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Background: New medicines have become available for the treatment of drug-resistant tuberculosis (DR-TB) and are introduced in sub-Saharan Africa (SSA) by the national TB programs (NTPs) through special access schemes. Pharmacovigilance is typically the task of national medicines regulatory agencies (NMRAs), but the active drug safety monitoring and management (aDSM) recommended for the new TB medicines and regimens was introduced through the NTPs.We assessed the strengths and challenges of pharmacovigilance systems in Eswatini, Ethiopia, Nigeria and Tanzania, focusing on their capacity to monitor safety of medicines registered and not registered by the NMRAs for the treatment of DR-TB. Methods: Assessment visits were conducted to all four countries by a multidisciplinary team. We used a pharmacovigilance indicator tool derived from existing tools, interviewed key stakeholders, and visited health facilities where DR-TB patients were treated with new medicines. Assessment results were verified with the local NMRAs and NTPs.Results: Most countries have enabling laws, regulations and guidelines for the conduct of pharmacovigilance by the NMRAs. The relative success of NTP-NMRA collaboration iss much influenced by interpersonal relationships between staff. Division of roles and responsibilities is not always clear and leads to duplication and unfulfilled tasks (e.g. causality assessment). The introduction of aDSM has increased awareness and adverse drug reaction (ADR) reporting to the NMRAs among DR-TB healthcare providers.Conclusion: aDSM has created awareness about the importance of pharmacovigilance among NTPs and has increased ADR reporting rates from the NTPs and/or TB healthcare providers to the NMRAs. In the future, a push for conducting pharmacovigilance through public health programs seems useful, but this needs to coincide with increased collaboration with between public health programs and NMRAs with clear formulation of roles and responsibilities.

Background New medicines have become available for the treatment of drug-resistant tuberculosis (DR-TB) and are introduced in sub-Saharan Africa (SSA) by the national TB programs (NTPs) through special access schemes. Pharmacovigilance is typically the task of national medicines regulatory agencies (NMRAs), but the active drug safety monitoring and management (aDSM) recommended for the new TB medicines and regimens was introduced through the NTPs. We assessed the strengths and challenges of pharmacovigilance systems in Eswatini, Ethiopia, Nigeria and Tanzania, focusing on their capacity to monitor safety of medicines registered and not registered by the NMRAs for the treatment of DR-TB. Methods Assessment visits were conducted to all four countries by a multidisciplinary team. We used a pharmacovigilance indicator tool derived from existing tools, interviewed key stakeholders, and visited health facilities where DR-TB patients were treated with new medicines. Assessment results were verified with the local NMRAs and NTPs. Results Most countries have enabling laws, regulations and guidelines for the conduct of pharmacovigilance by the NMRAs. The relative success of NTP-NMRA collaboration is much influenced by interpersonal relationships between staff. Division of roles and responsibilities is not always clear and leads to duplication and unfulfilled tasks (e.g. causality assessment). The introduction of aDSM has increased awareness among DR-TB healthcare providers. Conclusion aDSM has created awareness about the importance of pharmacovigilance among NTPs. In the future, a push for conducting pharmacovigilance through public health programs seems useful, but this needs to coincide with increased collaboration with between public health programs and NMRAs with clear formulation of roles and responsibilities.

The treatment option for AIDS have drastically changed since 1987 when the first drug of HIV/AIDS Zidovudin (ZDV) was approved, mono therapy has been replaced by the most effective currently is HAART which includes three drugs from one or all the three categories to decrease incidence of viral resistance. From about, 1,387,039 people living with HIV/AIDS in Ethiopia 167,271 people were initiated on ART by October 2009. The aim of this study is to determine comparative effects of ART on CD4 + cell count in Jimma University Specialized Hospital and assess comparative effects of ZDV and d4T based combinations on CD4 + cell count, to assess comparative effects of EFV and NVP based combinations on CD4 + cell count. Cross-sectional retrospective study was employed. Data (from June 2006 to October 1, 2013) was collected from patient records using data collection format to determine comparative effects of ART regimen on CD4 + cell count in Jimma university specialized hospital. One hundred twenty three patients fulfilled the inclusion criteria and were studied. At six month the EFV based regimens CD4 + cell count had increased with mean of 332 cells/mm 3 in the ZDV/3TC/EFV (n = 4) (baseline 139 cells/mm 3), a mean of 302.36 cells/mm 3 in the d4T/3TC/EFV (n = 11) (baseline 102.82 cells/mm 3) and a mean 283.06 cells/mm 3 in the TDF/3TC/EFV (n = 17) (baseline 110.06 cells/mm 3). The mean CD4 + cell count recoveries of EFV and NRTIs were higher than NVP and NRTIs. ZDV/3TC/EFV mean CD4 count was greater than TDF/3TC/EFV.

Introduction: Acute Kidney injury (AKI), is defined as an abrupt reduction in kidney function measured by a rapid decline in glomerular filtration rate resulting in the retention of metabolic waste products and dysregulation of fluid, electrolyte, and acid-base homeostasis. AKI is also defined in terms of a rise in serum creatinine concentration or by azotemia (a rise in blood urea nitrogen [BUN] concentration). The causes of acute renal disease can be related to the factors that interfere with structure and function of renal arteries, glomerular, renal tubules and urinary tracts. The current treatment for AKI is mainly supportive in nature; no therapeutic modalities to date have shown efficacy in treating the condition. Maintenance of volume homeostasis and correction of biochemical abnormalities remain the primary goals of treatment. Methods: I undertook a systemic review different books and journals and came up with summary statement. Accordingly supporting evidence and general recommendation was generated for the future research. Result: using the literature review the definition, causes and treatment algorithm of acute kidney injury was jotted down. Conclusion: Acute kidney injury (formerly known as acute renal failure) is a syndrome characterised by the rapid loss of the kidney's excretory function and is typically diagnosed by the accumulation of end products of nitrogen metabolism (urea and creatinine) or decreased urine output, or both.