In vivo efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria in Dembia District, northwest Ethiopia

Background: Artemether-lumefantrine (AL) has been used as a first-line treatment for uncomplicated Plasmodium falciparum malaria in Ethiopia since 2004. Antimalarial drug resistance is one of the major obstacles for malaria control and curtails the lifespan of several drugs. Thus, continued monitoring of the efficacy of AL is of great public health importance in malaria endemic areas. Objective: This study aimed to investigate the therapeutic efficacy and safety of AL for the treatment of uncomplicated P. falciparum malaria in the Dembia district, northwest Ethiopia. Methods: A prospective study was conducted from April 2015 to February 2016 at Kola Diba Health Center (KHC) in the Dembia district to determine the therapeutic efficacy and safety of AL for the treatment of uncomplicated P. falciparum monoinfection. Patients were treated with the six-dose regimen of AL over 3 days and followed up for 28 days as per the World Health Organization protocol. Results: Of the total 80 patients enrolled in the AL efficacy study, 75 patients completed the 28 days follow-up. None of the participants reported major adverse events. No early treatment failure or late clinical failure were observed during the study, but there were 6 (8.0%) late parasitological failures. The uncorrected per protocol cure rate of AL was 92.0 (95% CI: 85.7-98.3). Treatment with AL cleared parasitemia and fever in >95% of the patients by day 3. Conclusion: This study showed that AL is well tolerated and remains efficacious for treatment of uncomplicated P. falciparum malaria in northwest Ethiopia. However, the observed late parasitological failures in this study are of a concern and warrant continued monitoring of drug efficacy as per the World Health Organization recommendations

Magnitude of Helicobacter pylori among Dyspeptic patients attending at University of Gondar Hospital, Gondar, Northwest Ethiopia

Background: Helicobacter pylori (H.pylori) infection is predominantly acquired in childhood from family members. The infection can cause dypepepsia, chronic and acute gastritis and gastric cancer. Dyspepsia is the most common illness in the Ethiopian population visiting outpatient department of health facilities, and it has also been associated with H.pylori infection. The aim of this study was to assess the magnitude of H.pylori and its associated factors among dyspeptic patients who visited University of Gondar Hospital Outpatient Department.Materials and Methods: An institutional-based cross-sectional study was conducted on 354 dyspeptic patients. A systematic random sampling technique was employed to select study participants. Data were collected by using structured questionnaire via face-to-face interview. H.pylori infection was diagnosed using stool antigen test method. The data were entered into Epi info version 3.5.3 and transferred to Statistical Package for Social Sciences version 20. Both Bivariable and  multivariable binary logistic regression analyses were performed to see the effect of independent variables on the dependent variable.Result: Of the total study participants, 201(56.8%), 195(55.1%) and 182(51.4%) were married, urban residents and females, respectively. The overall magnitude of H.pylori infection was 37.6%. In bivariable logistic regression analysis, sex and marital status were significantly associated with H.pylori infection, but in multivariable logistic regression analysis only marital status was significantly associated with H.pylori infection.Conclusion: The magnitude of H.pylori infection is high indicating that it is a public health problem in the study to area. According to this study, none of the variables were significantly associated with H.pylori infection. Hence, effective preventive, control and screening strategies need to be designed to reduce the burden of the disease.Keywords: Associated factor, Dyspepsia, Helicobacter pylor

Reference intervals of routine clinical chemistry parameters among apparently healthy young adults in Amhara National Regional State, Ethiopia.

BACKGROUND:Clinical laboratory reference intervals (RIs) are essential for clinical diagnosis, treatment and therapeutic monitoring. Locally established RIs are required to correctly interpret clinical laboratory results. In Ethiopia, clinical laboratory test results are interpreted based on RIs derived from a western population. METHODS:A multicenter cross-sectional study was conducted among blood donors in Amhara National Regional State, Ethiopia from March 2016 to May 2017. A total of 1,175 apparently healthy study participants were included in the study from four blood banks in the region. All clinical chemistry parameters were analyzed using Mindray BS-200E full automated clinical chemistry analyzer. The 95% RIs were estimated using reference limits at 2.5th percentile for the lower reference limit and 97.5th percentile for the upper reference limit. Kolmogorov-Sminorv and Wilcoxon rank-sum tests were used to check data distribution normality and whether partitions were needed between variables, respectively. RESULTS:RIs established include: ALT 5.13-42.88 U/L for males and 4.3-37 U/L for females; AST 12.13-46.88 for males and 10-43.8 U/L for females; ALP 77.2-475.8 U/L for males and 89-381 U/L for females; amylase 29-309.8 U/L for males and 29-287.9 U/L for females; GGT 7-69.8 U/L for males and 6-39.1 U/L for females; total bilirubin 0.11-1.18 mg/dl for males and 0.08-0.91 mg/dl for females; creatinine 0.48-1.13 mg/dl for males and 0.47-1.09 mg/dl for females; total cholesterol 78.13-211.75 mg/dl for males and 83.6-202.7 mg/dl for females; total protein 5.7-9.7 g/dl for males and 5.6-9.47 for females; triglycerides 36-221.9 mg/dl for males and 35.3-201.5 mg/dl for females; urea 12-43 mg/dl for males and 10-38.7 mg/dl for females; and uric acid 2.7-6.9 mg/dl for males and 2.1-5.9 mg/dl for females. CONCLUSION:This study has established RIs for routine clinical chemistry parameters. These RIs are important as they support the interpretation of clinical laboratory results for medical decision making and other health-related activities

Deux fois dans le même fleuve : roman ; suivi de Un jour en mai : nouvelles / Jean-Marie Magnan

Contient une table des matièresAvec mode text

Structural integrity of the antigen is a determinant for the induction of T-helper type-1 immunity in mice by gene gun vaccines against E. coli beta-galactosidase.

The type of immune response is critical for successful protection and typically determined by pathogen-associated danger molecules. In contrast, protein antigens are usually regarded as passive target structures. Here, we provide evidence that the structure of the antigen can profoundly influence the type of response that is elicited under else identical conditions. In mice, gene gun vaccines induce predominantly Th2-biased immune reactions against most antigens. One exception is E. coli beta-galactosidase (βGal) that induces a balanced Th1/Th2 response. Because both, the delivered material (plasmid DNA-coated gold particles) as well as the procedure (biolistic delivery to the skin surface) is the same as for other antigens we hypothesized that Th1 induction could be a function of βGal protein expressed in transfected cells. To test this we examined gene gun vaccines encoding structural or functional variants of the antigen. Employing a series of gene gun vaccines encoding individual structural domains of βGal, we found that neither of them induced IgG2a antibodies. Even disruption of the homo-tetramer association of the native protein by deletion of a few N-terminal amino acids was sufficient to abrogate IgG2a production. However, enzymatically inactive βGal with only one point mutation in the catalytic center retained the ability to induce Th1 reactions. Thus, structural but not functional integrity of the antigen must be retained for Th1 induction. βGal is not a Th1 adjuvant in the classical sense because neither were βGal-transgenic ROSA26 mice particularly Th1-biased nor did co-administration of a βGal-encoding plasmid induce IgG2a against other antigens. Despite this, gene gun vaccines elicited Th1 reactions to antigens fused to the open reading frame of βGal. We interpret these findings as evidence that different skin-borne antigens may be differentially handled by the immune system and that the three-dimensional structure of an antigen is an important determinant for this

Reference intervals of routine clinical chemistry parameters among apparently healthy young adults in Amhara National Regional State, Ethiopia

<div><p>Background</p><p>Clinical laboratory reference intervals (RIs) are essential for clinical diagnosis, treatment and therapeutic monitoring. Locally established RIs are required to correctly interpret clinical laboratory results. In Ethiopia, clinical laboratory test results are interpreted based on RIs derived from a western population.</p><p>Methods</p><p>A multicenter cross-sectional study was conducted among blood donors in Amhara National Regional State, Ethiopia from March 2016 to May 2017. A total of 1,175 apparently healthy study participants were included in the study from four blood banks in the region. All clinical chemistry parameters were analyzed using Mindray BS-200E full automated clinical chemistry analyzer. The 95% RIs were estimated using reference limits at 2.5th percentile for the lower reference limit and 97.5th percentile for the upper reference limit. Kolmogorov–Sminorv and Wilcoxon rank-sum tests were used to check data distribution normality and whether partitions were needed between variables, respectively.</p><p>Results</p><p>RIs established include: ALT 5.13–42.88 U/L for males and 4.3–37 U/L for females; AST 12.13–46.88 for males and 10–43.8 U/L for females; ALP 77.2–475.8 U/L for males and 89–381 U/L for females; amylase 29–309.8 U/L for males and 29–287.9 U/L for females; GGT 7–69.8 U/L for males and 6–39.1 U/L for females; total bilirubin 0.11–1.18 mg/dl for males and 0.08–0.91 mg/dl for females; creatinine 0.48–1.13 mg/dl for males and 0.47–1.09 mg/dl for females; total cholesterol 78.13–211.75 mg/dl for males and 83.6–202.7 mg/dl for females; total protein 5.7–9.7 g/dl for males and 5.6–9.47 for females; triglycerides 36–221.9 mg/dl for males and 35.3–201.5 mg/dl for females; urea 12–43 mg/dl for males and 10–38.7 mg/dl for females; and uric acid 2.7–6.9 mg/dl for males and 2.1–5.9 mg/dl for females.</p><p>Conclusion</p><p>This study has established RIs for routine clinical chemistry parameters. These RIs are important as they support the interpretation of clinical laboratory results for medical decision making and other health-related activities.</p></div

The RIs of clinical chemistry parameters among blood donors in Amhara National Regional State, Ethiopia, 2017 (N = 1,175; Male = 644, and Female = 531).

<p>The RIs of clinical chemistry parameters among blood donors in Amhara National Regional State, Ethiopia, 2017 (N = 1,175; Male = 644, and Female = 531).</p

The 90% CI of reference limits of clinical chemistry parameters RIs among blood donors in Amhara National Regional State, Ethiopia, 2017 (N = 1,175; Male = 644 and Female = 531).

<p>The 90% CI of reference limits of clinical chemistry parameters RIs among blood donors in Amhara National Regional State, Ethiopia, 2017 (N = 1,175; Male = 644 and Female = 531).</p