Research Articles (School of Pharmacy)

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Evaluating the perceived implementation and impact of the chronic dispensing unit in the Western Cape
(Frontiers Media SA, 2026) Matthew Ilona; Viljoen Michelle; McCartney Jane; Bheekie Angeni
Introduction: The research explores the perceived implementation and impact of the Chronic Dispensing Unit (CDU) within a South African primary healthcare system, with a focus on chronic disease management, using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) and CFIR (Consolidated Framework for Implementation Research) frameworks. Equitable access to healthcare and medicine is still a challenge; it demands long-term care and ongoing medical interventions. Introduced in 2005, the CDU in the Western Cape was designed to overcome the challenges in access by centralizing dispensing and distribution of chronic medicines. Two decades after its implementation, its contribution is underexplored. This research evaluated the long-term performance and sustainability of the CDU using implementation frameworks. Method: A qualitative design was used, using virtual semi-structured interviews with purposively selected participants (n = 8) involved in the implementation and maintenance of the CDU. Interviews were analyzed thematically. A deductive-inductive strategy was applied, guided by the RE-AIM and CFIR frameworks. Results: The CDU demonstrated substantial Reach and Effectiveness. It has refined operational processes and reduced patient waiting times. Challenges with data integration and the non-collection of medicine limit the CDU’s ability to inform clinical outcomes and long-term sustainability. Conclusions: The CDU is still an effective, well-integrated system that supports chronic disease management but is constrained by disconnected data systems. This study evaluated a large-scale health intervention that facilitated data-driven decision-making to monitor, evaluate, and report on evidence-based programmes addressing barriers to sustainment. Integrating two frameworks provided an assessment of a patient-centerd intervention, granting insights into equity in access to medicine, to strengthen primary healthcare systems.
Knowledge, attitudes, and self-reported practices of South African pharmacists regarding pediatric pharmaceutical care
(Pediatric Pharmacy Advocacy Group, Inc, 2025) Van Heerden Yasmine
OBJECTIVE Evidence on South African pharmacists’ pediatric knowledge is limited. This study explored the knowledge, attitudes, and self-reported practices of South African pharmacists regarding pediatric pharmaceutical care. METHODS A descriptive cross-sectional online survey was conducted among registered South African pharmacists. The survey, which was developed by the researcher based on previous studies, consisted of 4 sections: demographics, knowledge, attitudes, and self-reported practices. Contact information of pharmacists was obtained from The South African Pharmacy Council. Pharmacists were invited to participate via email, and a reminder email was sent after 2 weeks. The study was closed 3 days thereafter. Quantitative data were analyzed using descriptive and inferential statistics (significance set at p < 0.05), and qualitative responses underwent thematic analysis. RESULTS A total of 436 surveys were fully completed (response rate of 2.4%). The median knowledge score of pharmacists was 9 out of 12 (IQR, 8–10). Participants performed well (90% correct) in questions on basic pediatric medicine, but more poorly in questions on pediatric dose calculations (66% correct), formulation challenges (67% correct), and pharmacokinetics (55% correct). There was no significant correlation between knowledge scores and years of practice, sector of practice, highest qualification, or training in pediatrics. There was a statistically significant correlation between participant knowledge and attitude scores (p = 0.003). CONCLUSION The study sample possesses knowledge of basic pediatric principles; however, gaps in knowledge remain. Participants expressed a lack of perceived preparedness for pediatric care following undergraduate training, underscoring the need for further research and educational reform.
Differentiating resistance from formulation failure: isoniazid instability and poor dissolution in crushed multi-drug paediatric preparations
(Multidisciplinary Digital Publishing Institute (MDPI), 2026) Samsodien, Halima; Aucamp, Marique; Winkler, Jana
Background: Bedside manipulation of adult anti-tuberculosis tablets for paediatric dosing is common in low-resource settings, yet it can compromise drug stability. This study investigated how grinding and multi-drug co-suspension affect the supramolecular organisation, thermal stability, and dissolution of isoniazid (INH). Methods: INH raw, INH branded tablets (whole and ground), and multi-drug combination mixtures (MCMs) that simulate paediatric multi-drug-resistant tuberculosis (MDR-TB) regimens were assessed. Samples were analysed as solids and aqueous suspensions using hot-stage microscopy (HSM), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), Raman spectroscopy, FTIR-ATR, USP dissolution, and HPLC (LOD 0.0015 mg mL−1; LOQ 0.005 mg mL−1). Results: Grinding and co-mixing lowered melting points and masked typical INH events. Spectroscopy revealed the broadening and shifting of OH/NH and pyridine-ring bands, consistent with the formation of new hydrogen-bonding networks, correlative with supramolecular rearrangements. In multi-drug suspensions, INH fell below the HPLC quantification limit in both pH 1.2 and 6.8 media, despite visible residue, suggesting the formation of non-dissociable supramolecular complexes. Using a validated HPLC assay, no quantifiable INH was detected from the crushed multi-drug suspensions in either pH 1.2 or pH 6.8, whereas intact API/tablets showed measurable release. Conclusions: Co-suspension of INH with companion tuberculosis (TB) drugs disrupts its supramolecular integrity, leading to pre-administration degradation and a loss of quantifiable drug. Dissolution testing showed minimal INH release at pH 1.2 and none at pH 6.8, contrasting with intact tablets/API. These observations highlight that converting an immediate-release tablet into an aqueous suspension fundamentally alters its physicochemical environment and requires rational formulation design to preserve molecular stability, differentiating true resistance from formulation failure.
Can systemic corruption be prevented by legal means? The market for pharmaceuticals in Southern Ethiopia
(Taylor and Francis Ltd., 2025) Mengesha, Akalework; Bastiaens, Hilde; Ravinetto, Raffaella; Gibson, Linda; Dingwall, Robert
Some international and national regulatory and policy actors assume that strengthening domestic laws and tightening enforcement measures will be sufficient to reduce the extra-legal supply of medicines, whether legal, substandard, or falsified, to patients in low- and middle-income countries. This paper uses a qualitative study of the pharmaceutical market in Southern Ethiopia to argue that this assumption is unjustified, given the common lack of institutional capacity and the complexity of supply chains by which medicines reach local markets. Data are drawn from interviews with pharmacists, wholesalers, pharmacy owners, regulators, law enforcement agents, and health professionals, supplemented by participant observation and review of relevant policy and legal documents. These data were analyzed through the frame of Actor-Network Theory, to trace the journey of medicines from producer to consumer. Officially endorsed regulatory and enforcement mechanisms are entangled in an intricate web of practices involving different actors responding to local demands. The extra-legal supply of medicine, particularly if substandard or falsified, is an important global public health concern, but it will only be reduced by measures that place law and regulation within the context of the social, economic, and cultural factors that shape local markets and undermine the integrity of legal supply chains.
Differentiating resistance from formulation failure: Isoniazid instability and poor dissolution in crushed multi-drug paediatric preparations
(Multidisciplinary Digital Publishing Institute (MDPI), 2026) Samsodien, Halima; Aucamp, Marique; Winkler, Jana
Bedside manipulation of adult anti-tuberculosis tablets for paediatric dosing is common in low-resource settings, yet it can compromise drug stability. This study investigated how grinding and multi-drug co-suspension affect the supramolecular organisation, thermal stability, and dissolution of isoniazid (INH). Methods: INH raw, INH branded tablets (whole and ground), and multi-drug combination mixtures (MCMs) that simulate paediatric multi-drug-resistant tuberculosis (MDR-TB) regimens were assessed. Samples were analysed as solids and aqueous suspensions using hot-stage microscopy (HSM), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), Raman spectroscopy, FTIR-ATR, USP dissolution, and HPLC (LOD 0.0015 mg mL−1; LOQ 0.005 mg mL−1). Results: Grinding and co-mixing lowered melting points and masked typical INH events. Spectroscopy revealed the broadening and shifting of OH/NH and pyridine-ring bands, consistent with the formation of new hydrogen-bonding networks, correlative with supramolecular rearrangements. In multi-drug suspensions, INH fell below the HPLC quantification limit in both pH 1.2 and 6.8 media, despite visible residue, suggesting the formation of non-dissociable supramolecular complexes. Using a validated HPLC assay, no quantifiable INH was detected from the crushed multi-drug suspensions in either pH 1.2 or pH 6.8, whereas intact API/tablets showed measurable release. Conclusions: Co-suspension of INH with companion tuberculosis (TB) drugs disrupts its supramolecular integrity, leading to pre-administration degradation and a loss of quantifiable drug. Dissolution testing showed minimal INH release at pH 1.2 and none at pH 6.8, contrasting with intact tablets/API. These observations highlight that converting an immediate-release tablet into an aqueous suspension fundamentally alters its physicochemical environment and requires rational formulation design to preserve molecular stability, differentiating true resistance from formulation failure.
Development of aware-based quality indicators to assess the appropriateness of antibiotic prescribing in primary healthcare in South Africa
(Multidisciplinary Digital Publishing Institute (MDPI), 2026) Johnson, Yasmina; Coetzee, Renier; Chigome, Audrey K.
Background/Objectives: The overuse and misuse of antibiotics contribute to antimicrobial resistance (AMR) globally. The appropriateness of antibiotic prescribing at the primary healthcare (PHC) level must be urgently addressed to reduce high levels of inappropriate antibiotic prescribing and associated AMR. This study aimed to develop quality indicators, based on the World Health Organization (WHO)’s Access, Watch, Reserve (AWaRe) guidance, to assess the appropriateness and quality regarding antibiotic prescribing in public PHC settings in South Africa. Methods: Potential indicators were identified from indicators developed by City St George’s, University of London (SGUL); a review of AWaRe-based indicators; and the results from point prevalence surveys at PHC clinics in South Africa. The indicators were developed using the RAND/UCLA Appropriateness Method. In Round 1, 12 experts individually rated 78 indicators for clarity and appropriateness. In Round 2, 10 experts rated 89 indicators for appropriateness and feasibility during an interactive online meeting. Results: The final set had 61/89 indicators (68.5%) that were rated both appropriate and feasible with agreement. Dental infections (9/9; 100%) alongside skin and soft tissue infections (11/13; 84.6%) had the highest percentage of indicators that were rated appropriate and feasible with agreement. Lower urinary tract infections (6/11; 54.5%) and general (4/8; 50%) categories had the lowest percentage of indicators rated appropriate and feasible with agreement. Conclusions: The process proved valuable in developing potential indicators for use in future antimicrobial stewardship programmes to improve antibiotic prescribing in public sector PHC facilities in South Africa and beyond.
Value addition to african natural product-based drug discovery initiatives
(American Chemical Society, 2025) Beukes, Denzil; Mayoka, Godfrey; Cheuka, Peter Mubanga
Natural products are vital to drug discovery, yet Africa’s vast biodiversity remains underutilized. This perspective examines barriers limiting Africa’s impact such as weak infrastructure, limited translational capacity, and minimal integration of medicinal chemistry. We advocate for advancing beyond basic extraction to include systematic isolation, pharmacokinetics studies, and semisynthetic derivatization. Emphasis is placed on integrating AI, cheminformatics, and biotransformation, alongside embedding drug discovery training into academic curricula. Strengthening regional networks, fostering interdisciplinary collaborations, and securing Africa-sensitive funding are essential. Strategic implementation of these actions will enable Africa to harness its natural resources for global drug discovery and address local health challenges.
South African retail pharmacists' knowledge of cannabidiol and cannabis, and training recommendations
(AOSIS (pty) Ltd, 2025) Naik, Yugeshnee; Ebrahim, Naushaad
Background: With the evolving legal landscape in South Africa, cannabidiol (CBD) and non-medical cannabis products are increasingly available, posing challenges for healthcare professionals. Retail pharmacists, as key figures in patient care, face a critical knowledge gap in providing informed advice on these products. This study assessed the attitudes and clinical knowledge of retail pharmacists in South Africa regarding the recommendation and patient counselling with respect to CBD and non-medical cannabis. Methods: A cross-sectional quantitative design study was conducted, using an online survey to evaluate pharmacists’ knowledge and attitudes towards CBD and non-medical cannabis. A sample of 178 pharmacists provided a statistical power of 0.997, ensuring robust results. Results: While 69% of pharmacists recognised CBD’s therapeutic potential, 63% felt unprepared to recommend it because of insufficient knowledge and 60% cited a lack of resources in their pharmacies. Only 13% scored above 50% in the knowledge assessment, which included legislative and clinical understanding related to CBD and non-medical cannabis, with 31% reporting no formal training to educate themselves on CBD products. Conclusion: This study highlights the need for targeted educational initiatives and clear South African Health Products Regulatory Authority (SAHPRA) guidelines to bridge knowledge gaps among retail pharmacists. Updated resources on CBD safety, interactions and therapeutic use are critical to empower pharmacists to deliver evidence-based counselling. Contribution: The findings contribute to healthcare education, policy reform, and health promotion by emphasising the importance of equipping pharmacists with the tools necessary for safe and effective counselling on CBD and cannabis products.
Physicochemical stability of aspalathin-rich rooibos iced tea powders under accelerated storage conditions as affected by formulation
(Elsevier Ltd, 2026) Aucamp, Marique; de Beer, Dalene; Human, Chantelle
A stable, palatable, aspalathin-rich rooibos iced tea powder in a convenient single-serve format offers a viable functional beverage for reducing sugar intake. Our initial goal was to determine the optimal ratio of green rooibos extract (GRE) to fermented rooibos extract (FRE). This was essential to create a formulation that combined high aspalathin content with the sought-after sensory profile of traditional fermented rooibos. The second goal was to ascertain how the addition of common beverage ingredients (xylitol, citric, and ascorbic acid) and moisture (6 % and 53 % relative humidity, RH) affected the physicochemical stability of the mixtures during accelerated shelf-life storage (40 °C; 12 weeks). An FRE:GRE ratio of 1:0.5 was found to have a similar sensory profile as FRE, generally accepted by consumers, with a high aspalathin content (83.5 mg L−1) compared to FRE alone (5.5 mg L−1). During storage at 53 % RH, crystalline ingredients significantly decreased the color (lower L∗ and h°) and aspalathin (based on first-order reaction rate constants) stability. Changes in the crystal structure, affected by the interaction between ingredients, were observed using powder X-ray diffraction and Fourier-transform infrared spectroscopy. Minimal changes were observed for all parameters when storing the iced tea powders at 6 % RH, regardless of formulation. Ready-to-reconstitute aspalathin-rich rooibos iced tea powders should be stored in moisture-impermeable packaging to ensure a physically (including color) and chemically stable product.
An investigation into the effect of maltitol, sorbitol, and xylitol on the formation of carbamazepine solid dispersions through thermal processing
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Aucamp, Marique Elizabeth; Poka, Madan Sai; Milne, Marnus
Background: Carbamazepine (CBZ) is a Biopharmaceutical Classification System (BCS) class II drug, that is practically insoluble in water, influencing the oral bioavailability. Polyols are highly hydrophilic crystalline carriers studied for their success in developing solid dispersions (SDs) for improved solubility and dissolution rate. Polyols are generally regarded as safe (GRAS) and maltitol (MAL), xylitol (XYL) and sorbitol (SOR) are among the approved polyols for market use. While xylitol (XYL) and sorbitol, have shown promise in improving the solubility and dissolution rates of poorly soluble drugs, their full potential in the context of improving the solubility of carbamazepine have not been thoroughly investigated. To the best of our knowledge, maltitol (MAL) was not studied previously as a carrier for preparing SDs. Hence, the purpose of this study was to investigate their use in the preparation of CBZ SDs by the fusion method. Methods: CBZ-polyol SDs were prepared in varying molar ratios (2:1, 1:1 and 1:2) and characterised for solid-state nature, solubility and in-vitro dissolution rate. Results: Solid-state characterisation of the CBZ-polyol SDs revealed the existence of the SDs as continuous glass suspensions with fine CBZ crystallites suspended in the amorphous polyol carriers. Among the polyols studied, XYL exhibited good miscibility with CBZ and showed significant improvement in the solubility and dissolution rate. The prepared SDs showed a 2 to 6-folds increase in CBZ solubility and 1.4 to 1.9-folds increase in dissolution rate in comparison with pure CBZ. Conclusions: The study explains the possible use of polyols (XYL and SOR) based SDs of BCS Class II drugs with good glass forming ability for enhanced solubility and dissolution.
Phytochemical components and GC–MS analysis of Petiveria alliaceae L. fractions and volatile oils
(De Gruyter, 2023) Odugbemi, Adeshina Isaiah; Egieyeh, Samuel Ayodele; Adesanya, Enitan Omobolanle
Phytochemical constituents are important in the determination of plant activities. Their presence in medicinal plants gives their therapeutic values. These phytoconstituents possesses pharmacological activities that include antimicrobial, antioxidant, anti-inflammatory, analgesics, anti-diabetic, anti-hypertensive, antidiarrheal and several other activities. These activities can be determined by the identification of the phytochemicals present in medicinal plants. Petivera alliaceae L. is one of the medicinal plants in the family of phtytolaccaceae used traditionally as an antirheumatic, analgesics, antimicrobial, anticancer and immunomodulators. It is believed to possess rich phytoconstituents especially sulphur containing a broad-spectrum antimicrobial activity. Although the root extracts is been explored but there are limited publication to its root fractions. Therefore, the study is aimed at screening phytochemicals present in the fractions and volatile oil of the root parts of P. alliaceae using qualitative tests and Gas Chromatography–Mass Spectrometry (GC–MS) analysis. Fresh root parts of Petivera allliaceae plant were collected and air-dried. The dried root parts was macerated in absolute methanol for 72 h. The solution was extracted and dried. The dried root methanol extract was partitioned into n-hexane (PAH) and methanol fractions (PAM), while volatile oil (PAO) was extracted using Clevenger-type hydrodistillation method. The result shows that alkaloids, saponins and flavonoids were present while cardiac glycosides, phenol, terpenoids and anthraqunione glycosides were absent in both fractions. The GC–MS analysis identified 18 compounds in PAH, 19 compounds in PAM and 28 compounds in PAO. The fractions and volatile oils of P. alliaceae roots are rich in phytochemical constituents and compounds should be isolated from the fractions and explored for their potentials.
Surface-modified dendrimer nanoconjugate for targeting delivery of rifampicin
(Elsevier B.V, 2025) Ahmed, Rami; Aucamp, Marique; Samsodien, Halima
Objective: The study aimed to formulate and evaluate the efficiency of surface-modified Polyamidoamine dendrimer (PAMAM) as a targeted nanocarrier for the antimycobacterial agent rifampicin. Methods: The periphery of dendrimer was modified with mannose using α-D-mannopyranosylphenyl isothiocyanate and characterized using analytical techniques i.e., infrared spectroscopy (FTIR) and nuclear magnetic resonance spectroscopy (NMR). Then, rifampicin was encapsulated into mannosylated dendrimers and evaluated for size, shape, encapsulation efficiency (EE%), drug-dendrimer interaction, and drug release. The toxicity of the nanoconjugates were assessed towards macrophages using the MTT technique. The study investigated the internalization of dendrimer nanoparticles into macrophages to assess the impact of mannose conjugation. Dendrimers were fluorescently labelled and the internalization was quantified using a fluorescence spectroscopy and flow cytometer methods. Results: Mannosylated dendrimers with different mannose densities were successfully developed. The nanoparticles were within the nanoscopic scale. The dendrimers appeared spheroidal under scanning electron microscopy (SEM), and thermal analysis confirmed the conjugation of rifampicin into the dendrimers. The nanoparticles exhibited a good EE% for rifampicin at 10.34 % w/w. After surface mannosylation, the EE% further increased, ranging from 43.43 % to 57.91 % w/w. Mannose-functionalized dendrimers prolonged rifampicin release in physiological pH, while a rapid release in pH 4.5 medium was noticed. The cytotoxicity of the dendrimers in RAW macrophages was considerably reduced after mannose functionalization. In vitro studies indicated that mannose significantly increased the macrophage uptake of nanoconjugates, likely via lectin receptor-mediated endocytosis. Conclusion: Overall results suggested mannosylated dendrimers as an effective targeted pulmonary delivery system for rifampicin with negligible cytotoxicity.
Advanced therapeutic technologies for malaria, tuberculosis, HIV infection and neglected tropical diseases
(John Wiley and Sons Inc, 2025) Dube, Admire; Laverty, Garry; Balogun, Mohammed
We are pleased to present this special issue to highlight advances in therapeutic technologies for infectious diseases, in particular for treatment of tuberculosis (TB), HIV/AIDS and malaria. Informative reviews as well as original research articles form part of this Issue. The world’s deadliest infectious diseases TB, HIV/AIDS and malaria are responsible for close to 2.5 million deaths world-wide, each year.[1] Over 90% of deaths due to malaria occur in subSaharan Africa, with the majority of deaths occurring in children under 5 years of age. Infectious diseases are responsible for ≈704 million disability-adjusted life-years (DALYs) and the African region bears the highest burden, with ≈314 million DALYs; while high-income countries account for only ≈31.8 million DALYs.[2]
Targeting myeloid cells with platelet-derived extracellular vesicles to overcome resistance of immune checkpoint blockade therapy
(Elsevier Ltd, 2025) Dube, Admire; Yao, Chenlu; Ma, Qingle
Immune checkpoint blockade (ICB) therapy is designed to boost antitumor immune responses, yet it may unintentionally alter the chemokine profile, which can attract suppressive myeloid cells to the tumor, leading to acquired immune resistance. To address this, we developed a platform that targets myeloid cells post-ICB therapy using platelet-derived extracellular vesicles (PEVs). Unlike free drug administration, this system selectively targets anti-PD-L1-treated tumors through the CXCL-CXCR2 axis, effectively redirecting myeloid cells and overcoming ICB resistance. Consequently, mice exhibited robust responses to subsequent ICB therapy cycles, resulting in significantly enhanced tumor clearance and prolonged survival. The PEVs’ targeting capability was also effective in tumors treated with chemotherapy and radiotherapy, suggesting a wide range of potential applications. In summary, PEVs offer a versatile platform for targeted immunomodulation to counteract acquired immune resistance during ICB therapy.
Assessing the potential for red seaweed Asparagopsis taxiformis aquaculture in Seychelles
(Western Indian Ocean Marine Science Association, 2025) Lerata, Mookho; Beukes, Denzil; de Vos, Bas
Asparagopsis taxiformis macroalgae can potentially reduce methane emissions when fed to rumi-nants, thus reducing the emission of greenhouse gasses into the atmosphere. Literature indicates water temperatures above 24 °C limit A. taxiformes growth rates during culture, however, it grows wild in Seychelles where water temperatures range from 25 to 31.5 °C. The feasibility of culti-vating the local strain of A. taxiformis in Seychelles was investigated, focusing on growth rates at higher temperatures and bromoform content, the compound responsible for methane reduction. Two tetrasporophyte growth trials were conducted in photobioreactors at 24 °C, 26 °C, 29 °C and 32 °C. In the first trial, unacclimated specimens showed poor growth, with no significant differences between temperatures. In the second trial, daily growth rates of acclimated specimens were 3.98 % across all temperatures, including 32 °C, where temperature did not significantly affect growth. Bromoform concentrations were lower than expected, likely due to storage con-ditions prior to sample processing. The local strain of A. taxiformis in Seychelles may therefore be adapted to higher temperatures, with potential for aquaculture. Further research to optimize cultivation techniques and ensure adequate bromoform content is required.
Formulation and clinical translation of inhalable nanomedicines for the treatment and prevention of pulmonary infectious diseases
(Springer, 2025) Ahmed, Rami; Aucamp, Marique; Dube, Admire
Pulmonary infections caused by bacteria, viruses and fungi are a significant global health issue. Inhalation therapies are gaining interest as an effective approach to directly target infected lung sites and nanoparticle-based pulmonary delivery systems are increasingly investigated for this purpose. In this review, we provide an overview of common pulmonary infectious diseases and review recent work on the application of inhalable nanoparticle-based formulations for pulmonary infectious diseases, the formulation strategies, and the current research for delivering inhalable nanomedicines. We also evaluate the current clinical development status, market landscape, and discuss challenges that impede clinical translation and propose solutions to overcome these obstacles, highlighting promising opportunities for future advancements in the field. Despite advancements made and products reaching the market, notable gap persists in translational research, with challenges in achieving the target product profile, availability of appropriate in vivo disease models, scale-up, and market related questions, likely hindering research translation to the clinic.
Development of an African paediatric oncology pharmacy curriculum: a SIOP Africa 2024 pharmacy workshop output
(SAGE Publications Ltd, 2025) Wiafe, Ebenezer; Zimbwe, Kauke Bakari; Mageto, Susan Nyabate
Background: The practice of paediatric oncology pharmacy (POP) has been in existence in Africa for several decades. However, most POP practitioners lack formal education and training. Training and credentialing of pharmacists requires the availability of an appropriate curriculum developed to meet local needs. Hence, the African POP technical working group (TWG) of the International Society of Paediatric Oncology (SIOP) embarked on a process to develop a curriculum in POP. Method: The curriculum development followed a modified Delphi approach: the formalisation of the POP TWG, the initial development of the curriculum, community and stakeholder engagement via a modified Delphi scoring, and the finalisation of the curriculum at the pharmacy workshop of the SIOP Africa Congress in South Africa. Results: A POP TWG of 23 members with diverse experiences was formed. The initial curriculum, focusing on 36 theoretical and 5 clinical components, was developed. The modified Delphi process restructured the 36 theoretical contents to 27, the 5 clinical contents to 9, and introduced 6 research modules. The theoretical and clinical components were assigned 86 and 240 credit hours respectively, with a research component culminating in a published manuscript. Twenty-eight individuals from 13 countries attended the workshop, resulting in unanimous approval of the curriculum. Conclusions: The SIOP Africa Pharmacy TWG has developed a POP curriculum specific to Africa. The implementation of the curriculum through African universities and specialist colleges is imperative to reduce the education and training gaps in POP.
The preparation of abacavir-loaded liposomes for improved drug solubility and dissolution rate
(Springer, 2025) Okafor, Nnamdi Ikemefuna; Nnaji, Nnaemeka Joshua.N.
This study was aimed at developing abacavir (ABC)-loaded liposomes to facilitate improved drug solubility and dissolution rate in an effort to provide a potential dose reduction of ABC with pediatric patients in mind. By utilizing the design of an experimental approach, various liposome formulation parameters were investigated. Drug-loaded liposomes were characterized in terms of particle size, zeta potential, polydispersity index, encapsulation efficiency, as well as other physicochemical characteristics such as thermal behavior, particle morphology, ABC equilibrium solubility, and finally ABC dissolution rate. The optimal formulation parameters were found to be a lecithin: cholesterol ratio of 1:1, a thin-film hydration time of 60 min, a vortex time of 2 min, a sonication time of 10 min, and 10 mLof water as hydration fluid in which 75 mg ABC was dissolved. The drug-loaded liposomes exhibited significant encapsulation efficiency, with the highest encapsulation efficiency of 98%, a particle size within a range of 523 nm, and a strong zeta potential of –53 mV. The liposomes further revealed an increased and enhanced aqueous solubility for the drug entrapped within the formulations, while showing the release of the drug from formulation. The results proved that ABC can be successfully loaded into a simple and cost-effective liposome formulation, providing a significantly enhanced ABC solubility and dissolution rate, which could ultimately have a positive effect on the bioavailability of ABC, especially because ABC is a BCS I drug, thus offering the potential to formulate a reduced dosage form aimed at pediatric patients.
The global, regional, and national burden attributable to low bone mineral density, 1990–2020: an analysis of a modifiable risk factor from the Global Burden of Disease Study 2021
(Elsevier Ltd, 2025) Okonji, Osaretin; Hsieh, Evelyn; Bryazka, Dana
Fractures related to osteoporosis and low bone mineral density lead to substantial morbidity, mortality, and cost to individuals and health systems. Here we present the most up-to-date global, regional, and national estimates of the contribution of low bone mineral density to the burden of fractures from falls and additional categories of injuries from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The burden of low bone mineral density was estimated from 1990 to 2020 in terms of years lived with disability (YLDs), disability-adjusted life years (DALYs), and deaths, for individuals aged 40 years and older, using data from population-based studies from 48 countries or territories (169 unique sources). Mean standardised femoral neck bone mineral density values were estimated by GBD location, age, and sex by meta-regression. Based on a separate meta-analysis of population-based studies from nine countries (12 unique sources), we also estimated the pooled relative risk of fractures per unit decrease in bone mineral density (g/cm²). The population-attributable fraction for low bone mineral density was calculated by comparing the observed distributions of standardised femoral neck bone mineral density to an age-specific and sex-specific counterfactual distribution, defined as the 99th percentile of five rounds of the National Health and Nutrition Examination Survey in the USA, by 5-year age group and sex. Hospital and emergency department data were used to derive the incidence of fractures for six categories of injury (road injuries, other transport injuries, falls, non-venomous animal contact, exposure to mechanical forces, and physical interpersonal violence) using ICD codes. Deaths due to fractures were estimated as the proportion of in hospital deaths due to the specified injury causes for which a fracture (nature of injury code) was more severe than the cause of injury code. YLDs and DALYs attributable to low bone mineral density by cause of injury were also determined according to previous GBD methods.
Dual GSK3β/SIRT1 modulators for Alzheimer’s: mechanisms, drug discovery and future perspectives
(Frontiers Media SA, 2025) Kareem, Afeez I; Kapp, Erika; Joubert, Jacques
Alzheimer’s disease (AD) remains without effective disease-modifying therapies, in part due to the limited efficacy of single-target approaches. Dual modulation of glycogen synthase kinase-3β (GSK3β), a key driver of tau hyperphosphorylation and amyloid-β (Aβ) production, and sirtuin-1 (SIRT1), a neuroprotective NAD+-dependent deacetylase, has emerged as a promising therapeutic strategy. This review explores the mechanistic rationale for concurrently inhibiting GSK3β and activating SIRT1 to disrupt AD’s pathological cascade while enhancing endogenous neuroprotective pathways. Natural compounds such as resveratrol, berberine, pterostilbene, and quercetin exhibit this dual activity and provide scaffolds for rational drug design. However, challenges related to target selectivity, blood-brain barrier penetration, and clinical translation persist. Advances in multi-target drug discovery, including pharmacophore hybridization, structure-based modelling, cheminformatics, nanoformulation and delivery strategies offer new avenues to overcome these hurdles. A dual GSK3β/SIRT1-targeting strategy exemplifies a systems-level approach to restoring neurophysiological balance and holds potential to achieve more effective, disease-modifying outcomes in AD.

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