The Pattern of Cardiac Diseases at the Cardiac Clinic of Jimma University Specialised Hospital, South West Ethiopia

BACKGROUND: Rheumatic heart disease is the commonest cardiac disease in most sub-Saharan African countries, followed by hypertensive heart disease which is rising along with the other non-communicable diseases. However the pattern in our setting is not known. This study aimed to determine the pattern of cardiac diseases among adult patients on follow-up at the cardiac follow-up clinic of Jimma University Specialized Hospital. METHODS: A cross-sectional study was conducted on cardiac patients who are newly enrolled to the cardiac follow up clinic of Jimma university specialized hospital during a five year period from 2003 to 2008. Out of the total 837 cases that were newly enrolled to the clinic in the five year period, 781 patients who had complete record about etiologic diagnosis were included in the study. The data were collected using structured record review checklist. The collected data were then analyzed using SPSS for windows version 12.0. RESULTS: Rheumatic heart disease was the diagnosis in 256 (32.8%) of the cardiac cases on follow-up followed by hypertensive heart disease and cardiomyopathy accounting for 189 (24.2%) and 158 (20.2%) of cases, respectively. Among Rheumatic heart disease patients; male to female ratio was 0.86:1 and the mean age was 31.4 years. One hundred ninety three (75.4%) of the cases with rheumatic heart disease had echocardiographic report that showed valve(s) involvements of pure MS in 99 (51.3%) and combined MS, MR in 49 (25.4%). Overall, hypertension contributed for a total of 241 (30.9%) of cardiac patients that included 189 (24.2%) hypertensive heart disease and 52 (6.7%) as one major risk factor for ischemic heart disease. CONCLUSION: Rheumatic, hypertensive and cardiomyopathic heart diseases accounted for more than three-quarters of cardiac diseases in the study population. This study highlighted the need for further study to determine the burden at community setting

Accessibility, availability and consumption of baobab during food emergencies in Kitui and Kilifi counties in Kenya

Baobab (Adansonia digitata L.) is an indigenous fruit tree (IFT) that grows in several dry parts of Kenya such as Kitui and Kilifi counties.  It plays a key role in dietary diversification thus contributing to food and nutrition security. This tree is adaptable to adverse climatic conditions such as droughts and floods, which are common in these counties. Consequently, it acts as a source of income and a food  buffer during disasters. This study evaluated the role baobab plays during food emergencies. The study employed a cross-sectional design where 216 household heads were interviewed through structured interviews. Data were analysed using SPSS version 24. Baobab was available during lean seasons and was used as a source of food and income. Respondents mainly consumed baobab fresh fruits without any processing (94%). During times of scarcity when there was nothing else available to eat. About 33.3% used baobab pulp to make porridge while 16.7% made a hard gruel (ugali). Drinks and candies, commonly called ‘mabuyu sweets’, accounted for 41.2% and 28.7%, respectively. In Kilifi, baobab pulp was mixed with coconut milk to be used as an accompaniment to ugali (34.3 %). About two thirds (60.7%) of the respondents collected and stored whole baobab fruits for use during lean seasons. Baobab pulp was sold by 34.7% of the respondents and the income was used to buy food (45.3 %), education (22.7%) and for healthcare (13. 3%). This study indicatesthat baobab fruit and pulp was available and accessible during lean seasons. The baobab pulp was mainly consumed without any processing as a snack. It also used to make different foods at times when many other foods were not available. Households sold baobab fruits to augment their income. Promotion of baobab products could bring better incomes and improve the nutritional status of communities in baobab growing areas and helps to overcome food insecurity in emergencies. Key words: lean seasons, baobab products, income, food insecurity, copin

External review : Governance, Equity and Health Program, IDRC, 2006-2011

Overall, the implementation of the Governance, Equity and Health (GEH) program has closely followed the program of work described in the Prospectus of April 2006 – March 2011. The program initiative places a unique focus on intensive knowledge translation within communities, civil societies and local and national governments. Achievements have been made in: convergence of research projects around primary health care; better integration and linkages with social justice to redress health inequities; wider geographical and increasing global reach of projects; and increased understanding of governance and health systems equity among GEH recipients

Techniques for Arbuscular Mycorrhiza Inoculum Reduction

It is well established that arbuscular mycorrhizal (AM) fungi can play a significant role in sustainable crop production and environmental conservation. With the increasing awareness of the ecological significance of mycorrhizas and their diversity, research needs to be directed away from simple records of their occurrence or casual speculation of their function (Smith and Read 1997). Rather, the need is for empirical studies and investigations of the quantitative aspects of the distribution of different types and their contribution to the function of ecosystems. There is no such thing as a fungal effect or a plant effect, but there is an interaction between both symbionts. This results from the AM fungi and plant community size and structure, soil and climatic conditions, and the interplay between all these factors (Kahiluoto et al. 2000). Consequently, it is readily understood that it is the problems associated with methodology that limit our understanding of the functioning and effects of AM fungi within field communities. Given the ubiquous presence of AM fungi, a major constraint to the evaluation of the activity of AM colonisation has been the need to account for the indigenous soil native inoculum. This has to be controlled (i.e. reduced or eliminated) if we are to obtain a true control treatment for analysis of arbuscular mycorrhizas in natural substrates. There are various procedures possible for achieving such an objective, and the purpose of this chapter is to provide details of a number of techniques and present some evaluation of their advantages and disadvantages. Although there have been a large number of experiments to investigated the effectiveness of different sterilization procedures for reducing pathogenic soil fungi, little information is available on their impact on beneficial organisms such as AM fungi. Furthermore, some of the techniques have been shown to affect physical and chemical soil characteristics as well as eliminate soil microorganisms that can interfere with the development of mycorrhizas, and this creates difficulties in the interpretation of results simply in terms of possible mycorrhizal activity. An important subject is the differentiation of methods that involve sterilization from those focussed on indigenous inoculum reduction. Soil sterilization aims to destroy or eliminate microbial cells while maintaining the existing chemical and physical characteristics of the soil (Wolf and Skipper 1994). Consequently, it is often used for experiments focussed on specific AM fungi, or to establish a negative control in some other types of study. In contrast, the purpose of inoculum reduction techniques is to create a perturbation that will interfere with mycorrhizal formation, although not necessarily eliminating any component group within the inoculum. Such an approach allows the establishment of different degrees of mycorrhizal formation between treatments and the study of relative effects. Frequently the basic techniques used to achieve complete sterilization or just an inoculum reduction may be similar but the desired outcome is accomplished by adjustments of the dosage or intensity of the treatment. The ultimate choice of methodology for establishing an adequate non-mycorrhizal control depends on the design of the particular experiments, the facilities available and the amount of soil requiring treatment

A pilot time-in-bed restriction intervention behaviorally enhances slow-wave activity in older adults

IntroductionIdentifying intervention methods that target sleep characteristics involved in memory processing is a priority for the field of cognitive aging. Older adults with greater sleep efficiency and non-rapid eye movement slow-wave activity (SWA) (0.5–4 Hz electroencephalographic activity) tend to exhibit better memory and cognitive abilities. Paradoxically, long total sleep times are consistently associated with poorer cognition in older adults. Thus, maximizing sleep efficiency and SWA may be a priority relative to increasing mere total sleep time. As clinical behavioral sleep treatments do not consistently enhance SWA, and propensity for SWA increases with time spent awake, we examined with a proof-of concept pilot intervention whether a greater dose of time-in-bed (TiB) restriction (75% of habitual TiB) would increase both sleep efficiency and SWA in older adults with difficulties staying asleep without impairing memory performance.MethodsParticipants were adults ages 55–80 with diary-reported sleep efficiency < 90% and wake after sleep onset (WASO) >20 min. Sleep diary, actigraphy, polysomnography (PSG), and paired associate memory acquisition and retention were assessed before and after a week-long TiB restriction intervention (n = 30). TiB was restricted to 75% of diary-reported habitual TiB. A comparison group of n = 5 participants repeated assessments while following their usual sleep schedule to obtain preliminary estimates of effect sizes associated with repeated testing.ResultsSubjective and objective sleep measures robustly improved in the TiB restriction group for sleep quality, sleep depth, sleep efficiency and WASO, at the expense of TiB and time spent in N1 and N2 sleep. As hypothesized, SWA increased robustly with TiB restriction across the 0.5–4 Hz range, as well as subjective sleep depth, subjective and objective WASO. Despite increases in sleepiness ratings, no impairments were found in memory acquisition or retention.ConclusionA TiB restriction dose equivalent to 75% of habitual TiB robustly increased sleep continuity and SWA in older adults with sleep maintenance difficulties, without impairing memory performance. These findings may inform long-term behavioral SWA enhancement interventions aimed at improving memory performance and risk for cognitive impairments

Agronomic Management of Indigenous Mycorrhizas

Many of the advantages conferred to plants by arbuscular mycorrhiza (AM) are associated to the ability of AM plants to explore a greater volume of soil through the extraradical mycelium. Sieverding (1991) estimates that for each centimetre of colonized root there is an increase of 15 cm3 on the volume of soil explored, this value can increase to 200 cm3 depending on the circumstances. Due to the enhancement of the volume of soil explored and the ability of the extraradical mycelium to absorb and translocate nutrients to the plant, one of the most obvious and important advantages resulting from mycorrhization is the uptake of nutrients. Among of which the ones that have immobilized forms in soil, such as P, assume particular significance. Besides this, many other benefits are recognized for AM plants (Gupta et al, 2000): water stress alleviation (Augé, 2004; Cho et al, 2006), protection from root pathogens (Graham, 2001), tolerance to toxic heavy metals and phytoremediation (Audet and Charest, 2006; Göhre and Paszkowski, 2006), tolerance to adverse conditions such as very high or low temperature, high salinity (Sannazzaro et al, 2006), high or low pH (Yano and Takaki, 2005) or better performance during transplantation shock (Subhan et al, 1998). The extraradical hyphae also stabilize soil aggregates by both enmeshing soil particles (Miller e Jastrow, 1992) and producing a glycoprotein, golmalin, which may act as a glue-like substance to adhere soil particles together (Wright and Upadhyaya, 1998). Despite the ubiquous distribution of mycorrhizal fungi (Smith and Read, 2000) and only a relative specificity between host plants and fungal isolates (McGonigle and Fitter, 1990), the obligate nature of the symbiosis implies the establishment of a plant propagation system, either under greenhouse conditions or in vitro laboratory propagation. These techniques result in high inoculum production costs, which still remains a serious problem since they are not competitive with production costs of phosphorus fertilizer. Even if farmers understand the significance of sustainable agricultural systems, the reduction of phosphorus inputs by using AM fungal inocula alone cannot be justified except, perhaps, in the case of high value crops (Saioto and Marumoto, 2002). Nurseries, high income horticulture farmers and no-agricultural application such as rehabilitation of degraded or devegetated landscapes are examples of areas where the use of commercial inoculum is current. Another serious problem is quality of commercial available products concerning guarantee of phatogene free content, storage conditions, most effective application methods and what types to use. Besides the information provided by suppliers about its inoculum can be deceiving, as from the usually referred total counts, only a fraction may be effective for a particular plant or in specific soil conditions. Gianinazzi and Vosátka (2004) assume that progress should be made towards registration procedures that stimulate the development of the mycorrhizal industry. Some on-farm inoculum production and application methods have been studied, allowing farmers to produce locally adapted isolates and generate a taxonomically diverse inoculum (Mohandas et al, 2004; Douds et al, 2005). However the inocula produced this way are not readily processed for mechanical application to the fields, being an obstacle to the utilization in large scale agriculture, especially row crops, moreover it would represent an additional mechanical operation with the corresponding economic and soil compaction costs. It is well recognized that inoculation of AM fungi has a potential significance in not only sustainable crop production, but also environmental conservation. However, the status quo of inoculation is far from practical technology that can be widely used in the field. Together a further basic understanding of the biology and diversity of AM fungi is needed (Abbott at al, 1995; Saito and Marumoto, 2002). Advances in ecology during the past decade have led to a much more detailed understanding of the potential negative consequences of species introductions and the potential for negative ecological consequences of invasions by mycorrhizal fungi is poorly understood. Schwartz et al, (2006) recommend that a careful assessment documenting the need for inoculation, and the likelihood of success, should be conducted prior to inoculation because inoculations are not universally beneficial. Agricultural practices such as crop rotation, tillage, weed control and fertilizer apllication all produce changes in the chemical, physical and biological soil variables and affect the ecological niches available for occupancy by the soil biota, influencing in different ways the symbiosis performance and consequently the inoculum development, shaping changes and upset balance of native populations. The molecular biology tools developed in the latest years have been very important for our perception of these changes, ensuing awareness of management choice implications in AM development. In this context, for extensive farming systems and regarding environmental and economic costs, the identification of agronomic management practices that allow controlled manipulation of the fungal community and capitalization of AM mutualistic effect making use of local inoculum, seem to be a wise option for mycorrhiza promotion and development of sustainable crop production

High seroprevalence of anti-SARS-CoV-2 antibodies among Ethiopian healthcare workers

BACKGROUND: COVID-19 pandemic has a devastating impact on the economies and health care system of sub-Saharan Africa. Healthcare workers (HWs), the main actors of the health system, are at higher risk because of their occupation. Serology-based estimates of SARS-CoV-2 infection among HWs represent a measure of HWs' exposure to the virus and could be used as a guide to the prevalence of SARS-CoV-2 in the community and valuable in combating COVID-19. This information is currently lacking in Ethiopia and other African countries. This study aimed to develop an in-house antibody testing assay, assess the prevalence of SARS-CoV-2 antibodies among Ethiopian high-risk frontline HWs. METHODS: We developed and validated an in-house Enzyme-Linked Immunosorbent Assay (ELISA) for specific detection of anti-SARS-CoV-2 receptor binding domain immunoglobin G (IgG) antibodies. We then used this assay to assess the seroprevalence among HWs in five public hospitals located in different geographic regions of Ethiopia. From consenting HWs, blood samples were collected between December 2020 and February 2021, the period between the two peaks of COVID-19 in Ethiopia. Socio-demographic and clinical data were collected using questionnaire-based interviews. Descriptive statistics and bivariate and multivariate logistic regression were used to determine the overall and post-stratified seroprevalence and the association between seropositivity and potential risk factors. RESULTS: Our successfully developed in-house assay sensitivity was 100% in serum samples collected 2- weeks after the first onset of symptoms whereas its specificity in pre-COVID-19 pandemic sera was 97.7%. Using this assay, we analyzed a total of 1997 sera collected from HWs. Of 1997 HWs who provided a blood sample, and demographic and clinical data, 51.7% were females, 74.0% had no symptoms compatible with COVID-19, and 29.0% had a history of contact with suspected or confirmed patients with SARS-CoV-2 infection. The overall seroprevalence was 39.6%. The lowest (24.5%) and the highest (48.0%) seroprevalence rates were found in Hiwot Fana Specialized Hospital in Harar and ALERT Hospital in Addis Ababa, respectively. Of the 821 seropositive HWs, 224(27.3%) of them had a history of symptoms consistent with COVID-19 while 436 (> 53%) of them had no contact with COVID-19 cases as well as no history of COVID-19 like symptoms. A history of close contact with suspected/confirmed COVID-19 cases is associated with seropositivity (Adjusted Odds Ratio (AOR) = 1.4, 95% CI 1.1-1.8; p = 0.015). CONCLUSION: High SARS-CoV-2 seroprevalence levels were observed in the five Ethiopian hospitals. These findings highlight the significant burden of asymptomatic infection in Ethiopia and may reflect the scale of transmission in the general population

A Benchmark of Simple Measurement Systems for Direct Irradiance

Accurate direct normal irradiance (DNI) measurements are essential for the design and the operation of concentrating solar power systems. Several measurement systems for DNI are available to users, but all commonly used systems still have drawbacks. Sun trackers with pyranometers and a pyrheliometer are expensive and require permanent checks and maintenance by qualified personnel, for example due to tracking errors and soiling effects. Simpler, i.e. more economic and robust sensors may have shortcomings regarding accuracy under various atmospheric conditions and might not be significantly less susceptible to soiling and user errors. Validations and benchmarking of simple radiometers for solar energy applications have been presented. To the best of our knowledge, no benchmarking study is available which evaluates some more recent simple measurement systems which are relevant for solar applications in 2023. Furthermore, most previous benchmarking studies did not measure atmospheric parameters like circumsolar irradiance which may directly influence the measurements of these sensors. We close this gap by benchmarking relevant measurement systems (Rotating Shadowband Irradiometer RSI and Rotating Shadowband Pyranometer RSP 4G; Delta-T SPN1, EKO MS-90, PyranoCam, Sunto CaptPro) at multiple sites. We also evaluate the influence of relevant atmospheric parameters which we measure with dedicated instruments at one site. We include the PyranoCam system in our benchmarking, a novel radiometer system suitable for all solar irradiance components including DNI. It consists of a pyranometer and a fisheye camera that takes photos of the whole sky and employs a combined physical and machine-learning model. The results of the study provide improved estimates of the sensors’ accuracies for a specific application and climatic condition and can assist in the development of corrections for the sensor technologies

A step forward for understanding the morbidity burden in Guinea: a national descriptive study

<p>Abstract</p> <p>Background</p> <p>Little evidence on the burden of disease has been reported about Guinea. This study was conducted to demonstrate the morbidity burden in Guinea and provide basic evidence for setting health priorities.</p> <p>Methods</p> <p>A retrospective descriptive study was designed to present the morbidity burden of Guinea. Morbidity data were extracted from the National Health Statistics Report of Guinea of 2008. The data are collected based on a pyramid of facilities which includes two national hospitals (teaching hospitals), seven regional hospitals, 26 prefectural hospitals, 8 communal medical centers, 390 health centers, and 628 health posts. Morbidity rates were calculated to measure the burden of non-fatal diseases. The contributions of the 10 leading diseases were presented by sex and age group.</p> <p>Results</p> <p>In 2008, a total of 3,936,599 cases occurred. The morbidity rate for males was higher than for females, 461 versus 332 per 1,000 population. Malaria, respiratory infections, diarrheal diseases, helminthiases, and malnutrition ranked in the first 5 places and accounted for 74% of the total burden, respectively having a rate of 148, 64, 33, 32, and 14 per 1,000 population. The elderly aged 65+ had the highest morbidity rate (611 per 1,000 population) followed by working-age population (458 per 1,000 population) and children (396 per 1,000 population) while the working-age population aged 25-64 contributed the largest part (39%) to total cases. The sex- and age-specific spectrum of morbidity burden showed a similar profile except for small variations.</p> <p>Conclusion</p> <p>Guinea has its unique morbidity burden. The ten leading causes of morbidity burden, especially for malaria, respiratory infections, diarrheal diseases, helminthiases, and malnutrition, need to be prioritized in Guinea.</p