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Soil-transmitted helminthiasis affects more than 1.5 billion people globally and largely remains a sanitary problem in Africa. These infections place a huge economic burden on poor countries and affect livestock production, causing substantial economic losses and poor animal health. The emergence of anthelmintic resistance, especially in livestock, and the potential for its widespread in humans create a need for the development of alternative therapies. Medicinal plants play a significant role in the management of parasitic diseases in humans and livestock, especially in Africa. This report reviews anthelmintic studies that have been conducted on medicinal plants growing in Africa and published within the past two decades. A search was made in various electronic databases, and only full articles in English were included in the review. Reports show that aqueous and hydroalcoholic extracts and polar fractions obtained from these crude extracts form the predominant (80%) form of the extracts studied. Medicinal plants, extracts, and compounds with different chemical groups have been studied for their anthelmintic potential. Polyphenols and terpenoids are the most reported groups. More than 64% of the studies employed in vitro assays against parasitic and nonparasitic nematode models. Egg hatch inhibition, larval migration inhibition, and paralysis are the common parameters assessed in vitro. About 72% of in vivo models involved small ruminants, 15% rodents, and 5% chicken. Egg and worm burden are the main factors assessed in vivo. There were no reports on interventions in humans cited within the period under consideration. Also, few reports have investigated the potential of combining plant extracts with common anthelmintic drugs. This review reveals the huge potential of African medicinal plants as sources of anthelmintic agents and the dire need for in-depth clinical studies of extracts, fractions, and compounds from African plants as anthelmintic agents in livestock, companion animals, and humans.

Background Antimicrobial resistance threatens adequate healthcare provision against infectious diseases. Antibiograms, combined with patient clinical history, enable clinicians and pharmacists to select the best empirical treatments prior to culture results. Objectives To develop a local antibiogram for the Ho Teaching Hospital. Methods This was a retrospective cross-sectional study, using data collected on bacterial isolates from January–December 2021. Samples from urine, stool, sputum, blood, and cerebrospinal fluid (CSF) were considered as well as, aspirates and swabs from wound, ears and vagina of patients. Bacteria were cultured on both enrichment and selective media including blood agar supplemented with 5% sheep blood and MacConkey agar, and identified by both the VITEK 2 system and routine biochemical tests. Data on routine culture and sensitivity tests performed on bacterial isolates from patient samples were retrieved from the hospital’s health information system. Data were then entered into and analysed using WHONET. Results In all, 891 pathogenic microorganisms were isolated from 835 patients who had positive culture tests. Gram-negative isolates accounted for about 77% of the total bacterial species. Escherichia coli (246), Pseudomonas spp. (180), Klebsiella spp. (168), Citrobacter spp. (101) and Staphylococcus spp. (78) were the five most isolated pathogens. Most of the bacterial isolates showed high resistance (>70%) to ampicillin, piperacillin, ceftazidime, ceftriaxone, cefotaxime, penicillin G, amoxicillin, amoxicillin/clavulanic acid, ticarcillin/clavulanic acid and trimethoprim/sulfamethoxazole. Conclusions The isolates from the various samples were not susceptible to most of the antibiotics used in the study. The study reveals the resistance patterns of E. coli and Klebsiella spp. to some antibiotics on the WHO ‘Watch’ and ‘Reserve’ lists. Using antibiograms as part of antimicrobial stewardship programmes would optimize antibiotic use and preserve their efficacy.

Herbal medicines are invaluable in African medicine, but quality and safety are not documented in many cases. Besides controlled farming, validated quality control methods are needed to ensure identity, purity, and content. Analytical specifications within modern monographs are needed for consistent batch quality. Combretum mucronatum leaves are widely used in West Africa, but state-of-the-art quality control methods and specifications are non-existent. The aim of the following study was the development of ICH-validated chromatographic protocols for identity, purity, content assay, and analytical specifications for consideration into pharmacopoeial monographs. UPLC-ESI-Q-TOF-MS/MS was used for untargeted phytochemical information on composition. Optimisation of extraction was based on phytochemical profiling. HPTLC was used for differentiation of C. mucronatum from other Combretum species and UPLC for simultaneous determination of 7 marker compounds. C. mucronatum batch analyses (n = 49) investigated the influence of harvest time and geographical origin. Pesticides screening from a 349-compound panel were carried out. 30 compounds, identified by LC-MS, were used for characterization of the plant material. Orietin, isoorientin, vitexin and isovitexin were used as specific marker compounds for qualitative and quantitative HPTLC purposes, while UPLC quantified additionally epicatechin, procyanidins B2 and C1. Influence of harvest time and geographic origin on the content of marker compounds was observed. Differences in the metabolite profiles of C. mucronatum compared to related Combretum species were established for quality control purposes. Contamination with high amoounts of chlorpyrifos, and folpet (sum of folpet and phtalimide, expressed as folpet) were also observed.The study provides analytical protocols, analytical specifications and a drafted monograph for consideration for African pharmacopoeias, and reveals potential challenges in the quality of C. mucronatum.

The study evaluated the antifungal activities of the 70% ethanol extracts of

Antimicrobial resistance (AMR) is a significant problem in global health today, particularly in Low- and Middle-Income Countries (LMICs) where antimicrobial stewardship programmes are yet to be successfully implemented. We established a partnership between AMR pharmacists leads from a UK NHS hospital and in Ho Teaching Hospital with the aim to by enhance antimicrobial stewardship knowledge and practice among healthcare providers through an educational intervention. We employed a mixed method approach including an initial before and after training survey on knowledge and awareness, followed by qualitative interviews with healthcare providers conducted six months after delivery of training. This study was carried out in Ho teaching hospital with 18 healthcare professionals including pharmacists, medical doctors, nurses and medical laboratory scientists. Ethical approval was obtained prior to data collection. In the first phase, we surveyed 50 health care providers including nurses (33%), pharmacists (29%) and biomedical scientists (23%). Of these, 58% of participants had engaged in continuous professional development on AMR/AMS, and above 95% demonstrated good knowledge on the general use of antibiotics. A total of 18 participants, which included 4 medical doctors, 5 pharmacists, 4 nurses, 2 midwives and 3 biomedical scientists, were interviewed in the second stage and demonstrated greater awareness of AMS practices, particularly the role of education for patients as well as healthcare professionals. We found that knowledge and practice with AMS was markedly improved six months after the training session. There is limited practice of AMS in LMICs, however through AMR focused training we demonstrate improved AMS skills and practice among health care providers in Ho Teaching hospital. There is need for continuous AMR training sessions for health care professionals in resource limited settings.

In Africa, herbalism supplements allopathic medicine's efforts to ensure Universal Health Coverage attainment. This review was conducted to identify and to summarise current literature on methodological approaches used for quality control of herbal medicines in Africa, to evaluate the gaps associated with existing strategies within context of best practices, and make recommendations for future improvements.A systematic search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were screened and assessed for eligibility.118 articles were included into the study. There was a high preference for impurity profiling tests (77%) indicating the prioritization for tests that guarantee safety despite the limited analytical resources available. Other classes of tests reported included identification tests (29%), physicochemical tests (18%), and content assays (12%). Although standard methods exist in preparing samples for impurity tests, different techniques were observed in different studies, and this could lead to differences in analytical outcomes. Content assays focused on single marker assessments, which may be inadequate to comprehensively assess the quality of products.This review provides knowledge of existing strengths and challenges for herbal medicine quality assessments in Africa. For future it is recommended to implement more studies on contaminants (e.g. mycotoxins) and pharmaceutical adulterants. The use of chemometrics to develop analytical methods should be promoted. Also, stakeholders in the medicine quality industry in Africa need to effectively collaborate to establish a well co-ordinated and harmonized system to provide a sustainable framework for the GACP and GMP guided production and quality assurance of herbal medicines.

A standardised Global Point Prevalence Survey (PPS) tool was used to determine the antimicrobial prescription pattern in the Ho Teaching Hospital on two separate occasions in a total of 14 wards in the hospital, including dedicated wards for paediatrics and neonates. Manually collected and anonymised data were entered, validated, analysed and reported using a web-based global PPS application. With 147 and 153 patients considered in the July 2019 and January 2020 surveys, respectively, 98 patients (66.7%) and 84 patients (54.9%) had received one or more antimicrobials. The prevalence of antimicrobial use in the adult wards was 64.3% (72/112) and 53.4% (63/118) in the first and second surveys, respectively. The prevalence in the paediatric wards was 60.0% (12/20) and 62.5% (10/16), respectively, in the two surveys, while that in the neonatal wards was 93.3% (14/15) and 57.9% (11/19), respectively. β-lactams were the most used antibiotics in both periods. Malaria was the most common diagnosis requiring the use of antimicrobials in July 2019, accounting for 19.4% of the diagnoses, whereas in January 2020, it was skin and soft-tissue conditions (28.1%). This reflects a seasonal association between malaria and rainfall patterns. Out of the antimicrobials prescribed during each of the survey periods, 95% were used for empirical treatment, and this could be attributed to a number of reasons, including logistical challenges, among others, that require further exploration in the context of local, national and international policy recommendations.

Introduction. The stem bark extract ofMaerua angolensisDC. (Capparaceae) is used as a traditional remedy for management of anxiety, psychosis, and epilepsy.Aim of the Study. We therefore aimed at evaluating the anxiolytic and antidepressant potential of the plant in mice models.Methods. The dried stem bark was extracted with petroleum ether/ethyl acetate (50:50) mixture to obtain the extract, MAE. We employed Irwin’s test to identify the preliminary behavioral and autonomic effects. Subsequently, MAE was administeredper osto male mice and subsequently assessed, 1 h later, for anxiety parameters in the elevated plus maze (EPM) and the regular Suok tests. The forced swim (FST) and tail suspension (TST) tests were employed to assess the antidepressant potential of the extract (100-1000 mg kg−1).Results. In our preliminary assay, MAE (100-5000 mg/kg) exhibited analgesic effects and a reduction in fear response in the Irwin’s test. The spontaneous locomotor activity was reduced at 1000 mg/kg. Additionally, MAE (1000 mg/kg) increased the latency to PTZ-induced convulsions, and duration to sleep in the pentobarbitone induced sleeping time assay. MAE (1000 mg/kg), similar to diazepam, in the anxiolytic assay, increased the percentage time spent in the open arms while decreasing protected head dips and unprotected stretch attend postures in the EPM. Correspondingly, there was a reduction in anxiety-induced immobility and freezing in the Suok test (300 mg/kg) without loss of sensorimotor coordination. Additionally, there was a significant reduction in immobility duration in the FST (300 mg/kg) and TST (1000 mg/kg).Conclusion. The petroleum ether/ethyl acetate fractions ofMaerua angolensisstem bark possess anxiolytic and acute antidepressant effects in mice.

This study investigated the antiinflammatory properties of betulinic acid (BA) and xylopic acid (XA) extracted from Margaritaria discoidea and Xylopia aethiopica, respectively. M. discoidea and X. aethiopica are plants native in Ghana and the West-African region and used traditionally to treat different pathologies including inflammatory conditions. The antiinflammatory effect of BA and XA was established by an in vivo assay using the carrageenan-induced pleural inflammation model in mice. Also, the ability of BA and XA to increase catalase, superoxide dismutase, glutathione levels and decrease lipid peroxidation level in reactive oxidative assays was assessed. In addition, the ability of XA and BA to prevent potential lung tissue damage was quantified. Pretreatment with BA and XA reduced significantly, signs of inflammation: neutrophil infiltration, oedema, and alveoli septal thickening in carrageenan-treated lung tissue. Additionally, BA or XA pretreatment lowered the degree of lipid peroxidation in the lung tissue while increasing the levels of catalase, superoxide dismutase, and glutathione in vivo. Comparatively, XA was more efficacious than BA in the prevention of lung tissue damage. BA and XA derived from X. aethiopica and M. discoidea possess antiinflammatory and in vivo antioxidant activities in mice pleurisy model. The effect of these compounds gives credence to the traditional use in the management of inflammatory conditions of the airway.

Introduction.The stem bark ofMaerua angolensisDC. (Capparaceae) is traditionally used for management of epilepsy. Our aim was to evaluate the antiseizure potential and identify possible mechanisms by which the effects are registered.Methods.The petroleum ether/ethyl acetate extract (100–1000 mg kg−1) was administered per os to male Sprague-Dawley rats after pretreatment with flumazenil (0.3 mg kg−1) or L-arginine (150 mg kg−1) or sildenafil (5 mg kg−1) and they subsequently received a subcutaneous injection of pentylenetetrazole (65 mg kg−1). Rats were observed for latency to and duration of myoclonic seizures and additionally the level of protection against oxidant markers and products was assessedin vitroandin vivo.Results.The extract (300 and 1000 mg kg−1, p.o.) significantly delayed the onset and decreased the duration and frequency of PTZ-induced convulsions. The anticonvulsant effect of MAE (300 mg kg−1, p.o.) was reversed by pretreatment with flumazenil, L-arginine, or sildenafil. Also, MAE (300 mg kg−1) treatment reversed significantly PTZ-induced oxidative stress in rat brain tissue.Conclusion.The petroleum ether/ethyl acetate fraction exhibits antiseizure activity by affecting GABAergic and nitric oxide-cGMP pathways. In addition, the extract protects against the generation of free radicals and the oxidative products of the PTZ-induced seizures.

Objective: Malaria is a major public health problem in Ghana and many indigenes, especially those in rural areas, resort to the use of medicinal plants to treat the disease. The plants: Persea americana Mill. (Lauraceae), Theobroma cacao L. (Malvaceae) and Tridax procumbens (L.) L. (Compositae) are used solely or in combination with other medicinal plants to manage malaria and its associated conditions. The leaves of the plants which are normally the main parts employed, were studied for their phytochemistry and antiplasmodial activity to establish their chemical profile and verify the antimalarial claim. Methods: Plant materials were subjected to basic phytochemical screening to identify the major secondary metabolites. The aqueous extracts were evaluated against chloroquine-sensitive 3D7 P. falciparum and chloroquine-resistant W2 P. falciparum strains, using the fluorescence-based SYBR® green I method to determine their antiplasmodial activity. Results: Basic phytochemical screening of the leaves revealed the presence of tannins, flavonoids and alkaloids in all three plant materials. T. cacao and P. americana, in addition, contained purine base alkaloids, triterpenoids including saponins. The aqueous extracts of the leaves showed antiplasmodial activity against the chloroquine-sensitive 3D7 P. falciparum (9.50 ± 1.38 ≤ IC50 ≤ 10.15 ± 0.45 µg/mL) and against chloroquine-resistant W2 P. falciparum strains (6.40 ± 1.94 ≤ IC50 ≤ 44.94 ± 1.12 µg/mL). The aqueous extract of T. cacao was the most active and was more active against W2 than 3D7 P. falciparum. Only T. procumbens displayed cytotoxicity (CC50