Dyslipidemia and serum cystatin C levels as biomarker of diabetic nephropathy in patients with type 2 diabetes mellitus

BackgroundDiabetic nephropathy is a leading cause of end-stage renal disease. The diagnostic markers of nephropathy, including the presence of albuminuria and/or a reduced estimated glomerular filtration rate, are not clinically ideal, and most of them are raised after a significant reduction in renal function. Therefore, it is crucial to seek more sensitive and non-invasive biomarkers for the diagnosis of diabetic nephropathy.Objective of the studyThis study aimed to investigate the serum cystatin C levels and dyslipidemia for the detection of diabetic nephropathy in patients with type 2 diabetes mellitus.MethodologyA hospital-based comparative cross-sectional study was conducted from December 2021 to August 2022 in Tikur, Anbessa specialized teaching hospital with a sample size of 140 patients with type2 diabetes mellitus. Socio-demographic data was collected using a structured questionnaire, and 5 mL of blood was collected from each participant following overnight fasting for biochemical analyses.ResultsIn type 2 diabetes patients with nephropathy, we found significant lipoprotein abnormalities and an increase in serum cystatin C (P < 0.001) compared to those without nephropathy. Serum cystatin C, systolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein, very low-density lipoprotein, high density lipoprotein, and duration of diabetes were identified as being significantly associated with diabetic nephropathy (P < 0.05) in multivariable logistic regression analysis. The mean values of total cholesterol levels, triglyceride levels, and high-density lipoprotein cholesterol levels were also found to be significantly higher (P < 0.05) in females as compared to male type-2 diabetic patients. The fasting blood glucose levels and lipid profiles of the participants were found to be significantly associated with serum cystatin C levels.ConclusionThe present study found significant serum cystatin C and lipoprotein abnormalities in T2DM patients with diabetic nephropathy when compared with those without diabetic nephropathy, and these lipoprotein abnormalities were significantly associated with serum cystatin C levels

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Security challenges in the transition to 4G mobile systems in developing countries

Abstract4 G mobile networks have evolved to meet the ever-increasing demand and requirements of users. 4 G will provide comprehensive IP solutions, allowing users to access voice, data, and streaming multimedia services at any time, from any location. Nonetheless, this transition will introduce new vulnerabilities and threats to service providers and customers. With the introduction of machine-to-machine (M2M) communication and the Internet of Things (IoT), malicious actors now have more attack ground. Attackers have an easier time sneaking into 4 G networks in developing countries because outdated and unprotected devices are still in use. Many startups and individuals did not invest in protecting their devices, owing to financial constraints and a lack of fundamental cyber security awareness. Because many network devices in developing countries are old and poorly protected, they could serve as a launching pad for perpetrators. This work thoroughly investigates and discusses fundamental security flaws in the 4 G network. These flaws could provide a path for malicious actors. Several factors exist in developing countries that expose them to perpetrators have been explained and elaborated on this work. Additionally, potential solutions to combat these issues are proposed

Determinants of low birth weight among neonates born in Amhara Regional State Referral Hospitals of Ethiopia: unmatched case control study

Abstract Objective This study was conducted to identify the determinants of low birth weight among infants born in Amhara Regional State Referral Hospitals of Ethiopia. Results This study found that mothers who delivered female infants (AOR: 1.7, 95% CI 1.1, 2.6), occurrence of health problems during current pregnancy (AOR: 2.8, 95% CI 1.7,4.5), absence of antenatal care (AOR: 2.3,95% CI 1.3,4.0), lack of iron supplementation (AOR: 2.8, 95% CI 1.6,4.9), maternal MUAC below 23 cm (AOR: 1.7, 95% CI 1.0,2.7), and gestational age below 37 completed weeks (AOR: 3.3; 95% CI 1.9, 5.7) were found to be determinants of low birth weight

Assessment of knowledge and perceptions towards diabetes mellitus and its associated factors among people in Debre Berhan town, northeast Ethiopia.

BackgroundGlobally, diabetes is a major public health burden that results in more than 3.2 million adult deaths per year. Currently, diabetes is increasingly becoming a major threat to global public health, particularly in Sub-Saharan Africa. Although previous studies emphasized knowledge and health beliefs about diabetes among patients living with diabetes, there is minimal evidence about knowledge and perception of risk for developing diabetes at the community level.ObjectiveThis study aimed to assess the knowledge and perception of diabetes mellitus and its associated factors among people in Debre Berhan town, northeast Ethiopia.MethodsA community-based cross-sectional study was conducted among 423 participants. The study was carried out from 25 February to 10 March 2019. Data were collected using a structured pretested questionnaire through face-to-face interviews. Data were entered into Epi data V 3.1 and exported to SPSS V 24 for analysis. A variable with pResultA total of 237 (56.02%) participants had good general knowledge about diabetes mellitus. In the multivariable analysis, participants who were single (AOR = 9.08, CI: 1.72-48), had a family history of diabetes (AOR = 2.83; CI: 1.10-7.24), and had exposure to health education (AOR = 3.27; CI: 2.02-5.31) were associated with good knowledge. In this study, few respondents (20.1%) felt that they had a higher risk of developing diabetes. Two-thirds of respondents (62.4%) saw diabetes is a serious disease. On the other hand, approximately 67% agreed to the perceived benefits of screening.ConclusionAlmost half of the Debre Berhan community was found to have inadequate knowledge of diabetes mellitus. Married, higher educational status, exposure to health education, and family history of diabetes mellitus were significantly associated with good knowledge. The perceived risk of developing diabetes was low at the community level, although many respondents felt that behavior change is important in the prevention of diabetes. Therefore, policy makers, healthcare managers, and healthcare workers need to work cooperatively to foster community knowledge towards diabetes mellitus

Factors associated with low birth weight at Debre Markos Referral Hospital, Northwest Ethiopia: a hospital based cross-sectional study

Abstract Objective To assess the prevalence and associated factors of low birth weight among newborns delivered at Debre Markos Referral Hospital, Northwest Ethiopia. Results From the total of 368 newborn baby/mother pairs planned to be participated, 338 agreed and involved in the study giving a response rate of 91.2%. In this study, the prevalence of low birth weight was 21.6 (95% CI 17.5, 26%). Being rural residence (AOR 2.0, 95% CI 1.0, 4.1), duration of pregnancy (AOR = 7.6, 95% CI 3.3, 17.4), and having complications during pregnancy (AOR 2.6, 95% CI 1.2, 5.7) were found to be factors significantly associated with low birth weight

Flooding events turned into farming opportunities: Innovation transforms livelihoods of pastoralists in Ethiopia

• Water Spreading Weirs: To capture and spread the torrential flood emerging in the neighboring highlands to low-lying rangelands and crop fields, five weirs were built based on land suitability studies. • Working together: Joint planning and execution between community leaders, landscape and crop researchers and development agents using a combination of good agronomy, remote sensing and GIS-based maps yielded positive results. • Success draws attention: Seeing the results, pastoralists were willing to take up farming. It created local confidence, drew government attention and benefited pastoralists

HIV rapid test performance among health facilities enrolled in HIV rapid test quality improvement initiative (RTQII) in Ethiopia

Abstract Background As the Human Immunodeficiency Virus (HIV) rapid testing services expanded to reach the global target that 95% of people living with the virus will know their status by 2030, ensuring the quality of those services becomes critical. This study was conducted to assess the performance of HIV Rapid testing at sites in health facilities that were enrolled in the Rapid Test Quality Improvement Initiative (RTQII) in Ethiopia. Methods Characterized HIV proficiency testing (PT) panels of Dried Tube Specimen (DTS) were prepared, verified, and distributed to testing sites from August to December 2019. In addition on-site evaluation of HIV testing sites (HTSs) was conducted using a checklist to assess testing conditions. For proficiency testing, the study included 159 HIV testing sites (HTSs) in 41 Health facilities (HFs) in five administrative regions and two city administrations. The collected data was analyzed by SPSS version 20 and chi-square test was applied to identify the association between acceptable performance and contributing factors. Testing sites with 100% PT score as well as conducting the test with adherence to the National HIV Testing Algorithm were considered acceptable. Results The overall acceptable performance (100% PT score with the correct algorithm followed) was found to be 62% while 12% scored 80% and 11% scored between 20 and 60%. The rest 15% were not considered as acceptable due to failure to adhere to the National HIV Testing Algorithm. Testing sites that participated in External Quality Assessment/Proficiency Testing schemes have shown better performance than those that did not participate with 70% and 56% performance respectively (p = 0.057)

Bivariable and multivariable logistic regression analysis of factors associated with mental distress those statically associated among DMU SMCHS students on mental distress, North West, Ethiopia, 2021(N = 461).

Bivariable and multivariable logistic regression analysis of factors associated with mental distress those statically associated among DMU SMCHS students on mental distress, North West, Ethiopia, 2021(N = 461).</p