Tolerability of Isoniazid Preventive Therapy in an HIV-Infected Cohort of Paediatric and Adolescent Patients on Antiretroviral Therapy from a Resource-Limited ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-02-13

AUTHORS

Tinashe Mudzviti, Tinei Shamu, Cleophas Chimbetete, Tilda Munengerwa, Sandra Bote, Margaret Pascoe

ABSTRACT

BackgroundTreating patients with latent tuberculosis infection (LTBI) to prevent development of active disease is an essential strategy for eliminating TB. There are concerns regarding the use of isoniazid due to the potential for hepatotoxicity. This study was conducted to determine the incidence of adverse hepatic events after isoniazid preventive therapy (IPT) commencement in a cohort of HIV-infected paediatric and adolescent patients on antiretroviral therapy (ART).MethodsThis was a retrospective records review, using data from HIV-infected paediatric and adolescent patients collected during routine clinical visits at Newlands Clinic, Harare, Zimbabwe. Patients included in the analysis had commenced IPT between January 2014 and June 2015 (inclusive) whilst receiving ART. A survival analysis was conducted for the period that participants were receiving IPT with end-points defined by grade 3 or grade 4 elevations in alanine aminotransferase (ALT) levels.ResultsData from 438 patients commenced on IPT were analysed; 202 (46.1%) of them were female. The median age at IPT commencement was 10 (IQR = 7–12) years. Twenty-eight patients developed grade 3 or 4 elevations in ALT. Concomitant use of nevirapine as part of an ART regimen was the only factor that showed a statistically significant association with ALT elevation [relative risk (RR): 2.7; confidence interval (CI): 1.2–6.3, p = 0.012] compared with those not receiving nevirapine. The incidence of grade 3 or 4 elevations in ALT was 31.5/100 person-years (CI 20.9–45.5).ConclusionThe incidence of IPT-associated ALT elevations was high in this population. We recommend vigilant monitoring of liver enzymes for patients receiving IPT, especially in patients concomitantly receiving nevirapine. More... »

PAGES

37-42

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s40801-019-0147-3

DOI

http://dx.doi.org/10.1007/s40801-019-0147-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112096457

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30758779


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Clinical Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1117", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Public Health and Health Services", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "School of Pharmacy, University of Zimbabwe, Mount Pleasant, P.O. Box MP167, Harare, Zimbabwe", 
          "id": "http://www.grid.ac/institutes/grid.13001.33", 
          "name": [
            "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe", 
            "School of Pharmacy, University of Zimbabwe, Mount Pleasant, P.O. Box MP167, Harare, Zimbabwe"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Mudzviti", 
        "givenName": "Tinashe", 
        "id": "sg:person.01354742521.81", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01354742521.81"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe", 
          "id": "http://www.grid.ac/institutes/None", 
          "name": [
            "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Shamu", 
        "givenName": "Tinei", 
        "id": "sg:person.01220175732.05", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01220175732.05"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe", 
          "id": "http://www.grid.ac/institutes/None", 
          "name": [
            "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Chimbetete", 
        "givenName": "Cleophas", 
        "id": "sg:person.01200656243.06", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01200656243.06"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "School of Pharmacy, University of Zimbabwe, Mount Pleasant, P.O. Box MP167, Harare, Zimbabwe", 
          "id": "http://www.grid.ac/institutes/grid.13001.33", 
          "name": [
            "School of Pharmacy, University of Zimbabwe, Mount Pleasant, P.O. Box MP167, Harare, Zimbabwe"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Munengerwa", 
        "givenName": "Tilda", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe", 
          "id": "http://www.grid.ac/institutes/None", 
          "name": [
            "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Bote", 
        "givenName": "Sandra", 
        "id": "sg:person.015101543333.25", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015101543333.25"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe", 
          "id": "http://www.grid.ac/institutes/None", 
          "name": [
            "Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Pascoe", 
        "givenName": "Margaret", 
        "id": "sg:person.015570734040.35", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015570734040.35"
        ], 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "sg:pub.10.1186/s12916-018-1033-7", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1101827997", 
          "https://doi.org/10.1186/s12916-018-1033-7"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2019-02-13", 
    "datePublishedReg": "2019-02-13", 
    "description": "BackgroundTreating patients with latent tuberculosis infection (LTBI) to prevent development of active disease is an essential strategy for eliminating TB. There are concerns regarding the use of isoniazid due to the potential for hepatotoxicity. This study was conducted to determine the incidence of adverse hepatic events after isoniazid preventive therapy (IPT) commencement in a cohort of HIV-infected paediatric and adolescent patients on antiretroviral therapy (ART).MethodsThis was a retrospective records review, using data from HIV-infected paediatric and adolescent patients collected during routine clinical visits at Newlands Clinic, Harare, Zimbabwe. Patients included in the analysis had commenced IPT between January 2014 and June 2015 (inclusive) whilst receiving ART. A survival analysis was conducted for the period that participants were receiving IPT with end-points defined by grade 3 or grade 4 elevations in alanine aminotransferase (ALT) levels.ResultsData from 438 patients commenced on IPT were analysed; 202 (46.1%) of them were female. The median age at IPT commencement was 10 (IQR\u2009=\u20097\u201312) years. Twenty-eight patients developed grade 3 or 4 elevations in ALT. Concomitant use of nevirapine as part of an ART regimen was the only factor that showed a statistically significant association with ALT elevation [relative risk (RR): 2.7; confidence interval (CI): 1.2\u20136.3, p\u2009=\u20090.012] compared with those not receiving nevirapine. The incidence of grade 3 or 4 elevations in ALT was 31.5/100 person-years (CI 20.9\u201345.5).ConclusionThe incidence of IPT-associated ALT elevations was high in this population. We recommend vigilant monitoring of liver enzymes for patients receiving IPT, especially in patients concomitantly receiving nevirapine.", 
    "genre": "article", 
    "id": "sg:pub.10.1007/s40801-019-0147-3", 
    "inLanguage": "en", 
    "isAccessibleForFree": true, 
    "isFundedItemOf": [
      {
        "id": "sg:grant.2438715", 
        "type": "MonetaryGrant"
      }
    ], 
    "isPartOf": [
      {
        "id": "sg:journal.1051855", 
        "issn": [
          "2199-1154", 
          "2198-9788"
        ], 
        "name": "Drugs - Real World Outcomes", 
        "publisher": "Springer Nature", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "1", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "6"
      }
    ], 
    "keywords": [
      "latent tuberculosis infection", 
      "antiretroviral therapy", 
      "adolescent patients", 
      "grade 3", 
      "ALT elevation", 
      "adverse hepatic events", 
      "routine clinical visits", 
      "grade 4 elevations", 
      "cohort of HIV", 
      "isoniazid preventive therapy", 
      "alanine aminotransferase levels", 
      "Resource-Limited Settings", 
      "retrospective cohort study", 
      "retrospective record review", 
      "use of isoniazid", 
      "hepatic events", 
      "therapy commencement", 
      "Newlands Clinic", 
      "ART regimen", 
      "active disease", 
      "aminotransferase levels", 
      "preventive therapy", 
      "cohort study", 
      "tuberculosis infection", 
      "median age", 
      "record review", 
      "clinical visits", 
      "concomitant use", 
      "liver enzymes", 
      "patients", 
      "vigilant monitoring", 
      "survival analysis", 
      "significant association", 
      "HIV", 
      "nevirapine", 
      "therapy", 
      "incidence", 
      "only factor", 
      "cohort", 
      "ALT", 
      "elevation", 
      "commencement", 
      "tolerability", 
      "regimen", 
      "MethodsThis", 
      "hepatotoxicity", 
      "clinic", 
      "pediatrics", 
      "infection", 
      "ResultsData", 
      "disease", 
      "isoniazid", 
      "visits", 
      "IPT", 
      "age", 
      "essential strategy", 
      "study", 
      "association", 
      "TB", 
      "participants", 
      "Harare", 
      "review", 
      "years", 
      "population", 
      "use", 
      "setting", 
      "period", 
      "factors", 
      "levels", 
      "events", 
      "analysis", 
      "monitoring", 
      "enzyme", 
      "concern", 
      "development", 
      "data", 
      "strategies", 
      "potential", 
      "Zimbabwe", 
      "part", 
      "isoniazid preventive therapy (IPT) commencement", 
      "preventive therapy (IPT) commencement", 
      "IPT commencement", 
      "incidence of IPT", 
      "Cohort of Paediatric"
    ], 
    "name": "Tolerability of Isoniazid Preventive Therapy in an HIV-Infected Cohort of Paediatric and Adolescent Patients on Antiretroviral Therapy from a Resource-Limited Setting: A Retrospective Cohort Study", 
    "pagination": "37-42", 
    "productId": [
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1112096457"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1007/s40801-019-0147-3"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "30758779"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1007/s40801-019-0147-3", 
      "https://app.dimensions.ai/details/publication/pub.1112096457"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2021-11-01T18:36", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-springernature-scigraph/baseset/20211101/entities/gbq_results/article/article_820.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://doi.org/10.1007/s40801-019-0147-3"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s40801-019-0147-3'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s40801-019-0147-3'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s40801-019-0147-3'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s40801-019-0147-3'


 

This table displays all metadata directly associated to this object as RDF triples.

195 TRIPLES      22 PREDICATES      113 URIs      103 LITERALS      7 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1007/s40801-019-0147-3 schema:about anzsrc-for:11
2 anzsrc-for:1103
3 anzsrc-for:1117
4 schema:author N22755823b696404c9682782ab8249f65
5 schema:citation sg:pub.10.1186/s12916-018-1033-7
6 schema:datePublished 2019-02-13
7 schema:datePublishedReg 2019-02-13
8 schema:description BackgroundTreating patients with latent tuberculosis infection (LTBI) to prevent development of active disease is an essential strategy for eliminating TB. There are concerns regarding the use of isoniazid due to the potential for hepatotoxicity. This study was conducted to determine the incidence of adverse hepatic events after isoniazid preventive therapy (IPT) commencement in a cohort of HIV-infected paediatric and adolescent patients on antiretroviral therapy (ART).MethodsThis was a retrospective records review, using data from HIV-infected paediatric and adolescent patients collected during routine clinical visits at Newlands Clinic, Harare, Zimbabwe. Patients included in the analysis had commenced IPT between January 2014 and June 2015 (inclusive) whilst receiving ART. A survival analysis was conducted for the period that participants were receiving IPT with end-points defined by grade 3 or grade 4 elevations in alanine aminotransferase (ALT) levels.ResultsData from 438 patients commenced on IPT were analysed; 202 (46.1%) of them were female. The median age at IPT commencement was 10 (IQR = 7–12) years. Twenty-eight patients developed grade 3 or 4 elevations in ALT. Concomitant use of nevirapine as part of an ART regimen was the only factor that showed a statistically significant association with ALT elevation [relative risk (RR): 2.7; confidence interval (CI): 1.2–6.3, p = 0.012] compared with those not receiving nevirapine. The incidence of grade 3 or 4 elevations in ALT was 31.5/100 person-years (CI 20.9–45.5).ConclusionThe incidence of IPT-associated ALT elevations was high in this population. We recommend vigilant monitoring of liver enzymes for patients receiving IPT, especially in patients concomitantly receiving nevirapine.
9 schema:genre article
10 schema:inLanguage en
11 schema:isAccessibleForFree true
12 schema:isPartOf N55c30f192d7845a8a4486bb66fad7b0b
13 Na7a001e0926f481897714d19bc5858de
14 sg:journal.1051855
15 schema:keywords ALT
16 ALT elevation
17 ART regimen
18 Cohort of Paediatric
19 HIV
20 Harare
21 IPT
22 IPT commencement
23 MethodsThis
24 Newlands Clinic
25 Resource-Limited Settings
26 ResultsData
27 TB
28 Zimbabwe
29 active disease
30 adolescent patients
31 adverse hepatic events
32 age
33 alanine aminotransferase levels
34 aminotransferase levels
35 analysis
36 antiretroviral therapy
37 association
38 clinic
39 clinical visits
40 cohort
41 cohort of HIV
42 cohort study
43 commencement
44 concern
45 concomitant use
46 data
47 development
48 disease
49 elevation
50 enzyme
51 essential strategy
52 events
53 factors
54 grade 3
55 grade 4 elevations
56 hepatic events
57 hepatotoxicity
58 incidence
59 incidence of IPT
60 infection
61 isoniazid
62 isoniazid preventive therapy
63 isoniazid preventive therapy (IPT) commencement
64 latent tuberculosis infection
65 levels
66 liver enzymes
67 median age
68 monitoring
69 nevirapine
70 only factor
71 part
72 participants
73 patients
74 pediatrics
75 period
76 population
77 potential
78 preventive therapy
79 preventive therapy (IPT) commencement
80 record review
81 regimen
82 retrospective cohort study
83 retrospective record review
84 review
85 routine clinical visits
86 setting
87 significant association
88 strategies
89 study
90 survival analysis
91 therapy
92 therapy commencement
93 tolerability
94 tuberculosis infection
95 use
96 use of isoniazid
97 vigilant monitoring
98 visits
99 years
100 schema:name Tolerability of Isoniazid Preventive Therapy in an HIV-Infected Cohort of Paediatric and Adolescent Patients on Antiretroviral Therapy from a Resource-Limited Setting: A Retrospective Cohort Study
101 schema:pagination 37-42
102 schema:productId N2537683e1ea448db98c7305ca1074586
103 N4b62948565c64c5b98033ba1527c8f7f
104 N896cc921eec54c4ea9088fc6083240bf
105 schema:sameAs https://app.dimensions.ai/details/publication/pub.1112096457
106 https://doi.org/10.1007/s40801-019-0147-3
107 schema:sdDatePublished 2021-11-01T18:36
108 schema:sdLicense https://scigraph.springernature.com/explorer/license/
109 schema:sdPublisher N0c5822c10d6949c49679a56b671d41c1
110 schema:url https://doi.org/10.1007/s40801-019-0147-3
111 sgo:license sg:explorer/license/
112 sgo:sdDataset articles
113 rdf:type schema:ScholarlyArticle
114 N09a5d4b579b841aca2727deabcda17a6 rdf:first sg:person.015570734040.35
115 rdf:rest rdf:nil
116 N0a84ef0422264d10ad0e5a58d235c879 rdf:first sg:person.01220175732.05
117 rdf:rest N8c471289e63d49dcb4e5e3dfdb823ffe
118 N0c5822c10d6949c49679a56b671d41c1 schema:name Springer Nature - SN SciGraph project
119 rdf:type schema:Organization
120 N1b89798f6c4344e39278b4f642d3de81 schema:affiliation grid-institutes:grid.13001.33
121 schema:familyName Munengerwa
122 schema:givenName Tilda
123 rdf:type schema:Person
124 N22755823b696404c9682782ab8249f65 rdf:first sg:person.01354742521.81
125 rdf:rest N0a84ef0422264d10ad0e5a58d235c879
126 N2537683e1ea448db98c7305ca1074586 schema:name dimensions_id
127 schema:value pub.1112096457
128 rdf:type schema:PropertyValue
129 N3a5ed1233ba1474081a98368b939a57d rdf:first sg:person.015101543333.25
130 rdf:rest N09a5d4b579b841aca2727deabcda17a6
131 N3e7d8e50a8e94361957a97a3fbd9a294 rdf:first N1b89798f6c4344e39278b4f642d3de81
132 rdf:rest N3a5ed1233ba1474081a98368b939a57d
133 N4b62948565c64c5b98033ba1527c8f7f schema:name doi
134 schema:value 10.1007/s40801-019-0147-3
135 rdf:type schema:PropertyValue
136 N55c30f192d7845a8a4486bb66fad7b0b schema:volumeNumber 6
137 rdf:type schema:PublicationVolume
138 N896cc921eec54c4ea9088fc6083240bf schema:name pubmed_id
139 schema:value 30758779
140 rdf:type schema:PropertyValue
141 N8c471289e63d49dcb4e5e3dfdb823ffe rdf:first sg:person.01200656243.06
142 rdf:rest N3e7d8e50a8e94361957a97a3fbd9a294
143 Na7a001e0926f481897714d19bc5858de schema:issueNumber 1
144 rdf:type schema:PublicationIssue
145 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
146 schema:name Medical and Health Sciences
147 rdf:type schema:DefinedTerm
148 anzsrc-for:1103 schema:inDefinedTermSet anzsrc-for:
149 schema:name Clinical Sciences
150 rdf:type schema:DefinedTerm
151 anzsrc-for:1117 schema:inDefinedTermSet anzsrc-for:
152 schema:name Public Health and Health Services
153 rdf:type schema:DefinedTerm
154 sg:grant.2438715 http://pending.schema.org/fundedItem sg:pub.10.1007/s40801-019-0147-3
155 rdf:type schema:MonetaryGrant
156 sg:journal.1051855 schema:issn 2198-9788
157 2199-1154
158 schema:name Drugs - Real World Outcomes
159 schema:publisher Springer Nature
160 rdf:type schema:Periodical
161 sg:person.01200656243.06 schema:affiliation grid-institutes:None
162 schema:familyName Chimbetete
163 schema:givenName Cleophas
164 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01200656243.06
165 rdf:type schema:Person
166 sg:person.01220175732.05 schema:affiliation grid-institutes:None
167 schema:familyName Shamu
168 schema:givenName Tinei
169 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01220175732.05
170 rdf:type schema:Person
171 sg:person.01354742521.81 schema:affiliation grid-institutes:grid.13001.33
172 schema:familyName Mudzviti
173 schema:givenName Tinashe
174 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01354742521.81
175 rdf:type schema:Person
176 sg:person.015101543333.25 schema:affiliation grid-institutes:None
177 schema:familyName Bote
178 schema:givenName Sandra
179 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015101543333.25
180 rdf:type schema:Person
181 sg:person.015570734040.35 schema:affiliation grid-institutes:None
182 schema:familyName Pascoe
183 schema:givenName Margaret
184 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015570734040.35
185 rdf:type schema:Person
186 sg:pub.10.1186/s12916-018-1033-7 schema:sameAs https://app.dimensions.ai/details/publication/pub.1101827997
187 https://doi.org/10.1186/s12916-018-1033-7
188 rdf:type schema:CreativeWork
189 grid-institutes:None schema:alternateName Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe
190 schema:name Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe
191 rdf:type schema:Organization
192 grid-institutes:grid.13001.33 schema:alternateName School of Pharmacy, University of Zimbabwe, Mount Pleasant, P.O. Box MP167, Harare, Zimbabwe
193 schema:name Newlands Clinic, 56 Enterprise Road, Highlands, Harare, Zimbabwe
194 School of Pharmacy, University of Zimbabwe, Mount Pleasant, P.O. Box MP167, Harare, Zimbabwe
195 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...