Host Preference and Seasonal Variation of Tick (Amblyomma cohaerens Donitz, 1909) on Naturally Infested Cattle in Jimma Zone, Southwestern Ethiopia

The seasonal dynamics of tick Amblyomma cohaerens on naturally infested cattle in Jimma Zone was studied from September 1998 to September 2000 using fifty cattles in five Localities. Monthly tick counts were made for two consecutive years. Although, Amblyomma cohaerens infestation occurred throughout the year, it was greater at the beginning and end of the rainy season. High humidity and temperature were the factors that influence the seasonal variation.Th e study on the host preference of different blood groups showed that host selection and specificity correlate with the abundance and distribution of the tick. These have been reflected by the presence of more tick in highbred cattle than the indigenous Zebu

Magnitude of undernutrition and its association with dietary diversity among older persons in Ethiopia: a systematic review and meta-analysis, 2023

Undernutrition in elders remains under-detected, under-treated, and under-resourced and leads to further weight loss, increased infections, and delay in recovery from illness as well as increased hospital admissions and length of stay. The reports of the findings were fragmented and inconsistent in Ethiopia. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of undernutrition and its association with dietary diversity among older persons in Ethiopia. Online databases (Medline, PubMed, Scopus, and Science Direct), Google, Google Scholar, and other grey literature were used to search articles until the date of publication. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity using Stata version 14.0 software. Out of 522 studies accessed, 14 met our criteria and were included in the study. A total of 7218 older people (aged above 60 years old) were included in the study. The pooled proportion of undernutrition among older persons in Ethiopia was 20⋅6 % (95 % CI 17⋅3, 23⋅8). Elders who consumed low dietary diversity scores were strongly associated with undernutrition among older persons. Therefore, promoting appropriate intervention strategies for elders to improve dietary diversity practices and nutritional status is crucial

Posterior lamellar versus bilamellar tarsal rotation surgery for trachomatous trichiasis: Long-term outcomes from a randomised controlled trial.

BACKGROUND: We re-examined the participants of a clinical trial four years after enrolment to identify which of the two most commonly used eyelid surgery procedures to treat the blinding stage of trachoma (trachomatous trichiasis, TT), the posterior Lamellar Tarsal Rotation (PLTR) and Billamelar Tarsal Rotation (BLTR), gives better results in the long-term. METHODS: A randomised, controlled, single masked clinical trial was done in Ethiopia. At baseline, adults (aged >18 years with upper lid unoperated TT were recruited from a community-based screening. Participants were randomly assigned (1:1), to either BLTR or PLTR surgery, stratified by surgeon. At 4 years an independent assessor masked to allocation examined the trial participants' eyes using the same procedures as for the baseline and earlier follow-ups. The primary outcome was the proportion of individuals who had recurrence (postoperative TT, PTT) at the 4-year examination, or a history of repeat surgery in the 4-year period. The intervention effect was estimated by logistic regression, controlled for surgeon as a fixed effect in the model. The trial is registered with the Pan African Clinical Trials Registry (number PACTR201401000743135). FINDINGS: 1000 participants with TT were enrolled, randomly assigned, and treated (501 in the BLTR group and 499 in the PLTR group) between Feb 13, 2014, and May 31, 2014. At year 4, 943 (94.3%) participants were re-examined (471, PLTR; 472, BLTR) and included in the primary outcome analysis. PTT had developed in 169/943 (17•9%) study eyes, among which 129 (76•3%) had minor trichiasis (≤5 lashes touching the eye). PTT was significantly more frequent at 4-year in the BLTR arm (105/472 [22•2%]) than the PLTR arm (64/471 [13•6%]), adjusted OR 1•82 (95% CI, 1•29-2•56); p = 0•0006, with 8•6% (95%CI 3•8-13•5) risk difference. INTERPRETATION: The PLTR surgical procedure had superior long-term outcomes to the BLTR with significantly lower risk of PTT supporting the current WHO guideline that the PLTR should be the procedure of choice for training new surgeons in the programmatic management of TT

Effect of repeated epilation for minor trachomatous trichiasis on lash burden, phenotype and surgical management willingness: A cohort study.

BACKGROUND: WHO endorsed the use of epilation as an alternative treatment to surgery for the management of both minor unoperated TT (UTT) and postoperative TT (PTT). However, some trachoma control programmes hesitated to implement epilation citing concerns that it would hamper TT surgical acceptance and result in larger numbers of and stiffer trichiatic eyelashes than the original TT lashes. We investigated the burden and phenotypes of post-epilation trichiatic eyelashes, and willingness to accept surgical management separately in unoperated and postoperative TT cases. METHODOLOGY/PRINCIPAL FINDINGS: We recruited cases with minor (≤5 eyelashes from the upper eyelid touching the eye or evidence of epilation in <1/3rd of the upper eyelid) UTT (170) and PTT (169) from community-based screenings in Amhara Region, Ethiopia. Participants eyes were examined and data on present and future willingness to accept surgical management collected at baseline and every month for 6-months. Eyelashes touching the eye were counted and their phenotypes documented. Participants were trained on how to epilate. Epilation was done by the participants at home and by the examiner during follow-ups when requested by the participant. Follow-up rates were ≥97%. There was evidence of a significant reduction in the burden of trichiatic eyelashes in unoperated (mean difference = -0.90 [-1.11- -0.69]; RR = 0.50 [95% CI, 0.40-0.62]; p<0.0001), and postoperative (mean difference = -1.16 [-1.36- -0.95]; RR = 0.38 [95% CI, 0.31-0.48]; p<0.0001) cases 6-month after frequent epilation. Post-epilation trichiatic eyelashes at 6-months had higher odds of being thin (40.2% vs 55.8%, OR = 1.88 [95% CI, 1.21-2.93]; p = 0.0048), weak (39.8% vs 70.8%, OR = 3.68 [95%CI,2.30-5.88]; p<0.0001), and half-length (30.9% vs 43.3%, OR = 1.71 [1.09-2.68]; p = 0.020) than the pre-epilation trichiatic eyelashes in unoperated cases. There was a significant increase in the proportion of weak trichiatic eyelashes (OR = 1.99 [95% CI, 1.03-3.83; p = 0.039) in postoperative cases. In all 6 follow-up time points, 120/164 (73.2%) of unoperated and 134/163 (82.2%) of postoperative cases indicated that they would accept surgery if their trichiasis progressed. CONCLUSIONS/SIGNIFICANCE: In this study setting, frequent epilation neither hampers surgical acceptance nor results in more damaging trichiatic eyelashes than the pre-epilation lashes; and can be used as an alternative to the programmatic management of minor unoperated and postoperative TT cases

The conjunctival transcriptome in Ethiopians after trichiasis surgery: associations with the development of eyelid contour abnormalities and the effect of oral doxycycline treatment

Background: Surgery to correct trichiasis is a key component of the World Health Organisation trachoma control strategy, however unfavourable outcomes such as eyelid contour abnormalities (ECA) following surgery are relatively common. This study aimed to understand the transcriptional changes associated with the early development of ECA and the impact of doxycycline, which has anti-inflammatory and anti-fibrotic properties, upon these transcription patterns. Methods: One thousand Ethiopians undergoing trichiasis surgery were enrolled in a randomised controlled trial following informed consent. Equal groups of randomly assigned individuals were orally administered with 100mg/day of doxycycline (n=499) or placebo (n=501) for 28 days. Conjunctival swabs were collected immediately prior to surgery and at one- and six-months post-surgery. 3’ mRNA sequencing was performed on paired baseline and one-month samples from 48 individuals; 12 in each treatment/ECA outcome group. qPCR validation was then performed for 46 genes of interest in 145 individuals who developed ECA at one month and 145 matched controls, using samples from baseline, one and six months. Results: All treatment/outcome groups upregulated genes associated with wound healing pathways at one month relative to baseline, however no individual differences were detected between groups. The summed expression of a highly coexpressed cluster of pro-fibrotic genes was higher in patients that developed ECA in the placebo group relative to controls. qPCR validation revealed that all genes in this cluster and a number of other pro-inflammatory genes were strongly associated with ECA, however these associations were not modulated by trial arm. Conclusions: The development of post-operative ECA is associated with overexpression of pro-inflammatory and pro-fibrotic genes including growth factors, matrix metalloproteinases, collagens and extracellular matrix proteins. There was no evidence that doxycycline modulated the association between gene expression and ECA.</ns4:p

The conjunctival transcriptome in Ethiopians after trichiasis surgery: associations with the development of eyelid contour abnormalities and the effect of oral doxycycline treatment

Background: Surgery to correct trichiasis is a key component of the World Health Organisation trachoma control strategy, however unfavourable outcomes such as eyelid contour abnormalities (ECA) following surgery are relatively common. This study aimed to understand the transcriptional changes associated with the early development of ECA and the impact of doxycycline, which has anti-inflammatory and anti-fibrotic properties, upon these transcription patterns. Methods: One thousand Ethiopians undergoing trichiasis surgery were enrolled in a randomised controlled trial following informed consent. Equal groups of randomly assigned individuals were orally administered with 100mg/day of doxycycline (n=499) or placebo (n=501) for 28 days. Conjunctival swabs were collected immediately prior to surgery and at one- and six-months post-surgery. 3’ mRNA sequencing was performed on paired baseline and one-month samples from 48 individuals; 12 in each treatment/outcome group (Placebo-Good outcome, Placebo-Poor outcome, Doxycycline-Good outcome, Doxycycline-Poor outcome). qPCR validation was then performed for 46 genes of interest in 145 individuals who developed ECA at one month and 145 matched controls, using samples from baseline, one and six months. Results: All treatment/outcome groups upregulated genes associated with wound healing pathways at one month relative to baseline, however no individual differences were detected between groups. The summed expression of a highly coexpressed cluster of pro-fibrotic genes was higher in patients that developed ECA in the placebo group relative to controls. qPCR validation revealed that all genes in this cluster and a number of other pro-inflammatory genes were strongly associated with ECA, however these associations were not modulated by trial arm. Conclusions: The development of post-operative ECA is associated with overexpression of pro-inflammatory and pro-fibrotic genes including growth factors, matrix metalloproteinases, collagens and extracellular matrix proteins. There was no evidence that doxycycline modulated the association between gene expression and ECA.</ns4:p

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Untersuchung jahreszeitlicher Aktivität der Zecken (Amblyomma cohaerens und Boophilus decoloratus) und Entwicklung eines Managementplans zur Kontrolle der Zecken und durch Zecken übertragenen Krankheiten beim Rindern in der Jimma Zone, südwestliches Äthiopien

Im Gebiet von Jimma, im Südwesten Äthiopiens hängt der Lebensunterhalt hauptsächlich von Kaffee und Tierproduktion ab. Es wurde eine Untersuchung über den Artenreichtum die Belastung der Tiere mit Zecken und deren jahreszeitlche Aktivität bei einheimische Zebu-, taurinen Rindern und deren Kreuzungen durchgeführt.Für diese Untersuchung wurden Tiere aus dem Milchkühbestand der landwirtschaftlichen Hochschule und aus den Viehbeständen der Bauern der Umgebung sowohl einheimischer als auch exotischer Rassen benutzt. Das Endziel der Untersuchung sollte der Entwicklung eines Managmentplans zur Kontrolle der Zecken und durch Zecken übertragenen Krakheiten dienen.Untersuchungen zur Populationsdynamik der Zecken wurden von September 1998 bis August 1999 also für die Dauer eines Jahres durchgeführt. Im Laufe dieser Untersuchungen wurden 8642 Zecken vertreten durch acht Arten nämlich A. cohaerens 62%, B. decoloratus 33%, A. variegatum 3,8%, R. evertsi 0,9%, R. praetexatus 0,19%, R. bergeoni 0,06%, R. lunulatus 0,035% und H. aciculifer 0,012% identifiziert. Zu allen Jahreszeiten kamen zwei Zeckenarten, nämlich, Amblyomma cohaerens und Boophilus decoloratus, am häufigsten vor.Zur Untersuchung der Saisonalität wurden jeweils fünfzig Rinder aus funf Gegenden ausgewählt. Von diesen wurden im Laufe von zwei Jahren jeden Monat von September 1998 bis August 2000 Zecken gesammelt. Die Zecken wurden am Körper der Tiere während jeden Monats des gesamten Jahres gefunden. Die Zahl der Zecken je Tier war in der Trockenzeit jeweils geringer. Regen ist der wesentliche Einflussfaktor der die jahreszeitliche Variation des Zeckenbefalls am stärksten beeinflusst. Die Variation des Befallgrades zeigte das gleiche Muster während der beiden Jahre der Untersuchung. Die Spitzenintesitäten waren jedoch deutlich unterschiedlich.Wenn die Rinder entsprechend ihres Gehaltes an exotischen Blutbeimischungen in Gruppen aufgeteilt wurden, zeigte sich, daß bei den Tieren mit überwiegend exotischer Blutbeimischung der Befall deutlich höher war, als bei Tieren der überwiegend einheimischen Zebu-Rasse. Die höchsten Infestationsraten also wiesen dabei exotische Rinder auf. Einheimische Rinderrassen hatten nur geringe Befallsraten.Sowohl Vermehrung als auch Wachstum aller Zwischenstadien von Amblyomma cohaerens und Boophilus decoloratus sind abhängig von den mittleren Umwelttemperaturn. Sowohl Amblyomma cohaerens als auch Boophilus decoloratus zeigten zwei Spitzen- Infestationraten, mäβige im September und Oktober, maximale in Mai, Juni, und Juli.Die Vermehrung der Zeckenpopulation während der kurzen Regenzeit war unbedeutend. Zu einer erheblichen Steigerung des Befalles kommt es in der Hauptregenzeit. Es besteht offenbar eine Beziehung zwischen der Populationsmenge der Zecken und minimalen Temperaturen. Maximale Temperaturen schienen keinen Einfluß zu haben.Es erscheint naheliegend, daß Zecken und durch Zecken übertragbare Krankheiten in südwesten Äthiopiens in gleichem Maße bei den untersuchten Rindern in der gleichen Region zu erwarten sind. Eine solche Situationist durch enzootische Stabilität gekennzeichnet. Aus diesem Grunde erscheint eine Ausrottung von Zecken in gleichartigen Länder wie Äthiopien, weder erforderlich noch realistisch. Die bislang in großem Umfang durchgeführten Tauch- und Spritzprogramme waren letztlich erfolglos.Eine Strategie zur Kontrolle der Zeckenpopulation muß auf eine Hebung der Wiederstandsfäigkeit der Wirte der Zecken und die durch sie ubertragenen Krankheiten zielen. In Hinblick auf die jahreszeitliche Aktivität des Zeckenbefalles sollte die Verfügbarkeit von Medikamenten und Impfstoffen gegenuber den von Zecken übertragenen Krankheiten, Basis für eine sinnvolle und auch ökonomisch zu Bucheschlagende Strategie sein.In Anbetracht der im Untersuchungszeitraum festgestellten geringen Infestationsraten bei einheimische Rindern, die in der Jimma Zone festgestellt werden konnte, erscheint eine Zeckenbekämpfung weder unter wissenschaftlichen noch unter wirtschaftlichen Gesichtspunkten sinnvoll.In der Jimma Zone haben, wie gezeigt warden konnte, Wetter und Klima entscheidenden Einfluß auf Vermehrung und Entwicklung der Zecken. Die besondere Beffalsrate durch Zecken von April bis Oktober, erschwert die Kontrolle. In dieser Zeit erscheint wenig sinnvoll, zu versuchen, die Befallsrate der Rinder zu verringern oder aber Züchtungen zu verwenden, die für den Zeckenbefall weniger empfänglich sind.Als beste Lösung erscheint eine Kombination aus geeigneter Weidewirtschaft und Nutzung von Akariziden. Für die Tierzucht sollte eine geeignete Kombination aus minimaler Verwendung von Akariziden zu Zeiten geringen Befalls von November bis März und einer vermehrten Verwendung von Akariziden zu Zeiten höherer, jahreszeitlich bedingten Befalles von April bis Oktober in Erwägung gezogen werden