Effects of altitude on chronotype orientations in relation to cardiorespiratory and hematological quantities of college students in Ethiopia.

BackgroundThe mechanism by which Ethiopians adapt to altitude is quite unique compared to other Highlanders with respect to increased oxygen saturation of hemoglobin. Although the effects of altitude on cardiorespiratory and hematological quantities on athletics performances are well known, but there is little information about its underlying effect on chronotype orientations.MethodsIn this cross-sectional study 60 male college students with mean age 20±1.3 years from high and low altitude regions living in a tropical setting in Ethiopia were included. The participants' chronotype was determined using the self-administered Horne and Ostberg Morningness-Eveningness Questionnaires (MEQ). Measurements and estimations of hematological and cardiorespiratory parameters were performed from 7:00-9:00 AM, East African time zone, in order to minimize any variations that might occur in the course of the day. A multivariate binary logistic regression model was fitted to analyze the underlying chronotype predictors.Results28 (93.9%) of participants from high altitude were mainly intermediate type (I-type) dominant with (MEQ = 42-58). While, 16 (55.2%) of participants from low altitudes were morning type (M-type) dominant chronotype with (MEQ = 59-69). Our main finding confirmed that altitude is an independent predictor of chronotype orientations of the participants (p 0.05).ConclusionOur finding, reported for the first time that, the human chronotype varies according to the altitude, with no underlying effect of cardiorespiratory and hematological quantities

Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia:a cross-sectional study

Objectives - To evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests. Design - A cross-sectional study. Setting - Two public referral hospitals in Tigray, Ethiopia. Participants - A total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study. Primary and secondary outcome measures - A total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done. Results - The strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB. Conclusions - Our finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases