group), vitamin A 60 mg kg(-1), vitamin E 100 mg kg(-1), selenium 1 mg kg(-1), zinc 100 mg kg(-1) (test group F, G, H and I, respectively) 72 hours post inoculation. Antioxidant micronutrients demonstrated significant (p < 0.05) schizonticidal activity when compared with negative control during the 4 day curative test. Erythrocyte membrane disability was most markedly elevated in the tween 80 group (426.15%), followed closely by the chloroquine (373.85%) treated group and artesunate group (329.23%) and least in the zinc treated group (32.31%). There was no significant (p > 0.05) difference in MCFI values (0.115 +/- 0.002; 0.114 +/- 0.002 g dL(-1)) between vitamin A treated group and selenium treated group respectively. However, this was significant (p < 0.05) between the micronutrient treated groups and the control (negative, positive and vehicle). Conclusively, antioxidant micronutrients have antimalarial activity which may be due potentiation of erythrocyte membrane stabilization.

Effect of soil moisture stress on growth and yield of cassava in Nigeria

Nine cassava genotypes were evaluated for their growth responses and adaptability to soil moisture stress on the field and in the screenhouse in Nigeria. Genotypes were evaluated in three savanna agroecologies in a randomized complete block design with three replicates. Screenhouse evaluation was conducted using three moisture regimes of 75, 50 and 25% Field Capacity (FC) in a two-factor factorial experiment in CRD with three replicates. Morphological and yield data were collected on the field and in the screenhouse. Results showed significant (p < 0.05) difference among genotypes on the field and in the screenhouse. Field moisture stress led to a decline in plant height by 47%, stem girth by 15%, number of tubers by 95% and tuber yield by 87%. Screenhouse moisture condition of 25% FC led to a reduction in plant height by 12.6 and 21.2%, stem girth by 16.3 and 21.7%, number of roots by 94.5 and 88.7% and root weight by 93.3 and 94.9%, respectively at 16 and 30 WAP. Moisture stress therefore resulted into considerable reduction in both vegetative growth and yield of cassava genotypes. Therefore, a concerted effort in breeding cassava for drought tolerance is needed as cassava cultivation is expanding into nontraditional semiarid regions of sub-Saharan Africa. Germplasm introduced from Latin America (especially north-eastern Brazil) is providing a unique source of variability to further broaden the genetic base for drought tolerance in cassava.