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Background: Traditional medicines are widely used in the rapidly growing health system and are of economic importance. The study aimed at determining the frequency, pattern of use and factors that influence traditional medicines use during pregnancy. Materials and methods: A cross-sectional study was carried out at four district hospitals in Manicaland, Zimbabwe, using questionnaire based convenience sampling. Results: Traditional medicines use was found to be high with 54% (n = 337) of pregnant women using traditional medicines during pregnancy. The major purpose of use of traditional medicine was found to be preparation for delivery; cervical dila- tion in particular. The following factors showed a significant statistical association for use of traditional medicines: previous mode of delivery (p = 0.006), level of education (p = 0.016), family income (p = 0.007), and residential settlement (p = 0.026). Some of the common traditional medicines used during pregnancy include Camellia sinensis, Aloe, Spirostachys Africana, Thumbergia lancifolia, Dalbergiella nyasae, Steganotaenia oraliacea, Stomatostemma monteiroae and Cussonia arborea. Conclusion: A number of pregnant women use traditional medicines as partus preparators (labour aids) throughout the entire pregnancy period. This calls for obstetricians, general practitioners and midwives to inquire about use of traditional medicine in history. Keywords: Traditional medicines; pregnancy; Zimbabwe.

Background Many of the cancer cases in Zimbabwe are HIV related, making it a significant health concern in the country. This concern requires innovative ways, such as implementing Value-Added Tax (VAT) to finance cancer management through health insurance. The study explores the general public, cancer patients, and public authorities' perception regarding using the VAT system for financing cancer treatment. Method A qualitative cross-sectional study was conducted to explore the perception of study participants on ‘Value Added Tax’ as a source of healthcare financing in Harare. This was done through the use of in-depth interview guides. A total of 25 participants took part in the study. Fifteen were members of the general public, 5 were cancer patients, and 5 were key informants representing public authority. Members of the general public and cancer patients were conveniently selected, while key informants were purposively selected. Data were analyzed descriptively and by grounded theory whereby codes were developed by induction. Results The general public and cancer patients perceived cancer treatment as generally unaffordable and showed readiness to pay for a cancer levy through VAT. Cancer patients expressed disappointment at the low support for cancer treatment compared to HIV treatment concerning the already established AIDS levy. Public authorities also perceived the VAT system as an appropriate programme for health care financing. Conclusion This preliminary study found that a ‘Value-Added-Tax’ system could potentially be an acceptable model to finance public healthcare, including cancer treatment in highly informal settings like Zimbabwe.

Infection with Plasmodium falciparum parasites may result in a wide spectrum of symptoms ranging from asymptomatic to mild or severe. A number of factors are associated with this heterogeneous response to P. falciparum infection. In the present study, associations of sub-microscopic asymptomatic P. falciparum with Schistosoma species and TNF (rs1800629) polymorphism were investigated.361 clinically healthy primary school children were microscopically screened for S. haematobium, S. mansoni and P. falciparum. Sub-microscopic asymptomatic P. falciparum infections were determined by PCR. Genotypic profiles were identified using ARMS-PCR. Logistic regression was used to assess the association of sub-microscopic asymptomatic P. falciparum with Schistosoma species and TNF (rs1800629) polymorphism.17.2% of the children were infected with S. mansoni, and 27.4% were infected with S. haematobium. Microscopic examination of thick smears detected only one child infected with P. falciparum. Based on PCR results, 46.1% were infected with sub-microscopic asymptomatic P. falciparum. Children carrying heterozygous AG (OR: 16.964, 95% CI: 0.496-586.547) and homozygous GG (OR: 2.280, 95% CI: 0.111-46.796) genotypes of rs1800629 were associated with an increased likelihood of sub-microscopic asymptomatic P. falciparum infections compared with those carrying homozygous AA genotype. Children without S. haematobium infections (OR: 1.051, 95% CI: 0.146-8.985) and S. mansoni (OR: 2.658, 95% CI: 0.498-14.184) also had an increased likelihood (risk) of being infected with sub-microscopic asymptomatic P. falciparum compared with the Schistosoma-infected groups. However, all the associations observed were not statistical significant.No associations were observed between rs1800629 and schistosomiasis with sub-microscopic asymptomatic P. falciparum infections. This study also reports a high prevalence of sub-microscopic asymptomatic P. falciparum infection concomitant with low malaria transmission.L'infection par les parasites P. falciparum peut entraîner un large éventail de présentations allant d'asymptomatiques à bénignes ou sévères. Un certain nombre de facteurs sont associés à cette réaction hétérogène à l’infection à P. falciparum. Dans la présente étude, les associations entre la présentation asymptomatique sous-microscopique de P. falciparum avec les espèces de Schistosoma et le polymorphisme du TNF (rs1800629) ont été investiguées. MÉTHODES: 364 écoliers du primaire en bonne santé clinique ont subi microscopique pour S. haematobium, S. mansoni et P. falciparum. Les infections asymptomatiques sous-microscopiques à P. falciparum ont été déterminées par PCR. Les profils génotypiques ont été identifiés en utilisant ARMS-PCR. La régression logistique a été utilisée pour évaluer l'association entre la présentation asymptomatique sous-microscopique de P. falciparum avec les espèces de Schistosoma et le polymorphisme du TNF (rs1800629). RÉSULTATS: Parmi les enfants, 17,2% étaient infectés par S. mansoni et 27,4% étaient infectés par S. haematobium. L'examen microscopique de frottis épais n'a détecté qu'un seul enfant infecté par P. falciparum. D'après les résultats de la PCR, 46,1% étaient infectés par P. falciparum asymptomatique sous-microscopique. Les enfants porteurs des génotypes hétérozygotes AG (OR: 16,964 ; IC95%: 0,496-586,547) et homozygotes GG (OR: 2,280 ; IC95%: 0,111-46,796) de rs1800629 étaient associés à une probabilité accrue d'infections asymptomatiques sous-microscopiques à P. falciparum par rapport à ceux porteurs du génotype homozygote AA. Les enfants sans infection à S. haematobium (OR: 1,051 ; IC95%: 0,146-8,985) et S. mansoni (OR: 2,658 ; IC95%: 0,498 à 14,184) présentaient également une probabilité (risque) accrue d'être infectés par P. falciparum asymptomatique sous-microscopique par rapport à ceux infectés par Schistosoma. Cependant, toutes les associations observées n'étaient pas statistiquement significatives.Aucune association n'a été observée entre le rs1800629 et la schistosomiase avec des infections asymptomatiques sous-microscopiques à P. falciparum. Cette étude rapporte une prévalence élevée d' infection asymptomatique sous-microscopique à P. falciparum concomitante à une faible transmission du paludisme.

Background: Host genetic factors can influence susceptibility, morbidity and mortality from schistosomiasis. The study explored the association between single nucleotide polymorphisms (SNPs) in interleukin-10 (IL-10) and tumour necrosis factor alpha (TNF-α) promoter regions and susceptibility to Schistosoma haematobium infection. Methods: Urine specimens were collected from 361 primary school children aged 5–15 years from schistosomiasis endemic areas of Manicaland and Mashonaland central provinces. Schistosoma haematobium was diagnosed using the urine filtration method. Only 272 participants provided adequate blood for genotyping. Genotyping was performed using the amplification refractory mutation system-polymerase chain reaction. The association between IL-10 and TNF-α SNPs and S. haematobium infection was analysed using the chi-square test. Results: Schistosoma haematobium infection was confirmed in 26.8% of the participants. No significant difference in S. haematobium prevalence between men (51.6% of those infected) and women (48.4%) (χ 2 = 0.008, df = 1, p = 0.928) was observed. The total IL-10 -1082 G, IL-10 -819 C and TNF-α -308G allele distribution between S. haematobium infected and uninfected participants was 50.7% and 51.5% (χ 2 = 0.025, df = 1, p = 0.87), 54.3% and 60.6% (χ 2 = 1.187, df = 1, p = 0.187) and 82.1% and 80.9% (χ 2 = 0.099, df = 1, p = 0.753), respectively, and the differences were not significant. Conclusion: Interleukin-10 -1082 G/A, IL-10 -819 C/T and TNF-α -308 G/A SNPs were not significantly associated with susceptibility to S. haematobium infection. The prevalence of schistosomiasis is still in the moderate range and is similar in boys and girls.

Objectives To determine the price, availability, and affordability of antineoplastic medicines in private and public sector pharmacies in Harare Metropolitan Province, Zimbabwe. Methods The study was based on the methodology recommended by the World Health Organization and Health Action International. A total of 32 antineoplastic medicines in 3 public central hospitals and 150 private pharmacies were surveyed. The median price ratio, percentage availability, affordability, and percentage markups were calculated. Results Availability at the public institutions was 28%, whereas the private sector ranged from 1.3% to 42.7%. The median price ratio in the private sector ranged from 0.6 to 11, whereas the public sector ranged from 0.73 to 2.25. Affordability in the public sector ranged from 1 to 10 days wage and from 1 to 490 days wage in the private sector. The average percentage markup was 51.3% in the private sector and 34% in the public sector. Conclusion Antineoplastic medicines were more available in the private sector than in the public sector, but more affordable in the public sector. The average percentage markups for antineoplastic medicines demonstrated that medicines were not overpriced in the public sector, but in the private sector were sold at prices higher than the international reference price.

Herbal medicines are considered an intricate and integral part of humankind's knowledge systems. Time has proven their efficacy and safety for both human and animal applications. Modern science, guided by indigenous knowledge systems can further optimize the use of various herbal products. To widen the current focus on herbal medicines, a study was carried-out to determine antioxidant properties, phytochemical and mineral contents of some medicinal plants used in ethnoveterinary practices in the management of animal wounds in Zimbabwe. The studied plants were Cissus quadrangularis L, Erythrina abyssinica Lam. ExDC. and Adenium multiflorum Klotzsch. Radical scavenging activities, antioxidant properties were determined using the DPPH and the β-carotene-linoleic acid model while the total phenolic content was determined using the Folin C method, flavonoid content using the aluminium assay and mineral content was investigated using the ICP-OES method. All extracts investigated exhibited radical scavenging activities and antioxidant properties, with C. quadrangularis leaf extracts exhibiting superior activities such as radical scavenging (EC50 of 21.04 ± 3.00 μg/ml) and antioxidant properties (ORR of 0.03 ± 0.01). Variations were observed in the total phenolic, flavonoid and metal contents. C. quadrangularis leaf extracts exhibited highest amounts of total phenolic and flavonoid contents. The E. abyssinica (bark) and A. multiflorum extracts exhibited moderate (40–70%) affinity for protein binding while the rest of the extracts exhibited high affinity. Their antioxidant properties, phytochemical profile and mineral content justify applications in animal wound management and many other human and/or animal uses.

Background: Knowledge gaps exist between host genetic factors and susceptibility to schistosomiasis. Objective: This study determined cytokine levels and single nucleotide polymorphisms of tumour necrosis factor (TNF)-α (rs1800629) and interleukin (IL)-10 (rs1800871) and their possible impact on susceptibility to schistosomiasis in preschool-age children in the Madziva area of Shamva district, Mashonaland Central province, Zimbabwe. Methods: Urogenital schistosomiasis was diagnosed using the urine filtration method, while a sandwich enzyme-linked immunosorbent assay was used for cytokine level determination. The survey was done in August 2015 and reinfection levels post treatment were assessed at 3, 6 and 12 months. Amplification refractory mutation system polymerase chain reaction with visualisation on 2% agarose gel electrophoresis was used for genotyping. Results: Schistosomiasis prevalence was found to be 10.5% (59/563). Reinfections were detected in only six children at 3 months and only one was reinfected at 12 months. There were no significant differences in TNF-α-308 G/A allele or genotype frequencies between the Schistosoma haematobium infected participants (p = 0.360) and uninfected participants (p = 0.279). However, no children with the IL-10-819 TT genotype had schistosomiasis. The TNF-α GG genotype corresponded with significantly lower TNF-α levels when compared with the GA or AA genotypes (p 0.001), and TNF-α levels were significantly lower in infected children compared to uninfected children (p 0.001). Conclusion: Higher TNF-α levels and lower IL-10 levels are potentially protective against schistosomiasis infection. The IL-10-819 TT genotype is potentially protective against infection through its association with lower IL-10 levels.

Plants have arrays of phytoconstituents that have wide ranging biological effects like antioxidant, anti-inflammatory and antimicrobial properties key in wound management. In vivo wound healing properties of ointments made of crude methanolic extracts (10% extract w/w in white soft paraffin) of three plant species, Cissus quadrangularis L. (whole aerial plant parts), Adenium multiflorum Klotzsch (whole aerial plant parts) and Erythrina abyssinica Lam. Ex DC. (leaves and bark) used in ethnoveterinary medicine were evaluated on BALB/c female mice based on wound area changes, regular observations, healing skin's percentage crude protein content and histological examinations. White soft paraffin and 3% oxytetracycline ointment were used as negative and positive controls, respectively. Wound area changes over a 15 day period for mice treated with C. quadrangularis and A. multiflorum extract ointments were comparable to those of the positive control (oxytetracycline ointment). Wounds managed with the same extract ointments exhibited high crude protein contents, similar to what was observed on animals treated with the positive control. Histological evaluations revealed that C. quadrangularis had superior wound healing properties with the wound area completely returning to normal skin structure by day 15 of the experiment. E. abyssinica leaf and bark extract ointments exhibited lower wound healing properties though the leaf extract exhibited some modest healing properties.

Introduction: There is high malaria related morbidity and mortality amongst infants and children in malaria endemic areas. An In-depth understanding of protective immunity correlates enables the long due necessary development of an effective malaria vaccine. This study aimed at evaluating antibody responses to apical membrane antigen 1 (AMA 1) that helps P falciparum entry into red blood cells, Glutamate rich protein (GLURP), an antigen expressed in the whole life cycle of the malaria causing pathogen, merozoite surface protein-1 (MSP 1) coding for a major antigen in the asexual stage of P falciparum and merozoite surface protein 3 (MSP 3), a polymorphic blood stage malaria antigen in Zimbabwean children living in malaria endemic areas. Methods: We characterized humoral immune responses to malaria vaccine candidates in a two year longitudinal survey among 136 children (6-16 years) from Burma and Kariba in Zimbabwe. Blood samples were collected and analyzed for malaria parasites, plasma and antibody titers against malaria vaccine candidates [MSP1, MSP3, GLURP, AMA] by ELISA technique. The blood samples were also checked for potential confounders like anemia, bilharzia and HIV sero-status using the ELISA technique. Results: Ig levels were significantly different ( p < .0001) across the three time points, and against the different candidates ( p < .0001). MSP3 had the highest (13,552.2) and GLURP the least (4,741.6) IgM titers. However, IgG, IgG1, IgG3 and IgG4 levels were highest against AMA compared to other vaccine candidates, [anti-MSP3 IgG3 (15.3) and anti-GLURP IgG4 (58.7)]. Anemia burden was about 44% at baseline with a threefold decrease (-16%) over the 12 month follow up. Conclusions: This study highlights the need for robust evaluation of several malaria vaccine candidates in combination to understand correlates of protective immunity as suggested by the significant antibody levels against the four vaccine candidates. Longer follow up periods are needed to assess the impact of continuous malaria exposure on host immune responses. Multivalent malaria vaccine development offer a better chance towards an efficacious malaria vaccine compared to monovalent vaccine. Antibody levels against the four vaccine candidates were significant suggesting that an ideal malaria vaccine should target more than one antigen.

Objective: Grade three children (9-10 years) are recommended as the optimal study population for assessing community prevalence of schistosomiasis and soil transmitted helminthiasis (STHs).However their knowledge, attitudes and practices (KAP) of these children in relation to schistosomiasis, and malaria is not known. Methods: Using multistage sampling, grade 3 children (n=172) were randomly selected from four primary schools in Shamva and Mutare districts in Zimbabwe. And were interviewed using a pre-tested interviewer administered questionnaire. The urine filtration technique was used to determine S. haematobium infection status. Infection with S. mansoni and STHs was determined using a combination of results from the Kato Katz and formol ether concentration techniques. P. falciparum was diagnosed by examination of Giemsa stained thick blood smears. Results: The baseline knowledge proportions about the disease causes among the children were schistosomiasis (32.0%), STHs (19.2%) and malaria (4.1%) which increased after intervention to 67.4%, 71.5%, and 55.8%, respectively. Knowledge of school children about prevention measures of the same diseases improved from schistosomiasis (22.1%), STHs (19.2%), and malaria (5.8%), respectively at baseline to schistosomiasis (69.2%), STHs (66.3%) and malaria (59.3%), respectively. Prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum declined from 61.2%, 17.7%, 7.3% and 21.2% at baseline to 15.9%, 3.4%, 4.1%, and 6.8% respectively. Mean infection intensities for S. haematobium and S. mansoni decreased by 94.8% and 96.6% respectively. Conclusion: School based health education improves knowledge of children about disease transmission and control measures. However lack of enabling amenities such as soap, safe and clean water, ITNs in schools and the involvement of the community are yawning gaps that deserve urgent filling.

Bioactive compounds were extracted from 6 wild and 4 domesticated cereal grains of Zimbabwe, using 50% methanol with the aim of testing their capability to prevent phospholipid peroxidation and β-carotene bleaching. The highest yield of phenolic compounds was obtained from Eleusine indica (a wild cereal) with 7.16 mg GA/100 mg sample, while the least yield was obtained from Amaranthus hybridus with 1.13 mg GA/100 mg sample. Antioxidant activities of the cereal extracts were studied using the β-carotene-linoleic acid and the inhibition of phospholipid peroxidation assays. It was shown that Sorghum arundinaceum had the greatest (77%) increase in inhibition of phospholipid when its concentration was increased from 20 to 80 mg/ml, while Eleusine corocana, a domestic cereal grain had the least. Relative to a standard BHA (an artificial antioxidant), E. indica was found to have the highest ability (67%) to prevent bleaching of β-carotene, while Pennisetum spp with 17.3% inhibition, had the least ability. Owing to the ability of the cereal grain extracts to act as antioxidants, the studies can be further extended to exploit the phenolic extracts as replacements of artificial antioxidants like butylated hydroxyl anisole (BHA) in food and health supplements and nutraceuticals. Key words: Wild cereal grains, antioxidants, phospholipid peroxidation, health supplements.