Laboratory reference values of complete blood count for apparently healthy adults in Ethiopia

BACKGROUND

The objective of this study was to evaluate reference intervals for complete blood cell count parameters among apparently healthy 1,807 adults from Addis Ababa, Ethiopia.

METHODS

Blood specimens were collected from each participant using standard procedures. The collected aliquots were processed according to standard operating procedures to determine participants' complete blood counts. Non-parametric methods were employed to calculate the reference intervals and 90% confidence intervals for complete blood counts.

RESULTS

Overall the results show that reference ranges for women are lower than men. The white blood cell count, neutrophil, lymphocyte, monocyte, eosinophil, and basophil reference values appear to be lower than values reported elsewhere.

CONCLUSIONS

Our study is the first comprehensive study on reference intervals of complete blood count among apparently healthy adults in Ethiopia. Future studies that assess other hematological parameters and studies that assess reference values for African pediatric populations are warranted.

Iodine concentration in salt at household and retail shop levels in Shebe town, south west Ethiopia

OBJECTIVES

To determine the level of iodine in the salt at the retail shop and consumption levels and assess the knowledge, attitude and practice (KAP) of food caterers and shopkeepers about iodized salt and iodine deficiency disorders (IDD).

DESIGN

Cross-sectional community based.

SETTING

Retail shops and households in Shebe town-Jimma zone, southwest Oromiya region.

SUBJECTS

Thirty three shopkeepers and 299 food caterers of households in Shebe town.

RESULTS

The iodine content of household salt samples ranged, from 0-75 PPM and that of the shop samples ranged from 0.1-75 PPM. Eighty one per cent of household salt samples and 82% of shop salt samples have iodine levels below the minimum standard set by the Quality and Standard Authority of Ethiopia. Knowledge about iodized salt was fairly lower for food caterers (21%) than shopkeepers (57.6%). More (80%) of shopkeepers have favourable attitude than household food caterers (50.6%). Improper practices of food caterers related to iodized salt were found to be associated with female sex (P<0.01), Amhara ethnicity (P<0.001), Orthodox religion (P=0.008), literacy status (P=0.04) and occupation (P=0.01). Good knowledge, about iodized salt was significantly associated with favourable attitude among food caterers (P<0.001).

CONCLUSION

This study demonstrated that high proportions of residents in Shebe town were consuming inadequately iodized salt. There is a marked loss of iodine from salt by the time it reaches to consumption level in that some households were found to use salt with zero iodine content, whereas, all salt samples collected from the shops have at least some iodine. Poor awareness about iodized salt among food caterers and even in shopkeepers was also disclosed in this study. Socio-demographic factors such as ethnicity, religion, sex, lower educational level of food caterers might have an influence on poor, household practices like exposure of salt to sunlight. Information, education and communication on the importance consuming iodized salt and its proper handling in the house and regular monitoring of the salt iodine level at consumer level is essential for elimination of IDD.

Species of ticks on camels and their seasonal population dynamics in Eastern Ethiopia

A study was conducted to identify the species of ticks found on camels (Camelus dromedarius) and their seasonal population dynamics in Eastern Ethiopia. Collection and identification of the ticks were undertaken at 2-month intervals from December 1997 to August 1999. On each occasion, all the visible adult ticks were collected from one side of the body of each of the same 17 camels. The most abundant species of ticks on the camels were Rhipiephalus pulchellus (85.2%), Hyalomma dromedarii (5.9%), Amblyomma gemma (4.0%) and Amblyomma variegatum (1.8%). The average tick load per camel was higher during rainy months than during dry months. The smallest number of ticks per camel was observed during the driest month (December), whereas the highest was recorded in the wettest month (August). Any strategy intended to mitigate problems of tick infestation of camels in this area should take into account the identified tick species and their season of abundance.

Studies on seasonal dynamics of ticks of ogaden cattle and individual variation in resistance to ticks in eastern Ethiopia

In this study the dominant tick species identified were Amblyomma cohaerens 52.2%, Rhipicephaluspravus 19.3% and A. variegatum 14.6%. A. cohaerens occurred throughout the sampling period and showed a peak during March. Their number declined significantly (P < 0.01) from August to December. R. pravus occurred from July to December only and peaking in September (P < 0.01). A. variegatum occurred in low numbers throughout the study period with a marked seasonal variation (P < 0.01) and abundant numbers of ticks were observed from May to July. The other tick species identified were Boophilus decoloratus, R. bergeoni and R. evertsi evertsi. Individual variation in tick infestation level was observed among the animals (P < 0.05). Since all the animals were of the same breed, age group and were managed similarly the selection of animals with low infestation level can be a component of tick control strategy.

Epidemiological studies on gastrointestinal helminths of dromedary (Camelus dromedarius) in semi-arid lands of eastern Ethiopia

A total of 752 dromedaries were examined and 75% were found to be harbouring nematode eggs. The mean EPG was 1831 and the range was from 100 to 21,200. The prevalence rates in the four-age groups examined were 59.6% (3-7 years), 72.4% (8-12 years), 76.1% (13-17 years) and 83.9% (18-22 years). The prevalence rate for females and males were 77.6 and 64.8%, respectively and for long dry, short rainy, short dry and long rainy seasons were 66, 80, 69 and 82.6%, respectively. The mean EPG of faeces was significantly (P<0.01) higher for older animals compared to other group of younger animals (3-7 years), for females compared to males, and for rainy compared to dry season. Sixteen dromedary gastrointestinal organs were used for identification and counts of helminths. Among the adult worms identified, from the abomasum, Haemonchus longistipes had a 94% prevalence rate. From the small intestine Trichostrongylus colubriformis, Trichostrongylus probolurus, Impalaia tuberculata and Strongyloides papillosus were identified with prevalence rates of 75, 25, 63 and 20%, respectively. Moreover, cestodes such as Moniezia benedeni, Moniezia expansa, Avitellina spp. and Stilesia globipunctata with prevalence rates of 31, 13, 25 and 19%, respectively, were identified. I. tuberculata was identified for the first time in this country from a dromedary.The pathological lesions were more pronounced in higher infestations. Infestation level over approximately 1000 of H. longistipes and 15,000 in mixed infection of T. colubriformis and I. tuberculata, caused gross lesions of ulcerated and hyperaemic mucosa, and the odour of the fluid were fetid. The microscopic lesions observed were sloughing of epithelium, necrosis of glands, atrophy and loss of villi, haemorrhages and cellular infiltration mainly of eosinophiles and lymphocytes.

Studies on Cephalopina titillator, the cause of 'Sengale' in camels (Camelus dromedarius) in semi-arid areas of Somali State, Ethiopia

The overall prevalence rate of Cephalopina titillator in 778 slaughtered camels was 71.7%, 55% in males and 85% in females. The mean larval counts in infested camels were 26.7 +/- 25.9 and 34.6 +/- 30.8, for males and females, respectively. There were highly significant differences (p < 0.001) in the number of larvae in camels of different ages and sexes and also between the wet and dry seasons. The average time to pupate was 4.9 +/- 4.6 minutes, and the pupation period was 21 +/- 2.4 days. The major gross lesions observed were congestion of the pharyngeal mucosa with profuse secretions, and haemorrhage in early cases. In some cases, there were ulcer-like lesions and nodules, which contained pus. The dominant microscopic lesions were infiltration of the lamina propria by eosinophils, lymphocytes and macrophages, hyperplasia of the stratified squamous epithelium, necrotic changes in the mixed glands and desquamation of epithelial cells. A survey using questionnaires revealed that all the camel owners called the disease caused by infestation with C. titillator 'Sengale' and that 87% of them considered that infestation with these larvae results in reduced milk production and body weight. The major clinical signs of the disease were sneezing and expulsion of larvae (68%), abnormal movement of the head (45%), grooming (44%), nasal discharge (40%), poor appetite (26.7%), difficulty in breathing (18%), and sometimes bleeding from the nostrils (18%) and coughing (27%).

Effect of season on the productivity of camels (Camelus dromedarius and the prevalence of their major parasites in eastern Ethiopia

The productivity and the prevalence rates of the major parasites of camels (Camelus dromedarius) kept under traditional management conditions at Errer valley, Ethiopia were assessed for a year (October 1997-September 1998). The daily milk offtake was significantly higher (p < 0.05) during the wet season (3.12 +/- 0.03 L) than during the dry season (1.49 +/- 0.04 L). Likewise, significantly higher (p < 0.05) daily weight gains (50.68 +/- 0.54 g) were observed during the wet season than during dry season in immature camels aged 1-4 years. Trypanosoma evansi, Sarcoptes scabiei and strongyle parasites were present throughout the year, but their prevalence rates were higher during the rainy months than during the dry months. The minimum and maximum point prevalence rates for T. evansi were 5.4% and 20.6%, respectively. Similarly, the point prevalence rates for S. scabiei also varied from 4.7% during the dry season to 21.7% during the rainy months. The highest strongyle egg counts per gram of faeces and highest point prevalence rate (85.7%) were observed in October, a rainy month, whereas the lowest number of eggs per gram of faeces and the lowest point prevalence rate (61.5%) were recorded in April, a dry month.

Mastitis in lactating camels (Camelus dromedarius) in Afar Region, north-eastern Ethiopia

Quarter milk samples (n = 543) from 152 traditionally managed lactating camels (Camelus dromedarius) in Afar Region, north-eastern Ethiopia were examined to determine the prevalence of camel mastitis and identify its bacterial causes. Out of 152 camels examined, 19 (12.5%) were diagnosed as clinical mastitis cases based on clinical signs and bacteriological examinations. Of the 257 California Mastitis Test (CMT) positive quarter milk samples 162 (63.0%) yielded pathogenic bacteria. A positive correlation was observed between CMT positive results and presence of major pathogens in camel milk samples. The main mastitis pathogens isolated were Staphylococcus aureus, coagulase-negative staphylococci, Streptococcus agalactiae, S. dysgalactiae, and other species of streptococci, Pasteurella haemolytica and E. coli. Results of the present study suggest that mastitis in Afar camels is prevalent, Gram-positive cocci are the major isolates from camel milk samples and the CMT can be used as a screening test for the detection of mastitis in camels.

Studies on the respiratory disease 'sonbobe' in camels in the eastern lowlands of Ethiopia

New epidemics of respiratory disease have caused 29.6 morbidity and 6.4% mortality in camels in the Somalia region of Ethiopia. The major clinical signs observed were fever of 40-41.5 degrees C, depression, cough, loss of appetite and a watery nasal discharge that became mucopurulent at a later stage. Finally, the camel became recumbent and extended its neck straight along the ground. Some of the animals died within 8-9 days. The major post-mortem lesions were hydrothorax, adhesion of the lung to the thorax, red and grey hepatization, emphysema, hydropericardium and fibrinous pericarditis. A treatment trial indicated that oxytetracycline was more effective than a combination of penicillin and streptomycin, the results showing a significant difference (p < 0.05) between the treated and control groups. The bacteria isolated from lung, thoracic fluid and whole blood were Pasteurella haemolytica. Further studies on the epidemiology of this disease, the identification of the serotypes involved, and the demonstration of any primary viral initiating agent are recommended to allow the development of preventive methods.

Financial losses caused by ovine fasciolosis in the Ethiopian highlands

An estimate of the economic loss due to ovine fasciolosis in the Ethiopian highlands was made based on available data on mortality, weight loss, reduced reproductive efficiency and liver condemnation at slaughter. The economic effects of fasciolosis were identified and models for estimating the financial loss presented. Ovine fasciolosis losses were estimated at 48.4 million Ethiopian Birr per year of which 46.5, 48.8 and 4.7% were due to mortality, productivity (weight loss and reproductive wastage) and liver condemnation, respectively. These losses can be reduced substantially by fasciolosis control programmes that may include the use of anthelmintics, grazing management and nutritional supplementation.

Factors affecting morbidity and mortality on-farm and on-station in the Ethiopian highland sheep

Factors affecting morbidity and mortality of the Ethiopian highland sheep were studied both on-farm and on-station at Debre Berhan between 1989 and 1990. Primary causes of infectious origin resulted in high proportional morbidity (88.4% on-farm) and mortality (72.9% on-farm and 71.8% on-station) rates. Nutritional and managemental factors were also responsible for mortalities in lambs. The most frequent secondary causes of morbidity and/or mortality were ectoparasites and nasal myiasis. Health management interventions on-station were not high enough to produce performance improvements above the on-farm levels. However, the occurrence of gastrointestinal parasites significantly (P < 0.05) differed between the two management systems. The frequency of some of the major causes of morbidity and mortality such as pneumonia, fasciolasis and enteritis were significantly (P < 0.01) affected by season and age of an animal. In order to alleviate the major health constraints identified in this study, a proper health management intervention involving vaccination, strategic anthelmintic treatment and feeding management are suggested.

Causes of lamb morbidity and mortality in the Ethiopian highlands

A study was conducted to investigate causes of lamb morbidity and mortality on farms and on-station at Debre Berhan during 1989 and 1990. It showed pneumonia (bacterial and/or verminous), starvation-mismothering exposure (SME) complex, gastrointestinal parasites, enteritis, abomasal impaction and physical injuries to be important health constraints on productivity. Neonatal mortalities were 51.5% and 46.3% on farms and on-station respectively and occurred owing to management problems such as SME, abomasal impaction and physical injuries. On the farms the lamb birth weight was 2.56 +/- 0.25 kg and was significantly (p < 0.05) affected by the dam's age, lambing weight, litter size, sex of lamb and year of lambing, but not by the season of lambing. Birth weight significantly (p < 0.05) influenced lamb mortality. Lambs with a low birth weight tended to die from SME. Morbidities and mortalities due to infectious causes increased in older lambs, suggesting that infections were acquired with age when resistance was lowered owing to inadequate nutrition and poor management. Heavy loss of lambs could be overcome by such health management interventions as foster mothering, warming lambs during the cold season and vaccination with polyvalent vaccines against pasteurellosis, clostridial infection and Dictyocaulus filaria.

Repeatability of measurements of packed cell volume and egg count as indicators of endoparasite load and their relationship with sheep productivity

Monthly measurements of packed cell volume (PCV) and nematode and trematode eggs per gram (EPG) were made in Ethiopian highland sheep at Debre Berhan, Dejen, Deneba, Tulu Meko and Wereilu from June 1988 to December 1989. High frequencies of low PCV, high nematode EPG and high trematode EPG were found at Tulu Meko. Among the productivity traits examined, body condition scores and live-weights were significantly (P less than 0.05) associated with differences in PCV and nematode and trematode EPG levels at most sites. The lambing interval was, however, not significantly (P greater than 0.05) affected by these variables. Monthly repeatabilities of PCV, body weight and body condition scores were 0.44 +/- 0.01, 0.71 +/- 0.01 and 0.35 +/- 0.01, respectively, while those of nematode (0.09 +/- 0.01) and trematode EPGs (0.20 +/- 0.02) were much lower. The high repeatability for PCV indicates that it was less affected by the variable factors influencing egg output, and hence it could be utilized in conjunction with nematode and trematode EPG levels for endoparasite monitoring. Repeatability of the lambing interval across parities was 0.43 +/- 0.14.

Clinical pharmacology of intravenous enoximone: pharmacodynamics and pharmacokinetics in patients with heart failure

Twenty-one patients with heart failure (New York Heart Association [NYHA] class II to IV) received a 24-hour infusion of enoximone followed by a 12-hour washout period. Patients were randomly assigned to one of four treatment groups. Groups I to III received an 0.5 mg/kg bolus, followed by a maintenance infusion of 2.5, 5.0, or 10.0 micrograms/kg/min. Group IV patients received a maintenance infusion of 5.0 micrograms/kg/min without a loading dose. Serial assessment of hemodynamics, plasma levels of enoximone and enoximone sulfoxide, and ventricular ectopy were performed. Enoximone produced a clinically significant increase in cardiac index, and a decrease in mean pulmonary artery wedge pressure and systemic vascular resistance in all groups. Enoximone mildly increased heart rate, and had a minimal effect on mean arterial pressure. There was no statistically significant change in ventricular ectopy during the infusion. Significant hemodynamic improvement was noted at even the lowest infusion rate, and did not increase in linear fashion at higher infusion rates. In patients who did not receive an initial loading bolus of 0.5 mg/kg, the increase in cardiac index was delayed by approximately 1 hour. Plasma concentrations of both enoximone and its major metabolite continued to rise throughout the 24-hour infusion in group III (10.0 micrograms/kg/min), rather than reaching steady state as predicted by the terminal exponential half-lives of these compounds. This is suggestive of nonlinear pharmacokinetics and indicates a potential for excessive accumulation of enoximone and its metabolite during prolonged infusion. These findings may have important implications in guiding the intravenous administration of enoximone.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacodynamics of enoximone during intravenous infusion

Twenty-one patients with heart failure (NYHA class II-IV) received a 24-hour infusion of enoximone, followed by a 12-hour washout period. Patients were randomly assigned to one of four treatment groups. Groups I-III received a 0.5 mg/kg bolus, followed by a maintenance infusion of 2.5, 5.0 or 10.0 micrograms/kg/minute. Group IV patients received a maintenance infusion of 5.0 micrograms/kg/minute without the bolus. Serial assessments of haemodynamics, plasma levels of enoximone and enoximone sulphoxide, and ventricular ectopy were performed. Enoximone produced a significant increase in cardiac index (28.1-46.7%) and a decrease in mean pulmonary artery wedge pressure (6.4-35.7%) and systemic vascular resistance (34.7-78.9%). Enoximone had minimal effect on heart rate and blood pressure. In patients who did not receive an initial bolus of 0.5 mg/kg, haemodynamic changes were delayed by approximately 1 hour. Significant haemodynamic improvement was noted at even the lowest infusion rate and did not increase in linear fashion at higher infusion rates. During infusion of enoximone at 10.0 micrograms/kg/minute, both enoximone and its sulphoxide accumulated non-linearly and did not achieve a steady state. No significant adverse effects were noted in these patients. Enoximone infusion at rates greater than 5.0 micrograms/kg/minute may confer minimal additional haemodynamic benefit, while resulting in significant accumulation of enoximone and enoximone sulphoxide. Ventricular ectopy did not increase significantly in most patients.

Toxoplasmosis in sheep, goats and cattle in central Ethiopia

In a seroepidemiological survey using an indirect haemagglutination assay, the prevalence rate of toxoplasmosis in central Ethiopia was 22.9% of 899 sheep, 11.6% of 753 goats and 6.6% of 785 cattle. There were high titres of 1:256 or more which suggest current infections. These results indicate that toxoplasmosis may be an important cause of reproductive wastage in small ruminants. The public health significance of this disease is discussed. Improved hygiene and management could reduce the prevalence of the disease.

The effects of enoximone on renal function in patients with congestive heart failure

Enoximone is an investigational cardiotonic agent with positive inotropic and vasodilatory properties. In this protocol the effects of enoximone on parameters of renal function in patients (n = 14) with New York Heart Association class II or III congestive heart failure were determined after intravenous (IV) treatment (2 mg/kg) and after chronic oral administration (150 mg t.i.d.), either alone or with added furosemide (40 mg b.i.d.). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), filtration fraction, mean arterial pressure (MAP), renal blood flow (RBF), and renal vascular resistance (RVR) were determined each time. Plasma volume (PV) was determined at baseline and after oral enoximone and after oral enoximone plus furosemide. Significant reductions in GFR (18%) and ERPF (20%) were observed after IV treatment but not after oral treatment with or without furosemide. MAP also was lowered significantly by 14% after IV administration but not after oral treatments. PV after oral enoximone plus furosemide was reduced significantly (31%) compared with baseline. These results demonstrate that enoximone produces acute reductions in GFR and ERPF when given intravenously but has no effect on parameters of renal function when given orally, either alone or with furosemide.

The effect of handling methods on subsequent plasma progesterone levels in sheep

The mean progesterone concentration in the plasma of 10 adult Ethiopian Highland sheep obtained immediately after slaughter was 10.56 +/- 3.98 ng/ml. Samples were subsequently incubated at 4 degrees C, room temperature (19-22 degrees C) or 26 degrees C as either plasma or intact but citrated blood. Failure to separate plasma affected the progesterone content at 2-72 h at room temperature or 26 degrees C (p less than 0.01 - p less than 0.0001). Incubation temperature affected the plasma concentration at 18 h (p less than 0.05) and 24 h (p less than 0.001). Although progesterone values were generally higher in separated plasma, disparity with the values from plasma separated from incubated citrated blood was small (r = 0.76-0.98). Progesterone concentration declined haphazardly after collection but sometimes exceeded the initial readings. This kept the average concentration of progesterone in plasma separated immediately after collection fairly constant and within 15% of zero time samples during the first 48 h.