School of Pharmacy

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A comparative study of the leaf and root extracts of Stephania abyssinica (Dillon & A. Rich) Walp on wound healing activity in mice
(Addis Ababa University, 2023-07) Girma,Minilu; Petros,Zelalem (PhD); Tamirat,Dagnachew(MD)
The roots and leaves of Stephania abyssinica are traditionally used to treat wounds in several regions of Ethiopia. The pharmacological screening for wound-healing activity of the plant was done for the crude extract and solvent fractions of the root extract. But there have been no pharmacological studies done on the wound-healing effect of the leaf extract. In this study, the wound-healing effects of both the 80% methanol extract of the leaves and the roots of S. abyssinica were evaluated using the excision wound model, and the results were compared. Histopathological investigations were also carried out. The antioxidant activity of both the leaf and root extracts was also assessed. In addition, preliminary phytochemical screening tests and quantification of total phenolic, flavonoid, and alkaloid contents were done for both the leaf and root extracts. Both the root and the leaf extracts significantly increased the rate of wound contraction (p < 0.05) and shortened the re-epithelialization period (p < 0.01). The root extract significantly increased the skin‟s tensile strength (p ˂ 0.001). The quantity of secondary metabolites in the root extract, such as total phenolic, flavonoid, and alkaloid contents, was found to be higher than those of the leaf extract, and this concentration difference demonstrated a substantial difference in its wound healing activity.
A Queuing Analysis of Medicines Registration System Performance in Ethiopian Food and Drug Authority
(Addis Ababa University, 2023) Alamneh,Abebe; Ali,Eskinder Eshetu(Dr.); Marew,Tesfa
Background: The limited number of approved medicines and long waiting time for registration are the major challenges limiting the performance of the regulatory system in Ethiopia. Queue analysis is used for characterizing and estimating the queue process and operating variables of the system to alleviate the challenges related to target timelines. Objective: To assess the queuing performance of the registration system at the Ethiopian Food and Drug Authority (EFDA). Methods: A mixed sequential explanatory study design was used for the study. Quantitative data collection involved a review of applications submitted to the EFDA from July 8, 2019 to July 7, 2020. Basic operating characteristics of the registration system performance were executed using single queue multiple server model of the queuing analysis. In-depth interviews with purposively selected registration experts from the EFDA and private organizations were done for the qualitative data collection. Analysis of the interviews involved the thematic analysis approach. Results: Mean arrival rate of applications to the registration system (λ=10.99 services per day) was 23.74% higher than the mean effective service rate of the system (cμ=8.38 services/day). Basic system performance average operating characteristics of the system could not be estimated indicating that an infinite queue of applications built up over time and was hard to achieve any target timeline in EFDA’s current registration system. The qualitative study also showed that the system is being frequently challenged with backlogs. Conclusion: The study documented weak system performance with lengthy registration process. Appropriate measures to improve mean effective registration service rate should be introduced to meet international standards and the agreed citizen’s charter of 2016.
Acceptability of Azithromycin Mass Treatment for Trachoma Elimination in Injibara Town and Adjacent Banja Woreda of Awi Zone, Amhara Region
(Addis Ababa University, 2014-06) Tilahun, Zelalem; Gedif, Teferi(PhD)
Trachoma is the leading cause of infectious blindness worldwide. Globally 1.2 billion people live in endemic areas. In Ethiopia, approximately 67 million people are at risk for trachoma. The Amhara National Regional State of Ethiopia is the most trachoma-endemic among all nine regional states and two city administrations, with Trachomatous inflammation Follicular prevalence of 62.6%. Mass azithromycin treatment is the one arm of the SAFE strategy. The trachoma elimination program would be successful if and only if the coverage is as high as possible with full community participation. If not all the community members attend the mass treatment, the trachoma infection will return to the baseline prevalence after the treatment stopped due to high transmission rate. The objective of this study was to assess the acceptability of the azithromycin mass treatment and its determinants in Injibara town and the adjacent Banja woreda of Awi zone, Amhara National Regional State. A community based cross sectional survey with both quantitative and qualitative methods was conducted from July 7-25, 2013. Households’ survey with structured questionnaire, FGDs and key informant interviews were used for data collection. A total of 5826 eligible household members from 1267 households were enrolled in the survey. The 2012 annual azithromycin mass treatment coverage obtained from the present study was 92.9%. From the total 6 rounds of azithromycin mass treatment in the study area, only half (50.6%) of the community took for more than three times. On average, each illegible person in the community had taken the drug for 3.6 times. The percentage of rural household members who had taken azithromycin more than three times was higher than the corresponding urban members. The rural residents were at better performance in taking the 2012 treatment as compared to the urban residents (AOR=2.35; 95%CI [1.80-3.06]). Household heads interference with the drug uptake of their family members’ has negative association with azithromycin uptake (AOR=0.153; CI=95% (0.086-0.272). All the study participants who were X greater than 30 years more likely took azithromycin more than 3 times as compared with children less than 15 years (COR=2.81, AOR=2.74, 95% CI [1.95-3.02]). Azithromycin uptake status of female household heads was less than the corresponding male household heads (AOR=0.41; 95% CI [0.24-0.720]). Household heads awareness about trachoma (AOR=2.55; 95% CI [1.19-5.44]) and azithromycin mass treatment (AOR=7.19; 95% CI [3.27-15.82]) had positive association with acceptability. The 2012 azithromycin mass treatment coverage in Injibara town and Banja woreda was higher than the WHO minimum target. But, concerning to the overall coverage, the data taken from the present study contradicts the coverage data taken from the woreda. The communities’ Azithromycin mass treatment acceptability had increased in the recent campaigns as compared to the previous campaigns. There is low coverage and acceptability of the treatment in the urban community as compared to the rural residents. Supplementary benefits of azithromycin, health education about trachoma and the drug, willingness and being old are some of the factors positively related with acceptability whereas educational status, marital status and experience with side effects were not associated with the drug uptake status. Strengthen the program in the urban and consideration of additional campaigns for both areas as well as providing additional health education with skilled health professionals is mandatory. Key words: Azithromycin mass treatment, Mass drug administration, Acceptability, Trachoma, Trachoma elimination
Access to Essential Psychotropic Medicines in Addis Ababa: A CrossSectional Study
(Addis Ababa University, 2022-01) Ayehu, Molla Teshager; Prof.Fenta, Teferi Gedif; Prof.Araya, Mesfin
Background: Mental disorders are becoming a growing public health problem worldwide, especially in low- and middle-income countries. To provide quality mental health services, regular and adequate supplies of appropriate, safe and affordable medications are required. However, significant percentages of people with severe mental disorders are not getting the treatment. Availability and affordability of psychotropic medicines, amongst others, are the major barriers for many patients in meeting their medication needs. This study aimed to assess the availability, prices and affordability of essential psychotropic medicines in the private and public health sectors of Addis Ababa city. Methods: A cross-sectional study design was used in 60 retail medicine outlets. Quota sampling and purposive sampling was applied to select the retail outlets. Data was entered and analyzed by using the pre-programmed WHO/HAI workbook and SPSS version 25. Outcome measures were described as percentage availability, median price and median price ratios, and the number of days' wages needed to purchase medicines by the lowest-paid unskilled government worker. Finally, the results were presented as statements, tables, figures and graphs. Results: The mean availability of LPG psychotropic medicines was 24.33% in Addis Ababa (28.7% in the public sector and 19.80% in the private sector), and of OB medicines were 2.42 %( 2% in the private and 2.8% in the public sectors). Similarly, the public procurement prices for 16 LPGs ranged from 0.25-4.83 MPRs and the median procurement price was 0.96 MPR. The patient prices for the LPGs ranged from 0.52-6.43 MPRs in public and 1.08- 24.28 MPRs in private sectors. The patient prices for OB medicine were 5.21 MPR in public and 11.17 in private sectors. The cost of standard treatment varied from 0.1–7.8 days' wages in public and 0.8-25 days' in private sectors for the lowest-paid government worker to purchase a month's supply. Conclusions: Essential psychotropic medicines were poorly available with high prices and low affordability in Addis Ababa. To ensure access, an efficient supply across all levels of care and financial protection for key medicines should be in place.
Activity Testing, Toxicity Assay and Characterization of Chemical Constituents of Medicinal Plants Used to Treat Tuberculosis in Ethiopian Traditional Medicine
(Addis Ababa University, 2016-04) Kahaliw, Wubayehu; Engidawork, Ephrem (PhD); Abebe, Markos (PhD)
Background: Tuberculosis (TB) is the leading killer disease worldwide. In 1993, WHO declared TB as a ‘global emergency,’ which requires emergency action and launched several programs to curb the disease, including the search for newer remedies and/or anti- TB agents to complement currently used agents. Hence, herbal remedies have become the readily available alternatives in the search for new antimycobacterial compounds. Objective: To investigate antimycobacterial activity and toxicity of selected Ethiopian medicinal plants (Otostegia integrifolia, Vernonia amygdalina, Persea americana, Pterolobium stellatum and Carissa edulis) as well as to isolate the main active principles through a bioassay guided process. Methods: Antimycobacterial activity test was conducted using the broth microdilution and microtitre resazurin assay methods in 96 well microtitre plates and MIC was determined by colony counting and resazurin color change observation for all test materials. Cytotoxicity test was performed based on the CellTiter 96® AQueous One Solution Cell Proliferation Assay on HepG2 cells. Genotoxic effects of extracts were evaluated using SCGE method on HepG2 cells. Results: Chloroform and 80% methanol extracts of P. stellatum and O. integrifolia as well as 80% methanol and acetone extracts of P. americana had significant antimycobacterial activity (p < 0.001) against M. tuberculosis H37Rv, while chloroform extract of V. amygdalina and C. edulis didn’t show significant activity compared to negative controls. The MIC of positive control was 0.125 μg/ml against the standard strain. However, MDR-TB clinical isolates were isoniazid resistant. Fractionation and activity testing of the chloroform extract of P. stellatum revealed that ethyl acetate ii fraction to be the most active fraction against M. tuberculosis H37Rv with MIC of 0.195 μg/ml. The MICs of compound 1, 2 and 3 were 1.25, 2.5 and 0.625 μg/ml, respectively. In the cytotoxicity test, V. amygdalina chloroform extract showed the highest IC50 value (3.202±0.3375), which suggests its safety. O. integrifolia and P. stellatum chloroform extracts were the most toxic in dose dependent manner as one can see the steepness of the dose-response curve. DNA damage in the form of comet tail has been observed for 1 and 0.5 mg/ml P. stellatum chloroform and 80% methanol extracts on HepG2 cells, respectively. The rest of test extracts seemed to be without genotoxic effect up to a concentration of 0.5 mg/ml. Cytotoxicity test was not in the objectives of my study. Conclusion: P. stellatum, O. integrifolia and P. americana have potential to be developed into new anti-TB drugs or standardized herbal medicines. P. stellatum chloroform extract was the most active extract and hence, three compounds were isolated from ethyl acetate fraction and they were active against M. tuberculosis H37Rv. The results have also validated indigenous medical knowledge from the local people regarding the use of these species to treat TB. The IC50 value of P. stellatum chloroform extract was relatively higher compared to other extracts, suggesting its safety. In addition, its selectivity index was 13.5, which demonstrated > 10 selectivity index, considered as being of interest to the pharmaceutical companies. The genotoxicity assay findings revealed that the chloroform and 80% methanol extracts of P. stellatum caused DNA damage at 1 mg/ml and 0.5 mg/ml concentrations. Thus, necessary precautions should be taken during utilization of this plant.
Adverse Drug Reactions And Associated Clinical Outcomes In Patients With DrugResistant Tuberculosis: A Facility-Based Retrospective Cohort Study In Addis Ababa, Ethiopia
(Addis Ababa University, 2024-04-13) Solomon, Bisrat; Manyazewal, Tsegahun; Manyazewal, Yimtubezinash
Drug-resistant Tuberculosis (DR-TB) poses a significant global public health threat, with adverse drug reactions (ADRs) during treatment complicating medication outcomes and leading to substantial mortality. In Ethiopia, despite a high prevalence of DR-TB, there have been limited studies on ADRs during treatment and their effects on patient outcomes
Aminoalkyl and Oxazine of 2-Naphthol Derivatives: Synthesis, In vitro Antimicrobial and In Silico Studies
(Addis Ababa University, 2024-02) Motbaynor,Gizachew; Bisrat,Daniel(PhD); Asres,Kaleab(PhD)
Despite remarkable advancements in the past decade, infectious diseases continue to pose a significant threat, affecting millions and burdening global public health systems and economies. Currently, there is growing interest in 2-naphthol derivatives, particularly 1-aminoalkyl-2- naphthol derivatives, owing to their biological activities and their potential application in synthesizing other significant bioactive molecules. Therefore, in this study, two compounds were synthesized from a 2-naphthol framework. The synthesized compounds were purified through column chromatography, and their chemical structures were identified using 1H and 13C, DEPT- 90, and DEPT-135 NMR spectral data, as 1-(phenyl(ortho-tolylamino)methyl)naphthalene-2-ol (37) and 2-benzyl-2,3-dihydro-1H-naphtho[1,2-e][1,3]oxazine (39). The potential antimicrobial activity of the synthesized compounds was evaluated by the disk diffusion and broth dilution method. At the same time, molecular docking and ADMET studies were conducted to investigate their possible mechanism of action and drug-like properties. From our findings, both synthesized compounds exhibited promising antibacterial activity against most tested bacterial strains at 200 μg/ml, showing zones of inhibitions (ZOIs) ranging from 6.0 mm to 15.5 mm. The positive standard ciprofloxacin demonstrated ZOIs between 11.5 mm and 20.5 mm. Compound 37 exhibited greater susceptibility against E. coli with a MIC value of 25 μg/ml followed by V. cholera (MIC) at 50 μg/ml. v In contrast, Gram-positive bacteria such as Bacillus pumilus and B. subtilis demonstrated the lowest sensitivity to compounds (37) and (39), displaying a ZOI value of 6.0 mm at 200 μg/ml. Both compounds 37 and 39 also displayed antifungal activity against most tested fungal species. In molecular docking analysis, compounds (37) and (39) demonstrated significant binding energy within the binding pocket of E. coli DNA gyrase B, yielding docking scores of -8.092 and -7.754 kcal/mol, respectively. Similarly, with C. albicans lanosterol 4α-demethylase, they displayed docking scores of -7.792 and -8.995 kcal/mol, respectively. Following the ADMET prediction analysis, both synthesized compounds exhibit favorable pharmacokinetics and drug-like characteristics, making them suitable for oral administration. In addition to the in vitro bioassay activity test, molecular docking results and ADMET predictions collectively convey the promising antimicrobial properties of both synthesized compounds. These findings imply that conducting further synthesis and evaluation of 2-naphthol derivatives could be beneficial in the ongoing efforts to develop antimicrobial drugs for combating infectious diseases and microbial resistance.
Analgesic and anti-inflammatory activities of Albizia gummifera (J. F. Gmel) C.A. Sm. bark hydro-alcoholic extract and its fractions in rodents
(Addis Ababa University, 2023-10) Tamirat,Mesfin; Petros,Zelalem(PhD); Shibeshi,Workineh(PhD)
Background: The majority of illnesses present as pain and inflammation. Despite advancement in pain medicines, there is a need for safe, effective analgesic drugs. In folkloric medicine, A.gummifera has been used for pain and inflammation, but not scientifically evaluated. Objectives: This study aimed to investigate the analgesic and anti-inflammatory activities of A.gummifera bark crude extract and its fractions in rodents. Methods: The analgesic activity of the A.gummifera was evaluated using an acetic-acid- induced writhing test and hot plate test by using acetyl salicylic acid 150 mg/kg and morphine 10 mg/kg as standard, respectively. Carrageenan-induced paw edema and cotton pellet granuloma methods were used to investigate the anti-inflammatory effect with Indomethacin 10 mg/kg and dexamethasone 0.5 mg/kg as the reference drugs, respectively. Three doses are selected based on the acute toxicity test result: 100 mg/kg, 200 mg/kg, and 400 mg/kg. Results: The A.gummifera bark crude extract and its fractions did not show any sign of toxicity at 2000 mg/kg. The crude extract and its fractions showed statistically significant analgesic and anti-inflammatory activities as compared to the control group (p<0.05). The crude extract and methanol fractions reduced writhes by 66.68% and elongate latency period by 61.47% on 60 and 90 minute, respectively. The maximum edema inhibition was 62.15% in the aqueous fraction after 2 hours of administration. Aqueous fraction produces maximum exudate and granuloma inhibition (62.07% and 65.66%, respectively). Conclusion: This study found that, A.gummifera bark crude extract and its fractions possessed promising analgesic and anti-inflammatory property.
Analgesic and Antinflammatory Activities of the Root extract of Grewia schweinfurthii and its Constituent and Determination of Nutritional and Antinutritional Compositions of its Fruit
(Addis Ababa University, 2023) Leta,Abdi; Hymete, Ariaya (PhD); Tadesse,Solomon(PhD); Giday,Mirutse(PhD)
The utilization of current treatments can often result in harmful side effects, and cause patients to experience pain and inflammation. In Ethiopian, traditional healers have relied on medicinal herbs, such as Grewia schweinfurthii, which possess analgesic and anti-inflammatory properties. Despite their widespread use, studies regarding the nutritional content of wild edible plants (WEPs) in low-income nations like Ethiopia are limited. This study aimed to evaluate the analgesic and anti-inflammatory effects of 80% methanolic root extract of G. schweinfurthii and its chemical constituents, as well as to examining the nutritional and antinutritional content of its fruit. The root extract of G. schweinfurthii and its constituents were evaluated for their analgesic activity using acetic acid-induced writhing and hot plate tests. The root extract was subjected to column chromatography (silica gel) to isolate a compound coded as AL-03 and tentatively identified as 4-(2''-(4'-isopropylphenyl) propan-2''-yl)-2,3-dihydrofuran based on spectroscopic (1H, 13C NMR & HSQC) data. The root extract G. schweinfurthii demonstrated significant analgesic activity (p < 0.001) in the acetic acid-induced writhing test at doses of 200 and 400 mg/kg. Additionally, in the hot plate method, a dose of 400 mg/kg of root extract showed noteworthy analgesic activity (p < 0.001). In the carrageenan-induced acute inflammation model, all doses (100, 200, 400 mg/kg) of the root extract resulted in a significant decrease in paw edema compared to the negative control. Compound AL-03 also exhibited antinflammatory activities in a dose-dependent manner against carrageenan-induced paw edema. XI Proximate analysis was used to assess various nutritional parameters of G. schweinfurthii fruit, including crude protein, fat, total ash, crude fiber, and carbohydrates. In this regard, G. schweinfurthii fruit revealed the following composition: moisture (4.09 ± 0.10%); crude protein (11.24 ± 0.68%); fat (1.99 ± 0.01%); total ash (5.36 ± 0.20%); crude fiber (32.50 ± 0.50%); carbohydrate (44.82 ± 0.82%); and total energy (242.12 ± 1.72 kcal). Furthermore, phytate (62.97 ± 0.83%), tannin (3.97 ± 0.12%), and oxalate (0.28 ± 0.03%) were identified as antinutritional components. Overall, G. schweinfurthii fruit was found to be a reliable source of nutrients and bioactive compounds. The findings support the traditional medicinal use of the plant for analgesic and antinflammatory activities. Further research is recommended to explore additional bioactive compounds from the root extract of G. schweinfurthii and to analyze the mineral composition, such as amino acids, and vitamin C content of G. schweinfurthii fruit, as well as to conduct sub-acute and chronic toxicology testing
Anthelmintic Activity of the Seed Oil of Ricinus communis
(Addis Ababa University, 2023-03) Berhanu,Temesgen; Asres, Kaleab(Prof.); Bisrat, Daniel(Dr.)
Helminthic infections are among the most widespread parasitic infections in humans. It is estimated that more than half of the world’s population suffer from parasitic infections. It poses morbidity particularly in children and pregnant women. Helminthic infections are more common in developing countries with poorer personal and environmental hygiene. Plant-derived drugs and herbal remedies remain important resources to alleviate and cure diseases, especially in developing countries. Variety of plants from various families including Ricinus communis from the family Euphorbiaceae are used to treat helminthiasis across the world. R.communis is an annual oilseed crop commonly known as castor. Antimicrobial, antifungal, anticancer, antidiabetic, anti-inflammatory and antimalarial are some of the pharmacological activities that have been reported from extracts of R. communis. In the present study, the petroleum ether seed extract of R. communis, its base hydrolysate and the major constituent of the hydrolysate were tested for their anthelmintic activities against the model organism Caenorhabditis elegans. The dried and powdered seeds were extracted using petroleum ether and then the oil collected was subjected to base hydrolysis to obtain the hydrolysate. Fractionation of the hydrolysate by column chromatography packed with silica gel 60-G resulted in the isolation of the hydroxylated fatty acid (9Z)-12-hydroxyoctadec-9-enoic acid (ricinoleic acid). The isolated free fatty was esterified by 5% Potassium hydroxide solution in methanol to get ricinoleic acid methyl ester. Structural elucidation of the compounds was achieved by spectroscopic techniques including ESI-MS, 1H and 13C-NMR spectral data. Results of the anthelmintic assay revealed that VIII ricinoleic acid and its methyl ester are strongly active against C. elegans worms compared to the oil. Ricinoleic acid exhibited 97% mortality at the tested concentration of (1 mg/ml). In conclusion, the present study demonstrated that the oil of R. communis seeds possesses strong anthelmintic activity against the model nematode C. elegans worms and the activity of the oil would be attributed to the presence of ricinoleic acid as a major constituent.
Anti Tuberculosis Drug Induced Hepatotoxicity in Hiv Positive and Negative Patients
(Addis Ababa University, 2005-06) Yimer, Getnet; Aseffa, Abraham(PhD)
Anti-tuberculosis drug induced hepatotoxicity (DIH) is a common problem in the management of tuberculosis. This study was intended to identify possible risk factors for development of DIH, including degree of immunosuppression. In this prospective 2-month cohort study, 103 HIV positive and 94 HIV negative newly diagnosed tuberculosis patients were followed after initiation of DOTS (direct observed treatment short course). CD4 count was measured for the HIV positive patients. All patients were also evaluated for different risk factors including HBsAg, Anti-HCV, alcohol intake, use of other drugs including traditional medicines, acetylation status and presence of chronic illness. Patients were monitored biochemically (by liver function tests) and clinically for development of DIH weekly in the first month and bi-weekly in the second month after start of therapy. Biochemical hepatotoxicity was seen in 17.3% of the patients. CD4 counts of these patients were 0-50 for 7 (35%), 51-100 for 8 (40%), 101-200 for 4 (20%), and > 200 for 1 (5%). Three patients were positive for HBsAg and none had anti-HCV. Five patients died of non-hepatic causes among the patients who developed DIH. Eight out of the 34 patients with biochemical hepatotoxicity (23.5%) developed clinical hepatotoxicity that necessitated discontinuation of their anti-TB drugs. Seven of the eight were HIV positive, seven were female, and 2 were positive for HBsAg. Biochemical hepatotoxicity was significantly associated with HIV co-infection (p=0.002), concomitant drug intake (p=0.008), decrease in CD4 count (p=0.001), high mortality (p=0.001), and having Wt/Wt allele for acetylation status (p=0.026). Clinical hepatotoxicity is also significantly associated with being female (p=0.027), HIV co-infection (p=0.043), concomitant drug intake (p=0.003), HBsAg (p=0.046), decrease in CD4 count (p=0.025), and high mortality (p=0.0001). No significant association was seen between hepatotoxicity with alcohol intake, age, body mass index, type of TB and anti HCV positivity. The findings would assist in selectively managing patients at risk. It is recommended to have a regular biochemical and clinical follow up for those patients who are at risk of developing DIH .These patients include HIV positive patients, with special emphasis to those with a lower CD4 count, and patients who take drugs other than their anti TB medication. We also recommend that further work should be done to explore the reason for the observed association between DIH and female sex, HBsAg positivity, and acetylation status. Key words: Tuberculosis, HIV, Hepatotoxicity, Acetylation status, NAT2 gene
Anti-hyperglycemic activities of hydro-alcoholic, alkaloid and non-alkaloid extracts of Calpurnia aurea (aiton) benth (Fabacea) against streptozocin induced diabetic mice
(Addis Ababa University, 2023-11) Beyene, Habtamu; Engidawork,Ephrem(Prof.); Shibeshi,Workineh(PhD)
Background: Diabetes mellitus is a metabolic disease with several etiologies that is typified by persistently high blood sugar levels. Given the rising rates of diabetes-related morbidity and death in low- and middle-income countries, it is critical to evaluate the potential pharmacological effects of medicinal plants in order to complement current diabetes treatments. The experimental plant Calpurinaaurea(Aiton)Benth is among the Fabaceae species, which is used traditionally for diabetes and other health disorders. Objectives:The purpose of this study was to assess the effects of crude, alkaloid, and non- alkaloid leaf extractsof C.aurea on blood glucose control in streptozotocin-induced diabetic mice and normoglycemic mice. Methods: The crude, alkaloid, and non-alkaloid extracts were prepared using the proper solvents prior to the commencement of the in-vivo investigation. Swiss albino mice, weighing between 20 and 30 grams, were selected for the animal trials. In order to study the hypoglycemic/antihyperglycemic effect of the extract, nine groups of diabetic mice and eleven groups of normal mice were used. Streptozotocin was used to induce diabetes, and blood glucose levels were measured with a glucometer. Doses of the plant alkaloid and non-alkaloid extract (100, 200, and 400 mg/kg) were administered to the test groups in each model while the crude extract was administered at lower doses(50, 100, and 200 mg/kg). Glibenclamide(5 mg/kg) served as a standard drug. The negative control, and the normal control were given 1% of tween 80 (10 mg/kg). Results: The results demonstrated that crude, alkaloid, and non-alkaloid extracts of C.aurea leaves lowered the incidence of hypoglycemia. After the administration of2.5 mg/kg of glucose, the alkaloid extract demonstrated significant lowering of blood glucose levels: 200 mg/kg at 80 minutes (p<0.05) and 400 mg/kg at the first and second hour (p<0.01). All extract-treated groups of streptozotocin induced diabetic mice had decreased blood glucose levels, besides the mice iv administered the alkaloid extract showed a statistically significant drop in blood glucose levels. The alkaloid extract reduced blood glucose levels in the 200 (P<0.05) and 400 mg/kg doses (162±5.21, 142±3.51), respectively, were used in a single dose study. Furthermore, the alkaloid extract at the middle dose (p<0.05), higher dose (p<0.01), and all doses at the third week all significantly decreased the fasting blood glucose level. Furthermore, compared to the negative control group, the groups treated with crude, alkaloid and non-alkaloid extracts experienced a lesser drop in body weight following the onset of diabetes mellitus.Conclusion:it can be concluded that the alkaloid extracts of C.aurea leaves are effective in lowering blood glucose levels in diabetic mice and lack a hypoglycemic effect in normoglycemic mice. Additionally, the extracts were observed to exhibit no acute toxicity.
Anti-Malarial Drug and Mosquito Net Use Pattern in Pawe Special Woreda: A Community Based Survey
(Addis Ababa University, 2009-06) Mussa, Seid; Gedif, Teferi (PhD)
Anti-Malarial Drug and Mosquito Net Use Pattern in Pawe Special Woreda: A Community Based Survey
(Addis Ababa University, 2009-07) Mussa, Seid; Gedif, Teferi (PhD)
Background: Malaria is a major public health problem and the leading communicable disease in Ethiopia. Interruption of contact between humans and mosquitoes through the use of insecticidetreated bed nets (ITNs) is a promising approach to protect people from malaria infection. Treatment failures and mortality due to malaria has risen in recent years, probably due to increasing resistance to anti-malarial medicines. Improper drug storage and rampant selfmedication are some of the factors that may contribute to an increase in the development of drug resistance by malaria parasites towards anti-malarials. Study objective: To assess the utilization pattern of anti-malarial drugs, and mosquito net coverage in Pawe special Woreda, Beneshangul-Gumuz National Regional State. Methodology: The study was conducted in Pawe Special Woreda, Beneshangul-Gumuz Regional State between August and September 2008. Both quantitative and qualitative methods were employed in the data collection. Qualitative methods employed include focus group discussions and key-informant interviews. The quantitative method used is a community based cross-sectional household survey. The study utilized a trained interviewer administered questionnaire for data collection. Data was collected primarily from mothers. Quantitative data was entered using EPI-Info software Version 6.04 and analyzed by SPSS version 11 statistical packages. Qualitative data were analysed through thematic content analysis in an attempt to answer key questions of the study. Results: Perceived malaria prevalence was found to be 6.1 %. Sixty nine, (38.8%) of those with reported malaria/symptom complexes in the last two weeks preceding the interview date se lfmedicated themselves with anti-malarials. Households with a family size of less than or equal to 5 persons (OR=0.47, CI=0.25, 0.90, P=0.02) were less likely to self-care with anti-malarials than those with a family size of more than 5 persons.
Anti-TB Medicines Supply Chain Management Practices and Related Challenges in Gurage Zone Public Health Facilities, Southern Ethiopia
(Addis Abeba University, 2021-09) Gezahagn, Sifrash; Dr. Ali, Eskinder Eshetu
Introduction: Gaps in managing the supply chain of anti-tuberculosis (TB) medicines result in supply interruptions posing significant health-related and economic consequences. Objective: To assess anti-TB medicines supply chain management practices and related challenges in Gurage Zone public health facilities. Methods: A concurrent/parallel explanatory mixed methods design was followed in this study. Institutional based cross-sectional study was conducted from August to September, 2020. Simple random and purposive sampling was used to select study participants. A structured questionnaire and observational check list was used to collect quantitative data and analyzed using Microsoft Excel 2013 and SPSS version 25. For the qualitative part, an interview guide was used to collect data from fifteen key informants and analyzed thematically. Results: Twenty public health facilities (HFs) in Gurage Zone providing TB management and care were included in the study. Majority of the HFs (18, 90%) were using only stock recording cards to control the inventory of anti-TB medicines. The average physical stock count corresponding to inventory recorded count for a set of anti-TB medicines was 76.6%. For a set of anti-TB medicines the average availability was 82.6% and the average stock out duration was 11.23 ± 1.38 days per a year (Min=0, Max=115). The average wastage rate for a set of first-line anti-TB medicines was 4.78%. Qualitative interviews showed the absence of computerized drug management system to manage anti-TB drugs supply chain and the lack of healt h facilit ies’ involvement in drug quantification as major barriers for the effective management of anti-TB medicines supply. Conclusions: The most current version of the national TB treatment guidelines and job aids were not available in the majorit y of public healt h facilities and it was also noted that quantificat ion of ant i-TB drugs was a major problem. In majorit y of the health facilit ies storage condit ion needs early intervent ions and inventory control system was totally manual.
Anti-ulcer activity of aqueous root extract of Ensete ventricosum (Welw.) Cheesman (Musaceae) in experimental rats
(Addis Abeba University, 2021-07) Hailu, Dejene; Shibeshi, Workineh (PhD); Umer, Shemsu (PhD); Arayaselassie, Mahlet (MD)
Peptic ulcer is a chronic disease of gastrointestinal system caused by an imbalance between damaging factors and protective factors. Even though many antiulcer drugs used to treat this disease are available, most of these drugs produced undesirable side effects, microbial resistance and danger of drug interactions during therapy. An ethnobotanical study showed that Ensete ventricosum is used for treatment of peptic ulcer but the efficacy and safety are not established. Thus, this study was aimed to evaluate the anti-ulcer activity of aqueous root extract of Ensete ventricosum (E. ventricosum) in experimental rats. The effect of the extract on gastric ulcer was evaluated against indomethacin, ethanol and pyloric ligation-induced ulcer models at doses of 100, 200 and 400mg/kg. Dose levels were selected based on outcome of acute toxicity study. Pantoprazole at a dose of 40mg/kg was used as a standard drug while distilled water was used as negative control. In indomethacin and ethanol-induced ulcer, pretreatment with aqueous root extract of E. ventricosum significantly reduced level of gastric mucosal ulceration and improved ulcer protection. Furthermore, histopathological findings of rats pretreated with aqueous root extract of E. ventricosum also revealed gastroprotective activity. In pyloric ligation-induced ulcer, administration of E. ventricosum at a dose of 200 and 400mg/kg significantly (p<0.05) reduced both ulcers number and severity scores and histopathological findings also revealed gastroprotective activity of the extract. The extract at a dose of 400mg/kg exerted best ulcer protection (98.53%) which was comparable to standard drug in pyloric ligation-induced ulcer as compared to other models studied. The extract at a dose of 200 and 400mg/kg also displayed antisecretory activity as revealed by significant (p<0.05, p<0.001) reduction in volume, free and total acidity of gastric juice with significant (p<0.05, p<0.001) increment in pH of the gastric juice in both ethanol and pyloric ligation-induced ulcer in dose dependent manner. In conclusion, the aqueous root extract of E. ventricosum showed significant antiulcer activity.
Antibiotic Use Practice and Predictors of Hospital Outcome Among Patients with Systemic Bacterial Infection at Tikur Anbessa Specialized Hospital: Identifying Targets for Antibiotic and Health Care Resource Stewardship
(Addis Ababa University, 2015-04) Alemkere, Getachew; Tenna, Admasu(PhD)
Background: Despite massively used in different settings, about half of antimicrobial agents prescribed to hospital in-patients were considered inappropriate. Such malpractice and excess use has been associated with increased mortality, adverse drug reactions, financial cost and the development of resistant bacteria, which have become a threat for the generation. These calls for an integrated intervention that should better are preceded with identification of targets. Objective: To assess the antibiotic use practice and to identify predictors of hospital outcome among patients with systemic bacterial infection to uncover targets for antibiotic and health care resource stewardship Methods: A prospective cross-sectional study was performed from 9 April to 7 July in the internal medicine wards of Tikur Anbessa specialized Hospital. Patients who had and/or developed systemic bacterial infections during this period were strictly followed. Data abstraction format was used to collect data on demographic, disease, drug and microbiologic related factors. Pattern of antibiotic use was assessed and predictors for mortality and length of stay (LoS) were identified. Descriptive statistics and Binary logistic regression were used for statistical analysis. Results: Females accounted for about 52% of the 323 study participants whose mean age was 41.8. Of all, 75.2% of the participants had suspected infection during ward admission. Cephalosporins were the most widely prescribed class of drugs in the internal medicine wards and the medical ICU. Based on changes to microbiologic culture reports the initial antibiotic uses were inappropriate in all of the ICU and 99.3% of the ward patients. About 28% of the wards and 59% of the ICU patients were died during the in-hospital stay. The mean (+ SD) LoS was 18.5+12.2 in the wards and 8.9+4.9 days in the ICU. Whilst presence of HIV, liver-cirrhosis, different signs and symptoms of disease, neoplasm, sepsis, meningitis, renal failure, vancomycin and increased antibiotic courses (> 2) were iv positive predictors, prolonged antibiotic days (>10) and simultaneous antibiotic uses (>3) were negative predictors of mortality. On the other hand, age range of 25-44, hospital acquired infection and prolonged agent days (>21) (positively) and on admission infection (negatively) were independently associated with prolonged LoS. Conclusion: Generally, these observations call for the establishment and implementation of antimicrobial stewardship that facilitate appropriate use of antimicrobials as a whole in the context of resource limited settings. Any stewardship activity should better start by addressing infections like pulmonary, sepsis and meningitis and drugs like vancomycin. Key words: Antimicrobial Stewardship, Antibiotic use, Length of Stay, In-hospital Mortality, Tikure Anbesa Specialized Hospital, Ethiopia
Antibiotics self-medication practices among health care professionals in selected public hospitals of Addis Ababa
(Addis Ababa University, 2019-03) Kassa, Tsehay; Prof.Gedif, Teferi
Introduction: Self-medication is the first option and response to most illness episodes. Use of antimicrobials without health care professionals’ guidance may result in greater probability of inappropriate, missed diagnosis, delays in appropriate treatment, pathogen resistance and increased morbidity. There is no sector in the health care community which is immune to drug abuse or misuse of which the worst offenders include Physicians, Nurses and Pharmacists. Self-medication among health care professionals may be an indicator that the health professional is neglecting his or her own health. This is important because the health habits and attitudes of health care professionals influence the counseling and care they provide to patients. Objective: This study was conducted to assess the prevalence of self-medication practices of antibiotics and factors associated with it among health care professionals in selected hospitals of Addis Ababa. Methods: Cross-sectional survey using self-administered questionnaires was employed to collect information from health professionals working in hospitals which were selected by using simple random sampling method. Data were collected from April to May, 2017. Results: A total of 317 respondents participated in this study. The prevalence of self-medication using antibiotics among health care professionals in one month recall period was found to be 72 (22.7%). The main reasons given for this were being familiar with the treatment options 31 (37%) , to get quick relief 25 (30%), lack of time. Respiratory problems accounted for self-medication 29 (40.3%) followed by gastro intestinal problems 28 (38.9%) were the two most common perceived illnesses for self-medication with antibiotics. Penicillins 30 (42%) and Fluroquinolones 29 (40%) were the most commonly used antibiotics for self-medication. None of the variables had significant association with the practice of self-medication with antibiotics. Conclusions and Recommendations: Overall, the prevalence of self-medication using antibiotics among health care professionals was high, which might contribute for the increasing antibiotic resistance. Therefore, the regulatory body should strictly regulate the sale of antibiotics without prescription. Regular short term training for all health care professionals on antibiotic self-medication and the consequences of antimicrobial resistance should be done to curb these practices.
Anticoagulation Management Practice, and Associated Factors in Atrial Fibrillation Patients on Warfarin Therapy at Saint Paul Hospital Millennium Medical College
(Addis Abeba University, 2021-05) Shiferaw, Nuredin; Umer, Shemsu (PhD, Assistant Professor); Assefa, Tamrat (Assistant Professor)
Anticoagulants are cornerstones in management of Atrial Fibrillation to prevent stroke. Monitoring of warfarin depends on time in therapeutic range, frequency of international normalization range measurements, warfarin dose adjustments, warfarin drug interaction and bleeding adverse event. This study aimed to assess the anticoagulation management, and factors affecting anticoagulation management in atrial fibrillation patients taking warfarin. Institutionalbased Retrospective Cross-Sectional study was conducted from August to October 2019 at St. Paul Hospital Millennium Medical College. Data were collected retrospectively from a total of 300 patient medical records. Patients who have taken warfarin as an indication of primary prevention of atrial fibrillation were included in the study. A systematic random sampling technique was employed while recruiting the study participants. The data were entered to Statistical Package for Social Science window version 25 for analysis. Descriptive summaries were presented by using frequencies and percentages. Time in therapeutic range was calculated using the Rosendaal method, international normalization range frequency and drug interaction with warfarin were assessed and warfarin dose adjustments were also checked. Univariate and multivariate analysis were used to determine factors affecting time in therapeutic range and bleeding events. P-value ≤0.05 was considered as statistically significant. The mean age of the patient was 56.37 years and 65.3% of the study participants were females. Percent time in therapeutic range was found to be 42.03 ± 18.75. Only 12.67% patients had a time in the therapeutic range above 65%. Out of the 3162 INR tests, only 1094(34.60%) tests were within the therapeutic range. Bleeding event was recorded on 62 (20.70%) of the patients. Poor time in therapeutic range was associated with only age between 65 and 74, number of comedication of 1 and 2 and presence of congestive heart failure. Anticoagulation management was found to be poor in this study compared to other studies.
Anticoagulation Outcomes and Associated Factors among Acute Kidney Injury Patients during Hemodialysis at Two Selected Hospitals in Addis Ababa, Ethiopia: A Prospective Study
(Addis Ababa University, 2023-11) Muzeyin, Hanan; Ayalew,Eskinder(Ass.Prof.); Assefa,Tamrat(Ass.Prof.); Melkie,Addisu(Ass.Prof.)
Background: During hemodialysis (HD), clots in the dialyzer reduce the effective surface area of the dialyzer and in extreme situations clots in the circuit may prevent treatment from continuing and result in loss of blood in the circuit. Anticoagulation is essential during HD to prevent clot formation the circuit without putting the patient at risk of bleeding. Objective: The study aimed to assess anticoagulation outcomes and associated factors among Acute Kidney Injury (AKI) patients during HD at Tikur Anbessa Specialized Hospital (TASH) and St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. Method: A prospective, multicenter observational study was conducted between October 1st, 2021, and March 31st, 2022, at TASH and SPHMMC in Addis Ababa, Ethiopia. The study included all AKI patients who were undergoing HD at least once during the study period. Descriptive statistics were used to summarize the data while multinomial logistic regression analysis was used to determine factors associated with clotting and bleeding. Results: Data were extracted from 1010 HD procedures performed on 175 patients. Extracorporeal circuit clotting occurred in 34 patients in 39 (3.9%) dialysis sessions, and 27 patients in 29 (2.9%) sessions had experienced bleeding. The total number of HD sessions (AOR=1.932, 95% CI, 1.227-3.043) and blood flow rate (AOR=0.868, 95% CI, 0.812-0.928) showed a statistically significant association with clotting. Bleeding was associated with length of hospitalization (AOR=1.247, 95% CI, 1.053-1.478), serum creatinine at admission (AOR=1.886, 95% CI, 1.285-2.769), uremic signs and symptoms (AOR=0.092, 95% CI, 0.009-0.955), and use of an anticoagulant and/or antiplatelet drug (AOR=0.017, 95% CI, 0.001-0.446). Conclusion: A comparable number of circuit clotting was found when compared to other studies. However, it resulted in treatment interruptions and blood loss. Additionally, the study revealed a notable incidence of bleeding during HD, with most cases being minor.

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