Sero-prevalence and risk factors of hepatitis C virus infection among pregnant women in Bahir Dar city, Northwest Ethiopia: cross sectional study

Viral hepatitis during pregnancy is associated with high risk of maternal complications and has become a leading cause of fetal death. So the main objective of this study is to determine the prevalence of hepatitis C viral infections among pregnant women attending the antenatal clinic in Bahir Dar health institutions, Ethiopia. This was institutional based cross-sectional study that included 318 pregnant women who attended the antenatal clinic in Bahir Dar health institutions from January 2013 to June 2013. Appropriate data was gathered from study participants. Sero-prevalence of hepatitis C virus was determined by detecting immunoglobulin of HCV using ELISA kit. Data was entered and analyzed with SPSS version 16 statistical software. The overall prevalence of hepatitis C virus among pregnant women was 0.6%. None of the expected risk factors had significant outcome. In conclusion, prevalence of the Hepatitis C virus among pregnant women attending in Bahir Dar health institutions was low and expected variables were not statistically significant

Risk factors for multidrug resistant tuberculosis patients in Amhara National Regional State.

Background: Multidrug resistant tuberculosis(MDR-TB) is becoming a major threat to tuberculosis control programs in Ethiopia.Objectives: To determine risk factors of MDR-TB patients in Amhara National Regional State, Ethiopia.Methods: Case-control study was conducted from May 2013 to January 2014. Resistance to rifampicin and isoniazid were done molecularly using line probe assay. TB patients infected with MDR-M.tuberculosis and non MDR-M.tuberculosis strain were considered as cases and controls, respectively. Data was collected using structured questionnaire with face to face interview. Patients’ clinical record review was also done.Multivariate analysis was computed to determine the risk factors of MDR-TB.Results: A total of 153 MDR-TB and equal number of non MDR-TB patients’ participated in the study. Patients who had TB treatment failure (AOR=13.5,CI=2.69-70), cavitations on chest x-ray (AOR=1.9,CI=1.1-3.38) and contact with MDR-TB patients (AOR=1.4,CI=0.19-0.39) were more likely to be MDR-TB patients. Low monthly income (AOR=1.1,CI=0.34-0.47),alcohol consumption (AOR=1.5,CI=0.2-0.98) and young age (AOR=2.9,CI=1.07-7.68) were the other risk factors of MDR-TB.Conclusions: TB treatment failure, cavitation on chest X-ray, contact with MDR-TB patients and low socioeconomic status were important risk factors for development of MDR-TB. Therefore, strict adherence to directly observed therapy, appropriate management of TB patients and advice on the value of nutrients are helpful to control the spreading of MDR-TB.Key words: Risk factors, MDR-TB, Ethiopia

Reproductive Life Planning in Adolescents

Unplanned pregnancy in adolescents contributes to the burden of disease, mortality, and health and educational disparities experienced by young people during this vulnerable period between childhood and adulthood. Reproductive life planning (RLP) is an approach that has been endorsed and adopted internationally, which prompts individuals and couples to set personal goals regarding if and when to have children based on their own personal priorities. This review discusses RLP tools, their acceptability, effectiveness, and issues in implementation across different contexts, with a specific focus on how RLP has been applied for adolescents. While a range of RLP tools are available and considered acceptable in adult populations, there is minimal evidence of their potential benefits for adolescent populations. Online platforms and information technology are likely to promote reach and implementation of RLP interventions in adolescents. Consideration of the socioecological contexts where adolescent pregnancies are more common should be integral to much needed future work that explores RLP interventions in adolescents

BayesGmed : An R-package for Bayesian Causal Mediation Analysis

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Study on knowledge, attitude and dog ownership patterns related to rabies prevention and control in Addis Ababa, Ethiopia

The study was conducted from May 2003 to August 2003 in Addis Ababa with the objective of understanding the distribution of stray and owned dogs, dog ownership patterns and attitudes of people towards rabies and its prevention and control methods. A total of 2390 households were selected from 6 Sub Cities of Addis Ababa using stratified random sampling and were interviewed using structured questionnaires. From the total households interviewed, 969 (40.5%) of them were known to own one or more dogs, and the total number of owned dogs was estimated to be 225,078. Male dogs make up 1042 (78.4%) of the total owned dogs. Almost half of all the dogs 463 (47.8%) were tied only for some time during the day whereas 320 (33.1%) of the dogs were not tied at all and freely move from place to place and contribute to high dog bites in human beings and for the widespread occurrence of canine rabies in Addis Ababa. Six hundred fifty five (67.6%) of the interviewed households who owned dogs had a well fenced house. Most of the owned dogs 856 (88.4%) get their food from their owners and only 321 (33.3%) of the owners reported that they let their dogs to be vaccinated while the majority of the owners 644 (66.5%) do not let their dogs vaccinated regularly. A significant proportion of the interviewed households 2,323 (97.2%), (P < 0.05) indicated that they have the knowledge that dogs, cats and other animals can transmit rabies to humans and 1,752 (73.4%) of the households replied that rabies can be transmitted through bite, scratch and lick to open wounds. Analysis of the list of 2400 post exposure human antirabies treatments recorded at the EHNRI Zoonoses Laboratory from February 2002 to October 2003 showed that the most common animals involved in biting people were dogs. A total of 2198 (91.6%) people were bitten by dogs during the same period and most of them, 2053 (85.5%) were bitten on their hands and legs. All the above data indicated the need for a strong and coordinated rabies control activities to be conducted in the city

Cervical cancer screening uptake in Sub-Saharan Africa:a systematic review and meta-analysis

OBJECTIVES: The objective of this study is to estimate the pooled uptake of cervical cancer screening and identify its predictors in Sub-Saharan Africa. STUDY DESIGN: Systematic review and meta-analysis. METHODS: We searched PubMed, EMBASE, CINAHL, African Journals OnLine, Web of Science and Scopus electronic databases from January 2000 to 2019. All observational studies published in the English language that reported cervical cancer uptake and/or predictors in Sub-Saharan Africa were initially screened. We assessed methodological quality using the Newcastle-Ottawa Scale. An inverse variance-weighted random-effects model meta-analysis was performed to estimate the pooled uptake and odds ratio (OR) of predictors with a 95% confidence interval (CI). The I2 test statistic was used to check between-study heterogeneity, and the Egger's regression statistical test was used to check publication bias. RESULTS: We initially screened 3537 citations and subsequently 29 studies were selected for this review, which included a total of 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2 = 98.5%). A meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly five times (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors of cervical screening uptake include educational level, age, Human Immune deficiency Virus (HIV) status, contraceptive use, perceived susceptibility and awareness about screening locations. CONCLUSIONS: Cervical screening uptake is low in Sub-Saharan Africa as a result of several factors. Health outreach and promotion programmes to target these identified predictors are required

Tuberculous lesions not detected by routine abattoir inspection: the experience of the Hossana municipal abattoir, southern Ethiopia

Summary The efficacy of the meat inspection procedures implemented for the detection of tuberculous cattle was evaluated by testing for bovine tuberculosis in 751 animals. The study involved routine inspection at slaughter, collection of tissues for detailed examination in the laboratory, and bacteriological investigation to identify Mycobacterium bovis. Of the 751 carcasses examined, 34 (4.5%) were found to have tuberculous lesions. Routine abattoir inspection detected only 29.4% of the carcasses with visible lesions. Eighty-four percent of the tuberculous lesions were found in the lungs and thoracic lymph nodes, 11.5% in the lymph nodes of the head, and the remaining 4.5% in the mesenteric and other lymph nodes of the carcasses. In addition, M. bovis was isolated from a carcass that presented no gross tuberculosis lesions. The low sensitivity of routine abattoir inspection demonstrates that existing necropsy procedures should be improved

Remote sampling of biomarkers of inflammation with linked patient generated health data in patients with rheumatic diseases:an Ecological Momentary Assessment feasibility study

BACKGROUND: People with rheumatic diseases experience troublesome fluctuations in fatigue. Debated causes include pain, mood and inflammation. To determine the relationships between these potential causes, serial assessments are required but are methodologically challenging. This mobile health (mHealth) study explored the viability of using a smartphone app to collect patient-reported symptoms with contemporaneous Dried Blood Spot Sampling (DBSS) for inflammation. METHODS: Over 30 days, thirty-eight participants (12 RA, 13 OA, and 13 FM) used uMotif, a smartphone app, to report fatigue, pain and mood, on 5-point ordinal scales, twice daily. Daily DBSS, from which C-reactive Protein (CRP) values were extracted, were completed on days 1–7, 14 and 30. Participant engagement was determined based on frequency of data entry and ability to calculate within- and between-day symptom changes. DBSS feasibility and engagement was determined based on the proportion of samples returned and usable for extraction, and the number of days between which between-day changes in CRP which could be calculated (days 1–7). RESULTS: Fatigue was reported at least once on 1085/1140 days (95.2%). Approximately 65% of within- and between-day fatigue changes could be calculated. Rates were similar for pain and mood. A total of 287/342 (83.9%) DBSS, were returned, and all samples were viable for CRP extraction. Fatigue, pain and mood varied considerably, but clinically meaningful (≥ 5 mg/L) CRP changes were uncommon. CONCLUSIONS: Embedding DBSS in mHealth studies will enable researchers to obtain serial symptom assessments with matched biological samples. This provides exciting opportunities to address hitherto unanswerable questions, such as elucidating the mechanisms of fatigue fluctuations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-022-05723-w

Multi-cancer early detection test sensitivity for cancers with and without current population-level screening options

There are four solid tumors with common screening options in the average-risk population aged 21 to 75 years (breast, cervical, colorectal, and, based on personalized risk assessment, prostate), but many cancers lack recommended population screening and are often detected at advanced stages when mortality is high. Blood-based multi-cancer early detection tests have the potential to improve cancer mortality through additional population screening. Reported here is a post-hoc analysis from the third Circulating Cell-free Genome Atlas substudy to examine multi-cancer early detection test performance in solid tumors with and without population screening recommendations and in hematologic malignancies. Participants with cancer in the third Circulating Cell-free Genome Atlas substudy analysis were split into three subgroups: solid screened tumors (breast, cervical, colorectal, prostate), solid unscreened tumors, and hematologic malignancies. In this post hoc analysis, sensitivity is reported for each subgroup across all ages and those aged ⩾50 years overall, by cancer, and by clinical cancer stage. Aggregate sensitivity in the solid screened, solid unscreened, and hematologic malignancy subgroups was 34%, 66%, and 55% across all cancer stages, respectively; restricting to participants aged ⩾50 years showed similar aggregate sensitivity. Aggregate sensitivity was 27%, 53%, and 60% across stages I to III, respectively. Within the solid unscreened subgroup, aggregate sensitivity was >75% in 8/18 cancers (44%) and >50% in 13/18 (72%). This multi-cancer early detection test detected cancer signals at high (>75%) sensitivity for multiple cancers without existing population screening recommendations, suggesting its potential to complement recommended screening programs. Clinical trial identifier: NCT02889978

Liver Enzyme Abnormalities and Associated Risk Factors in HIV Patients on Efavirenz-Based HAART with or without Tuberculosis Co-Infection in Tanzania.

To investigate the timing, incidence, clinical presentation, pharmacokinetics and pharmacogenetic predictors for antiretroviral and anti-tuberculosis drug induced liver injury (DILI) in HIV patients with or without TB co-infection. A total of 473 treatment naïve HIV patients (253 HIV only and 220 with HIV-TB co-infection) were enrolled prospectively. Plasma efavirenz concentration and CYP2B6*6, CYP3A5*3, *6 and *7, ABCB1 3435C/T and SLCO1B1 genotypes were determined. Demographic, clinical and laboratory data were collected at baseline and up to 48 weeks of antiretroviral therapy. DILI case definition was according to Council for International Organizations of Medical Sciences (CIOMS). Incidence of DILI and identification of predictors was evaluated using Cox Proportional Hazards Model. The overall incidence of DILI was 7.8% (8.3 per 1000 person-week), being non-significantly higher among patients receiving concomitant anti-TB and HAART (10.0%, 10.7 per 1000 person-week) than those receiving HAART alone (5.9%, 6.3 per 1000 person-week). Frequency of CYP2B6*6 allele (p = 0.03) and CYP2B6*6/*6 genotype (p = 0.06) was significantly higher in patients with DILI than those without. Multivariate cox regression model indicated that CYP2B6*6/*6 genotype and anti-HCV IgG antibody positive as significant predictors of DILI. Median time to DILI was 2 weeks after HAART initiation and no DILI onset was observed after 12 weeks. No severe DILI was seen and the gain in CD4 was similar in patients with or without DILI. Antiretroviral and anti-tuberculosis DILI does occur in our setting, presenting early following HAART initiation. DILI seen is mild, transient and may not require treatment interruption. There is good tolerance to HAART and anti-TB with similar immunological outcomes. Genetic make-up mainly CYP2B6 genotype influences the development of efavirenz based HAART liver injury in Tanzanians