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Fekadu S, Kibru S, Tesfaye S, Egeno T, Tamiso A, Engiso H, Deyno S. Prevalence of Helicobacter pylori infection and effectiveness of first-line triple eradication therapy among dyspeptic patients at hospitals in Hawassa City, Ethiopia: a cross-sectional follow-up study. Gut Pathog 2024; 16:23. [PMID: 38678267 PMCID: PMC11056052 DOI: 10.1186/s13099-024-00618-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Dyspepsia is a common gastrointestinal illness sometimes associated with Helicobacter pylori (H. pylori) infection. Screening and eradicating the bacterium reduces the risk of infection-related complications. The aim of this study was to determine the magnitude of H. pylori infection among dyspeptic patients and the effectiveness of triple eradication therapy at hospitals in Hawassa city, Ethiopia. RESULTS The prevalence of H. pylori infection was 48.5%. The H. pylori eradication rate using first-line triple therapy was 83.8%. Eradication therapy failure is associated with previous exposure compared to no exposure (AOR: 4.8, 95% CI: 1.37-10.97), a regimen for 10-days compared to 14-days (AOR: 4.05, 95% CI: 1.42-11.55), and self-reported side effects compared to no report (AOR: 2.5, 95% CI: 1.12-5.97). Based on Morisky-eight scale 230 (79.0%) patients were adherent to their triple therapy. Participants with no reports of adverse effects showed increased odds of adherence to triple therapy compared to those who had reports (AOR = 2.45, 95% CI: 1.29-4.62). CONCLUSIONS This study demonstrated that about half of adult dyspeptic patients were infected with H. pylori, and moderate eradication was observed. Factors such as previous history of eradication therapy, duration of the eradication regimen, and perception of potential adverse effects are associated with eradication rate and should be considered during the initiation of eradication therapy.
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Affiliation(s)
- Sintayehu Fekadu
- School of Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia.
| | - Seyife Kibru
- Department of Internal Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Sisay Tesfaye
- Department of Internal Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Tariku Egeno
- Internal Medicine and Cardiology Unit, Abem Primary Hospital, P. O. Box 1162, Hawassa, Ethiopia
| | - Alemu Tamiso
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O. Box 1560, Hawassa, Ethiopia
| | - Hizkel Engiso
- School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Serawit Deyno
- School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
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Tuasha N, Fekadu S, Deyno S. Prevalence of herbal and traditional medicine in Ethiopia: a systematic review and meta-analysis of 20-year studies. Syst Rev 2023; 12:232. [PMID: 38093343 PMCID: PMC10717384 DOI: 10.1186/s13643-023-02398-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The widely accepted prevalence of traditional medicine (TM) in Ethiopia was about 80 %, of which 95 % were sourced from plants. The purpose of this study was to update knowledge of the prevalence of herbal medicine or TM in Ethiopia and describe the characteristics of the population mostly relying on herbal medicine or TM to inform health policy-makers. METHODS PubMed, Google Scholar, Hinari, Scopus, and the Directory of Open Access Journals (DOAJ) were searched. The methodological quality of each included study was assessed using the quality assessment checklist for prevalence studies. Meta-analysis was conducted using STATA version 17, and the heterogeneity between studies was assessed using I2 test statistics based on the random effect model. Forest and funnel plots were used to present the data. Subgroup analysis was done by the study population, region, and setting. RESULTS Thirty-six studies with a total of 16,288 participants met the inclusion criteria. Meta-analysis of the study revealed that the prevalence of herbal medicine use in Ethiopia is 46 % (95 % CI, 37-54 %), with significant heterogeneity among the studies (I2 = 99.19 %). Egger's test for publication bias of herbal medicine use revealed significant results (Egger, P = 0.002) which indicates possible missing of small sample size studies. The prevalence of TM use in Ethiopia is 65 % (95 % CI, 52-77 %) with significant heterogeneity among the studies (I2 = 99.18 %). Egger's test for publication bias of TM use revealed non-significant results (Egger, P = 0.275). The subgroup analysis by the study setting and the region revealed variability amongst the studies. Community-based studies and Oromia National Regional State showed higher prevalence. By population type, a higher prevalence of TM use was observed amongst children and lowest amongst malaria suspects. CONCLUSIONS The current study revealed that TM/herbal medicine utilization remained an important source of primary healthcare in Ethiopia. In comparison to the commonly reported prevalence of TM/herbal medicine, there is a considerable decline in TM/herbal medicine prevalence. High TM/herbal medicine use tendency during pregnancy necessitates safety studies to optimize the utilization.
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Affiliation(s)
- Nigatu Tuasha
- Department of Biology, Hawassa College of Teacher Education, Sidama National Regional State, P. O. Box 115, Hawassa, Ethiopia.
| | - Sintayehu Fekadu
- School of Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Serawit Deyno
- School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
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Fekadu S, Engiso H, Seyfe S, Iizasa H, Godebo A, Deyno S, Yoshiyama H. Effectiveness of eradication therapy for Helicobacter pylori infection in Africa: a systematic review and meta-analysis. BMC Gastroenterol 2023; 23:55. [PMID: 36882697 PMCID: PMC9990047 DOI: 10.1186/s12876-023-02707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND The effectiveness of Helicobacter pylori (H. pylori) eradication depends on the treatment protocol. This study investigates the H. pylori eradication rate in Africa using the best available evidence from databases. METHODS Databases were searched and results were pooled together. Heterogeneity between studies was assessed using I2 test statistics. Stata version 13 software was employed to compute the pooled eradication rate. In the subgroup analysis comparison, the finding is considered significant when the confidence intervals did not overlap. RESULTS Twenty-two studies from 9 African countries with a total population of 2,163 were included in this study. The pooled eradication rate of H. pylori was 79% (95% CI: 75%-82%), heterogeneity (I2 = 93.02%). In the subgroup analysis by study design, a higher eradication rate was reported from observational studies (85%, 95% CI: 79%-90%), compared to randomized control trials (77%, 95% CI: 73%-82%); by the duration of therapy, higher eradication rate was reported in 10-days regimen (88%, 95% CI: 84%-92%), compared to 7-days regimen (66%, 95% CI: 55%-77%); by country, the highest eradication rate was found in Ethiopia (90%; 95% CI: 87%-93%) and the lowest eradication rate was reported in Ivory Coast (22.3%; 95% CI:15%-29%); by type of H. pylori test, the highest eradication rate was reported when rapid urease test coupled with histology (88%, 95% CI: 77%-96%), and the lowest eradication rate was reported with histology alone (22.3%; 95% CI:15%-29%). Significant heterogeneity was observed with pooled prevalence (I2 = 93.02%, P < 0.000). CONCLUSIONS In Africa, the first-line therapy showed a variable eradication rate for H. pylori. This study demonstrates the necessity to optimize current H. pylori treatment regimens in each country, taking into account the antibiotic susceptibility. Future RCT studies with standardized regimens are warranted.
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Affiliation(s)
- Sintayehu Fekadu
- School of Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia.
| | - Hizkel Engiso
- School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Sisay Seyfe
- Department of Biochemistry, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Hisashi Iizasa
- Department of Microbiology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Ashebir Godebo
- Department of Soil Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - Serawit Deyno
- School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Hironori Yoshiyama
- Department of Microbiology, Faculty of Medicine, Shimane University, Shimane, Japan
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Abstract
Background: Sub-Saharan Africa, is a region that records high rates of TB infection. Mycobacterium tuberculosis mixed strain infection, especially when the strains involved are of different susceptibilities, is an area of great interest because it is linked with an increased risk of treatment failure and transmission of resistant strains within the population. This paper reviewed original studies that reported MTB mixed infection and heteroresistance in the region between 2010 and 2020 to understand the extent of mixed strain infection and heteroresistance in the region. This information is very critical in the control of TB and ending the TB epidemic by 2035 as per the World Health Organization's vision.
Methods: Pubmed, Scopus, JSTOR, AJOL, and Google Scholar databases were searched through both key terms and subject headings. The literature was screened, assessed for the quality and evidence synthesized.
Results: Eighteen original articles were included in this review after having met the inclusion criteria. The frequency of mixed strain infection reported in these studies varied between 2.8% and 21.1% while drug resistance range between 0.06% to 19% depending on the study design and the drug susceptibility screening technique utilized. The majority of the studies (50%) utilized Spoligotyping in conjunction with MIRU-VNTR typing in the detection of mixed infections.
Conclusion: Despite the scarcity of data on mixed infections and heteroresistance in sub–Saharan Africa, various studies have revealed that these conditions are frequent in the region than previously thought. Given the evidence of the effect of mixed infections on drug resistance and treatment outcome, we conclude that mixed infection is an unavoidable topic for future studies.
Keywords: Tuberculosis; mixed infection; drug resistance.
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Affiliation(s)
- Lisa Nkatha Micheni
- Department of Microbiology, Mbarara University of Science and Technology, Box 1410 Mbarara, Uganda
- Department of Microbiology and Immunology, Kampala International University Western Campus, Box 71, Bushenyi, Uganda
| | - Serawit Deyno
- Department of Microbiology, Mbarara University of Science and Technology, Box 1410 Mbarara, Uganda
- Department of Pharmacology, Mbarara University of Science and Technology, Box 1410 Mbarara, Uganda
| | - Joel Bazira
- Department of Microbiology, Mbarara University of Science and Technology, Box 1410 Mbarara, Uganda
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Beressa TB, Deyno S, Mtewa AG, Aidah N, Tuyiringire N, Lukubye B, Weisheit A, Tolo CU, Ogwang PE. Potential Benefits of Antiviral African Medicinal Plants in the Management of Viral Infections: Systematic Review. Front Pharmacol 2022; 12:682794. [PMID: 35002686 PMCID: PMC8740180 DOI: 10.3389/fphar.2021.682794] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 12/07/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Viruses cause various human diseases, some of which become pandemic outbreaks. This study synthesized evidence on antiviral medicinal plants in Africa which could potentially be further studied for viral infections including Coronavirus disease 2019 (COVID-19) treatment. Methods: PUBMED, CINAHIL, Scopus, Google Scholar, and Google databases were searched through keywords; antiviral, plant, herb, and Africa were combined using “AND” and “OR”. In-vitro studies, in-vivo studies, or clinical trials on botanical medicine used for the treatment of viruses in Africa were included. Results: Thirty-six studies were included in the evidence synthesis. Three hundred and twenty-eight plants were screened for antiviral activities of which 127 showed noteworthy activities against 25 viral species. These, were Poliovirus (42 plants), HSV (34 plants), Coxsackievirus (16 plants), Rhinovirus (14plants), Influenza (12 plants), Astrovirus (11 plants), SARS-CoV-2 (10 plants), HIV (10 plants), Echovirus (8 plants), Parvovirus (6 plants), Semiliki forest virus (5 plants), Measles virus (5 plants), Hepatitis virus (3 plants), Canine distemper virus (3 plants), Zika virus (2 plants), Vesicular stomatitis virus T2 (2 plants). Feline herpesvirus (FHV-1), Enterovirus, Dengue virus, Ebola virus, Chikungunya virus, Yellow fever virus, Respiratory syncytial virus, Rift Valley fever virus, Human cytomegalovirus each showed sensitivities to one plant. Conclusion: The current study provided a list of African medicinal plants which demonstrated antiviral activities and could potentially be candidates for COVID-19 treatment. However, all studies were preliminary and in vitro screening. Further in vivo studies are required for plant-based management of viral diseases.
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Affiliation(s)
- Tamirat Bekele Beressa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Serawit Deyno
- Pharm-Biotechnology and Traditional Medicine Center of Excellence, Mbarara University of Science and Technology, Mbarara, Uganda.,School of Pharmacy, Faculty of Medicine, Hawassa University, Hawassa, Ethiopia
| | - Andrew G Mtewa
- Chemistry Section, Department of Applied Studies, Institute of Technology, Malawi University of Science and Technology, Limbe, Malawi
| | - Namuli Aidah
- Pharm-Biotechnology and Traditional Medicine Center of Excellence, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Naasson Tuyiringire
- Pharm-Biotechnology and Traditional Medicine Center of Excellence, Mbarara University of Science and Technology, Mbarara, Uganda.,School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - Ben Lukubye
- Department of Biology, Faculty of Science, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Anke Weisheit
- Pharm-Biotechnology and Traditional Medicine Center of Excellence, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Casim Umba Tolo
- Pharm-Biotechnology and Traditional Medicine Center of Excellence, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Patrick Engeu Ogwang
- Pharm-Biotechnology and Traditional Medicine Center of Excellence, Mbarara University of Science and Technology, Mbarara, Uganda
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Yadesa TM, Kitutu FE, Deyno S, Ogwang PE, Tamukong R, Alele PE. Prevalence, characteristics and predicting risk factors of adverse drug reactions among hospitalized older adults: A systematic review and meta-analysis. SAGE Open Med 2021; 9:20503121211039099. [PMID: 34422271 PMCID: PMC8377309 DOI: 10.1177/20503121211039099] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 07/23/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Occurrence of adverse drug reactions is a major global health problem mostly affecting older adults. Identifying the magnitude and predictors of adverse drug reactions is crucial to developing strategies to mitigate the burden of adverse drug reactions. This study's objectives were to estimate and compare the prevalences of adverse drug reactions, to characterize them and to identify the predictors among hospitalized older adults. METHODS A comprehensive systematic literature search including both prevalence and risk factors of adverse drug reactions in hospitalized older adults was conducted using PubMed, Scopus and Google Scholar, involving all articles published in English. Descriptive statistics and comparison of means was performed using SPSS version 20.0 and metaprop command was performed in STATA version 13.0. Heterogeneity was assessed using I 2 statistic. RESULTS A total of 18 studies, involving 80,695 participants with a median age of 77 years, were included in this study. The pooled prevalence of adverse drug reaction was 22% (95% confidence interval: 17%, 28%; I 2 = 99.23%). Among high-income countries, the prevalence of adverse drug reactions was 29% (95% confidence interval: 16%, 42%) as compared to 19% (95% confidence interval: 14%-25%) in low and middle-income countries (p value = 0.176). Of the 620 adverse drug reactions categorized, most were type A (89%), which are generally predictable and preventable. Two-thirds (795, 67%) of the adverse drug reactions were probable and most (1194, 69%) were mild or moderate. The majority (60%) of the categorized adverse drug reactions were preventable and less than one-third (31%) were severe. The most consistently reported predictors of adverse drug reactions in hospitalized older patients were medication-related factors, including polypharmacy and potentially inappropriate medications followed by disease-related factors-renal failure, complex comorbidity, heart failure and liver failure. CONCLUSION Almost one-quarter of all hospitalized older adults experienced at least one adverse drug reaction during their hospital stay. The majority of the adverse drug reactions were preventable. Medication-related factors were the most consistently reported predictors of adverse drug reactions followed by disease-related factors.
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Affiliation(s)
- Tadele Mekuriya Yadesa
- PHARMBIOTRAC, World Bank’s ACE-II Project, Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Pharmacy, College of Medicine & Health Sciences, Ambo University, Ambo, Ethiopia
| | - Freddy Eric Kitutu
- Sustainable Pharmaceutical Systems (SPS) Unit, Pharmacy Department, School of Health Sciences, Makerere University, Kampala, Uganda
| | - Serawit Deyno
- PHARMBIOTRAC, World Bank’s ACE-II Project, Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- School of Pharmacy, College of Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Patrick Engeu Ogwang
- PHARMBIOTRAC, World Bank’s ACE-II Project, Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Robert Tamukong
- PHARMBIOTRAC, World Bank’s ACE-II Project, Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Paul E Alele
- Department of Pharmacology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Deyno S, Eneyew K, Seyfe S, Wondim E. Efficacy, safety and phytochemistry of medicinal plants used for the management of diabetes mellitus in Ethiopia: a systematic review. Clin Phytosci 2021. [DOI: 10.1186/s40816-021-00251-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract
Background
Despite tremendous developments in synthetic medicine, medicinal plants are still commonly used for the management of diabetes mellitus. This study synthesized scientific evidence on commonly used medicinal plants for the management of diabetes mellitus (DM) in Ethiopia.
Methods
Databases (PubMed, Cochrane, CINAHL and Google Scholar) have been thoroughly sought and evidence was synthesized.
Results
Thirty studies conducted anti-diabetic activities studies on 19 medicinal plants in Ethiopia. Most of the studies were in vivo studies (25). Others include; clinical study (1), in vitro studies (2), and both in vivo and in vitro study (2). Trigonella foenum-graecum L., clinical study, showed an improved lipid profile in type II diabetic patients. Comparable blood sugar level (BSL) lowering effect to glibenclimide was observed with Persea Americana and Moringa stenopetala. Noteworthy in vitro half maximal inhibitory concentration (IC 50) of Aloe megalacantha B and Aloe monticola R were observed. Animal model studies demonstrated the relative safety of the plants extract and phytochemistry studies showed various components.
Conclusion
Medicinal plants used for management of diabetes mellitus in Ethiopia are worthy for further study for pharmacologically active ingredients and clinical evaluation.
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Deyno S, Mtewa AG, Hope D, Bazira J, Makonnen E, Alele PE. Antibacterial Activities of Echinops kebericho Mesfin Tuber Extracts and Isolation of the Most Active Compound, Dehydrocostus Lactone. Front Pharmacol 2021; 11:608672. [PMID: 33597879 PMCID: PMC7883827 DOI: 10.3389/fphar.2020.608672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/02/2020] [Indexed: 12/28/2022] Open
Abstract
Echinops kebericho Mesfin is traditionally used for the treatment of various infectious diseases. This study investigated antibacterial activity of the essential oil (EO) and the different fractions of ethanol extract. The most active component was isolated and identified. Isolation and purification was accomplished using chromatographic techniques while identification was done by spectroscopic method. Minimum inhibitory concentration (MIC) was determined using the broth micro-dilution method. In bioactive-guided isolation, percent inhibition was determined using optical density (OD) measurement. The MICs of the essential oil ranged from 78.125 μg/ml to 625 μg/ml, and its activity was observed against methicillin-resistant Staphylococcus aureus (MRSA, NCTC 12493). Ethyl acetate fraction showed high activity against MRSA (NCTC 12493), MIC = 39.075 μg/ml followed by Enterococcus faecalis (ATCC 49532), MIC = 78.125 μg/ml and was least active against Klebsiella pneumoniae (ATCC 700603), MIC = 1,250 μg/ml. MIC of hexane fraction ranged from 156.2 µg/ml to Escherichia coli (ATCC 49532) to 1,250 μg/ml to E. coli (NCTC 11954). The MICs of chloroform fraction ranged from 312.5 to 2500 μg/ml; while butanol fraction could be considered pharmacologically inactive as its MIC value was 2,500 μg/ml for all and no activity against E. coli (NCTC 11954). Dehydrocostus lactone was successfully isolated and identified whose MIC was 19.53 μg/ml against MRSA. Dehydrocostus lactone isolated from E. kebericho M. showed noteworthy antibacterial activity which lends support to ethnopharmacological use of the plant. Further optimization should be done to improve its antibacterial activities and pharmacokinetic profile.
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Affiliation(s)
- Serawit Deyno
- Department of Pharmacology, Mbarara University of Science and Technology, Mbarara, Uganda.,Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.,Pharmbiotechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, Mbarara, Uganda
| | - Andrew G Mtewa
- Chemistry Section, Department of Applied Sciences, Malawi Institute of Technology, Malawi University of Science and Technology, Limbe, Malawi
| | - Derick Hope
- MSF Mbarara Research Base, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joel Bazira
- Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Eyasu Makonnen
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa University, Addis Ababa, Ethiopia
| | - Paul E Alele
- Department of Pharmacology, Mbarara University of Science and Technology, Mbarara, Uganda
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Tuyiringire N, Deyno S, Weisheit A, Tolo CU, Tusubira D, Munyampundu JP, Ogwang PE, Muvunyi CM, Heyden YV. Three promising antimycobacterial medicinal plants reviewed as potential sources of drug hit candidates against multidrug-resistant tuberculosis. Tuberculosis (Edinb) 2020; 124:101987. [DOI: 10.1016/j.tube.2020.101987] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 01/03/2023]
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Mathew LS, Mtewa AG, Ajayi CO, Deyno S, Weisheit A, Tolo CU, Deng AL, Engeu Ogwang P. Ethnopharmacology, Pharmacology and Phytochemistry of Aristolochia bracteolata Lam: A Review of an Antimalarial Plant. ACTA ACUST UNITED AC 2020. [DOI: 10.24248/easci-d-19-00011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Deyno S, Abebe A, Tola MA, Hymete A, Bazira J, Makonnen E, Alele PE. Acute and sub-acute toxicity of Echinops kebericho decoction in rats. BMC Complement Med Ther 2020; 20:2. [PMID: 32020865 PMCID: PMC7076833 DOI: 10.1186/s12906-019-2794-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 12/11/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Echinops kebericho is widely used for treatment of a variety of diseases including infectious, non-infectious disease and fumigation during child birth. Antibacterial, antimalarial, anti-leshimania, anti-diarrheal and insect repellent activities have been elucidated. Its toxicity profile is not yet investigated and thus this study was to investigate acute and sub-acute toxicity of E. kebericho decoctions. METHODS Acute toxicity study was performed in female Wistar albino rats with single oral dose and followed up to 14 days. The sub-acute oral dose toxicity studies were conducted in rats of both sexes in accordance with the repeated dose 28-day oral toxicity study in rodent OECD guidelines. Physical observations were made regularly during the study period while body weight was measured weekly. Organ weight, histopathology, clinical chemistry and hematology data were collected on the 29th day. Results were presented as mean ± standard deviation. One-way analysis of variance (ANOVA) was performed if assumptions were met; otherwise Kruskal-Wallis analysis was performed. RESULT Oral administration of E. kebericho decoction showed no treatment-related mortality in female rats up to the dose of 5000 mg/kg. In sub-acute toxicity studies, no significant treatment-related abnormalities were observed compared to negative controls. Food consumption, body weight, organ weight, hematology, clinical chemistry, and histopathology did not show significant variation between controls and treatment groups. However, creatinine, relative lung weight, triglycerides, and monocytes were lower in treated compared to control groups. Significant variations between male and female groups in food consumption, relative organ weight, hematology, clinical chemistry were observed. Histolo-pathology of high-dose treated groups showed fatty liver. CONCLUSION Echinops kebericho showed LD50 of greater than 5000 mg/kg in acute toxicity study and is well tolerated up to the dose of 600 mg/kg body weight in sub-acute toxicity study.
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Affiliation(s)
- Serawit Deyno
- Department of Pharmacology, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda. .,Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, P.O.BOX 1560, Hawassa, Ethiopia. .,Pharmbiotechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Abiy Abebe
- Traditional and Modern Drug Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesfin Asefa Tola
- Department of Pathology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ariya Hymete
- Department of Pharmaceutical chemistry and Pharmacognosy, Addis Ababa University, Addis Ababa, Ethiopia
| | - Joel Bazira
- Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Eyasu Makonnen
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Paul E Alele
- Department of Pharmacology, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda
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Deyno S, Eneyew K, Seyfe S, Tuyiringire N, Peter EL, Muluye RA, Tolo CU, Ogwang PE. Efficacy and safety of cinnamon in type 2 diabetes mellitus and pre-diabetes patients: A meta-analysis and meta-regression. Diabetes Res Clin Pract 2019; 156:107815. [PMID: 31425768 DOI: 10.1016/j.diabres.2019.107815] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Cinnamon has been used as a dietary component and in the management of diabetes mellitus. This study systematically reviewed and synthesized evidence on the efficacy of cinnamon for the treatment of type 2 diabetes mellitus (T2DM) and pre-diabetes patients. METHODS Databases of Web of Sciences, the Cochrane library, PubMed, CINAHL and SCOPUS were searched. Stata version 13 (College Station, Texas 77845 USA) and RevMan var. 5.3 software were used for meta-analysis. Heterogeneity was assessed using Chi-square and I2 tests. RESULTS Sixteen randomized controlled studies were included in the meta-analysis. Cinnamon significantly reduced fasting blood glucose (FBG) and homeostatic model assessment for insulin resistance (HOMA-IR) level compared to placebo with weighted mean difference (WMD) of -0.545 (95% CI: -0.910, -0.18) mmol/L, I2 = 83.6% and -0.714(-1.388, -0.04), I2 = 84.4% respectively. There was no significant change in weighted mean difference of glycosylated hemoglobin A1C (HbA1c) % and lipid profiles (mmol/L). Meta-regression did not show any factor significantly affecting the treatment response. CONCLUSION Cinnamon reduced FBG and HOMA-IR, level in T2DM and pre-diabetes patients compared to placebo. High heterogeneity observed among included studies warrants further clinical trials after standardization of cinnamon formulation.
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Affiliation(s)
- Serawit Deyno
- Pharm-BioTechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda; Faculty of Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia.
| | - Kassahun Eneyew
- Faculty of Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Sisay Seyfe
- Faculty of Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Naasson Tuyiringire
- Pharm-BioTechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda; School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, University Avenue, P.O. Box 56, Butare, Rwanda.
| | - Emanuel L Peter
- Pharm-BioTechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda; Department of Innovation, Technology Transfer & Commercialization, National Institute for Medical Research, Barack Obama Drive, P.O. Box 9653, 2448 Dar Es Salaam, Tanzania.
| | - Rekik Ashebir Muluye
- Traditional and Modern Drug Research Directorate, Ethiopian Public Health Institute, Ethiopia
| | - Casim Umba Tolo
- Pharm-BioTechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Patrick Engeu Ogwang
- Pharm-BioTechnology and Traditional Medicine Center of Excellence (PHARMBIOTRAC), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
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Peter EL, Kasali FM, Deyno S, Mtewa A, Nagendrappa PB, Tolo CU, Ogwang PE, Sesaazi D. Momordica charantia L. lowers elevated glycaemia in type 2 diabetes mellitus patients: Systematic review and meta-analysis. J Ethnopharmacol 2019; 231:311-324. [PMID: 30385422 DOI: 10.1016/j.jep.2018.10.033] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/23/2018] [Accepted: 10/25/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Momordica charantia Linnaeus (Cucurbitaceae) has been extensively used traditionally as food and herbal medicine for type 2 diabetes mellitus in Asia, Brazil, and east Africa. In vitro and in vivo studies suggest its glycemic control potential; however, clinical studies produced conflicting results. AIM OF THE STUDY To evaluate the efficacy of M. charantia preparations in lowering elevated plasma glucose level in prediabetes and type 2 diabetes mellitus patients. METHODS Electronic search of the Cochrane library, PubMed®, CINAHL, and SCOPUS databases was done from 1st January 1960-30th April 2018 without language restriction. Two independent reviewers extracted data and assessed risk of bias of articles. Revman var. 5.3 software was used for data synthesis in meta-analysis. Heterogeneity was assessed using Chi-square and I2 tests. Treatment effect was estimated using mean difference at follow up in outcome measures between M. charantia preparations and placebo or oral hypoglycemic agents control group. The protocol of this study has a registration number PROSPERO CRD42018083653. RESULTS Ten studies of type 2 diabetes mellitus (n = 1045) were included in the meta-analysis. They had 4-16 weeks follow up and overall moderate to high risk of bias. Compared to placebo, M. charantia monoherbal formulation significantly reduces FPG, PPG and HBA1c with mean difference of - 0.72 mmol/L, (95% CI: -1.33, -0.12), I2 = 14%, - 1.43 mmol/L, (95% CI: -2.18, -0.67), I2 = 0, - 0.26%, (95% CI: -0.49, -0.03), I2 = 0 respectively. M. charantia also lowered FPG in prediabetes (mean difference -0.31 mmol/L, n = 52); the evidence was downgraded to low quality because the study had unclear risk of bias and inadequate sample size. No serious adverse effects were reported. CONCLUSION M. charantia adjunct preparations improved glycemic control in T2DM patients. However, this conclusion is based on low to very low quality evidences for the primary outcomes and sparse data for several safety outcomes, thus, warrant further research. Particularly needed are the researches that focus on standardizing M. charantia formulation and determine its efficacy and safety in clinical trials with adequate sample size, designed with random sequence generation, allocation concealment of intervention and blinding of both research personnel and participants.
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Affiliation(s)
- Emanuel L Peter
- Pharm-BioTechnology and Traditional Medicine Center (PHARMBIOTRAC), World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, Uganda.
| | - Félicien Mushagalusa Kasali
- Pharm-BioTechnology and Traditional Medicine Center (PHARMBIOTRAC), World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, Uganda.
| | - Serawit Deyno
- Pharm-BioTechnology and Traditional Medicine Center (PHARMBIOTRAC), World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, Uganda.
| | - Andrew Mtewa
- Pharm-BioTechnology and Traditional Medicine Center (PHARMBIOTRAC), World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, Uganda.
| | - Prakash B Nagendrappa
- School of Integrative Health Sciences, Trans-disciplinary University, 74/2, Jarakabande Kaval, Post Attur Via Yelahanka, Bengaluru 560064, India.
| | - Casim Umba Tolo
- Pharm-BioTechnology and Traditional Medicine Center (PHARMBIOTRAC), World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, Uganda.
| | - Patrick Engeu Ogwang
- Pharm-BioTechnology and Traditional Medicine Center (PHARMBIOTRAC), World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, Uganda.
| | - Duncan Sesaazi
- Pharm-BioTechnology and Traditional Medicine Center (PHARMBIOTRAC), World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, Uganda; Department of Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Uganda.
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Peter EL, Deyno S, Mtewa A, Kasali FM, Nagendrappa PB, Sesaazi D, Tolo CU, Ogwang PE. Safety and efficacy of Momordica charantia Linnaeus in pre-diabetes and type 2 diabetes mellitus patients: a systematic review and meta-analysis protocol. Syst Rev 2018; 7:192. [PMID: 30442186 PMCID: PMC6238397 DOI: 10.1186/s13643-018-0847-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 10/19/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Momordica charantia Linnaeus (Cucurbitaceae) has been used traditionally as a nutritious food and as a herbal medicine for type 2 diabetes mellitus. However, human studies that investigated its glycemic control have generated inconsistent findings. Therefore, this systematic review and meta-analysis is aimed at evaluating the safety and efficacy of M. charantia L. preparations in human studies that have investigated its role in glycemic control. METHODS This protocol has been prepared according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The review will include randomized clinical trials and non-randomized clinical trials. The included studies will have assessed glycemic control of M. charantia preparations with placebo or standard oral anti-hyperglycemic agents in adult pre-diabetes and/or type 2 diabetes mellitus patients and have at least 4 weeks of follow-up. The primary outcomes of review are fasting blood glucose levels, glycosylated hemoglobin A1c, and post-prandial blood glucose level. Electronic database search for published literatures will be conducted without language restriction in EMBASE, MEDLINE/PubMed, the Cochrane Library, SCOPUS, Web of Sciences, and CINAHL databases. Search for gray literatures and references of the retrieved full-text articles will be conducted in Google, Google Scholar, OpenGrey, ProQuest dissertations & Theses, British Library EThos, and university digital library systems. Two independent reviewers will later evaluate full texts, extract data, and assess risk of bias of eligible articles. Publication biases will be assessed by testing asymmetry of funnel plot using Egger's or Begg's tests while heterogeneity will be assessed using Cochran Q test, P value, and I2. Revman software version 5.3 will be used for meta-analysis including subgroup and sensitivity analysis. DISCUSSION This systematic review and meta-analysis will investigate both safety and efficacy of M. charantia preparations in type 2 diabetes mellitus. The review results will be published in a peer-reviewed journal. The results will bring better understanding of clinical outcomes in treatment of type 2 diabetes mellitus patients and highlight gaps for future research. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018083653 .
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Affiliation(s)
- Emanuel L. Peter
- Pharm-BioTechnology and Traditional Medicine Center, World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
- Department of Innovation, Technology Transfer & Commercialization, National Institute for Medical Research, 2448 Baracka Obama drive, P.O. Box 9653, Dar Es Salaam, Tanzania
| | - Serawit Deyno
- Pharm-BioTechnology and Traditional Medicine Center, World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Awasa, Ethiopia
| | - Andrew Mtewa
- Pharm-BioTechnology and Traditional Medicine Center, World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
- Chemistry Section, Department of Applied Sciences, Malawi Institute of Technology, Malawi University of Science & Technology, Limbe, Malawi
| | - Félicien Mushagalusa Kasali
- Pharm-BioTechnology and Traditional Medicine Center, World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
- Department of Pharmacy, Faculty of Medicine and Pharmacy, Official University of Bukavu, Bukavu, Democratic Republic of Congo
| | | | - Duncan Sesaazi
- Pharm-BioTechnology and Traditional Medicine Center, World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Casim Umba Tolo
- Pharm-BioTechnology and Traditional Medicine Center, World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Patrick Engeu Ogwang
- Pharm-BioTechnology and Traditional Medicine Center, World Bank-Africa Center of Excellence (ACE II), Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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Deyno S, Fekadu S, Seyfe S. Prevalence and antimicrobial resistance of coagulase negative staphylococci clinical isolates from Ethiopia: a meta-analysis. BMC Microbiol 2018; 18:43. [PMID: 29801462 PMCID: PMC5970528 DOI: 10.1186/s12866-018-1188-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 05/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background Antimicrobial resistant Coagulase-negative Staphylococci (CoNS) have limited treatment options, rendered diseases untreatable and made hospitals to be reservoirs of the resistant strains. The aim of this study was to estimate the pooled prevalence and antimicrobial resistance of clinical isolates of CoNS from Ethiopia. Results The electronic database search yielded 6511 articles of which 21 met predefined inclusion criteria. The pooled prevalence of CoNS from Ethiopia was 12% (95% confidence interval (CI): 8, 16%). The analyses revealed high level of CoNS resistance to methicilin (37%[95% CI: 21, 55%]), vancomycin (911%[95% CI: 0, 35%]), penicillin (58%[95% CI: 42, 74%]), amoxicillin (42%[95% CI: 23, 61%]), amoxicillin-clavulanate (27%[95% CI: 2, 27%]), ampicillin (64%[95% CI: 46, 80%]), tetracycline (60% [95% CI: 49, 70%]), doxycycline (36%[95% CI:19,55%]), Sulfamethoxazole-trimethoprim (50%[95% CI: 36, 64%]), ceftriaxone (27% [95% CI: 18, 38%]), cephalothin (32% [95% CI: 7, 62%]), norfloxacin (39%[95% CI: 24, 56%]), chloramphenicol (40%[95% CI: 23, 58%]), clindamycin (11% [95% CI: 2, 27%]), ciprofloxacin (14%[95% CI: 6, 22%]), gentamicin (27%[95% CI:19,36%]) and erythromycin (30%[95% CI:20%,42%]). High heterogeneity, I2 ranging from 69.04 to 96.88%; p-values ≤0.01, was observed. Eggers’ test did not detect publication bias for the meta-analyses and low risk of bias was observed in included studies. Conclusions CoNS has gotten resistant to commonly used antimicrobials from Ethiopia. There is a need of launching national antimicrobial treatment, development and implementation of policy guidelines to contain the threat. Further research focusing on factors promoting resistance and the effect of resistance on treatment outcome studies are warranted. Electronic supplementary material The online version of this article (10.1186/s12866-018-1188-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Serawit Deyno
- PHARMBIOTRAC, Mbarara University of Science and Technology, Mbarara, Uganda. .,Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia.
| | - Sintayehu Fekadu
- Department of Microbiology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Sisay Seyfe
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Deyno S, Fekadu S, Astatkie A. Resistance of Staphylococcus aureus to antimicrobial agents in Ethiopia: a meta-analysis. Antimicrob Resist Infect Control 2017; 6:85. [PMID: 28852476 PMCID: PMC5569497 DOI: 10.1186/s13756-017-0243-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/15/2017] [Indexed: 11/12/2022] Open
Abstract
Background Emergence of antimicrobial resistance by Staphylococcus aureus has limited treatment options against its infections. The purpose of this study was to determine the pooled prevalence of resistance to different antimicrobial agents by S. aureus in Ethiopia. Methods Web-based search was conducted in the databases of PubMed, Google Scholar, Hinari, Scopus and the Directory of Open Access Journals (DOAJ) to identify potentially eligible published studies. Required data were extracted and entered into Excel spread sheet. Statistical analyses were performed using Stata version 13.0. The metaprop Stata command was used to pool prevalence values. Twenty-one separate meta-analysis were done to estimate the pooled prevalence of the resistance of S. aureus to twenty-one different antimicrobial agents. Heterogeneity among the studies was assessed using the I2 statistic and chi-square test. Publication bias was assessed using Egger’s test. Because of significant heterogeneity amongst the studies, the random effects model was used to pool prevalence values. Results The electronic database search yielded 1317 studies among which 45 studies met our inclusion criteria. Our analyses demonstrated very high level of resistance to amoxicillin (77% [95% confidence interval (CI): 68%, 0.85%]), penicillin (76% [95% CI: 67%, 84%]), ampicillin (75% [95% CI: 65%, 85%]), tetracycline (62% [95% CI: 55%, 68%]), methicillin (47% [95% CI: 33%, 61%]), cotrimoxaziole (47% [95% CI: 40%, 55%]), doxycycline (43% [95% CI: 26%, 60%]), and erythromycin (41% [95% CI: 29%, 54%]). Relatively low prevalence of resistance was observed with kanamycin (14% [95% CI: 5%, 25%]) and ciprofloxacin (19% [95% CI: 13%, 26%]). The resistance level to vancomycin is 11% 995% CI: (4%, 20%). High heterogeneity was observed for each of the meta-analysis performed (I2 ranging from 79.36% to 95.93%; all p-values ≤0.01). Eggers’ test did not show a significant publication bias for all antimicrobial agents except for erythromycin and ampicillin. Conclusions S. aureus in Ethiopia has gotten notoriously resistant to almost to all of antimicrobial agents in use including, penicillin, cephalosporins, tetracyclines, chloramphenicol, methicillin, vancomycin and sulphonamides. The resistance level to vancomycin is bothersome and requires a due attention. Continued and multidimensional efforts of antimicrobial stewardship program promoting rational use of antibiotics, infection prevention and containment of AMR are urgently needed. Electronic supplementary material The online version of this article (doi:10.1186/s13756-017-0243-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Serawit Deyno
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Sintayehu Fekadu
- Department of Microbiology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Ayalew Astatkie
- School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Deyno S, Toma A, Worku M, Bekele M. Antimicrobial resistance profile of staphylococcus aureus isolates isolated from ear discharges of patients at University of Hawassa comprehensive specialized hospital. BMC Pharmacol Toxicol 2017; 18:35. [PMID: 28506250 PMCID: PMC5433016 DOI: 10.1186/s40360-017-0141-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/04/2017] [Indexed: 12/23/2022] Open
Abstract
Background Drug-resistant microorganism are a growing global danger. Strains of S. aureus have developed resistance to many commonly used antimicrobials due to indiscriminate use of antimicrobials, and treatment becoming a challenge. Studies assessing pattern and determinants of S. aureus resistance in ear infection in Ethiopia are very scarce. This study presents overview of pattern and determinants S. aureus resistance from samples of ear discharge in Ethiopia. Method A prospective cross-sectional study was conducted on patients who visit ENT clinic of University of Hawassa comprehensive specialized hospital from February 1, 2016 to November 1, 2016. 117 specimens were collected with sterile applicator cotton swab from 117 patients with ear discharge visiting the clinic. Data was fed and then edited, cleared, entered and analyzed using SPSS version 20. Result The prevalence of S.aureus infection was 28.2%. S. aureus isolates revealed up to 97.0% level of resistance pattern to the antimicrobials tested. In the determination of the susceptibility of S. aureus on nine selected antibiotics by disk diffusion technique, 97.0% of the isolates were resistant to cloxacilin and 74.2% showed resistance to vancomycin. The overall rate of MDR was 100%, all of the isolates were found to be resistant to more than two tested antimicrobials. Conclusion S. aureus has gotten frighteningly resistant to many of common antimicrobials. Resistance rate to vancomyin is terrifyingly high. It urges us to take measures to delay resistance. Emergence of resistance highlights the value of prudent prescribing of antimicrobials and avoiding their irrational use. Further researches focusing on identifying dynamics promoting resistance, identifying high risk strains and molecular basis of resistance are required.
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Affiliation(s)
- Serawit Deyno
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, University of Hawassa, P. O. Box 1560, Hawassa, Ethiopia.
| | - Alemayehu Toma
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, University of Hawassa, P. O. Box 1560, Hawassa, Ethiopia
| | - Mesfin Worku
- Department of medical laboratory technology, College of Medicine and Health Sciences, University of Hawassa, Hawassa, Ethiopia
| | - Muluken Bekele
- Department of ear, nose and throat, School of Medicine, College of Medicine and Health Sciences, University of Hawassa, Hawassa, Ethiopia
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Toma A, Deyno S, Fikru A, Eyado A, Beale A. In vivo antiplasmodial and toxicological effect of crude ethanol extract of Echinops kebericho traditionally used in treatment of malaria in Ethiopia. Malar J 2015; 14:196. [PMID: 25958112 PMCID: PMC4429705 DOI: 10.1186/s12936-015-0716-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medicinal plants have contributed significantly to current malaria treatment. Emergence of resistance to currently available drugs has necessitated the search for new plant-based anti-malarial agents and several plant-based, pharmacologically active anti-malarial compounds have been isolated. This study was conducted to validate the traditional usage of Echinops kebericho for treating malaria in the traditional health care system of Ethiopia. METHODS The roots of E. kebericho were collected from Masha Woreda, Sheka Zone. After collection, the plant materials were identified by a taxonomist, dried under shade and crushed to powder for extraction. The powdered roots were extracted by maceration using 70 % ethanol. Acute toxicity study of the crude extract was carried out in Swiss albino mice. The in vivo anti-malarial activity of plant extract (200, 350 and 500 mg/kg) of E. kebericho roots against a chloroquine (CQ) sensitive strain of Plasmodium berghei strain ANKA was assessed using the four-day suppressive test procedure. Parameters such as parasitaemia, packed cell volume, body weight and survival time were then determined using standard tests. RESULTS Oral administration of the ethanol extract showed significant (P<0.001) parasitaemia suppression at dose levels of 350 and 500 mg/kg in dose-related manner compared with the negative control. Five hundred mg/kg showed the highest (57.29±1.76 %) parasitaemia suppression. The survival times of P. berghei-infected mice were also increased in a dose-dependent manner but the test material did not prevent weight loss associated with increased parasitaemia. The result also showed the plant material prevented the loss in packed cell volume associated with increased parasitaemia. Its oral LD50 was found to be greater than 5,000 mg/kg, indicating its wider safety margin in mice. CONCLUSION The result revealed the ethanol extract of E. kebericho roots has anti-malarial activity against P. berghei in an animal model and lends support to the use of the plant to combat malaria in Ethiopian folk medicine. Further work is necessary to isolate, identify and characterize the active principles from the plant material.
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Affiliation(s)
- Alemayehu Toma
- Pharmacology Unit, School of Medicine, Hawassa University, PO Box 1560, Hawassa, Ethiopia.
| | - Serawit Deyno
- Pharmacology Unit, School of Medicine, Hawassa University, PO Box 1560, Hawassa, Ethiopia.
| | - Abrham Fikru
- Biomedical team, School of Veterinary Medicine, Hawassa University, Hawassa, Ethiopia.
| | - Amalework Eyado
- Department of Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Andrew Beale
- Independent scholar, AuthorAID Mentor, Milange, Mozambique.
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Debito T, Deyno S. Rate and Predictors of Adherence to Antiretroviral Therapy among Clients on Antiretroviral Therapy at Tepi Health Center, South-west Ethiopia. ACTA ACUST UNITED AC 2014. [DOI: 10.4314/star.v3i3.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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