Mother-to-child transmission of HIV and its predictors among HIV-exposed infants at a PMTCT clinic in northwest Ethiopia

BACKGROUND: Mother-to-child transmission of HIV (MTCT) accounts for more than 90% of pediatric Acquired Immunodeficiency Syndrome (AIDS) cases. Prevention of mother to child transmission (PMTCT) programs are provided for dual benefits i.e. prevention of HIV transmission from mother to child and enrolment of infected pregnant women and their families into antiretroviral treatment (ART). This study assessed risk and predictors of HIV transmission among HIV-exposed infants on follow up at a PMTCT clinic in a referral hospital. METHODS: Institution based retrospective follow up study was carried at Gondar University referral hospital PMTCT clinic. All eligible records of HIV-exposed infants enrolled between September 2005 and July 2011 were included. A midwife nurse collected data using a structured data extraction format. Data were then entered in to EPI INFO Version 3.5.1 statistical software and analyzed by SPSS version 20.0. Both bivariate and multivariate analyses were carried out to identify associations. RESULTS: A total of 509 infant records were included in the analysis. The median age of infants at enrolment to follow up was 6 weeks (inter quartile range [IQR] = 2 weeks). A total of 51(10%, 95% CI: 7.8% - 13%) infants were infected with HIV. Late enrolment to the exposed infant follow up clinic (Adjusted Odds Ratio [AOR] = 2.89, 95% CI: 1.35, 6.21), rural residence (AOR = 5.05, 95% CI: 2.34, 10.9), home delivery (AOR = 2.82, 95% CI: 1.2, 6.64), absence of maternal PMTCT interventions (AOR = 5.02, 95% CI: 2.43, 10.4) and mixed infant feeding practices (AOR = 4.18, 95% CI: 1.59, 10.99) were significantly and independently associated with maternal to child transmission of HIV in this study. CONCLUSIONS: There is a high risk of MTCT of HIV among exposed infants on follow up at the PMTCT clinic of the University of Gondar referral hospital. The findings of this study will provide valuable information for policy makers to enhance commitment and support for rural settings in the PMTCT scaling-up program

Magnitude and patterns of injuries among patients in Gondar University Hospital, northwest Ethiopia: an institutional-based study

Tadesse Awoke Ayele,1 Berihun Megabiaw Zeleke,1 Gizachew Assefa Tessema,2 Melkitu Fentie Melak3 1Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia; 2Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: The World Health Organization (WHO) estimates that injuries constitute 16% of the global burden of disease. This translates into 5.8 million injury-related deaths annually, worldwide. The aim of this study was to determine the magnitude and pattern of injury in the Gondar University Hospital (GUH) in the year 2013. Methods: A retrospective study was conducted in GUH from March to April 2013. All charts of injured patients who visited the hospital from January 1 to December 30, 2012 were included in this study. A total of 616 patients’ charts were included in this study. Data were entered and cleaned using Epi Info and exported to Stata version 11 for analysis. Binary logistic regression was used, and odds ratios with 95% confidence interval were reported. Results: During the study period, a total of 84,254 patients visited the hospital, of whom 16,611 (19.7%) were surgical cases. Injury accounted for 25% of surgical emergency cases. Patients were predominantly young males (82%). Three in five (59.4%) of the injured patients were within the age range of 15–30 years. Approximately one in three, 187 (32.2%), and one in four, 141 (24.3%), of those injured patients were students and farmers, respectively. The injury mechanism for nearly half (48.9%) of students was assault, followed by 45.2% of road traffic accidents. Intentional injuries occurred among 291 (47.24%) cases, of whom 84.5% were males. Fracture (22.9%) and head injury (17.2%) were the leading outcomes of injuries. Severe injuries accounted for ~13% of all cases. Residence, physical nature of injury and place of work were found to be significantly associated with the outcome of injury. Conclusion and recommendation: The magnitude of injury in this hospital was found to be high when compared with other similar settings. Assault and road traffic accidents were the two common mechanisms of injury. Appropriate prevention strategies should be designed and implemented against assault and road traffic accidents. Keywords: road traffic accident, surgical department, University Hospital, Ethiopi

Radiofrequency electromagnetic field exposure assessment: a pilot study on mobile phone signal strength and transmitted power levels

In many epidemiological studies mobile phone use has been used as an exposure proxy for radiofrequency electromagnetic field (RF-EMF) exposure. However, RF-EMF exposure assessment from mobile phone use is prone to measurement errors limiting epidemiological research. An often-overlooked aspect is received signal strength levels from base stations and its correlation with mobile phone transmit (Tx) power. The Qualipoc android phone is a tool that provides information on both signal strength and Tx power. The phone produces simultaneous measurements of Received Signal Strength Indicator (RSSI), Reference Signal Received Power (RSRP), Received Signal Code Power (RSCP), and Tx power on the 3G and 4G networks. Measurements taken in the greater Melbourne area found a wide range of signal strength levels. The correlations between multiple signal strength indicators and Tx power were assessed with strong negative correlations found for 3G and 4G data technologies (3G RSSI −0.93, RSCP −0.93; 4G RSSI −0.85, RSRP −0.87). Variations in Tx power over categorical levels of signal strength were quantified and showed large increases in Tx power as signal level decreased. Future epidemiological studies should control for signal strength or factors influencing signal strength to reduce RF-EMF exposure measurement error

Radiofrequency Electromagnetic Radiation and Memory Performance: Sources of Uncertainty in Epidemiological Cohort Studies

Uncertainty in experimental studies of exposure to radiation from mobile phones has in the past only been framed within the context of statistical variability. It is now becoming more apparent to researchers that epistemic or reducible uncertainties can also affect the total error in results. These uncertainties are derived from a wide range of sources including human error, such as data transcription, model structure, measurement and linguistic errors in communication. The issue of epistemic uncertainty is reviewed and interpreted in the context of the MoRPhEUS, ExPOSURE and HERMES cohort studies which investigate the effect of radiofrequency electromagnetic radiation from mobile phones on memory performance. Research into this field has found inconsistent results due to limitations from a range of epistemic sources. Potential analytic approaches are suggested based on quantification of epistemic error using Monte Carlo simulation. It is recommended that future studies investigating the relationship between radiofrequency electromagnetic radiation and memory performance pay more attention to treatment of epistemic uncertainties as well as further research into improving exposure assessment. Use of directed acyclic graphs is also encouraged to display the assumed covariate relationship

Markers of Cardiovascular Disease among Adults Exposed to Smoke from the Hazelwood Coal Mine Fire

Little research has examined the effects of high concentration, medium-duration smoke exposure on cardiovascular health. We investigated whether six weeks of exposure to smoke from the 2014 Hazelwood coal mine fire in Victoria (Australia), was associated with long-term clinical or subclinical cardiovascular disease approximately four years later, in adult residents of the towns of Morwell (exposed, n = 336) and Sale (unexposed, n = 162). The primary outcome was serum high sensitivity (hs) C-reactive protein (CRP). Blood pressure, electrocardiogram, flow mediated dilatation and serum levels of hs-troponin, N-terminal pro B-type natriuretic peptide and lipids were secondary outcomes. There was no significant difference in weighted median hsCRP levels between exposed and unexposed participants (1.9 mg/L vs. 1.6 mg/L, p = 0.273). Other outcomes were comparable between the groups. hsCRP was associated in a predictable manner with current smoking, obesity and use of lipid-lowering therapy. Four years after a 6-week coal mine fire, this study found no association between smoke exposure and markers of clinical or subclinical cardiovascular disease in exposed adults