Early post-stroke cognitive impairment and in-hospital predicting factors among stroke survivors in Ethiopia

BackgroundIn low-and middle-income countries, post-stroke cognitive impairment (PSCI) is the least investigated stroke complication that clinically is given little attention. Finding patients who are at high risk of having cognitive problems after a stroke could allow targeted follow-up and help with prognosis discussions, which would then contribute to improved treatment outcomes. The main aim of this study was to determine the incidence and predictors of PSCI among stroke survivors in Northwest Ethiopia.MethodsThe study was a multicenter prospective cohort study. The study participants were 403 stroke survivors who were alive on follow-up after 3 months of stroke onset at the neurology department of three hospitals in Northwest Ethiopia. To investigate the link between the outcome and the explanatory variables, analyses of bivariable and logistic multivariable regression were performed. A value of p of 0.05 or less was regarded as statistically significant, and data were presented as odds ratios and 95% confidence intervals.ResultsThe mean age of the participants was 61.3 years (SD = 0.7), 56% were females, the mean time from symptom onset to hospital arrival was 46 h (SD = 3.32), and the mean National Institute of Health Stroke Scale (NIHSS) score at admission was 14.79 (SD = 0.25). PSCI was observed in 122 patients (30.3%) after 90 days of stroke onset, that is, 83 (20.6%) of female and 39 (9.7%) of male stroke survivors. The result of multivariable logistic regression analysis revealed PSCI was independently associated with age (adjusted OR = 1.04, 95% CI = 1.061–1.981), women (AOR = 1.390, 95% CI = 1.221–2.690), admission modified Rankin scale (mRS) (AOR = 1.629, 95% CI = 1.381–2.037), moderate Glasgow coma scale (GCS) score (AOR = 1.149, 95% CI = 1.402–3.281), and poor GCS score (AOR = 1.632, 95% CI = 1.610–4.361) and stage one (AOR = 1.428, 95% CI = 1.198–2.922) and stage two hypertension (AOR = 1.255, 95% CI = 1.107–2.609).ConclusionNearly one-third of stroke survivors developed PSCI. Moreover, further research is needed with a larger sample size, showing a time trend and longer follow-up duration

Prevalence and determinants of anemia among children aged from 6 to 59 months in Liberia: a multilevel analysis of the 2019/20 Liberia demographic and health survey data

BackgroundAnemia is a serious worldwide public health issue that happens at any stage of life but primarily affects young kids and pregnant mothers. Although anemia has a significant impact on child health, its magnitude and associated factors in children aged 6–59 months have not been yet studied in Liberia. Therefore, the aim of this study was to identify the prevalence and determinants of anemia in children aged 6–59 months in Liberia.MethodsThe data was extracted from Liberia Demographic and Health Survey, conducted from October 2019 to February 2020. The sample was obtained using a stratified two-stage cluster sampling technique. An overall weighted sample of 2,524 kids aged 6–59 months was involved in the final analysis. We used Stata version 14 software for data extraction and analysis. A multilevel logistic regression model was employed to identify factors associated with anemia. Variables with a P-value of <0.2 in the bivariable logistic regression analysis were selected as candidates for multivariable analysis. In multivariable analysis, the adjusted odds ratios (AOR) with the 95% confidence interval (CI) were declared as the determinants of anemia.ResultsThe prevalence of anemia in children aged 6–59 months in Liberia was 70.8% [95% CI: 68.9%, 72.5%]. Of these, 3.4% were severe anemia, 38.3% were moderate anemia and 29.1% were mild anemia. Children aged 6–23 and 24–42 months, being stunted, children from households with unimproved toilet facilities, children from households with unimproved water sources, and lack of media (television) exposure were significantly associated with higher odds of anemia. However, using mosquito bed nets, living in the Northwestern and Northcentral region were significantly associated with lower odds of anemia among children 6–59 months.ConclusionIn this study, anemia in kids aged 6–59 months in Liberia was a main public health issue. Age of the child, stunting, toilet facility, water source, exposure to television, mosquito bed net use, and region were significant determinants of anemia. Therefore, it is better to provide intervention for the early detection and management of stunted children. Similarly, interventions should be strengthened to address unimproved water sources, unimproved toilet facilities, and lack of media exposure

Hygienic Practice during Complementary Feeding and Associated Factors among Mothers of Children Aged 6–24 Months in Bahir Dar Zuria District, Northwest Ethiopia, 2019

Introduction. Breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore food is needed. Microbiologically contaminated food is particularly harmful for children <2 years of age. There is scanty of information on hygienic practice and associated factors during complementary feeding among mothers of children aged 6 to 24 months in the country, particularly in the study setting. Objective. The study was aimed to assess hygienic practices and associated factors during complementary feeding among children aged 6 to 24 months in Bahir Dar Zuria District, Northwest Ethiopia. Methods. A community-based cross sectional study was conducted from March 20 to April 20, 2019. A multistage sampling technique was used to select the study participants. Data were collected using the structured interviewer administered questionnaire. Bivariable and multivariable logistic regression analyses were used to identify the factors associated with hygienic practice during complementary feeding. Data were entered by using Epi Data version 3.1, and then it was exported to SPSS version 21 for analysis, and at 95% CI, p value <0.05 was considered statistically significant. Result. Among 604 respondents, 235 (38.9%) of study participants had good hygienic practice during complementary feeding. Access to media (AOR: 8.8, 95% confidence interval (CI): 3.8–20.3), private latrine ownership (AOR: 4.11, 95% CI: 1.90–8.49), presence of hand washing facility at doorstep (AOR: 6.75 95% CI: 3.16–14.41), and residence of the study participants (AOR: 85.42, 95% CI: 1.94–15.2) were significantly associated with good hygienic practice of mothers during complementary feeding. Conclusion. Majority of mothers had poor hygienic practice during complementary feeding. Attitude of mothers, access to media, household private latrine ownership, presence of handwashing facility, and residence of the study participants were significantly associated with hygiene practice of mothers during complementary feeding. The health sector should train mothers on good hygiene practices during complementary feeding

Current updates on generations, approvals, and clinical trials of CAR T-cell therapy

Chimeric antigen receptor (CAR) T-cell therapy is a novel, customized immunotherapy that is considered a ‘living’ and self-replicating drug to treat cancer, sometimes resulting in a complete cure. CAR T-cells are manufactured through genetic engineering of T-cells by equipping them with CARs to detect and target antigen-expressing cancer cells. CAR is designed to have an ectodomain extracellularly, a transmembrane domain spanning the cell membrane, and an endodomain intracellularly. Since its first discovery, the CAR structure has evolved greatly, from the first generation to the fifth generation, to offer new therapeutic alternatives for cancer patients. This treatment has achieved long-term and curative therapeutic efficacy in multiple blood malignancies that nowadays profoundly change the treatment landscape of lymphoma, leukemia, and multiple myeloma. But CART-cell therapy is associated with several hurdles, such as limited therapeutic efficacy, little effect on solid tumors, adverse effects, expensive cost, and feasibility issues, hindering its broader implications

The results of random effect analysis and model fitness for the assessment of anemia among women of reproductive (15–49 years) in Liberia.

The results of random effect analysis and model fitness for the assessment of anemia among women of reproductive (15–49 years) in Liberia.</p

<i>PLOS ONE</i> clinical studies checklist.

BackgroundAnemia is a global public health problem, principally affecting young children and reproductive-age mothers. Although anemia is a main public health concern in low-income countries, there is no evidence about its prevalence and associated factors among women of reproductive age in Liberia. Thus, the purpose of this study was to identify the prevalence and associated factors of anemia among women of reproductive age in Liberia.MethodsWe used the data extracted from the fifth Liberia Demographic and Health Survey (LDHS-V) that were carried out between October 2019 and February 2020. The sample was chosen using a stratified two-stage cluster sampling procedure. Overall weighted samples of 4027 women of reproductive age were used in the analysis. Data weighting was carried out to obtain reliable estimates and standard errors as well as to restore the representativeness of the data. Stata version 14 software was used for data extraction, coding, and analysis. We used multilevel analysis to identify the significant factors associated with anemia among women of reproductive age.ResultsThe prevalence of anemia among women of reproductive age in Liberia was 44.51 (95% CI: 42.97–46.04). From these, about 23.10% of women of reproductive age were mildly anemic, 20.63% were moderately anemic and 0.78% was severely anemic. In multivariable analysis; women with the groups of 20–24 years (adjusted odds ratio (AOR) = 0.72, 95% CI: 0.56, 0.92), 25–29 years (AOR = 0.57, 95% CI: 0.43, 0.77), 30–34 years (AOR = 0.59, 95% CI: 0.43, 0.83), 35–39 years (AOR = 0.56, 95% CI: 0.41, 0.79), 40–44 years (AOR = 0.61, 95% CI: 0.43,0.87), 45–49 years (AOR = 0.57, 95% CI: 0.39,0.82), overweight (AOR = 0.83; 95% CI: 0.70, 0.98), obese (AOR = 0.72; 95% CI: 0.58, 0.88), using modern contraceptive methods (AOR = 0.61; 95% CI: 0.52, 0.72), and being from the Northcentral region (AOR = 0.55; 95% CI: 0.43, 0.72) were significantly associated with lower odds of anemia. However, being pregnant (AOR = 1.34; 95% CI: 1.04, 1.73) and having higher parity (3 children or more) (AOR = 1.40; 95% CI: 1.03, 1.93) were significantly associated with higher odds of anemia.ConclusionIn the present study, the prevalence of anemia in women of reproductive age was relatively high. Therefore, it is better to provide special emphasis on high-risk groups such as pregnant and multiparous women.</div

Shows bivariable and multivariable multilevel regression analysis to determine factors associated with anemia among reproductive-age women in Liberia (N = 4027).

Shows bivariable and multivariable multilevel regression analysis to determine factors associated with anemia among reproductive-age women in Liberia (N = 4027).</p

The prevalence of anemia among women of reproductive age in Liberia.

The prevalence of anemia among women of reproductive age in Liberia.</p

Socio-demographic characteristics of reproductive-age women in Liberia (N = 4027).

Socio-demographic characteristics of reproductive-age women in Liberia (N = 4027).</p

Cognitive adverse effects of epilepsy and its predictors attending outpatient department of South Gondar zone hospitals, Amhara Region, Ethiopia 2020 /2021.

BackgroundEpilepsy is the most common neurologic disorder which is further complicated by neurobehavioral co-morbidities, cognitive impairment, psychiatric disorders, and social problems. However, assessments of cognitive status of epileptic patients are far too low during clinical visits. This calls for early neuropsychological assessment soon after the diagnosis of epilepsy for a better treatment plan and outcome for epileptic patients.ObjectiveThis study aimed to assess the cognitive adverse effects of epilepsy and its predictors attending outpatient departments of South Gondar Zone hospitals Amhara region Ethiopia 2020/2021.MethodsA multi-center institutional-based cross-sectional study was conducted. A total of 509 respondents were included with a response rate of 93.9%. Previously adapted pretested structured questionnaire was used containing, socio-demographic, clinical, and seizure related factors. Mini-Mental State Examination (MMSE) was used to measure cognitive impairment. A systematic random sampling technique was applied. Data were entered into Epi data version 4.4.2 then exported to SPSS version 24 for analysis. Descriptive statistics, bivariable and multivariable binary logistic regressions with odds ratios and 95% confidence interval were employed. The level of significance of association was determined at a p-value ResultsPrevalence of cognitive impairment in this study was 69.2% (95%CI; 65.4, 73.1). Rural residents (AOR = 4.16,95%CI, 1.99,8.67), respondents who couldn't read and write (AOR = 2.62, 95%CI; 1.24, 5.5,) longer duration of seizure disorder (AOR = 4.59,95%CI; 2.01,10.52), taking combined Phenobarbital and Phenytoin (AOR = 4.69,95%CI; 1.88,11.69), having history of head injury (AOR = 3.29,95%CI;1.30,8.32), having depression (AOR = 4.76,95%CI;2.83,7.98), and anxiety (AOR = 3.11,95%CI; 1.58,6.12) were significantly associated with cognitive impairment.ConclusionsPrevalence of cognitive impairment in this study was high. Regular neuropsychiatric assessment of patients with epilepsy should be encouraged especially for those participants with longer durations of illness, who are rural residents, who take combined Phenobarbital and Phenytoin, participants who had a history of head injury, depression, and anxiety