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11 pages, 1406 KiB

Open AccessArticle

Assessment of the Antimalarial Treatment Failure in Ebonyi State, Southeast Nigeria

by Chinedu Ogbonnia Egwu, Chinyere Aloke, Jennifer Chukwu, Joshua Chidiebere Nwankwo, Chinemerem Irem, Kingsley E. Nwagu, Felix Nwite, Anthony Ogbonnaya Agwu, Esther Alum, Christian E. Offor and Nwogo Ajuka Obasi

J. Xenobiot. 2023, 13(1), 16-26; https://doi.org/10.3390/jox13010003 - 3 Jan 2023

Cited by 8 | Viewed by 4006

Abstract

The fight against malaria is a continuum as the epidemic is not abating. For proper deployment of tools in the fight against malaria, an assessment of the situation is necessary. This work assessed the level of antimalarial drug treatment failure in Ebonyi State, Nigeria. Both survey and in vitro analyses were adopted. The survey was used to obtain qualitative information from both the malaria subjects and the pharmacies where antimalarial drugs are sourced. The results from the survey were complemented by an in vitro assay of the level of active pharmaceutical ingredients (APIs) in the commonly used artemisinin combination in Nigeria; artemether/lumefantrine. Results from the survey revealed that artemisinin combination therapies (ACTs) remain the mainstay in the treatment of malaria, even though other non-artemisinin drugs are still used. It also revealed that many patients still self-medicate, although, this may not be connected to the treatment failure seen among some malaria subjects. The in vitro assay showed that ACT contains the right quantity of APIs. Further surveillance is, therefore, necessary to understand the real cause of treatment failure among malaria subjects in Nigeria. Full article

(This article belongs to the Section Drug Therapeutics)

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25 pages, 557 KiB

Open AccessReview

Combating Lassa Fever in West African Sub-Region: Progress, Challenges, and Future Perspectives

by Chinyere Aloke, Nwogo Ajuka Obasi, Patrick Maduabuchi Aja, Chinedum Uche Emelike, Chinedu Ogbonnia Egwu, Olamide Jeje, Chuks Oswald Edeogu, Olalekan Olugbenga Onisuru, Obasi Uche Orji and Ikechukwu Achilonu

Viruses 2023, 15(1), 146; https://doi.org/10.3390/v15010146 - 3 Jan 2023

Cited by 26 | Viewed by 4345

Abstract

Lassa fever (LF) is a rodent-borne disease that threatens human health in the sub-region of West Africa where the zoonotic host of Lassa virus (LASV) is predominant. Currently, treatment options for LF are limited and since no preventive vaccine is approved for its infectivity, there is a high mortality rate in endemic areas. This narrative review explores the transmission, pathogenicity of LASV, advances, and challenges of different treatment options. Our findings indicate that genetic diversity among the different strains of LASV and their ability to circumvent the immune system poses a critical challenge to the development of LASV vaccines/therapeutics. Thus, understanding the biochemistry, physiology and genetic polymorphism of LASV, mechanism of evading host immunity are essential for development of effective LASV vaccines/therapeutics to combat this lethal viral disease. The LASV nucleoprotein (NP) is a novel target for therapeutics as it functions significantly in several aspects of the viral life cycle. Consequently, LASV NP inhibitors could be employed as effective therapeutics as they will potentially inhibit LASV replication. Effective preventive control measures, vaccine development, target validation, and repurposing of existing drugs, such as ribavirin, using activity or in silico-based and computational bioinformatics, would aid in the development of novel drugs for LF management. Full article

(This article belongs to the Section Human Virology and Viral Diseases)

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13 pages, 288 KiB

Open AccessReview

Current Advances in the Management of Diabetes Mellitus

by Chinyere Aloke, Chinedu Ogbonnia Egwu, Patrick Maduabuchi Aja, Nwogo Ajuka Obasi, Jennifer Chukwu, Blessing Oluebube Akumadu, Patience Nkemjika Ogbu and Ikechukwu Achilonu

Biomedicines 2022, 10(10), 2436; https://doi.org/10.3390/biomedicines10102436 - 29 Sep 2022

Cited by 45 | Viewed by 17662

Abstract

Diabetes mellitus (DM) underscores a rising epidemic orchestrating critical socio-economic burden on countries globally. Different treatment options for the management of DM are evolving rapidly because the usual methods of treatment have not completely tackled the primary causes of the disease and are laden with critical adverse effects. Thus, this narrative review explores different treatment regimens in DM management and the associated challenges. A literature search for published articles on recent advances in DM management was completed with search engines including Web of Science, Pubmed/Medline, Scopus, using keywords such as DM, management of DM, and gene therapy. Our findings indicate that substantial progress has been made in DM management with promising results using different treatment regimens, including nanotechnology, gene therapy, stem cell, medical nutrition therapy, and lifestyle modification. However, a lot of challenges have been encountered using these techniques, including their optimization to ensure optimal glycemic, lipid, and blood pressure modulation to minimize complications, improvement of patients’ compliance to lifestyle and pharmacologic interventions, safety, ethical issues, as well as an effective delivery system among others. In conclusion, lifestyle management alongside pharmacological approaches and the optimization of these techniques is critical for an effective and safe clinical treatment plan. Full article

(This article belongs to the Section Endocrinology and Metabolism Research)

13 pages, 1241 KiB

Open AccessEditor’s ChoiceReview

Impact of Drug Pressure versus Limited Access to Drug in Malaria Control: The Dilemma

by Chinedu Ogbonnia Egwu, Nwogo Ajuka Obasi, Chinyere Aloke, Joseph Nwafor, Ioannis Tsamesidis, Jennifer Chukwu and Sunday Elom

Medicines 2022, 9(1), 2; https://doi.org/10.3390/medicines9010002 - 4 Jan 2022

Cited by 8 | Viewed by 4596

Abstract

Malaria burden has severe impact on the world. Several arsenals, including the use of antimalarials, are in place to curb the malaria burden. However, the application of these antimalarials has two extremes, limited access to drug and drug pressure, which may have similar impact on malaria control, leading to treatment failure through divergent mechanisms. Limited access to drugs ensures that patients do not get the right doses of the antimalarials in order to have an effective plasma concentration to kill the malaria parasites, which leads to treatment failure and overall reduction in malaria control via increased transmission rate. On the other hand, drug pressure can lead to the selection of drug resistance phenotypes in a subpopulation of the malaria parasites as they mutate in order to adapt. This also leads to a reduction in malaria control. Addressing these extremes in antimalarial application can be essential in maintaining the relevance of the conventional antimalarials in winning the war against malaria. Full article

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