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Microbicide, Solution To Female HIV Infection?



Since the Human Immune Virus and the Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic became known in Nigeria in the mid eighties, no illness has caused more commotion and separated families and friends alike.

From being a rumour initially, it became a cruel reality which raised so much pandemonium that how it is transmitted from person to person became more horrifying and confusing almost by the day.

However, from the mid eighties to now, so much water had passed under the bridge. Form being regarded as the most dreaded diseases, which had no cure, HIV/AIDS is now manageable.

In fact, research has proved that an infected person can live a normal life like every other person. All it requires is awareness in the part of the infected person.

In spite of this encouraging development, however, research has also shown that the virus is still spreading and fastly too, for various reasons, which include the fact that people, mostly out of fear of being discriminated upon, prefer to keep their infection to themselves, or refuse to know their status.

Research has alo showed that majority of those infected are women, thus raising questions regarding why it is so.

It did not take long for researchers to reason that perharps this will not be far from the fact that women seem to be the most vulnerable when it comes to adopting preventive measures during heterosexual intercourse.

This is because the presumed efficacy  of such preventive measures as abstinence, use of condoms and being faithful to a partner could not stop more women from being infected. Hence the decision to come up with a preventive measure strictly to be controlled by women.

In the words of Dr. Orikomaba Korifama Obunge, consultant clinical microbiologist and Head of Medical Microbiology department, University of Port Harcourt Teaching Hospital (UPTH) ‘‘a lot of them (women) are still being infected, not because their partners are a little bit more adventurous, and the ability of them negotiating for the use of preventive measures such as condoms is not working much as it should.

‘‘The issue is that, can we not provide a preventive measure that is controlled by the women, that is capable of forming a barrier during heterosexual intercourse?’’

It is the search for this measure, according to Dr Obunge, that resulted in the emergence of  a concept of a microbiocide by a group of researchers and activities, which also include Dr Obunge.

According to a recent UNAIDS estimates, in 2009 more than 33 million people were living with HIV and approximately 2.5 million people were newly infected.

The estimates also showed that worldwide, nearly half of all individuals living with HIV are now women, who acquired the virus largely by heterosexual exposure.

Further more, many women, because  of limited economic options and gender inequality, cannot reliably negotiate sexual encounters, leaving them vulnerable to unwanted pregnancies and sexually transmitted infections (STIs), including HIV.

Thus, with clinical deployment of safe and effective HIV Vaccine still likely to be years away, topical microbicide formulations that are applied vaginally or rectally are receiving increasing attention as another strategy for HIV prevention.

The microbicide is a product in the form of a gel which could be infected intraveinously with the sole objective of preventing the transmission of the virus during heterosexual intercourse to the woman.

According to the researchers, a review of preclinical and clinical research on the development of microbicides formulated to prevent vaginal HIV transmission yielded 118 studies globally.

Presently, mathematical modeling has shown that if there is such a preventive measure that is workable, then millions of new infections could be prevented and it would be an encouragement for donor agencies to start working on it. Hence the emergence of research on microbicides.

In the words of Dr. Alan Stone of the Medical Research Council in the United Kingdom, ‘‘the development of an effective microbicide is a global priority of the highest order… The question is not whether the microbicide approach will prevent HIV infection but, rather, what proportion of HIV infections it will prevent.’’

Towards coming up with such a microbicide, two research organizations, FHI and Vera Halpen using collaborators in various countries embarked on research for the purpose. In Nigeria the collaborators were Dr. Orikomaba Korifama Obunge and Dr F.S.Ogusola of the university of Lagos.

The research went through the first and second phases, which are smaller studies that look at safety at does and at efficacy before this third phase which entailed randomized clinical/controlled trails on large groups of participants to look at the efficacy of the microbicide.

The products of the investigation were 6% Sodium Cellulose Sulphate (CS), which is a gel that was tested as a possible topical microbicide, but in 2007 was found to be  in effective. Researchers thought that CS could potentially block HIV infection (and possibly others STIs) by creating a barrier between the virus and the woman’s cells in the vagina which the virus targets for infection. This would make it more difficult for the virus to enter the woman’s cell.

The other products of investigation are vaginal gel, single use applicator, and 3.5ml of gel.

According to the researchers, the study design at this phase III entailed randomized placebo controlled trail, in which a total of 2160 women at high risk of HIV/STI were in Lagos while the other half were in Port Harcourt.

The placebo is not the treatment being tested, but looks exactly like the treatment. For topical microbicides trails, the control group received a gel that looked and was used the same day as the gel given to the intervention group, except that it did not contain the microbicide.

Placebos are used in blinded clinical trails so that participants for twelve months, while tests were carried out for HIV, gonnorhoea and Chlamydia at baseline and at each monthly follow up visits.

A summary of the research showed that the duration of the study was 12 months of participants recruitment, 12 months of product used for each participants and 26 total months in the fields including screening and close-down, while the primary objective of the study was to determine the effectiveness of CS gel in preventing male-female vaginal transmission of HIV infection among women of high risk.

The primary endpoint is the incidence of HIV-1 and HIV-2 infection as determined by detection of HIV antibodies from all Mucosal Transudate (OMT) specimens, while the secondary objective is to determine the effectiveness of CS gel in preventing malae-female  transmission of gonnorrhoea and chlamydial infection among women at high risk.

The secondary end point is the incidence of the genital gonorrhea or chlamydial infections as determined by DNA probe technology from self-administered vaginal swabs .

At the end of the study, it was found that the CS gel (this microbicide) did not protect against HIV and canot be used, “there were more infection in CS group compared to the placebo group from other studies outside Nigeria resulting in the stoppage of the study on CS3, and the preventive measure (HIV risk reduction messages works)”

It was thus agreed that community/scientist rapport must recognize that community involvement is an essential component in microbicide trail; that the approach to such involvement must consider the local setting (community politics and environment) that the relationship is a dynamic one.

Others are that it is clear the development of a topical microbicide to prevent the sexual transmission of HIV is scientifically, ethically and culturally complicated; and that in spite of these the benefit in lives protected may far exceed those risks seen and, as yet, unforeseen.

The implication of the foregoing is as encouraging as it is dreadful. Encouraging  because by this and other researches carried out, all in pursuit of a solution to the HIV/AIDS pandemic show that there is a relentless quest to get a solution .

However, the situation looks dreadful considering that such solution seem to have remained evasive and hence almost impossible to come by.

This, therefore, is an indicator that a lot of work still needs to be done to thoroughly put the transmission of HIV under check, particularly as it concerns the most vulnerable groups.

Such areas that require more job to be done include community sensitization/involvement, capacity building programmes for various stakeholders, including families.

The question that should thus be on every bodies mind is “which way forward in HIV prevention.”


Sogbeba Dokubo

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Hypertension Treatment To Cut Down Death,WHO Assures



The World Health Organisation(WHO) yeasterday released its first report on the global impact of high blood pressure, assuring that with treatment improvement life expectancy may rise in 2050.
The dangerous effects of high blood pressure are highlighted in a new report by the World Health Organisation that identifies the condition as one of the world’s leading risk factors for death and disability.
WHO’s first report on the global impact of high blood pressure, also known as hypertension, offers recommendations on ways to combat the “silent killer.”
Hypertension, categorized as a blood pressure reading of 140/90 mmHg or higher, affects 1 in 3 adults worldwide, according to the report. It commonly leads to a number of other health problems including stroke, heart attack, heart failure and kidney damage.
Aspirin can help reduce risk of second heart attack, but study finds less than half of eligible adults take it
“Hypertension can be controlled effectively with simple, low-cost medication regimens, and yet only about one in five people with hypertension have controlled it,” Dr. Tedros Adhanom Ghebreyesus, the WHO director-general, said in a news release.
High-performing countries like Canada and South Korea have delivered comprehensive national hypertension treatment programs, according to WHO, and both nations have surpassed the 50 per cent mark for blood pressure control in adults with hypertension.
“An increase in the number of people effectively treated for hypertension to levels observed in high-performing countries could prevent 76 million deaths between 2023 and 2050”, the WHO said.

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Neuropsychiatric Hospital Staff Dissociate Selves From Protest



Members of staff of the Federal Neuropsychiatric Hospital, Enugu have dissociated themselves from a recent protest staged at the hospital.
The protest was organised by a coalition of civil society organisations.
However, addressing journalists yesterday, the workers’ unions in the hospital said no member of staff took part in the said protest, but fingered touts who were hired to protest.
They include the Joint Health Sector Union, JOHESU, National Association of Nigeria Nurses and Midwives, NANNM, Association of Resident Doctors, ARD, and Medical and Dental Consultants Association of Nigeria, MDCAN, of the Federal Neuropsychiatric Hospital, Enugu.
Dr. Jane Nnabuchi of MDCAN, Dr Mbachu Ferguson of ARD, and Comrade Obinna Eze of JOHESU addressed the media on the issues.
The workers said touts were rather recruited by some persons to destabilise the hospital.
In a joint press statement issued by the workers, they debunked what they called “the stage-managed protest by a group of hired thugs that called themselves Civil Society Organisation (CSO) members, alleging that there is no peace in the hospital and that the workers are unhappy alongside other allegations levelled against the Medical Director, Prof. Monday Igwe.
“We hereby state categorically that the piece of information are not only false, but were made to mislead the general public and to cause confusion.”
The workers declared that: “there is no crisis in our hospital, Federal Neuropsychiatric Hospital, Enugu.
“That our hospital is peaceful and workers are happy with the administration of the Medical Director, Prof. Monday Igwe.
“That the stage-managed protest on 30th August, 2023 was done by thugs hired to discredit and destabilise the Medical Director and our hospital’s activity.
“We want to challenge anybody on that protest video circulating around to provide any proof of identity as staff of Federal Neuropsychiatric Hospital, Enugu or student of the School of Post Basic Psychiatric and Mental Health Nursing of our Hospital”.
“Ordinarily, we would have ignored the publication and the perpetrators of this dastardly and worthless act, but we are issuing a rejoinder to stop them from misleading the general public and most importantly, to put the information in the proper perspective.”
While making reference to a recent incident in the hospital, they called for an end to further harassment of the Medical Director.
“The situation created a scene and disrupted the activities of the hospital Community and would have escalated to an uglier scenario if not for the intervention of Enugu State Police Command.
“The members of Staff have been enjoying peace, infrastructural and human capacity development since the inception of Prof Monday Igwe’s leadership in 2019.
“We, the members of Joint Health Sector Union (JOHESU), National Association of Nigeria Nurses and Midwives (NANNM), Association of Resident Doctors (ARD), and Medical and Dental Consultants Association of Nigeria (MDCAN) of the Federal Neuropsychiatric Hospital, Enugu therefore, distance ourselves from and condemn that stage-managed protest of 30th August 2023 as well as the attempted abduction “arrest” of our Medical Director on Thursday, 14th September, 2023,” the workers further stated.


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How Soft Drinks Affect Male Fertility -Research



DIET indeed has a significant influence on our health, a fact that cannot be denied. What we eat and drink greatly affect not only our physical health but also the ability to conceive. Consumption of soft drinks has a marked effect on fertility in both males and females.
Researchers, following a study in animals, even extrapolated that prolonged consumption of soft drinks is bad for male fertility. Its prolonged consumption has a stimulating effect on weight, with corresponding adverse effects on sperm production.
A global decline in total sperm counts, especially among men in western countries, continues to spark doomsday predictions. From chemicals in packaging to tight trousers, the decline in total sperm counts and quality has been attributed to multiple factors. High sugar intake as part of unhealthy modern lifestyles is also on the risk list.
It is well noticed in society today that people consume drinks without giving due consideration to the quantity taken, contents, the amount required by the body and the possible implications associated with excessive consumption.
The study, titled: ‘Adverse Effects of Excessive Soft Drinks Consumption on Male Fertility in Wistar Rat Models’ was in the March edition of the International Journal of Health and Medical Research.
Thirty-five male wistar rats were divided into five groups with the control groups administered with distilled water only and four other test groups administered with single dose (1.2ml) Coca-Cola, double dose (2.4ml) Coca-Cola (Cocacolax2), 0.6ml bullet drinks and 1.2ml sugar solution. Aside from the administered samples, food and water were regularly kept at their disposals.
Bullet drink is a caffeinated energy drink. The absence of regulatory supervision has resulted in over indulgence in the marketing of energy drinks. The effect of caffeine from natural coffee, tea, cocoa and foods that contain these ingredients has not been fully elucidated.
The rationale behind the use of albino wistar rats for human studies is that they are physiologically similar to humans and are small, sociable and easy to handle.
The weights of albino wistar rats before and after administration were measured to ascertain the effects of the test samples on the mean weight difference as well as their mean relative weight difference.
In addition, sperm parameters like the sperm count, motility, viability and morphology were taken to ascertain the effects of the test samples on fertility in the study which lasted 40 days.
After 40 days of administration of the test substances, there was an increase in the average body weights in all soft drink administered test groups, compared to how it was in the control group.
In relative terms, there were elevations in all relative body weights by 40.0 percent, 40.0 percent, 63.33 percent and 23.33 percent in single dose Coca Cola group, double dose group, bullet drink group and sugar solution group
respectively, compared to the control.
In the study, soft drinks administration insignificantly decreased the motility, count and viability with corresponding increase in percentage of sperm with abnormal morphology.
According to the researchers, the increase in mean weight difference and their corresponding relative weight differences noted among the test groups suggest the premise that all test substances generally and the bullet drink specifically, contain ingredients that cause voracious feeding resulting in increased obesity and marked weight gain.
They stated that the deleterious effects of the soft drinks on the sperm characteristics could be attributed to decreased and unfavourable sperm production activities in the testis.

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