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Decades ago, the United Nations declared that access to essential medicines was a key element of universal human rights. Accordingly, member states have been striving to address this issue through strategic policies and programs. Strengthening local pharmaceutical production has been a pivotal strategy adopted by many developing countries including Ethiopia. The government of Ethiopia identified local pharmaceutical production as a key industrial sector and has been implementing a ten-years strategic plan to improve capabilities and attract investment. Such support is needed because local production could satisfy only 15 to 20% of the national demand, typically from a limited portfolio of medicines in conventional dosage forms.The increasing prevalence of chronic diseases has accentuated the need for a more sustainable supply to reduce reliance on imports and increase access to essential medicines. A full understanding of the structure, constraints and complexities of the Ethiopian pharmaceutical market structure is vital to direct effective policies, target most impactful investments and exploit opportunities for leapfrogging. Hence, the purpose of this review was to assess the trends and challenges in access to essential medicines and local pharmaceutical production in Ethiopia. Literature search through major databases and review of policy documents and performance reports from relevant sector institutions were made to extract information for the review.&nbsp

Cellulose, the most abundant biomass material in nature finds wide applications in the pharmaceutical industry. Sugarcane bagasse (SCB) is one of the main agricultural lignocellulose byproducts. The objective of this study was to prepare and characterize native and microcrystalline cellulose (MCC) from SCB and evaluate the MCC as a directly compressible pharmaceutical excipient. Cellulose was extracted from SCB by chlorine-free methods with or without dewaxing. MCC was prepared from the cellulose by hydrolysis using hydrochloric acid, and subsequently oven-dried (OD) or spray-dried (SD). The as-obtained cellulose and MCC were characterized in terms of yield, degree of polymerization (DP), chemical functionality, crystallinity, morphology and thermal stability. The chemical composition, particle size, densities and direct compressibility of MCCs were also determined. Cellulose yields on a dry weight basis were found to be 42.8 ± 1.10% and 43.5 ± 0.5% from non-dewaxed and dewaxed SCB, respectively. Dewaxed SCB cellulose (DSCBC) provided higher yield of MCC (DSCB-MCCOD, 83 ± 0.74%) than non-dewaxed SCB cellulose (SCBC) (SCB-MCCOD; 78 ± 1.07%). The DP of SCBC and DSCBC were 580.56 and 592.75, respectively, while the DP of MCC ranged from 230.10 - 251.40. The FTIR spectra of both cellulose and MCC were similar with that of Avicel PH-101. The degree of crystallinity of the dewaxed cellulose (77.34%) and MCCOD (79.56%) and MCC-SD (81.87%) were higher than non-dewaxed cellulose (74.50%) and MCC-OD (78.11%) and MCC-SD (79.62%). Scanning electron micrographs (SEM) showed a fibrous structure for DSCBC and rod-shaped for DSCB-MCC. Thermogravimetric analysis (TGA) revealed dewaxed products exhibited better thermal stability than non-dewaxed products. All MCC samples exhibited monomodal normal particle size distributions. The Hausner ratio and Carr’s index of DSCB-MCCOD and Avicel PH-101 were not significantly different (p < 0.05) indicating similar flow property and compressibility of the materials, respectively. Also, plain tablets prepared from SCB-MCC showed reasonably high crushing strengths (MCC-SD > MCC-OD), although tablets of Avicel PH-101 showed the highest crushing strengths. Thus, SCB could be an alternative source of cellulose and MCC for pharmaceutical applications.

Hydroalcoholic extracts of four different plant species [Artimesia absinthum L. (Asteraceae), Asparagusafricanus Lam. (Liliaceae), Datura stramonium L. (Solanaceae) and Nigella sativa L. (Ranunculaceae)]commonly used in traditional medicine in Ethiopia for the treatment of skin disorders were evaluated fortheir potential antimicrobial activities against pathogenic bacteria (Escherhia coli, Pseudomonas aeruginosa,Staphylococcus aureus, and Streptococcus pyogenes) and fungi (Candida albicans, Epidermophyton floccosum,Microsporum canis, Trichophyton verrucosum, and Trichophyton violaceum) using agar diffusion method. Allthe extracts showed antibacterial activities against one or more test organisms. The extract of N. sativa seedsexhibited the highest antibacterial activity against all the bacterial species tested. The minimum inhibitoryconcentrations (MICs) of the methanolic extract of N. sativa seeds were 0.156 and 2.5 mg/ml on standardstrains of S. aureus and C. albicans, respectively. Successive extraction of the seeds of N. sativa withpetroleum ether, chloroform, acetone and methanol revealed that the chloroform extract exhibited largerdiameter of zone of inhibitions against the test organisms. Phytochemical screening of the total extract of N.sativa powdered seeds revealed the presence of flavonoids, polyphenols, terpenoids, and steroids which arethought to be responsible for the activity of the extracts of N. sativa seeds. Of the various, topicalformulations of the crude extract of N. sativa seeds, the O/W emulsion based formulation showed largerdiameter of zone of inhibition. In mice paw oedema induced by carrageenan, the crude extract of N. sativa ata dose of 300 mg/kg showed the strongest anti-inflammatory activity (64.2%) followed by A. Africanus(50.1%). Keywords: skin disorders, plant extracts, antimicrobial activity, anti-inflammatory activity, minimum inhibitoryconcentration

Starch from the tubers of Ethiopian potato (Plectranthus edulis) (Fam. Lamiaceae) has been isolated and examined for its chemical composition, amylose content and physicochemical properties. The starch yield was about 80.4% on dry weight basis. The proximate composition of the starch on dry weight basis was found to be 0.14% ash, 0.21% lipid, 0.43% protein, and 99.2% starch. The amylose content was 30.6%. Its true density and moisture content values were 1.47 g/mL and 11.2%, respectively. Scanning electron microscopy (SEM) of the starch granules showed characteristic morphology that was by and large oblong (elliptical) with some oval-shaped granules. The starch has normal granule size distribution with a mean particle size of 36.2 µm. The DSC thermograms of the starch obtained from starch-water mixtures (1:1), exhibited gelatinization onset temp. (To) of 69.2 oC, peak temp. (Tp) of 74.3 oC and endset temp. (Te) of 83.3 oC. X-ray diffraction pattern of the starch was typical B-type with a distinctive maximum peak at 17.5o 2θ.The starch possesses higher swelling power and moisture sorption pattern but lower solubility values than those of potato starch at all temperatures studied. Considering the high yield and some similar physicochemical properties to those of potato starch, P. edulis (Ethiopian potato) can be explored as an alternative source of starch for various applications.

Starch has been intensively studied over decades due to the fact that native starches are diverse, biodegradable, amenable to modifications and have enormous applications. In this study, Dioscorea abyssinica starch has been chemically dual modified by cross-linking using sodium hexametaphosphate (SHMP) followed by acetylation with acetic anhydride (AA). The physicochemical and tablet forming properties of the modified starches were investigated to determine potential usages in sustained release (SR) applications. Moisture sorption and swelling properties of the native starch (NS) were improved by the dual modification. The reduction observed in viscosity values indicated the effectiveness of cross-linking in reducing swelling of the NS. On the basis of powder properties analysis, it was evident that acetylation improved the poor flow property of NS. The starch acetylated at starch:AA ratio of 1:2 was found to be free flowing with angles of repose of 23.02o and flow rate 10.54 g/sec. The Hausner ratio and Carr’s index also confirmed the same, 1.25 and 20.24, respectively. Tablets were prepared and evaluated for hardness, tensile strength, friability, and disintegration time. Results indicated that both cross-linking and acetylation processes improved tablet forming properties of the NS with more significant effect in the dual modified starches. Matrix tablets containing Ac-CLS-F, where cross-linked starch (CLS – at 15% SHMP) reacted in a 1:2 ratio with AA, loaded with 20, 30 and 40% theophylline released 80% of theophylline in about 10.62, 9.35, and 8.18 h, respectively. From the foregoing, it can be concluded that Ac-CLS-F could have a potential for use as a sustained release excipient.Keywords: Dioscorea abyssinica, cross-linking, acetylation, dual modification, sustained release

Starch obtained from Colocasia esculenta, Araceae (locally known as godare) has been pregelatinized, cross-linked and evaluated as a sustained release excipient and hydrophilic matrix former in tablet formulations. The pregelatinized starch (PGS) was cross-linked in a microwave oven at three different powers (90, 220 and 350 W) and reaction times ranging from 1 to 6 min, using sodium hexametaphosphate (SHMP) as cross-linking agent. Theophylline tablets containing 30, 40, and 50% and the modified starches were compressed at a constant compression force. Dissolution profiles of theophylline were determined in 0.1 N HCl for the first 2 h and then in phosphate buffer pH 6.8 for the remaining 10 h. Degree of cross-linking (DC) increased with increasing reaction power and time. The resulting modified starches were found to be freely flowing, moisture and acid resistant. Two of the nine theophylline tablet formulations sustained the release over the study period of 12 h releasing about 90% of the drug. The in vitro drug release showed best fit to Higuchi and Hixson-Crowell models depending on the polymer-drug ratio and the type of matrix formers. The dual modified starch in a concentration ranging from 40 to 50% exhibited the attributes of sustained release matrix-forming polymer in the tablet formulations studied. Keywords: godare starch, dual modification, microwave, sustained release, hydrophilic matrix

Introduction: In Ethiopia, most people are dependent on traditional medicine (TM), mainly of plant origin for human and animal health problems. The practice of herbal medicine varies widely, in keeping with the societal and cultural heritage of different countries. The heritage has not been well documented in the developing countries including Ethiopia and this is even more so in the emerging regions of the country. The objective of this study was to document medicinal plant knowledge of the people and identifying factors determining the use of medicinal plants in Jigjiga Woreda, Somali Regional State, eastern Ethiopia.Methods: A cross-sectional study was conducted in five kebeles from where ethno-medicinal information was collected using semi-structured questionnaire. The questionnaire was administered to 800 heads of households. Data were entered and analyzed using Statistical Packages for Social Sciences version 20. Multivariable logistic regression was performed to show possible associations between the dependent and independent variable and statistical significance was set at p < 0.05.Results: The study documented an overall prevalence of 40% to use of herbal medicine during one month recall period. A total of 45 medicinal plant species were collected and botanically identified. The study found that leaves are the most frequently utilized plant part (30.5%), followed by roots (23.0%). The reasons for preference of herbal drugs were related to lower price, efficacy and geographic accessibility as compared to modern medicine. Age, gender, educational status and occupation were identified as important determinants for the use of herbal medicine.Conclusion: This ethno-medicinal study showed that community in Jigjiga Woreda relies on traditional medicinal plant species to treat a wide spectrum of human ailments. It is therefore suggested that more in depth studies be condicted to explore the potential of traditional medicine in the region to preserve this indigenous knowledge. [Ethiop. J. Health Dev. 2017;31(3):188-199]Keywords: Ethnomedicine, Jigjiga Woreda, Medicinal plants, Somali ethnic group

Glibenclamide is practically insoluble in water and its GI absorption is limited by its dissolution rate. This study was conducted to improve the solubility and dissolution properties of glibenclamide using solid dispersion technique. The carriers used were polyethylene glycol (PEG) 6000 and polyvinyl pyrrolidone (PVP) K-30 with or without sodium lauryl sulphate (SLS) in different weight ratios and prepared by solvent evaporation, melting and physical mixing techniques. PVP K-30 was used only for solvent evaporation method. Equilibrium solubility, in vitro dissolution, fourier transform infrared (FTIR) spectroscopy and differential scanning calorimetry (DSC) studies were performed. Equilibrium solubility and in vitro dissolution studies showed remarkable improvements in drug solubility and release from the solid dispersions and physical mixtures as compared to the drug alone. This can be attributed to the improved wettability, dispersibility and decreased crystallinity of the drug, particularly in the solid dispersions. The ternary solid dispersion of the drug with PVP K-30 at a ratio of 1:5 with SLS showed the highest dissolution rate of 94.41 ± 0.47% in comparison to pure drug (30.26 ± 0.06%), binary solid dispersion (86.71 ± 0.57%), physical mixture (57.72 ± 0.88%) and other solid dispersions. Solid dispersion prepared with PVP K-30 showed better improvement in solubility and dissolution rate of glibenclamide than PEG 6000. Glibenclamide with PEG 6000 solid dispersions by melting method showed highest dissolution relative to the solvent evaporation. The dissolution rate of glibenclamide was directly proportional to increment in proportion of the carrier. The results obtained from FTIR spectroscopy showed good evidence of drugcarrier compatibility for those solid dispersions that showed highest dissolution and solubility. Crystallinity of the drug was reduced in the solid dispersions as revealed by the DSC thermograms. The results suggested that solid dispersion with selected excipients is a powerful tool to accelerate the dissolution of glibenclamide, a poorly water-soluble drug.Keywords: glibenclamide, solid dispersion, PEG 6000, PVP K-30, dissolution

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BACKGROUND: Self-care is a response of individuals to promote or restore their health. Self-medication, one form of self-care, it is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms of illnesses. Although there are arguments for and against self-medication, its contribution in the promotion of health is beyond doubt. This study deals with self-medication on modern drugs and it attempts to assess self-medication practices of drug consumers. METHODS: A multi-stage stratified sampling of drug retail outlets in Addis Ababa was employed. Convenient sampling was used to select respondents from among those who came to the community pharmacies to purchase drugs for self-medication. Respondents were interviewed after they made their requests but before they were provided with information on the drugs they requested. Data were collected using a pre-tested semistructured questionnaire. RESULTS: Socio-demographic characteristics of respondents revealed that drug consumers consisted of all age categories of both genders; as well as pregnant and breast-feeding mothers of varying educational background levels. The most frequently reported illnesses that prompted self-medication of respondents were gastrointestinal diseases, headache, fever and respiratory tract infections. Slightly greater than 30% of illnesses/symptoms of illnesses were less than 24 hours and around one-fifth, one or more weeks of duration. The most common reasons reported for self-diagnosis and selfmedication were non-seriousness of the disease, emergency use and prior experience on the drug. Two-thirds of the drug consumers requested drugs by specifically mentioning the name of the drug or category to which it belongs and 20.7% by telling their illness or symptoms of illnesses. More than 100 different types of drugs were requested, the most frequent category of drugs being analgesics or antipyretics 30.1%, antimicrobials (26.4%) and gastrointestinal drugs (17.7%). CONCLUSION: Self-medication is widely practised for a wide range of illnesses or symptoms of illnesses, and for both over-the-counter and prescription only drugs. The public as well as the health care providers have to be educated on the scopes of selfmedication; i.e., the type of illnesses to be self-diagnosed and self-treated, and the type of drug products to be used in order to promote responsible self-medication.Ethiop J Health Sci. Vol. 14, No. 1 January 2004