Cholera Epidemiology in Zambia from 2000 to 2010: Implications for Improving Cholera Prevention and Control Strategies in the Country

Objective: To review the cholera epidemiology in Zambia from 2000 to 2010 in order to highlight the key lessons learned. Based on our findings, we make recommendations for improving cholera prevention and control in country.Design: Ten years descriptive cholera data was extracted from the national IDSR database and analysed.Setting: The study was conducted in Zambia using national epidemiology data which were disaggregated by Province.Subjects: NoneResults : Starting from 2003, there has been a progressive increase in yearly incidence of cholera in the country. In 2010, 6794 cases (500% increase compared to 2003) and 115 deaths (CFR 1.6%) of the disease were reported with Lusaka Province accounting for 85% of the total cases. Outbreaks start between epidemiological weeks 40 to 45 of the year and ends between weeks 20 to 25 of the following year (which correspondsto the Zambian rainy season). Outbreaks are largely confined to the peri-urban areas of Lusaka, Luapula, Southern and Copperbelt Provinces.Conclusion: In the last 10-20 years, the epidemiology of cholera in Zambia has changed; Laboratory confirmation of Vibrio cholerae in the country on a yearly basis in the last ten years suggests that the country is now endemic for cholera hence the need to review current cholera prevention and control strategies

Quality of life following a major lower limb ampu tation in Johann esburg, South Africa.

To determine the impact of lower limb amputation on qualityof life in people in the Johannesburg metropolitan area of South Africa, duringtheir reintegration to their society/community of origin.A longitudinal pre- test- post test design was utilized. Consecutive samplingwas used to recruit and interview participants (n=73) who met the inclusioncriteria. Ethical clearance was obtained. The hospitals and participants gaveinformed consent.The EQ-5D, Barthel Index, and Modified Household Economic andSocial Status Index were used to collect data. Participants were interviewed preoperatively and then followed upthree months post-operatively. Data were analysed using STATA version 10. Categorical data were analysedusing Chi-square/Fischer’s exact test and continuous data were analysed using Wilcoxon signed rank and medianregression.Most (n=21, 52.5 %) participants had no income. One participant was homeless, 17.5% (n=7) lived in shacks.The preoperative and postoperative median VAS of the EQ-5D was 60 and 70 respectively showing no significantimprovement in QOL (median EQ-5D VAS). The preoperative and postoperative median total BI score was 20 and 19respectively, showing a significant reduction in function (median total BI) three months postoperatively (p<0.001).Preoperative mobility was a predictor of postoperative quality of life. Being female was a predictor of higher qualityof life.The average EQ-5D VAS score and overall function (total BI) were generally scored high both preoperativelyand postoperatively but there was no significant improvement in EQ-5D VAS score and there was a significant reductionin function after three months. Higher scores in mobility preoperatively is a predictor of higher quality of lifepostoperatively

Enantioselective analysis of amisulpride in pharmaceutical formulations by means of capillary electrophoresis

A capillary electrophoretic method has been developed for the enantioselective analysis of amisulpride in pharmaceutical formulations, using &#946;-cyclodextrin sulfate as the chiral selector. Several parameters, such as cyclodextrin type and concentration, buffer concentration and pH and capillary temperature were investigated for method optimisation. Baseline enantioseparation of the racemic compound was achieved in less than 10 minutes using a fused silica capillary (50 &#956;m I.D. and 33.0 cm, 8.5 cm, total and effective length, respectively), filled with a background electrolyte consisting of a 10 mM citrate buffer at pH 3.5 supplemented with 0.22% (w/v) &#946;-cyclodextrin sulfate at 20\ub0C and applying a voltage of +15 kV. Formulation analysis was carried out after analyte extraction by methanol. The method was fully validated, with good results in terms of precision, selectivity, accuracy and amount of drug found with respect to the label claim. Thus, the method seems to be suitable for the enantiomeric analysis of amisulpride in pharmaceutical formulations

Separation of amisulpride enantiomers in pharmaceutical formulations by means of capillary electrophoresis

Amisulpride (4-amino-N-[(1-ethyl-2-pyrrolidinyl)methyl]-5-(ethylsulfonyl)-2-methoxy-benzamide) is an atypical antipsychotic drug which is administered at low doses (50 mg/day) for the treatment of dysthymia and negative symptoms of schizophrenia, while at higher doses (400-1200 mg/day) it is efficacious in reducing the positive symptoms of schizophrenia. It has a chiral benzamidic structure and exerts its action by interacting with the D2 and D3 mesolimbic receptors. The main side effects of the drug are, hyperkinesia, anxiety and insomnia; minor extrapiramidal symptoms have been reported . Amisulpride is administered as the racemate, in the form of oral tablets (Deniban\uae, Solian\uae or Sulamid\uae), even if binding studies showed that the S(-) enantiomer is several times more potent than the R(+) enantiomer. However, only one HPLC method is currently available in the literature for the enantioselective determination of Amisulpride in biological fluids . The aim of this work is the development of a method based on capillary electrophoresis with diode-array detection for the enantiomeric separation of Amisulpride and its analysis in commercially available tablets. An uncoated fused silica capillary (effective length 8.5 cm, internal diameter 50 \ub5m) was used, injecting the samples by pressure at the cathodic side. The effect of several parameters such as pH and buffer composition, as well as the applied voltage and the capillary temperature were investigated in order to obtain a complete separation in the shortest analysis time. The applied voltage was +15 kV, with the capillary thermostatted at 20\ub0C and the detector set at 227 nm. Negatively charged beta-cyclodextrin was added to the BGE in order to separate Amisulpride enantiomers; the BGE consisted of a 10 mM pH 3.5 citrate buffer, containing beta-cyclodextrin sulfated (0.22%, w/v), which was sufficient to determine anodic migration of both enantiomers. Under these conditions a complete separation of Amisulpride enantiomers was obtained within a 10 min electrophoretic run, using Lamotrigine as the internal standard. A very simple procedure, consisting of a single extraction with MeOH, allows to quantitatively extract Amisulpride from the formulation. The method has been fully validated in terms of linearity (linearity range from 2.5 to 25 \ub5g/mL), precision and accuracy (recovery percentage always &#8805; 90%). Finally, it has been successfully applied to the quality control of commercially available tablets (Deniban\uae) containing racemic Amisulpride

Determination of vigabatrin in human plasma by means of capillary electrophoresis with laser-induced fluorescence detection

A method has been developed for the quantitation of the antiepileptic drug vigabatrin in human plasma. It is based on capillary electrophoresis with laser-induced fluorescence (LIF) detection. The effect of the pH of the buffer and of N-methylglucamine addition to the background electrolyte constituent was investigated. The final background electrolyte consisted of 50 mM borate buffer, pH 9.0, with 100 mM N-methylglucamine and enabled separation within 12 min at 20 kV voltage. A solid phase extraction procedure was used for pre-treatment of biological samples, based on mixed-mode lipophilic \u2013 cation exchange cartridges, followed by a derivatisation step with 6-carboxyfluorescein-N-succinimidyl ester. Fluorescence was excited by an Ar-Ion laser (excitation wavelength = 488 nm). Linearity was observed in the 10-120 ng mL-1 plasma concentration range. Extraction yield was >96%, precision (expressed as RSD) was &lt;6.7%, accuracy (recovery) was between 97.0 and 101.6%. The method has been successfully applied to the analysis of vigabatrin in plasma of epileptic patients undergoing therapy with the drug