commerciallyThe magnitude and associated factors of ocular lesions/complications among leprosy patients treated at Boru Meda General Hospital, Ethiopia: Cross-sectional study design, 2021

BACKGROUND: Leprosy, also known as Hansen’s disease, is one of the world’s oldest diseases, and it is one of the major blinding diseases. Visual impairment in leprosy patients needs special consideration by dermatologists and ophthalmologists, not only preventable but also has a severe burden that affects productivity if not managed early. Nevertheless, little was understood about ocular complications and associated factors among leprosy patients in low income countries like Ethiopia, including the study locality. MATERIAL AND METHODS: An institution based cross-sectional study was conducted among a total of 423 leprosy patients at the dermatology clinic at Boru Meda Hospital, Dessie, Ethiopia. The collected data were entered into EpiData v3.1 and exported to the statistical package for SPSS v.20 for statistical analysis. The odds ratio (OR) and a 95% confidence interval (CI) were estimated to measure the strength of the association between dependent and independent variables. p ≤ 0.05 was used to determine the level of statistical significance. RESULT: 419 leprosy patients participated in this study, accounting for a response rate of 99%. The proportion of ocular complications was found to be 69.9% (95% CI: 65.09–73.9). Age 40 years and above [adjusted odds ratio (AOR) = 5.2, 95% CI: 3.14–8.83], presence of leprosy reaction (AOR = 1.92, 95% CI: 1.12–3.24), and leprosy disability grading [grade 1 disability (AOR = 2.9, 95% CI: 1.35–6.33), grade 2 disability (AOR = 3.0,95% CI: 1.36–7.08) ]were associated with the presence of ocular complication among leprosy patients. CONCLUSION: Our finding showed that the ocular complication/lesion magnitude was high. Age 40 and above, the presence of leprea reaction and disability were significant factors associated with developing ocular complications among leprosy patients. Our results emphasize the need for solid collaboration efforts and commitment to handling ophthalmologic complications among leprosy patients aged 40 and above with leprosy reactions and disabilities

Effectiveness of intralesional sodium stibogluconate for the treatment of localized cutaneous leishmaniasis at Boru Meda general hospital, Amhara, Ethiopia: Pragmatic trial.

BACKGROUND: Cutaneous leishmaniasis (CL) is generally caused by Leishmania aethiopica in Ethiopia, and is relatively hard to treat. Sodium stibogluconate (SSG) is the only routinely and widely available antileishmanial treatment, and can be used systemically for severe lesions and locally for smaller lesions. There is limited data on the effectiveness of intralesional (IL) SSG for localized CL in Ethiopia and therefore good data is necessary to improve our understanding of the effectiveness of the treatment. METHODOLOGY/PRINCIPAL FINDINGS: A pragmatic (before and after Quazi experimental) study was done to assess the effectiveness of intralesional SSG among localized CL patients at Boru Meda general hospital, Northeast Ethiopia. Patients who were assigned to intralesional SSG by the treating physician were eligible for this study. Study subjects were recruited between January and August 2021. Infiltration of intralesional SSG was given weekly to a maximum of six doses. However, when a patient's lesions were already cured before getting 6 doses, treatment was not conintued, and patient were only asked to come for lesion assessment. Skin slit smears (SSS) were taken each week until they became negative. Outcomes were assessed at day 90, with patients who had 100% reepithelization (for ulcerative lesions) and/or flattening (for indurated lesions) defined as cured. Multi-level logistic regression was done to assess factors associated with cure. A total of 83 patients were enrolled, and final outcomes were available for 72 (86.75%). From these 72, 43 (59.7%, 95% confidence interval 0.44-0.69) were cured at day 90. Adverse effects were common with 69/72 patients (95.8%) reporting injection site pain. Factors associated with cure were age (OR 1.07 95% CI: 1.07-1.27), being male (OR 1.79, 95% CI: 1.10-2.25), size of the lesion (OR 0.79, 95% CI: 0.078-0.94) and skin slit smear (SSS) result +1 grading (OR 1.53, 95% CI: 1.24-1.73) and +2 grading (OR 1.51, 95% CI: 1.41-3.89) compared to the SSS grade +6. CONCLUSION: Our findings revealed that intralesional sodium stibogluconate resulted in a cure rate of around 60%, with almost all patients experiencing injection site pain. This emphasizes the need for local treatment options which are more patient-friendly and have better cure rates

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Multi-level logistic regression or fixed effects on the effectiveness of IL SSG for the treatment of LCL, Boru Meda general hospital, 2021.

Multi-level logistic regression or fixed effects on the effectiveness of IL SSG for the treatment of LCL, Boru Meda general hospital, 2021.</p

IL SSG treatment outcomes among LCL patients on IL SSG treatment, Boru Meda General Hospital, 2021.

IL SSG treatment outcomes among LCL patients on IL SSG treatment, Boru Meda General Hospital, 2021.</p

Patient characteristics of LCL patients on IL SSG treatment, Boru Meda General Hospital, 2021.

Patient characteristics of LCL patients on IL SSG treatment, Boru Meda General Hospital, 2021.</p

Measurements of LCL Before and while ongoing treatment (follow ups), Boru meda general Hospital, 2021.

Table B: Lesion summary tables of missed follow-up LCL patients, Boru Meda general hospital, 2021. Table C: Missed follow-up patients’ description and clinical profiles for IL SSG treating LCL, Boru Meda general hospital, 2021. Table D: The fit and residual values of the models of effectiveness of IL SSG treating LCL, Boru meda general hospital, 2021. (DOCX)</p