Electroencephalographic patterns in Ethiopian patients with epilepsy: A retrospective review

Background: Epilepsy is a common problem throughout sub-Saharan Africa, including Ethiopia. Electroencephalography (EEG) is useful for the diagnosis and proper treatment of this condition. However, the literature is scanty of reports describing EEG patterns in Ethiopian patients with epilepsy. This study attempts to bridge that gap and provide a baseline for further research into the etiological basis of specific epileptiform abnormalities.Objective: To review EEG patterns in Ethiopian patients with epilepsy.Methods: We retrospectively reviewed EEG records of patients with epilepsy presenting to a specialized referral hospital (Addis Ababa University Tikur Anbessa Teaching Hospital) and a private clinic (Yehuleshet Higher Clinic) between September 2008 and August 2010.Results: Two hundred and fifty one patients with mean age of 26 years (SD 14.8) and 1.2:1 male: female ratio was included in the study. One hundred and forty nine patients (59.4%) harbored EEG abnormalities. The majority of these abnormalities 61.1% were epileptiform discharges; the remainder 38.9% being nonspecific patterns. The most common epileptiform discharges were focal, with or without secondary generalization in 63.7%. These focal discharges originated from the left cerebral hemisphere in 43.1% cases and the right in 39.7%; 17.2% were bilateral. Multifocal cerebral and temporal lobe discharges accounted for 43.1% and 39.7% of all focal discharges, respectively.Conclusion: The most common EEG abnormalities in Ethiopian patients with epilepsy are focal interictal epileptiform discharges, typically originating from multifocal cerebral loci and the temporal lobe, without hemispheric lateralization. It provides a foundation for prospective studies to address the etiological basis of focal abnormalities

Reverse vaccinology-based identification of a novel surface lipoprotein that is an effective vaccine antigen against bovine infections caused by Pasteurella multocida.

Pasteurella multocida can infect a multitude of wild and domesticated animals, with infections in cattle resulting in hemorrhagic septicemia (HS) or contributing to bovine respiratory disease (BRD) complex. Current cattle vaccines against P. multocida consist of inactivated bacteria, which only offer limited and serogroup specific protection. Here, we describe a newly identified surface lipoprotein, PmSLP, that is present in nearly all annotated P. multocida strains isolated from cattle. Bovine associated variants span three of the four identified phylogenetic clusters, with PmSLP-1 and PmSLP-2 being restricted to BRD associated isolates and PmSLP-3 being restricted to isolates associated with HS. Recombinantly expressed, soluble PmSLP-1 (BRD-PmSLP) and PmSLP-3 (HS-PmSLP) vaccines were both able to provide full protection in a mouse sepsis model against the matched P. multocida strain, however no cross-protection and minimal serum IgG cross-reactivity was identified. Full protection against both challenge strains was achieved with a bivalent vaccine containing both BRD-PmSLP and HS-PmSLP, with serum IgG from immunized mice being highly reactive to both variants. Year-long stability studies with lyophilized antigen stored under various temperatures show no appreciable difference in biophysical properties or loss of efficacy in the mouse challenge model. PmSLP-1 and PmSLP-3 vaccines were each evaluated for immunogenicity in two independent cattle trials involving animals of different age ranges and breeds. In all four trials, vaccination with PmSLP resulted in an increase in antigen specific serum IgG over baseline. In a blinded cattle challenge study with a recently isolated HS strain, the matched HS-PmSLP vaccine showed strong efficacy (75-87.5% survival compared to 0% in the control group). Together, these data suggest that cattle vaccines composed of PmSLP antigens can be a practical and effective solution for preventing HS and BRD related P. multocida infections