Cryptococcal Meningitis Diagnostics and Screening in the Era of Point-of-Care Laboratory Testing.

Over the past ten years, standard diagnostics for cryptococcal meningitis in HIV-infected persons have evolved from culture to India ink to detection of cryptococcal antigen (CrAg), with the recent development and distribution of a point-of-care lateral flow assay. This assay is highly sensitive and specific in cerebrospinal fluid (CSF), but is also sensitive in the blood to detect CrAg prior to meningitis symptoms. CrAg screening of HIV-infected persons in the blood prior to development of fulminant meningitis and preemptive treatment for CrAg-positive persons are recommended by the World Health Organization and many national HIV guidelines. Thus, CrAg testing is occurring more widely, especially in resource-limited laboratory settings. CrAg titer predicts meningitis and death and could be used in the future to customize therapy according to burden of infection

Motivation and Factors Affecting It among Health Professionals in the Public Hospitals, Central Ethiopia

BACKGROUND: Motivation is an individual’s degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region.METHOD: Facility based cross-sectional survey was employed. All health professionals who served at least for 6 months in Ambo, Gedo and Gindeberet hospitals were included. Self-administered Likert scale type questionnaire was used. Data were analyzed using SPSS version 20. Mean motivation calculated as percentage of maximum scale score was used. Bivariate and multiple linear regression analyses were done to see the independent effects of explanatory variables.RESULTS: The overall motivation level of health professionals was 63.63%. Motivation level of health professionals varied among the hospitals. Gindeberet Hospital had lower motivation score as compared to Ambo Hospital (B = -0.54 and 95% CI; -0.08,-0.27). The mean motivation score of health professionals who got monthly financial benefit was significantly higher than those who did not (B = 0.71 and 95% CI; 0.32, 1.10). Environmental factors had higher impact on doctors’ motivation compared to nurses’ (B = 0.51 and 95% CI; 0.10, 0.92). Supervisor-related factors highly varied in motivation relative to other variables.CONCLUSIONS: Motivation of health professionals was affected by factors related to supervisor, financial benefits, job content and hospital location. Efforts should be made to provide financial benefits to health professionals as appropriate especially, to those who did not get any such benefits. Officially recognizing best performance is also suggested.KEYWORDS: Motivation, Health Professionals, West Shoa, Hospital, Oromia, Ethiopi

Refinement Type Inference via Horn Constraint Optimization

We propose a novel method for inferring refinement types of higher-order functional programs. The main advantage of the proposed method is that it can infer maximally preferred (i.e., Pareto optimal) refinement types with respect to a user-specified preference order. The flexible optimization of refinement types enabled by the proposed method paves the way for interesting applications, such as inferring most-general characterization of inputs for which a given program satisfies (or violates) a given safety (or termination) property. Our method reduces such a type optimization problem to a Horn constraint optimization problem by using a new refinement type system that can flexibly reason about non-determinism in programs. Our method then solves the constraint optimization problem by repeatedly improving a current solution until convergence via template-based invariant generation. We have implemented a prototype inference system based on our method, and obtained promising results in preliminary experiments.Comment: 19 page

Amino-substituted naphthalene sulfonic acid/graphene composite as metal -free catalysts for oxygen reduction reactions

Composites of reduced graphene oxide (rGO) and conducting polymers synthesized from 8-amino-2-naphthalene sulfonic acid (8-ANSA), 5-amino-1-naphthalene sulfonic acid (5-ANSA), 2-amino-1-naphthalene sulfonic acid (2-ANSA), and 4-amino-1-naphthalene sulfonic (4-ANSA) were prepared for use as an electrocatalyst in oxygen reduction reaction (ORR). The electrocatalytic activities were examined in oxygen saturated 0.1 M KOH solution using cyclic and linear sweep voltammetry. The best performing polymer composite was found to be GC/poly(8-ANSA)/rGO, with an enhanced electrocatalytic activity over the rGO only and poly(8-ANSA) only films. More than 100 mV positive shift in the onset potential and 1.6 times increase in current density were observed. The catalytic activity of 2-ANSA, 4-ANSA, 5-ANSA, and 8-ANSA was also validated by density functional theory (DFT). Our calculations predict a much better catalytic activity for 8-ANSA than that of 2-ANSA, 4-ANSA, and 5-ANSA.               KEY WORDS: Poly(amino naphthalene sulfonic acid), Reduced graphene oxide, Oxygen reduction reaction, Electrocatalyst Bull. Chem. Soc. Ethiop. 2019, 33(2), 359-372.DOI: https://dx.doi.org/10.4314/bcse.v33i2.1

Use integrated management of childhood illnesses guidelines: a need for adaptation for use in Ghindae hospital, Eritrea

Background: Diarrheal diseases are among the commonest causes of morbidity and mortality among infants and young children in the developing world and most commonly in the sub-Saharan including Eritrea. Integrated Management of Childhood Illnesses (IMCI) is a strategy developed by UNICEF and WHO for developing countries and other resource poor countries currently being practiced in Africa, Asia, and South America. IMCI guidelines are simplified system of diagnosis and treatment that is designed for use by health workers with limited training and little or no laboratory support. According to this guideline bloody diarrhea is treated with ORS, additional fluid support and cotrimoxazole empirically with the assumption that the etiologic agent is shigella. If the child does not improve on follow up then metronidazole is added with the assumption that the etiologic agent is parasitic mainly amoeba and giardia. Objective: The objective of this study was to assess the use of IMCI guidelines in children presenting with diarrhea at Ghindae Hospital. Methods: The study was a prospective in which all children below the age of 5 years, who presented primarily with all forms of diarrhea during the one month period from June 1st 2008 to June 30 2008, were included in the study. All stool samples were subjected to laboratory analysis. Results: Eighty seven children who presented with all forms of diarrhea to the IMCI OPD or as IPD were included in the study. More than 50% of the cases had parasitic infestation mainly Amoeba and Giardia. Less than 5% of the children presented with mild or severe dehydration. The majority (92%) of the cases had no dehydration had diarrhea with no dehydration. Conclusion: In Ghindae community there is a justification for use of metronidazole as a first line treatment of bloody diarrhea, because of the preponderance of parasitic infestation instead of bacterial causes for the majority of cases of children presenting with diarrhea, a clear need for adaptation of IMC

Resistance of maize varieties to the maize weevil Sitophilus zeamais (Motsch.) (Coleoptera: Curculionidae)

This study aimed at evaluating commonly used maize varieties, collected from Melkasa and Bako Agricultural Research Centers and Haramaya University, Ethiopia, against the maize weevil Sitophilus zeamais Motsch., one of the most important cosmopolitan stored product pests in maize. A total of 13 improved maize varieties were screened for their relative susceptibility to S. zeamais. The Dobie index of susceptibility was used to group the varieties. The variety, ‘BHQP-542’, had the least index ofsusceptibility and was regarded as resistant. The varieties, ‘Katumani’, ‘Melkasa-I’, ‘Melkasa-II’, ‘Melkasa-III’, ‘Coree’, ‘BH-541’, ‘BH-660’, ‘BH-540’, ‘Rare-I’, ‘Awasa-511’, ‘ACV3’ and ‘ACV6’, were moderately resistant. Weevils fed with the resistant variety produced low numbers of F1 progeny, had a high median developmental time and a low percentage of seed damage and seed weight loss. Maize varieties with a high F1 progeny tended to have a short median developmental time. An increasingnumber of F1 progeny resulted in an increasing seed damage and seed weight loss. We found an inverse relationship between the susceptibility index and percent mortality and median developmental time; however, the numbers of F1 progeny, percent seed damage and seed weight loss were positively related with the susceptibility index. The use of resistant varieties should be promoted in managing S.zeamais in stored maize under subsistence farming conditions in Africa

Bacteraemia among Severely Malnourished Children in Jimma University Hospital, Ethiopia

BACKGROUND: Sever acute malnutrition severely suppresses every component of the immune system leading to increased susceptibility and severity to infection. However, symptoms and signs of infections are often unapparent making prompt clinical diagnosis and early treatment very difficult. The aim of the study was to determine the magnitude of bacteraemia and antimicrobial sensitivity among severely malnourished children. METHODS: Severely malnourished children admitted in Jimma University Specialized Hospital were enrolled between October, 2009 to May, 2010. Blood samples were collected, processed and bacterial isolates were identified using standard bacteriological procedures. Then, antibiotic susceptibility pattern of the isolates was determined by using Kirby-Bauer technique. RESULTS: Bacteraemia was seen in 35 (20.6%) of the 170 study subjects. There were a total of 35 bacterial isolates, Gram positive bacteria constitute 24(68.6%) of the isolates, where Staphylococcus aureus was the leading Gram positive isolate while Klebsiella species were the dominant Gram negative isolates. Twelve (7.1%) children died and 4 (33.3%) of them had bacteraemia. While susceptibility was more than 80% to Gentamicin, Ciprofloxacin and Ceftriaxone, increased level of resistance was documented to commonly used antibiotics, such as Amoxycillin, Co-trimoxazole and Chloramphenicol. CONCLUSION: High prevalence of bacteraemia with predominating Gram positive isolates and increased level of resistance to commonly used antibiotics was shown among severely malnourished children in Jimma. Further studies are required to revise the current guideline for antibiotic choice. KEYWORDS: Bacteraemia, severe acute malnutrition, Antimicrobial susceptibility, JimmaEthiop J Health Sci. Vol. 21, No. 3 November 201

Grain yield, stem borer and disease resistance of new maize hybrids in Kenya

Evaluation of 30 maize hybrids for yield and resistance to stem borers and foliar diseases in four agroecologies in Kenya was conducted in 2009. There were significant differences among the hybrids in leaf damage, number of exit holes, tunnel length and grain yield in Kiboko. The maize hybrids CKPH08014, CKPH08025, and CKPH08026 showed the least leaf damage, exit holes and tunnel length, similar to the resistant check. Although ten hybrids yielded over 8 t/ha, two hybrids, CKPH09001 and CKPH08033, gave the highest yield of 8.99 and 8.86 t/ha, respectively, in Kiboko. There were significant differences among the hybrids in resistance to leaf rust and maize streak virus in Kakamega. The intensity of foliar diseases was high in Kakamega compared to the other sites. All hybrids appeared resistant to the foliar diseases at Kakamega. On the average, the highest yield of the hybrids was recorded in Kiboko (7.5 t/ha) followed by Kakamega (6.1 t/ha), and the least at Embu (3.5 t/ha), and Mtwapa (3.14 t/ha). The performance of the hybrids varied from site to site, with CKPH09002 and CKPH09003 performing well at Mtwapa, CKPH09001 at Kiboko, CKPH08039 at Embu, CKPH 08002 and CKPH08010 at Kakamega.Key words: Host plant resistance, maize, pest management, stem borer, foliar disease

Ex vivo cytokine mRNA levels correlate with changing clinical status of ethiopian TB patients and their contacts over time.

There is an increasing body of evidence which suggests that IL-4 plays a role in the pathogenesis of TB, but a general consensus on its role remains elusive. We have previously published data from a cohort of Ethiopian TB patients, their contacts, and community controls suggesting that enhanced IL-4 production is associated with infection with M. tuberculosis, rather than overt disease and that long-term protection in infected community controls is associated with co-production of the IL-4 antagonist IL-4d2, alongside elevated IL-4. Here, for the first time, we compare data on expression of IFN-gamma, IL-4 and IL-4delta2 over time in TB patients and their household contacts. During the follow-up period, the TB patients completed therapy and ceased to display TB-like symptoms. This correlated with a decrease in the relative amount of IL-4 expressed. Over the same period, the clinical status of some of their contacts also changed, with a number developing TB-like symptoms or clinically apparent TB. IL-4 expression was disproportionately increased in this group. The findings support the hypothesis that elevated IL-4 production is generally associated with infection, but that TB disease is associated with a relatively increased expression of IL-4 compared to IFN-gamma and IL-4delta2. However, the data also suggest that there are no clear-cut differences between groups: the immune response over time appears to include changes in the expression of IFN-gamma, IL-4 and IL-4delta2, and it is the relative, not absolute levels of cytokine expression that are characteristic of clinical status