Factors Associated With Late Presentation of Suspected Tuberculosis Cases to Tuberculosis Management Facilities: The Case in Dagoretti District, Nairobi, Kenya.

Factors associated with late presentation of suspected tuberculosis cases to tuberculosis management facilities: The case in Dagoretti district, Nairobi, Kenya.

Filed under: Drug and Alcohol Rehabilitation

Pan Afr Med J. 2012; 12: 93
Njau IW, Karanja SM, Wanzala P, Omolo JO

Tuberculosis is a highly contagious disease accounting for a high number of deaths in the developing countries; its control can be effectively achieved if individuals with the disease receive adequate and timely treatment. The objective of this study was to determine the factors associated with late presentation of suspects to tuberculosis management facilities in Dagoretti district in Nairobi, Kenya.A cross sectional study was conducted on patients aged 18 years and above attending TB clinics in Dagoretti District, Nairobi Kenya. A total of 426 TB suspects were interviewed. The study covered 8 clinics in Dagoretti district. Analysis was done using SPSS version 16.0 and Epi info version 6, this included Chi Square for Bivariate analysis and Binary Logistic Regression for Multivariate Analysis.Out of the 426 tuberculosis suspects, 248 (58.2%) suspects had delayed in seeking medical care. In Bivariate analysis male gender (P = 0.039, O.R = 1.51; 95% Confidence Interval; 1.00- 2.27), level of education (Primary class 5-8) (P = 0.001, O.R= 2.06; 95% C.I 1.34-3.19) and place of first medical care (drug store) (P= 0.013, O.R = 1.63; 95% C.I 1.09-2.46) were all significantly associated with late presentation. After multivariate logistic regression, gender (P = 0,019, OR = 1.6), level of education (p = 0.029, OR = 1.26) and place of first medical care (P= 0.01 OR = 1.27), were found to be significantly associated with late presentation.This study shows that age, level of education and place of first medical care are the factors associated with late presentation of suspects to tuberculosis management facilities.
HubMed – drug

 

Adverse drug reactions of Highly Active Antiretroviral Therapy (HAART) in HIV infected patients at the General Hospital, Douala, Cameroon: a cross sectional study.

Filed under: Drug and Alcohol Rehabilitation

Pan Afr Med J. 2012; 12: 87
Namme Luma H, Doualla MS, Choukem SP, Temfack E, Ashuntantang G, Achu Joko H, Koulla-Shiro S

The use of highly active antiretroviral therapy (HAART) as the main option for management of people living with Human Immune deficiency virus (HIV) is associated with decrease morbidity and mortality. This is due to its effectiveness in inhibiting viral replication. However this effectiveness is not without adverse drug effects which in many settings are not monitored.A cross sectional clinical chart review of adult Cameroonian patients on HAART between 2003 and 2009 at the Douala General Hospital was done in search of reported HAART-associated Adverse Drug effects (ADRs). The prevalence of ADR defined as the proportion of the study population with ADR was determined and stratified by age, sex, weight and HAART regimen.Sixty-six (19.5%) of the 339 patients on HAART reported ADRs. Among those who reported ADRs, 29.6% were on D4T-3TC-EFV, 29.3% on D4T-3TC-NVP, 16% on AZT-3TC-EFV and 10.8% on AZT-3TC-NVP. Peripheral Neuropathy was the most common ADR and represented 21.2% of all ADRs. Patients on D4T containing regimens were more likely to develop ADR (OR = 3.5, 95% CI 1.5 – 9.8, p<0.01) and 56.1% of all ADRs were associated to D4T. Hospital admissions were for patients with severe anaemia, no fatal cases of ADRs were recorded.HAART-associated ADRs are common and therefore should be actively looked for by caregivers so as to ameliorate the quality of life of HIV patients on treatment. HubMed – drug

 

Efavirenz poisoning in a 12 year old HIV negative African boy.

Filed under: Drug and Alcohol Rehabilitation

Pan Afr Med J. 2012; 12: 86
Nazziwa R, Sekadde M, Kanyike F, Wobudeya E, Nabukeera-Barungi N

Efavirenz is an oral antiretroviral drug in the class of non nucleoside reverse transcriptase inhibitors. Toxicity at therapeutic doses has been documented but there is scarcity of data on presentation and management of Efavirenz overdose. We describe a case of Efavirenz poisoning in a 12-year old HIV Negative African boy with a very unique presentation after ingesting 3 grams of Efavirenz as a single dose. The most prominent problems were burning sensation in the throat immediately after ingestion then visual impairment one hour later then tremors, screaming at night and motor deficits in lower limbs for 5 days before admission. His medical history, physical exam and investigations revealed no other cause of his presentation other than the EFV. Unfortunately, it was not possible to do EFV levels. He was given supportive treatment and 10 days later he was completely well.
HubMed – drug

 

Activation of AMPK by the Putative Dietary Restriction Mimetic Metformin Is Insufficient to Extend Lifespan in Drosophila.

Filed under: Drug and Alcohol Rehabilitation

PLoS One. 2012; 7(10): e47699
Slack C, Foley A, Partridge L

The biguanide drug, metformin, commonly used to treat type-2 diabetes, has been shown to extend lifespan and reduce fecundity in C. elegans through a dietary restriction-like mechanism via the AMP-activated protein kinase (AMPK) and the AMPK-activating kinase, LKB1. We have investigated whether the longevity-promoting effects of metformin are evolutionarily conserved using the fruit fly, Drosophila melanogaster. We show here that while feeding metformin to adult Drosophila resulted in a robust activation of AMPK and reduced lipid stores, it did not increase lifespan in either male or female flies. In fact, we found that when administered at high concentrations, metformin is toxic to flies. Furthermore, no decreases in female fecundity were observed except at the most toxic dose. Analysis of intestinal physiology after metformin treatment suggests that these deleterious effects may result from disruptions to intestinal fluid homeostasis. Thus, metformin appears to have evolutionarily conserved effects on metabolism but not on fecundity or lifespan.
HubMed – drug

 

 

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