High-risk birth, fertility intention, and unmet need in Addis Ababa

Abstract: In 1993 a survey was conducted to examine family planning knowledge, attitude and use in Addis Ababa. One of the objectives of the survey was to look at those women who were exposed to high-risk birth (HRB), their contraceptive behaviour and the unmet HRB need for family planning. About 88 % of the women were found to be exposed to at least one bio-demographic risk factor. Most of the women in the high risk category (70.6 %) were exposed to high parity, followed by old age (56.6 %) and closely spaced births (15.2 %). A substantial number of women falling in the too old and too many bio-demographic risk categories expressed a desire to stop childbearing compared to women at no risk. Women in the too frequent category of high-risk birth significantly expressed a desire to space the next birth for at least two years when compared to those women who were not at risk of close birth spacing. The unmet HRB need among married women was 60 % which is 10% higher than the conventional unmet need for family planning. Contraceptive prevalence among high-risk women was found to be 26% with 18% of them in need of a better family planning method. [Ethiop. J. Health Dev. 1998;12(2):103-109

Unmet need and the demand for family planning in Addis Ababa

Abstract: A study was conducted in 1993 to estimate the unmet need for family planning service in Addis Ababa. The city was categorized for the purpose of the study, based on population density. Five kebeles were selected from each category and one hundred households from each kebele and a total of seven hundred fifty women were included. Among the interviewed, the total unmet need was 49% (368), of which 43.7% (328) want to limit and 5.3% (40) want to space. The prevalence of contraceptive use (met need) was 21.6% (162), indicating a great deal of potential users and the need for appropriate method to reach them. It was found that age, knowledge about contraception and level of education of respondents were the most important factors affecting unmet need and there was no significant interactive effect. [Ethiop. J. Health Dev. 1995;9(1):41-45

Estimation of child mortality in Addis Ababa

Abstract: Estimation of mortality level in children below the age of five may have profound impact on a number of demographic parameters. Childhood mortality data are also useful in assessing the impact of child survival programs and identifying child populations that are at risk. In March 1993 a survey was conducted to assess the child mortality rate in Addis Ababa. In the study a sample of 548 ever married women were interviewed regarding the number of children ever born, surviving and dead. A variant of the original Brass estimation procedure (Trussell's method) which is based on data classified by duration of marriage is applied. Accordingly, the under-five mortality rate (q5) is estimated to be 114 per 1000. The results, therefore, suggested that under five mortality rate remains high in Addis Ababa. Integrated maternal and child health intervention programmes have to be strengthened in order to reduce this high level of child mortality rate.[Ethiop. J. Health Dev. 1995;9(3):140-145

Assessment of unmet needs and the demand for family planning in Addis Ababa

A study was conducted to asses Unmet needs for FP in Addis Ababa. The city was categorized, for the Purpose of the study, in to two: inner which is densely Populated and periphery which is relatively sparsely Populated. Five kebeles from each category and hundred households from each kebele were selected randomly. A pretested questionnaire was administered through female enumerators, trained for this purpose. Among the interviewed (1(KX) women) the total number with unmet needs were 56.9% (559 women) of which 52.3% (523 women) Want to limit and 4.6% (46 women) Want to space their birth. The unmet need for limiting is higher at older age than at younger; in the case of spacing it is the vise versa. Unmet need was higher among the illiterate than among those with elementary, high school education and above. More than half of the women (56.9% ) were with Unmet needs, while the proportion of women who are currently using any type of contraceptive (CP) method was found to be 21.6%. This means that if the unmet need was to be satisfied, the prevalence may rise up to 78% -the total demand for family planning. A logistic and log linear analysis (using GLIM and SPSS/PC) was done in order to control confounders. And it was found that age, knowledge about CP and level of' education are the most important factors affecting Unmet need for FP and there was no significant interactive effect

Imaging receptor for advanced glycation end product expression in mouse model of hind limb ischemia

Background: The purpose of this study is to image the effect of diabetes on expression of receptor for advanced glycation endproducts (RAGE) in limb ischemia in live animals. Methods: Male wild-type C57BL/6 mice were either made diabetic or left as control. Two months later, diabetic and non-diabetic mice underwent left femoral artery ligation. The right leg served as lesion control. Five days later, mice were injected with 15.1 ± 4.4 MBq 99mTc-anti-RAGE F(ab’)2 and 4 to 5 h later (blood pool clearance) underwent SPECT/CT imaging. At the completion of imaging, mice were euthanized, hind limbs counted and sectioned, and scans reconstructed. Regions of interest were drawn on serial transverse sections comprising the hind limbs and activity in millicuries summed and divided by the injected dose (ID). Quantitative histology was performed for RAGE staining and angiogenesis. Results: Uptake of 99mTc-anti-RAGE F(ab')2 as %ID × 10−3 was higher in the left (ischemic) limbs for the diabetic mice (n = 8) compared to non-diabetic mice (n = 8) (1.20 ± 0.44% vs. 0.49 ± 0.40%; P = 0.0007) and corresponded to less angiogenesis in the diabetic mice. Uptake was also higher in the right limbs of diabetic compared to non-diabetic animals (0.82 ± 0.33% vs. 0.40 ± 0.14%; P = 0.0004). Conclusions: These data show the feasibility of imaging and quantifying the effect of diabetes on RAGE expression in limb ischemia

Imaging VEGF receptor expression to identify accelerated atherosclerosis

Background: The biology of the vulnerable plaque includes increased inflammation and rapid growth of vasa vasorum, processes that are associated with enhanced vascular endothelial growth factor (VEGF)/ imaging receptors for VEGF (VEGFR) signaling and are accelerated in diabetes. This study was designed to test the hypothesis that VEGFRs in atherosclerotic plaques with a SPECT tracer scVEGF-PEG-DOTA/99mTc (scV/Tc) can identify accelerated atherosclerosis in diabetes. Methods: Male apolipoprotein E null (ApoE−/−) mice (6 weeks of age) were made diabetic (n = 10) or left as non-diabetic (n = 13). At 26 to 28 weeks of age, 5 non-diabetic mice were injected with functionally inactivated scV/Tc (in-scV/Tc) that does not bind to VEGF receptors, while 8 non-diabetic and 10 diabetic mice were injected with scV/Tc. After blood pool clearance, at 3 to 4 h post-injection, mice were injected with CT contrast agent and underwent SPECT/CT imaging. From the scans, regions of interest (ROI) were drawn on serial transverse sections comprising the proximal aorta and the percentage of injected dose (%ID) in ROIs was calculated. At the completion of imaging, mice were euthanized, proximal aorta explanted for gamma well counting to determine the percentage of injected dose per gram (%ID/g) uptake and immunohistochemical characterization. Results: The uptake of scV/Tc in the proximal aorta, calculated from SPECT/CT co-registered scans as %ID, was significantly higher in the diabetic mice (0.036  ± 0.017%ID) compared to non-diabetic mice (0.017  ± 0.005%ID; P  < 0.01), as was uptake measured as %ID/g in harvested aorta, 1.81  ± 0.50%ID/g in the diabetic group vs. 0.98  ± 0.25%ID/g in the non-diabetic group (P  < 0.01). The nonspecific uptake of in-scV/Tc in proximal aorta was significantly lower than the uptake of functionally active scV/Tc. Immunostaining of the atherosclerotic lesions showed higher expression of VEGFR-1 and VEGFR-2 in the diabetic mice. Conclusion: These initial results suggest that imaging VEGFR with scV/Tc shows promise as a non-invasive approach to identify accelerated atherosclerosis

Imaging the effect of receptor for advanced glycation endproducts on angiogenic response to hindlimb ischemia in diabetes

Receptor for advanced glycation endproducts (RAGE) expression contributes to the impaired angiogenic response to limb ischemia in diabetes. The aim of this study was to detect the effect of increased expression of RAGE on the angiogenic response to limb ischemia in diabetes by targeting αvβ3 integrin with 99mTc-labeled Arg-Gly-Asp (RGD). Male wild-type (WT) C57BL/6 mice were either made diabetic or left as control for 2 months when they underwent femoral artery ligation. Four groups were studied at days 3 to 7 after ligation: WT without diabetes (NDM) (n = 14), WT with diabetes (DM) (n = 14), RAGE-/- NDM (n = 16), and RAGE-/- DM (n = 14). Mice were injected with 99mTc-HYNIC-RGD and imaged. Count ratios for ischemic/non-ischemic limbs were measured. Muscle was stained for RAGE, αvβ3, and lectins. There was no difference in count ratio between RAGE-/- and WT NDM groups. Mean count ratio was lower for WT DM (1.38 ± 0.26) vs. WT NDM (1.91 ± 0.34) (P<0.001). Mean count ratio was lower for the RAGE-/- DM group than for RAGE-/- NDM group (1.75 ± 0.22 vs. 2.02 ± 0.29) (P<0.001) and higher than for the WT DM group (P<0.001). Immunohistopathology supported the scan findings. In vivo imaging of αvβ3 integrin can detect the effect of RAGE on the angiogenic response to limb ischemia in diabetes

Imaging RAGE expression in atherosclerotic plaques in hyperlipidemic pigs

Background: Receptor for advanced glycated end product (RAGE) expression is a prominent feature of atherosclerosis. We have previously shown in apoE null mice uptake of a radiolabeled anti-RAGE antibody in atherosclerotic plaque and now evaluate RAGE-directed imaging to identify advanced plaques in a large animal model. Methods: Nine hyperlipidemic (HL) pigs were injected with 603.1 ± 129.5 MBq of 99mTc-anti-RAGE F(ab′)2, and after 6 h (blood pool clearance), they underwent single-photon emission computed tomography/computed tomography (SPECT/CT) imaging of the neck, thorax, and hind limbs. Two HL pigs received 99mTc non-immune IgG F(ab′)2, and three farm pigs were injected with 99mTc-anti-RAGE F(ab′)2. After imaging, the pigs were euthanized. The aorta from the root to bifurcation was dissected, and the innominates, proximal carotids, and coronaries were dissected and counted, stained for H&E and RAGE, and AHA-classified. Results: On pathology, 24% of the arterial segments showed AHA class III or IV lesions, and these lesions were confined almost exclusively to coronaries and carotids with % stenosis from 15% to 65%. Scatter plots of %ID/g for class III/IV vs. I/II lesions showed almost complete separation. Focal vascular uptake of tracer visualized on SPECT scans corresponded to class III/IV lesions in the coronary and carotid vessels. In addition, uptake in the hind limbs was noted in the HL pigs and corresponded to RAGE staining of small arteries in the muscle sections. Correlations for the vascular lesions were r = 0.747, P = 0.001 for %ID vs. %ID/g and r = 0.83, P = 0.002 for %ID/g vs. % RAGE staining. Conclusions: Uptake of radiolabeled anti-RAGE antibody in coronary and carotid fibroatheroma and in the small arteries of the hind limbs in a relevant large animal model of atherosclerosis supports the important role of RAGE in atherosclerosis and peripheral artery disease as a target for imaging and treatment

Blocking RAGE expression after injury reduces inflammation in mouse model of acute lung injury

Abstract Background Receptor for Advanced Glycated Endproducts (RAGE) plays a major role in the inflammatory response to infectious and toxin induced acute lung injury. We tested the hypothesis that a RAGE blocking antibody when administered after the onset of injury can reduce lung inflammation compared to control antibody. Methods Male and female C57BL/6 (WT) mice were used. Forty-six received lipopolysaccharide (LPS) and 26 PBS by nasal instillation on day one, repeated on day three. On day 2, 36 mice receiving LPS were divided into two groups of 18, one treated with 200 μg of non-immune isotype control IgG and the second group treated with 200 μg of anti-RAGE Ab, each dose divided between IV and IP. Ten of the 46 were not treated. On day 4, before euthanasia, mice were injected with fluorescein isothiocyanate (FITC) labelled albumen. BALF and serum samples were collected as well as lung tissue for immunohistochemistry (IHC). BALF was analyzed for cell (leukocyte) counts, for FITC BALF/serum ratios indicating pulmonary vascular leak, and for cytokines/chemokines using bead based multiplex assays. Quantitative IHC was performed for MPO and RAGE. Results Ten LPS mice showed minimal inflammation by all measures indicating poor delivery of LPS and were excluded from analysis leaving n = 11 in the LPS + IgG group and n = 12 in the LPS + anti-RAGE group. BALF cell counts were low in the PBS administered mice (4.9 ± 2.1 × 105/ml) and high in the LPS injured untreated mice (109 ± 34) and in the LPS + IgG mice (91 ± 54) while in comparison, LPS + anti-RAGE ab mice counts were significantly lower (51.3 ± 18 vs. LPS + IgG, P = 0.03). The BALF/serum FITC ratios were lower for the LPS + anti-RAGE mice than for the LPS + IgG mice indicating less capillary leakiness. Quantitative IHC RAGE staining was lower in the LPS + anti-RAGE ab mice than in the LPS + IgG treated mice (P = 0.02). Conclusions These results describe a four-day LPS protocol to sustain lung injury and allow for treatment and suggests that treatment aimed at blocking RAGE when given after onset of injury can reduce lung inflammation