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ANTITUBERCULOSIS AND PHYTOCHEMICAL INVESTIGATION OF THE DICHLOROMETHANE EXTRACT PLEUROTUS TUBER-REGIUM (FRIES) SINGER SCLEROTIUM
Afieroho O.E,Lawson L,Olutayo M. Adedokun,Emenyonu N
International Research Journal of Pharmacy , 2013,
Abstract: Incidence of tuberculosis infections is on the rise. The cost and length of orthodox treatment regimen coupled with the rise in multidrug resistance cases make the development of more effective and relatively cheaper alternative therapies imperative. The cold percolation method was used with dichloromethane as an extraction solvent to obtain dichloromethane extract of the edible mushroom Pleurotus tuber-regium. The extract was soluble in n-hexane and labeled PTHS. Antituberculosis screening was by using the colorimetric BACTEC MGIT 960 SIRES method. Phyto-constituents determination was by using standard phytochemical test reagents.The PTHS of Pleurotus tuber-regium inhibited the growth of clinical isolates of Mycobacterium tuberculosis at the test concentration of 32.5 μg/ml. Terpenoids and steroids were detected as the phytochemical constituents. This study confirmed the nutraceutical benefits of some edible mushrooms.
Pilot study on multidrug resistant tuberculosis in Nigeria
L Lawson, AG Habib, MI Okobi, D Idiong, I Olajide, N Emenyonu, N Onuoha, LE Cuevas, SO Ogiri
Annals of African Medicine , 2010,
Abstract: Background: Drug resistant tuberculosis (TB) has lately emerged and it represents a serious public health problem. We set out to determine drug resistance among TB patients. Methods: Using automated BACTEC cultures, multidrug resistant-tuberculosis (MDR-TB) was investigated in 117 diagnosed cases in Abuja, Nigeria. Results: Ten (31%) of 32 culture-positive patients were resistant to at least one and four (13%) to all of the four drugs tested. No association between drug resistance and human immunodeficiency virus (HIV) infection was found. Conclusions: MDR-TB is present in Nigeria and larger studies are urgently required. TB clinical management and control efforts should be improved.
Contraceptive Use and Associated Factors among Women Enrolling into HIV Care in Southwestern Uganda
Winnie Muyindike,Robin Fatch,Rachel Steinfield,Lynn T. Matthews,Nicholas Musinguzi,Nneka I. Emenyonu,Jeffrey N. Martin,Judith A. Hahn
Infectious Diseases in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/340782
Abstract: Background. Preventing unintended pregnancies among women living with HIV is an important component of prevention of mother-to-child HIV transmission (PMTCT), yet few data exist on contraceptive use among women entering HIV care. Methods. This was a retrospective study of electronic medical records from the initial HIV clinic visits of 826 sexually active, nonpregnant, 18–49-year old women in southwestern Uganda in 2009. We examined whether contraceptive use was associated with HIV status disclosure to one’s spouse. Results. The proportion reporting use of contraception was 27.8%. The most common method used was injectable hormones (51.7%), followed by condoms (29.6%), and oral contraceptives (8.7%). In multivariable analysis, the odds of contraceptive use were significantly higher among women reporting secondary education, higher income, three or more children, and younger age. There were no significant independent associations between contraceptive use and HIV status disclosure to spouse. Discussion. Contraceptive use among HIV-positive females enrolling into HIV care in southwestern Uganda was low. Our results suggest that increased emphasis should be given to increase the contraception uptake for all women especially those with lower education and income. HIV clinics may be prime sites for contraception education and service delivery integration. 1. Introduction Sub-Saharan Africa has the highest prevalence and incidence of HIV-1 infection in the world [1]. Women of reproductive age account for 60 percent of all adult infections and 75 percent of infections among people 15–24 years old [2]. Sub-Saharan Africa also has high fertility rates with an estimated 14 million unintended pregnancies annually [3]. In 2008, the number of children newly infected with HIV was approximately 430,000, of which 90 percent were infected through mother-to-child transmission (MTCT) [4]. The World Health Organization (WHO) lists preventing unintended pregnancies among people living with HIV as a second pillar of preventing mother-to-child transmission (PMTCT) [4]. Not only is preventing unintended pregnancies in HIV-infected women an effective strategy for reducing perinatal transmission [5–8], but it is also cost saving [8, 9] and would contribute to the reduction of maternal mortality, which may be higher among HIV-infected women [10–12]. However, most PMTCT efforts to date prioritize the provision of antiretroviral (ARV) prophylaxis to HIV infected pregnant women, their infants, and safer breastfeeding strategies [4, 13, 14]. In Uganda, HIV-1 seroprevalence among
Diminishing Availability of Publicly Funded Slots for Antiretroviral Initiation among HIV-Infected ART-Eligible Patients in Uganda
Elvin H. Geng,Mwebesa B. Bwana,Jerome Kabakyenga,Winnie Muyindike,Nneka I. Emenyonu,Nicholas Musinguzi,Peter Mugyenyi,Jeffrey N. Martin,David R. Bangsberg
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0014098
Abstract: The impact of flat-line funding in the global scale up of antiretroviral therapy (ART) for HIV-infected patients in Africa has not yet been well described.
Rethinking the “Pre” in Pre-Therapy Counseling: No Benefit of Additional Visits Prior to Therapy on Adherence or Viremia in Ugandans Initiating ARVs
Mark J. Siedner, Alexander Lankowski, Jessica E. Haberer, Annet Kembabazi, Nneka Emenyonu, Alexander C. Tsai, Conrad Muzoora, Elvin Geng, Jeffrey N. Martin, David R. Bangsberg
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0039894
Abstract: Background Many guidelines recommend adherence counseling prior to initiating antiretrovirals (ARVs), however the additional benefit of pre-therapy counseling visits on early adherence is not known. We sought to assess for a benefit of adherence counseling visits prior to ARV initiation versus adherence counseling during the early treatment period. Methods We performed a secondary analysis of data from a prospective cohort of HIV-infected patients in Mbarara, Uganda. Adults were enrolled upon initiation of ARVs. Our primary exposure of interest was ARV adherence counseling prior to initiating therapy (versus concurrent with initiation of therapy). Our outcomes of interest were: 1) average adherence >90% in first three months; 2) absence of treatment interruptions >72 hours in first three months; and 3) Viral load >400 copies/ml at the three month visit. We fit univariable and multivariable regression models, adjusted for predictors of ARV adherence, to estimate the association between additional pre-therapy counseling visits and our outcomes. Results 300 participants had records of counseling, of whom 231 (77%) completed visits prior to initiation of ARVs and 69 (23%) on or shortly after initiation. Median age was 33, 71% were female, and median CD4 was 133 cell/ml. Median 90-day adherence was 95%. Participants who completed pre-therapy counseling visits had longer delays from ARV eligibility to initiation (median 49 vs 14 days, p<0.01). In multivariable analyses, completing adherence counseling prior to ARV initiation was not associated with average adherence >90% (AOR 0.8, 95%CI 0.4–1.5), absence of treatment gaps (AOR 0.7, 95%CI 0.2–1.9), or HIV viremia (AOR 1.1, 95%CI 0.4–3.1). Conclusions Completion of adherence counseling visits prior to ARV therapy was not associated with higher adherence in this cohort of HIV-infected patients in Uganda. Because mortality and loss-to-follow-up remain high in the pre-ARV period, policy makers should reconsider whether counseling can be delivered with ARV initiation, especially in patients with advanced disease.
Retention in Care and Connection to Care among HIV-Infected Patients on Antiretroviral Therapy in Africa: Estimation via a Sampling-Based Approach
Elvin H. Geng,David V. Glidden,Mwebesa Bosco Bwana,Nicolas Musinguzi,Nneka Emenyonu,Winnie Muyindike,Katerina A. Christopoulos,Torsten B. Neilands,Constantin T. Yiannoutsos,Steven G. Deeks,David R. Bangsberg,Jeffrey N. Martin
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0021797
Abstract: Current estimates of retention among HIV-infected patients on antiretroviral therapy (ART) in Africa consider patients who are lost to follow-up (LTF) as well as those who die shortly after their last clinic visit to be no longer in care and to represent limitations in access to care. Yet many lost patients may have “silently” transferred and deaths shortly after the last clinic visit more likely represent limitations in clinical care rather than access to care after initial linkage.
A Molecular Epidemiological and Genetic Diversity Study of Tuberculosis in Ibadan, Nnewi and Abuja, Nigeria
Lovett Lawson, Jian Zhang, Michel K. Gomgnimbou, Saddiq T. Abdurrahman, Stéphanie Le Moullec, Fatima Mohamed, Gertrude N. Uzoewulu, Olumide M. Sogaolu, Khye Seng Goh, Nnamdi Emenyonu, Guislaine Refrégier, Luis E. Cuevas, Christophe Sola
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0038409
Abstract: Background Nigeria has the tenth highest burden of tuberculosis (TB) among the 22 TB high-burden countries in the world. This study describes the biodiversity and epidemiology of drug-susceptible and drug-resistant TB in Ibadan, Nnewi and Abuja, using 409 DNAs extracted from culture positive TB isolates. Methodology/Principal Findings DNAs extracted from clinical isolates of Mycobacterium tuberculosis complex were studied by spoligotyping and 24 VNTR typing. The Cameroon clade (CAM) was predominant followed by the M. africanum (West African 1) and T (mainly T2) clades. By using a smooth definition of clusters, 32 likely epi-linked clusters related to the Cameroon genotype family and 15 likely epi-linked clusters related to other “modern” genotypes were detected. Eight clusters concerned M. africanum West African 1. The recent transmission rate of TB was 38%. This large study shows that the recent transmission of TB in Nigeria is high, without major regional differences, with MDR-TB clusters. Improvement in the TB control programme is imperative to address the TB control problem in Nigeria.
Internet Use among Ugandan Adolescents: Implications for HIV Intervention
Michele L Ybarra ,Julius Kiwanuka,Nneka Emenyonu,David R Bangsberg
PLOS Medicine , 2006, DOI: 10.1371/journal.pmed.0030433
Abstract: Background The Internet is fast gaining recognition as a powerful, low-cost method to deliver health intervention and prevention programs to large numbers of young people across diverse geographic regions. The feasibility and accessibility of Internet-based health interventions in resource-limited settings, where cost-effective interventions are most needed, is unknown. To determine the utility of developing technology-based interventions in resource-limited settings, availability and patterns of usage of the Internet first need to be assessed. Methods and Findings The Uganda Media and You Survey was a cross-sectional survey of Internet use among adolescents (ages 12–18 years) in Mbarara, Uganda, a municipality mainly serving a rural population in sub-Saharan Africa. Participants were randomly selected among eligible students attending one of five participating secondary day and boarding schools in Mbarara, Uganda. Of a total of 538 students selected, 93% (500) participated. Of the total respondents, 45% (223) reported ever having used the Internet, 78% (175) of whom reported going online in the previous week. As maternal education increased, so too did the odds of adolescent Internet use. Almost two in five respondents (38% [189]) reported already having used a computer or the Internet to search for health information. Over one-third (35% [173]) had used the computer or Internet to find information about HIV/AIDS, and 20% (102) had looked for sexual health information. Among Internet users, searching for HIV/AIDS information on a computer or online was significantly related to using the Internet weekly, emailing, visiting chat rooms, and playing online games. In contrast, going online at school was inversely related to looking for HIV/AIDS information via technology. If Internet access were free, 66% (330) reported that they would search for information about HIV/AIDS prevention online. Conclusions Both the desire to use, and the actual use of, the Internet to seek sexual health and HIV/AIDS information is high among secondary school students in Mbarara. The Internet may be a promising strategy to deliver low-cost HIV/AIDS risk reduction interventions in resource-limited settings with expanding Internet access.
Post-Avian Flu Profitability and Resource Use Efficiency of Broiler Farmers in Akwa Ibom State, South-South, Nigeria
S.U.O. Onyeagocha,N.C. Ehirim,C.A. Emenyonu,C.S. Onyemauwa,F.O. Nwosu,D.O. Ohajianya,C.C. Eze,G.A. Anyanwu,N.N.O. Oguoma,B.O. Esonu
Agricultural Journal , 2013, DOI: 10.3923/aj.2010.37.44
Abstract: The profitability, determinants of the viability and resource use efficiency of broiler farmers in Akwa Ibom state, South-South, Nigeria were evaluated in this study after the incidence of Avian-flu pandemic in parts of Nigeria. Multi-stage, random sampling technique was employed in selecting 72 broiler farmers comprising backyard poultry, semi-commercial and commercial broiler farmers. Cost route approach was used in data collection. The data were analyzed using cost and return analysis, financial and efficiency ratios; as well as descriptive and inferential statistics. The result of the analysis indicated that the broiler enterprise was profitable although production was at low capacity. The variable cost constituted about 83% of the total cost and feed alone made up about 60% of this cost. Fixed cost constituted about 17% of total cost. The returns on gross and net profits were about 30 and 15%, respectively. For every bird sold, the farmer made a profit of N435 and the breakeven point (volume) was 348 broilers. A striking difference of over 35% profitability was observed between this study and a previous study in the same state before the Avian-flu attack in Nigeria, thus raising grave concerns of any direct attack for the industry in the area. Further, the regression analysis showed that feed, equipment and labour were statistically significant at 5% level, thus enhancing the usage of these inputs would increase profitability. The farmers, who were mainly of middle age group and school certificate holders, were found to be allocatively inefficient and operated at an increasing return to scale. This implied that they were operating in Zone 1 or Irrational Zone of the production function. To be efficient, the broiler farmers need to re-adjust downwards the over-utilized inputs, namely feed, labour, equipment and drugs by 35, 79, 99.8 and 99.9%, respectively. In addition, the under-utilized input, namely, size of stock, need to be re-adjusted upwards by 56%. Allied to this, is the need to enhance the farmers educational status (formal and informal) and encourage young graduates to take to farming. All stakeholders including the government, consumers and producers should synergize in the monitor and control of the Highly Pathogenic Avian Influenza (HPAI) strain H5NI, which rampaged parts of the country to stem possible morbidity of the disease.
How to Take HIV Antiretroviral Medications on Time without a Watch in Rural Uganda
Marissa Maier,Mwebesa Bwana,Nneka Emenyonu,Larry Pepper,David R Bangsberg
PLOS Medicine , 2006, DOI: 10.1371/journal.pmed.0030161
Abstract:
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