Plasma Soluble Human Elastin Fragments as an Intra-Aneurysmal Localized Biomarker for Ruptured Intracranial Aneurysm

Background—Fragmentation of the tunica media is a hallmark of intracranial aneurysm formation, often leading to aneurysmal progression and subsequent rupture. The objective of this study is to determine the plasma level of elastin fragments in the lumen of ruptured versus unruptured human intracranial aneurysms. Methods and Results—One hundred consecutive patients with/without ruptured saccular intracranial aneurysms undergoing endovascular coiling or stent-assisted coiling were recruited. Blood samples were collected from the lumen of intracranial aneurysm using a microcatheter. The tip of the microcatheter was placed inside the aneurysm’s sac in close proximity to the inner wall of the dome. Plasma levels of elastin fragments were measured using an ELISA-based method. Mean plasma level of soluble human elastin fragments was significantly greater in ruptured aneurysms when compared with nonruptured aneurysms (102.0±15.5 versus 39.3±9.6 ng/mL; P\u3c0.001). Mean plasma level of soluble human elastin fragments did not have significant correlation with age, sex, size, or aneurysm location. Conclusions—The present study revealed that a significantly higher concentration of soluble human elastin fragments in the lumen of ruptured intracranial aneurysms when compared with nonruptured ones. © 2018 The Authors

Farmers' investments in land management practices in the CRV of Ethiopia

ABSTRACT In order to combat land degradation in the form of water erosion and fertility depletion in the Central Rift Valley (CRV) of Ethiopia farmers are of crucial importance. If they perceive land degradation as a problem they will be more willing to invest in land management measures. This study presents farmers’ perceptions of land degradation, respective investments, and factors influencing their investments in land. In this study, water erosion and fertility depletion are taken as main indicators of land degradation. Results show that farmers perceive water erosion and soil fertility depletion as problems that have intensified over the last decade. However, despite awareness of these problems, farmers’ investments to control soil erosion and soil fertility depletion are very limited. This study shows that the major factors that positively influence farmers’ investments in land management practices are households’ resource endowments, access to information, social capital and availability of family labor. For sustainable land management strategies this implies that these should (i) be integrated within a comprehensive rural development strategy that generates improvements of farmers’ livelihoods and their financial capacity, (ii) trigger social capital and create enabling conditions for farmers to participate in different groups, cross site visits and farmer-to-farmer experience sharing, and (iii) stimulate collective action within the villages in order to enhance access to labor which is crucial for carrying out land management practices. Key words: Land degradation, farmers’ investments, sustainable land management, socioeconomic factors, factor analysi

Assessment of Knowledge and Practices Toward COVID-19 Prevention Among Healthcare Workers in Tigray, North Ethiopia

Background: The incidence rate of coronavirus disease 2019 (COVID-19) is increasing in several countries despite that public health measures are put in place. Given that COVID-19 is a newly emerging disease, there is little knowledge about the disease. The present study aims to assess knowledge, perception, and preventive practices toward COVID-19 among health workers in Tigray, North Ethiopia.Materials and Methods: A health facility-based cross-sectional study was conducted among health professionals working in public hospitals. Data were collected between April and May 2020. The researchers included 403 participants and recruited them via a simple random sampling technique. To collect data, the researchers prepared a structured questionnaire guided by the WHO survey questions. Data were entered into Epi-info 7 and exported to SPSS version 20.00 for analysis. The researchers applied descriptive and inferential statistical analyses. Tables and graphs were used to describe data, and multivariate binary logistic regression was used to determine factors affecting knowledge, perception, and practices toward COVID-19 prevention.Results: Among the participants, 79, 88, and 64.3% of them had adequate knowledge, positive perception, and good practice toward preventing COVID-19, respectively. Besides, 92% of the study participants knew that the COVID-19 virus does not have curative treatment and vaccine. The findings revealed that 55% of the respondents did not use the necessary personal protective equipment (PPE) at all times. The result showed that being female [AOR: 2.43, 95% CI (1.50–3.94)] and having a work experience of 2–5 years [AOR: 2.44, 95% CI (1.10–5.39)], news media as a source information [AOR: 7.11, 95% CI (3.07–16.49)], social media as a source information [AOR: 4.59, 95% CI (2.15–9.84)], and governmental website as a source information [AOR: 4.21, 95% CI (2.15–8.27)] were reported as protective factors; and being single [AOR: 0.15, 95% CI (0.03–0.75)] was reported as risk factor toward the prevention of COVID-19.Conclusion: Most health workers had adequate knowledge and positive attitude toward COVID-19; nevertheless, a significant proportion of health workers had poor practice toward the prevention of COVID-19, including the use of PPE. Additionally, some groups of health professional showed poor practices of implementing the public health measures, hence the call for them to improve in the prevention and control of COVID-19

Baseline assessment of pharmacovigilance activities in four sub-Saharan African countries: a perspective on tuberculosis.

BACKGROUND: New medicines have become available for the treatment of drug-resistant tuberculosis (DR-TB) and are introduced in sub-Saharan Africa (SSA) by the national TB programs (NTPs) through special access schemes. Pharmacovigilance is typically the task of national medicines regulatory agencies (NMRAs), but the active drug safety monitoring and management (aDSM) recommended for the new TB medicines and regimens was introduced through the NTPs. We assessed the strengths and challenges of pharmacovigilance systems in Eswatini, Ethiopia, Nigeria and Tanzania, focusing on their capacity to monitor safety of medicines registered and not registered by the NMRAs for the treatment of DR-TB. METHODS: Assessment visits were conducted to all four countries by a multidisciplinary team. We used a pharmacovigilance indicator tool derived from existing tools, interviewed key stakeholders, and visited health facilities where DR-TB patients were treated with new medicines. Assessment results were verified with the local NMRAs and NTPs. RESULTS: Most countries have enabling laws, regulations and guidelines for the conduct of pharmacovigilance by the NMRAs. The relative success of NTP-NMRA collaboration is much influenced by interpersonal relationships between staff. Division of roles and responsibilities is not always clear and leads to duplication and unfulfilled tasks (e.g. causality assessment). The introduction of aDSM has increased awareness among DR-TB healthcare providers. CONCLUSION: aDSM has created awareness about the importance of pharmacovigilance among NTPs. In the future, a push for conducting pharmacovigilance through public health programs seems useful, but this needs to coincide with increased collaboration with between public health programs and NMRAs with clear formulation of roles and responsibilities

Polymorphisms in Plasmodium falciparum chloroquine resistance transporter and multidrug resistance 1 genes: parasite risk factors that affect treatment outcomes for P. falciparum malaria after artemether-lumefantrine and artesunate-amodiaquine.

Adequate clinical and parasitologic cure by artemisinin combination therapies relies on the artemisinin component and the partner drug. Polymorphisms in the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance 1 (pfmdr1) genes are associated with decreased sensitivity to amodiaquine and lumefantrine, but effects of these polymorphisms on therapeutic responses to artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) have not been clearly defined. Individual patient data from 31 clinical trials were harmonized and pooled by using standardized methods from the WorldWide Antimalarial Resistance Network. Data for more than 7,000 patients were analyzed to assess relationships between parasite polymorphisms in pfcrt and pfmdr1 and clinically relevant outcomes after treatment with AL or ASAQ. Presence of the pfmdr1 gene N86 (adjusted hazards ratio = 4.74, 95% confidence interval = 2.29 - 9.78, P < 0.001) and increased pfmdr1 copy number (adjusted hazards ratio = 6.52, 95% confidence interval = 2.36-17.97, P < 0.001 : were significant independent risk factors for recrudescence in patients treated with AL. AL and ASAQ exerted opposing selective effects on single-nucleotide polymorphisms in pfcrt and pfmdr1. Monitoring selection and responding to emerging signs of drug resistance are critical tools for preserving efficacy of artemisinin combination therapies; determination of the prevalence of at least pfcrt K76T and pfmdr1 N86Y should now be routine

Effectiveness of GenoType MTBDRsl in excluding TB drug resistance in a clinical trial

OBJECTIVES: To assess the performance of the GenoType MTBDRsl v1, a line-probe assay (LPA), to exclude baseline resistance to fluoroquinolones (FQs) and second-line injectables (SLIs) in the Standard Treatment Regimen of Anti-tuberculosis Drugs for Patients With MDR-TB 1 (STREAM 1) trial. METHODS: Direct sputum MTBDRsl results in the site laboratories were compared to indirect phenotypic drug susceptibility testing (pDST) results in the central laboratory, with DNA sequencing as a reference standard. RESULTS: Of 413 multidrug-resistant TB (MDR-TB) patients tested using MTBDRsl and pDST, 389 (94.2%) were FQ-susceptible and 7 (1.7%) FQ-resistant, while 17 (4.1%) had an inconclusive MTBDRsl result. For SLI, 372 (90.1%) were susceptible, 5 (1.2%) resistant and 36 (8.7%) inconclusive. There were 9 (2.3%) FQ discordant pDST/MTBDRsl results, of which 3 revealed a mutation and 5 (1.3%) SLI discordant pDST/MTBDRsl results, none of which were mutants on sequencing. Among the 17 FQ- and SLI MTBDRsl-inconclusive samples, sequencing showed 1 FQ- and zero SLI-resistant results, similar to frequencies among the conclusive MTBDRsl. The majority of inconclusive MTBDRsl results were associated with low bacillary load samples (acid-fast bacilli smear-negative or scantily positive) compared to conclusive results (P < 0.001). CONCLUSION: MTBDRsl can facilitate the rapid exclusion of FQ and SLI resistances for enrolment in clinical trials

Spatio-temporal land use/cover dynamics and its implication for sustainable land use in Wanka watershed, northwestern highlands of Ethiopia

Long-term land use and land cover (LULC) dynamics information is essential to understand the trends and make necessary land management interventions, such as in the highlands of Ethiopia. This study analyzed six decades of LULC dynamics of Wanka watershed, Northwestern Ethiopian highlands. Two sets of aerial photographs (1957 and 2017), SPOT 5 and sentinel satellite imageries were analyzed. In addition, key informant interviews, focus group discussions and field observations were used to identify the drivers and impact of LULC change. It was found that cultivated and rural settlement land (CRSL), bare land, and urban built up area have been continuously expanded at the expenses of mainly forest and shrub lands. Over the entire study period (1957–2017) while the bare land and CRSL have increased by about 59% and 20% respectively, forest and shrub lands have declined by 59% and 57% respectively. Urban built up area has also expanded. The impact of popula- tion pressure and expansion of CRSL land were considerable. The trend of LULC dynamics in the study watershed implies adverse impact on the quality and quantity of the land resource. Hence, appropriate land use planning and strategies that reduce expansion of cultivated land need to be practiced