Assessment of liver marker enzymes and its association with type 2 diabetes mellitus in Northwest Ethiopia

A novel predictive model for optimizing diabetes screening in older adults

INTRODUCTION

The fasting blood glucose test is widely used for diabetes screening. However, it may fail to detect early-stage diabetes characterized by elevated postprandial glucose levels. Hence, we developed and internally validated a nomogram to predict the diabetes risk in older adults with normal fasting glucose levels.

MATERIALS AND METHODS

This study enrolled 2,235 older adults, dividing them into a Training Set (n = 1,564) and a Validation Set (n = 671) based on a 7:3 ratio. We employed the least absolute shrinkage and selection operator regression to identify predictors for constructing the nomogram. Calibration and discrimination were employed to assess the nomogram's performance, while its clinical utility was evaluated through decision curve analysis.

RESULTS

Nine key variables were identified as significant factors: age, gender, body mass index, fasting blood glucose, triglycerides, alanine aminotransferase, the ratio of alanine aminotransferase to aspartate aminotransferase, blood urea nitrogen, and hemoglobin. The nomogram demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.824 in the Training Set and 0.809 in the Validation Set. Calibration curves for both sets confirmed the model's accuracy in estimating the actual diabetes risk. Decision curve analysis highlighted the model's clinical utility.

CONCLUSIONS

We provided a dynamic nomogram for identifying older adults at risk of diabetes, potentially enhancing the efficiency of diabetes screening in primary healthcare units.

Hues of risk: investigating genotoxicity and environmental impacts of azo textile dyes

The textile industry, with its extensive use of dyes and chemicals, stands out as a significant source of water pollution. Exposure to certain textile dyes, such as azo dyes and their breakdown products like aromatic amines, has been associated with health concerns like skin sensitization, allergic reactions, and even cancer in humans. Annually, the worldwide production of synthetic dyes approximates 7 × 107 tons, of which the textile industry accounts for over 10,000 tons. Inefficient dyeing procedures result in the discharge of 15-50% of azo dyes, which do not adequately bind to fibers, into wastewater. This review delves into the genotoxic impact of azo dyes, prevalent in the textile industry, on aquatic ecosystems and human health. Examining different families of textile dye which contain azo group in their structure such as Sudan I and Sudan III Sudan IV, Basic Red 51, Basic Violet 14, Disperse Yellow 7, Congo Red, Acid Red 26, and Acid Blue 113 reveals their carcinogenic potential, which may affect both industrial workers and aquatic life. Genotoxic and carcinogenic characteristics, chromosomal abnormalities, induced physiological and neurobehavioral changes, and disruptions to spermatogenesis are evident, underscoring the harmful effects of these dyes. The review calls for comprehensive investigations into the toxic profile of azo dyes, providing essential insights to safeguard the aquatic ecosystem and human well-being. The importance of effective effluent treatment systems is underscored to mitigate adverse impacts on agricultural lands, water resources, and the environment, particularly in regions heavily reliant on wastewater irrigation for food production.

The effect of celery (Apium graveolens) powder on cardiometabolic factors in overweight/obese individuals with type 2 diabetes mellitus: A pilot randomized, double-blinded, placebo-controlled clinical trial

Celery (Apium graveolens) was shown to have beneficial effects on cardiometabolic factors in animal models. As the progression of type 2 diabetes mellitus (T2DM) adversely affects cardiometabolic factors, we aimed to assess the effects of celery powder on glycemic and anthropometric indices, lipid profile, liver function, oxidative stress, and blood pressure of individuals with T2DM. In a pilot randomized, double-blinded, placebo-controlled clinical trial, 50 eligible adults with T2DM were randomly divided into two groups of intervention and control to consume either 750 mg of celery powder (obtained from fresh celery) or placebo along with a low-calorie diet for 12 weeks, respectively. Dietary intake, physical activity, and cardiometabolic factors were assessed before and at the end of the study. Thirty-six patients finished the study (18 in each group). Consumption of celery powder significantly reduced body fat percentage (p = .021). Between-group analysis for changes in cardiometabolic factors did not show significant differences. Although malondialdehyde was reduced in the intervention group and increased in the control group, between-group changes were not significant. Although the insulin-level change was statistically insignificant, a clinical improvement was observed in the intervention group. A 750-mg daily supplementation of celery powder for 12 weeks did not improve the cardiometabolic factors of patients with T2DM. Further studies are suggested.

Prevalence and determinants of early neonatal mortality in Ethiopia: findings from the Ethiopian Demographic and Health Survey 2016

BACKGROUND

Early neonatal death accounts for a significant number of under-5 mortality worldwide. However, the problem is under-researched and under-reported in low-income and middle-income countries, particularly in Ethiopia. The magnitude of mortality during the early neonatal period and associated factors should be studied for designing appropriate policies, and strategies that could help tackle the problem. Hence, this study aimed to determine the prevalence and identify factors associated with early neonatal mortality in Ethiopia.

METHODS

This study was conducted by using data from Ethiopian Demographic and Health Survey 2016. A total of 10 525 live births were enrolled in the study. A multilevel logistic regression model was used to identify determinants of early neonatal mortality. Adjusted OR (AOR) at a 95% CI was computed to assess the strength and significance of the association between outcome and explanatory variables. Factors with a p<0.05 were declared statistically significant.

RESULTS

The national prevalence of early neonatal mortality in Ethiopia was 41.8 (95% CI 38.1 to 45.8) early neonatal deaths per 1000 live births. The extreme ages of pregnancy (under 20 years (AOR 2.7, 95% CI 1.3 to 5.5) and above 35 years (AOR 2.4, 95% CI 1.5 to 4)), home delivery (AOR 2.4, 95% CI 1.3 to 4.3), low birth weight (AOR 3.3, 95% CI 1.4 to 8.2) and multiple pregnancies (AOR 5.3, 95% CI 4.1 to 9.9) were significantly associated early neonatal mortality.

CONCLUSIONS

This study revealed a higher prevalence of early neonatal mortality as compared with prevalence in other low-income and middle-income countries. Thus, it is determined to be essential to design maternal and child health policies and initiatives with a priority on the prevention of early neonatal deaths. Emphasis should be given to babies born to mothers at extreme ages of pregnancy, to those born of multiple pregnancies delivered at home and to low birthweight babies.

Nutritional status and its associated factors among elderly people in Ilu Aba Bor Zone, Southwest Ethiopia: a community-based cross-sectional study

OBJECTIVES

This study aimed to assess the nutritional status and its associated factors among elderly people.

DESIGN

A community-based cross-sectional study.

SETTING

The study was conducted in urban and semiurban areas.

PARTICIPANTS

The study included 620 elderly community dwellers in Southwest Ethiopia from 3 October 2021 to 10 November 2021. Those who were seriously ill, could not get around or were on special diets were excluded from the study.

OUTCOME MEASURE

The Mini Nutritional Assessment was used to evaluate nutritional status and the STEPwise approach was used to collect data on backgrounds and lifestyle. SPSS V.22.0 was used for data analysis. Logistic regression was computed. The level of significance was set at 0.05.

RESULTS

Elderly people who were malnourished or at risk of malnutrition were found to make up 48.1% (44.1%) and 17.4% (14.5%) of the population, respectively. Those aged 80 years and older had a chance of being at risk of malnutrition (adjusted OR (AOR)=22.555; 95% CI: 7.963 to 63.881), while the odds of being malnourished were 11.5 times higher (AOR=11.755; 95% CI: 4.825 to 28.638). Informal education was a significant predictor of being at risk of malnutrition (AOR=6.102; 95% CI: 2.684 to 13.871). Urban dwellers were 8.9 times more likely to be malnourished. Inadequate financial resources make people 3.7 times more likely to be malnourished. A lower wealth index was a significant predictor of being at risk of malnutrition (AOR=4.156; 95% CI: 1.361 to 12.692). Single elderly people had a 3.4-fold higher risk of malnutrition. Elderly people with chronic pain, who were smokers and alcoholics, and who had depression were all at risk of nutritional problems.

CONCLUSION

The risk of malnutrition and malnourishment was high. Age, urbanisation, finances, education, economics, being a woman, smoking and alcohol are associated factors. Interventional studies are warranted to minimise malnutrition challenges in the study population.

Effects of physical activity interventions on physical activity and health outcomes in young people during treatment for cancer: a systematic review and meta-analysis of randomised controlled trials

Objective

Physical activity may improve health and reduce the adverse effects of cancer and/or its treatment in young people, therefore, interventions that promote physical activity are important. This systematic review and meta-analysis aims to synthesise evidence from randomised controlled trials (RCTs) that have assessed the effectiveness of physical activity interventions on health outcomes in young people undergoing cancer treatment.

Design

Systematic review with meta-analyses.

Data sources

Embase, PubMed, Medline, PsycINFO, PsychArticles, SPORTDiscus, Scopus, Web of Science and The Cochrane Library were searched from inception to January 2022.

Eligibility criteria for selecting studies

Studies were eligible for inclusion if they were RCTs, recruited young patients with cancer receiving cancer treatment and tested an aerobic physical activity intervention. Title/abstract reports were screened against the review eligibility criteria.

Results

Searches revealed seven eligible trials that had recruited 317 participants. No differences were found in minutes per day of participation in moderate to vigorous intensity physical activity (MD 2.61, 95% CI -3.67 to 8.89, p=0.42), total physical activity (standardised mean difference, SMD 0.35, 95% CI -0.39 to 1.09, p=0.35) or fatigue (SMD -0.50, 95% CI -1.03 to 0.02, p=0.06). Sensitivity analyses where trials with a high risk of bias were excluded, revealed significant effects for total physical activity (SMD 0.87, 95% CI 0.17 to 1.57, p=0.02) and fatigue (SMD 0.74, 95% CI -1.13 to -0.35), p=0.0002).

Conclusion

Evidence regarding the effects of physical activity interventions on the health of young people undergoing treatment for cancer is limited and mixed, where results from high-quality trials showed some promise.

Early initiation of antenatal care and its associated factors among pregnant women attending antenatal care at public health centres in Bahir Dar Zuria zone, Northwest Ethiopia, 2021: a cross-sectional study

OBJECTIVES

This study aimed to assess the prevalence of, and factors associated with, early initiation of antenatal care (ANC) follow-up among pregnant women attending ANC services at Bahir Dar Zuria zone public health centres (HCs), Bahir Dar, Northwest Ethiopia.

DESIGN

An institution-based, cross-sectional study was conducted from 15 December 2020 to 1 March 2021. A systematic random sampling technique was applied to select the study participants.

SETTING

Five public HCs (Han HC, Shimbit HC, Dagmawi Minilik HC, Shumabo HC and Meshentie HC) in Bahir Dar Zuria zone.

PARTICIPANTS

Pregnant mothers who were attending their ANC service during the data collection period were enrolled in this study. A total of 592 mothers were interviewed for the study.

OUTCOME MEASURE

Early initiation of ANC services (within 16 weeks of gestation).

RESULTS

48.6% (95% CI 41.6% to 53.5%) of participants began their first ANC service before 16 weeks of gestation. Family size less than five (adjusted OR 2.0, 95% CI 1.25 to 3.25), urban residence (3.0, 1.48 to 6.17), secondary education (2.1, 1.3 to 3.6), college-level education and above (3.5, 1.8 to 6.8), primigravida (2.6, 1.65 to 4.14), planned pregnancy (3.5, 1.5 to 8.1) and knowledge about early initiation of ANC (1.7, 1.14 to 2.55) were significantly associated with early initiation of ANC.

CONCLUSION

A substantial number of participants had not received ANC services in a timely manner. Sociodemographic and obstetric characteristics of the respondents were associated with timely booking of ANC services. Dissemination of information about recommended time to initiate ANC services and efforts to improve women's educational status to increase knowledge about early initiation of ANC are needed in the region.

Trends and patterns of inequalities in using facility delivery among reproductive-age women in Bangladesh: a decomposition analysis of 2007-2017 Demographic and Health Survey data

OBJECTIVES

The prime objectives of the study were to measure the prevalence of facility delivery, assess socioeconomic inequalities and determine potential associated factors in the use of facility delivery in Bangladesh.DesignCross-sectional.

SETTING

The study involved investigation of nationally representative secondary data from the Bangladesh Demographic and Health Survey between 2007 and 2017-2018.

PARTICIPANTS

The participants of this study were 30 940 (weighted) Bangladeshi women between the ages of 15 and 49.

METHODS

Decomposition analysis and multivariable logistic regression were both used to analyse data to achieve the study objectives.

RESULTS

The prevalence of using facility delivery in Bangladesh has increased from 14.48% in 2007 to 49.26% in 2017-2018. The concentration index for facility delivery utilisation was 0.308 with respect to household wealth status (p<0.001), indicating that use of facility delivery was more concentrated among the rich group of people. Decomposition analysis also indicated that wealth quintiles (18.31%), mothers' education (8.78%), place of residence (7.75%), birth order (5.56%), partners' education (4.30%) and antenatal care (ANC) seeking (8.51%) were the major contributors to the prorich socioeconomic inequalities in the use of facility delivery. This study found that women from urban areas, were overweight, had any level of education, from wealthier families, had ANC, and whose partners had any level of education and involved in business were more likely to have facility births compared with their respective counterparts.

CONCLUSIONS

This study found a prorich inequality in the use of facility delivery in Bangladesh. The socioeconomic disparities in facility delivery must be addressed if facility delivery usage is to increase in Bangladesh.

Prevalence and risk factors of work-related contact dermatitis symptoms among healthcare cleaners during the COVID-19 pandemic in Northwest Ethiopia: a multicentre cross-sectional survey

OBJECTIVE

This study was aimed to explore the prevalence and risk factors of work-related contact dermatitis (WRCD) symptoms among cleaners working in healthcare institutions in Gondar city, Northwest Ethiopia, during the COVID-19 pandemic.

DESIGN

A multicentre cross-sectional study was conducted from September to October 2021. An interviewer-administered standardised Nordic Occupational Skin Questionnaire, V.2002 (NOSQ-2002) was used to assess WRCD. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. The association between dependent and independent variables was computed with a binary logistic regression. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05.

SETTING

The study was conducted in Gondar city healthcare institutions, Northwestern Ethiopia.

PARTICIPANTS

A total of 409 cleaners participated in this study.

OUTCOME MEASURES

The primary outcome is the prevalence of WRCD symptoms, which was measured using the NOSQ-2002.

RESULTS

The response rate was 95.6%. The majority, 302 (73.8%), of the study participants were female. The mean age (±SD) was 31 (±7.87) years old. The overall prevalence of self-reported WRCD during the last 12 months was 213 (52.1%) (95% CI (47.1% to 57.0%)). The highest symptoms reported were skin redness, 51.6% (n=110), and the most affected skin body sites were hands (hand dermatitis), 74.2% (n=158). Hand washing frequency more than 20 times per day (AOR=1.73, 95% CI (1.03 to 2.92)), personal history of eczema (AOR=1.46, 95% CI (1.01 to 2.42)) and lack of training on skin hazards (AOR=2.06, 95% CI (1.16 to 3.63)) were factors influencing the occurrence of WRCD.

CONCLUSIONS

This study revealed the prevalence of WRCD is common during the COVID-19 pandemic. Adjusting hand washing frequency per day, educating people with atopy about the avoidance of exposure to skin irritants and providing training on skin hazards were recommended to minimise the condition.

Depression, anxiety and their associated factors among patients with cancer receiving treatment at oncology units in Amhara Region, Ethiopia: a cross-sectional study

OBJECTIVE

To assess the prevalence of anxiety and depression symptoms, and their associated factors among patients with cancer receiving cancer treatment in Amhara region oncology centres in Northwest, Ethiopia.

DESIGN

Institution-based cross-sectional study was conducted.

SETTING

Three oncology units at comprehensive hospitals in the Amhara region, Ethiopia.

PARTICIPANTS

Adult patients who had a pathologically confirmed cancer diagnosis and received cancer therapy were our study participants.

MAIN OUTCOME MEASURES

The Hospital Anxiety and Depression Scale was used to assess anxiety and depression symptoms.

RESULT

A total of 392 patients with cancer participated in this study, of which 57.1% (95% CI 52.1% to 62.1%) and 60.2% (95% CI 55.2% to 65.1%) had anxiety and depression, respectively.Poor social support (adjusted OR, AOR=4.43, 95% CI (1.70 to 11.50)), poor performance status (AOR=1.97, 95% CI (1.02 to 3.79)) and increased pain severity (AOR=1.30, 95% CI (1.14 to 1.48)) were factors associated with anxiety. Furthermore, poor performance status (AOR=2.77, 95% CI: (1.42, 5.39)) and pain severity (AOR=1.25, 95% CI: (1.11 to 1.42)) were significantly associated with depression.

CONCLUSION AND RECOMMENDATION

Anxiety and depression were common among patients with cancer. Social support, performance status and pain were determinant factors of anxiety in patients with cancer. Moreover, performance status and pain were associated with depressive symptoms. Therefore, patients with low social support, poor performance status and severe pain should get special emphasis.

Risk factors for the prevalence of poor sleep quality in lecturers during COVID-19 pandemic in Ethiopia: an institution-based cross-sectional study

OBJECTIVE

This study was conducted to assess the prevalence and risk factors of poor sleep quality (SQ) among the academic staff at the University of Gondar, Northwestern Ethiopia.

DESIGN

An institution-based cross-sectional study was conducted from March to April 2021. A validated, self-administered, standardised Pittsburgh Sleep Quality Index (PSQI) was used to quantify the amount of self-reported poor SQ. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. Binary logistic regressions were computed to determine the association between variables. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05.

SETTING

The study was conducted at the University of Gondar, Northwestern Ethiopia.

PARTICIPANTS

A total of 607 lecturers participated in this study.

OUTCOME MEASURES

The primary outcome is the prevalence of poor SQ, which was measured using the PSQI.

RESULTS

Overall response rate was 95.60% (N=607). The age of the participants ranges from 21 to 70 with a mean of 32.39 (SD±6.80) years. The magnitude of poor SQ during the COVID-19 pandemic in the last month was 60.30% (95% CI (56.28% to 64.21%)). Working greater than 10 hours per day (AOR=2.19, 95% CI (1.16 to 4.27)), electronic device use before bedtime (AOR=1.53, 95% CI (1.04 to 2.27)), high-risk perception of COVID-19 infections (AOR=1.60, 95% CI (1.04 to 2.46)) and perceived job stress (AOR=2.15 (95% CI (1.50 to 3.08)) were risk factors for poor SQ.

CONCLUSION

The study revealed that the prevalence of poor SQ was high during the COVID-19 pandemic. The finding highlights the importance of optimising the working hours per day, minimising electronic device use before bedtime, promoting risk perception toward COVID-19 infection and developing workplace coping strategies for stress, which play a substantial role in minimising poor SQ.

Prevalence and predictors of mother and newborn skin-to-skin contact at birth in Papua New Guinea

OBJECTIVE

This study examined the prevalence and predictors of maternal and newborn skin-to-skin contact at birth in Papua New Guinea.

DESIGN

Data for the study was extracted from the 2016-18 Papua New Guinea Demographic and Health Survey. We included 6,044 women with birth history before the survey in the analysis. Percentages were used to summarise the prevalence of maternal and newborn skin-to-skin contact. A multivariable multilevel binary logistic regression was adopted to examine the predictors of maternal and newborn skin-to-skin contact. The results were presented using adjusted ORs (aORs), with their respective 95% confidence intervals (CIs). Statistical significance was set at p<0.05.

SETTING

The study was conducted in Papua New Guinea.

PARTICIPANT

Mothers with children under 5 years.

OUTCOME MEASURES

Mother and newborn skin-to-skin contact.

RESULTS

The prevalence of mother and newborn skin-to-skin contact was 45.2% (95% CI=42.4 to 48.0). The odds of mother and newborn skin-to-skin contact was higher among women with primary education (aOR=1.38; 95% CI=1.03 to 1.83), women with four or more antenatal care attendance (aOR=1.27; 95% CI=1.01 to 1.61), those who delivered at the health facility (aOR=1.27; 95% CI=1.01 to 1.61), and women from communities with high socioeconomic status (aOR=1.45; 95% CI=1.11 to 1.90).

CONCLUSION

The study has demonstrated that the prevalence of mother and newborn skin-to-skin contact in Papua New Guinea is low. Factors shown to be associated with mother and newborn skin-to-skin contact were maternal level of education, antenatal care attendance, health facility delivery, and community socioeconomic status. A concerted effort should be placed in improving maternal health service utilisation such as antenatal care attendance and skilled birth delivery, which subsequently lead to the practice of skin-to-skin contact. Also, women should be empowered through education as it has positive impact on their socioeconomic status and health service utilisation.

Attitudes of mothers attending public hospitals in Addis Ababa, Ethiopia, to neonatal sunlight exposure: a cross-sectional study

BACKGROUND

Sunlight exposure helps the body produce vitamin D, prevents rickets and is used for neonatal jaundice treatment. Good neonatal sunlight exposure is exposing the neonate to sunlight in the morning, 8:00 to 10:00, for 30 to 60 min. However, little is known about the practice of neonatal sunlight exposure among mothers in Ethiopia. This study aimed to assess the practices and factors associated with neonatal sunlight exposure among mothers attending public hospitals in Addis Ababa, Ethiopia.

METHODS

An institution-based cross-sectional study was conducted among 420 mothers attending public hospitals in Addis Ababa. Study participants were selected using a systematic random sampling method. The collected data were entered into Epi-data V.4.6 and exported to SPSS V.26 for analysis. Descriptive and logistic regression analyses were conducted.

RESULTS

The practice of neonatal sunlight exposure among mothers was 27.1%. Neonatal age of 16-28 days (adjusted OR (aOR) 1.99, 95% CI 1.15 to 3.44), family members of 4-6 (aOR 1.86, 95% CI 1.08 to 3.21) and ≥7 (aOR 4.43, 95% CI 1.54 to 12.78), living in compound/villa houses (aOR 2.59, 95% CI 1.26 to 5.33), complete antenatal care (ANC) follow-up (aOR 2.79, 95% CI 1.49 to 5.22), delivery at term (aOR 2.54, 95% CI 1.06 to 6.07), poor knowledge of sunlight exposure (aOR 0.40, 95% CI 0.23 to 0.71) and no fear of sunlight exposure (aOR 1.83, 95% CI 1.08 to 3.12) were factors associated with the practice of neonatal sunlight exposure.

CONCLUSION

This study revealed that 27.1% of mothers had good sunlight exposure. Advanced neonatal age, larger family, living in compound/villa houses, complete ANC visits and term delivery were associated with good practices, whereas poor knowledge and fear of sunlight exposure were associated with poor practices. Therefore, interventions focusing on these findings are required to improve the practice of neonatal sunlight exposure.

Possible Role of Extracellular Vesicles in Hepatotoxicity of Acetaminophen

We examined proteomic profiles of rat liver extracellular vesicles (EVs) shed following treatment with a sub-toxic dose (500 mg/kg) of the pain reliever drug, acetaminophen (APAP). EVs representing the entire complement of hepatic cells were isolated after perfusion of the intact liver and analyzed with LC-MS/MS. The investigation was focused on revealing the function and cellular origin of identified EVs proteins shed by different parenchymal and non-parenchymal liver cells and their possible role in an early response of this organ to a toxic environment. Comparison of EV proteomic profiles from control and APAP-treated animals revealed significant differences. Alpha-1-macroglobulin and members of the cytochrome P450 superfamily were highly abundant proteins in EVs shed by the normal liver. In contrast, proteins like aminopeptidase N, metalloreductase STEAP4, different surface antigens like CD14 and CD45, and most members of the annexin family were detected only in EVs that were shed by livers of APAP-treated animals. In EVs from treated livers, there was almost a complete disappearance of members of the cytochrome P450 superfamily and a major decrease in other enzymes involved in the detoxification of xenobiotics. Additionally, there were proteins that predominated in non-parenchymal liver cells and in the extracellular matrix, like fibronectin, receptor-type tyrosine-protein phosphatase C, and endothelial type gp91. These differences indicate that even treatment with a sub-toxic concentration of APAP initiates dramatic perturbation in the function of this vital organ.

Seroprevalence of syphilis and its predictors among pregnant women in Buno Bedele zone, southwest Ethiopia: a community-based cross-sectional study

OBJECTIVES

The study was aimed at assessing the prevalence of syphilis and associated factors among pregnant women with antenatal care follow-up.

DESIGN

A health facility-based, cross-sectional study.

SETTING

The study was conducted in 12 health facilities in Buno Bedele zone, southwest Ethiopia.

PARTICIPANTS

Randomly selected 920 pregnant women who came to health facilities in the Buno Bedele zone for antenatal care services from May to August 2021 were included in the study. Women with previously diagnosed syphilis and those on treatment were excluded from the study.

OUTCOME MEASURES

Blood samples and data on sociodemographic and other risk factors for syphilis were collected. Sera were screened for syphilis using the one-step rapid syphilis diagnostic test kit, and positive tests were retested using the rapid plasma reagin test. Data were analysed using SPSS V.22. Bivariate and multivariate logistic regression analyses were used to identify risk factors for maternal syphilis at a p value less than 0.05.

RESULTS

The prevalence of syphilis among pregnant women was found to be 1.4% (95% CI: 0.8% to 2.3%, p=0.002). Women with no formal education (adjusted OR (AOR)=3.6; 95% CI: 1.02 to 13.2, p=0.047), husbands with a history of substance use (AOR=3.3, 95% CI: 1.04 to 10.7, p=0.042), more than one antenatal care visit (AOR=3.5, 95% CI: 1.07 to 10.5, p=0.038), age at marriage under 18 years (AOR=4.3, 95% CI: 2.2 to 7.9, p=0.045) and a woman's poor knowledge of syphilis (AOR=3.3, 95% CI: 1.04 to 10.4, p=0.042) were significantly associated with syphilis.

CONCLUSION

The prevalence of maternal syphilis in this study area was found to be comparable with the national prevalence. Women's educational status, husbands' history of substance use, antenatal care, age at marriage and knowledge about syphilis were the independent predictors of syphilis. Emphasis shall be given to screening all pregnant women, education of women, lifestyle factors and avoiding early marriage.

Association of distinct γ-glutamyltransferase trajectories with incident hyperglycemia using latent class growth mixture modeling: A longitudinal cohort study of Chinese adults

AIMS

To elucidate the association between distinct latent γ-glutamyltransferase (GGT) increasing trajectories in life time and incident hyperglycemia.

METHODS

4547 subjects were followed up for 3 years (January 2016-December 2019), and data regarding fasting plasma glucose, HbA_1c, GGT, and other indices were recorded. Latent class growth mixed modeling (LCGMM) was used to analyze GGT latent trajectories.

RESULTS

A three-class quadratic model was selected as the best fit by LCGMM. Subjects were categorized into three latent classes: high-increasing (n = 98, 2.16%), low-increasing (n = 364, 8.01%), and stable (n = 4085, 89.83%) classes. Adjusted hazard ratios of hyperglycemia for the high-increasing and low-increasing classes were 1.341 (1.076-2.051) and 1.264 (1.048-1.525) when compared with stable class, respectively. Odds Ratios (ORs) of GGT slopes were confirmed in the 28-57-year age group, shaped like an "M", ranging from 1.144 (1.059, 1.237) to 2.502 (1.384-3.862). Significant differences in the associations between model-estimated GGT values and hyperglycemia incidence were observed from 28 to 51 years of age, with ORs ranging from 1.011 (1.011, 1.012) to 1.014 (1.012, 1.019).

CONCLUSIONS

Our study demonstrated that subjects in GGT increasing classes exhibited higher risks of developing hyperglycemia. A steeper GGT slope is a more effective predictor of hyperglycemia than the GGT value.

Prevalence of intestinal parasites and associated factors among food handlers in food establishments in the Lideta subcity of Addis Ababa, Ethiopia: an institution-based, cross-sectional study

OBJECTIVE

This study was conducted to assess the prevalence of intestinal parasites and the associated factors among food handlers in the Lideta subcity of Addis Ababa, Ethiopia.

DESIGN

An institution-based, cross-sectional study design was used. Stool samples were collected from food handlers and examined using direct wet mount and formalin-ether concentration techniques. Personal and establishment-related information was collected using a pretested questionnaire, with a structured observation. Multivariable binary logistic regression was used to identify factors associated with the prevalence of intestinal parasites on the basis of adjusted OR (AOR) and 95% CI and p values <0.05.

SETTING

Food establishments in the Lideta subcity of Addis Ababa, Ethiopia.

PARTICIPANTS

411 food handlers participated in the study.

OUTCOME MEASURES

The primary outcome was the prevalence of intestinal parasites, defined as the presence of one or more intestinal parasitic species in stool samples.

RESULTS

One or more intestinal parasites were detected in 171 (41.6%; 95% CI 36.6% to 46.4%) stool samples. The most common intestinal parasites were Entamoeba histolytica/dispar (12.7%), Giardia duodenalis (11.2%) and Ascaris lumbricoides (8.3%). The presence of intestinal parasites among food handlers was associated with low monthly income (AOR: 2.83, 95% CI 1.50 to 8.84), untrimmed fingernails (AOR: 4.36, 95% CI 1.98 to 11.90), no food safety training (AOR: 2.51, 95% CI 1.20 to 5.58), low level of education (AOR: 3.13, 95% CI 1.34 to 7.44), poor handwashing practice (AOR: 2.16, 95% CI 1.03 to 4.22) and lack of medical check-up (AOR: 2.31, 95% CI 1.18 to 6.95).

CONCLUSION

The prevalence of intestinal parasites among food handlers in food establishments in the Lideta subcity of Addis Ababa was high. The presence of intestinal parasites was linked to socioeconomic conditions, poor hand hygiene conditions and absence of food safety training. It is crucially important to promote handwashing practices and provide food hygiene and safety training in these settings.

Serum liver enzymes and diabetes from the Rafsanjan cohort study

BACKGROUND

We evaluated the relation between ALT, AST, GGT and ALP with diabetes in the Rafsanjan Cohort Study.

MATERIALS AND METHODS

The present study is a cross-sectional research including 9991 adults participated via sampling. We used data obtained from the Rafsanjan Cohort Study (RCS), as a part of the prospective epidemiological research studies in IrAN (PERSIAN). Elevated serum levels of ALT, AST, GGT and ALP were defined according to the reference range of the laboratory in the cohort center. Serum liver enzymes levels within the normal range were categorized into quartiles, and their relationship with diabetes was evaluated by logistic regressions.

FINDINGS

In present study, elevated serum levels of ALT, AST, GGT, and ALP were associated with increased odds of diabetes (adjusted ORs: 1.81, 95%CI 1.51-2.17; 1.75, 95%CI 1.32-2.32; 1.77, 95%CI 1.50-2.08; 1.60, 95%CI 1.35-1.90 respectively). Also, in subjects with normal levels of ALT, GGT and ALP, a dose-response increase was shown for diabetes.

CONCLUSION

Elevated levels of ALT, AST, GGT and ALP are related to a higher odds of diabetes. Also, increased levels of ALT, GGT and ALP even within normal range were independently related with the increased odds of diabetes. These results indicated the potential of elevated liver enzymes as biomarkers for the possible presence of diabetes.

Mother and newborn skin-to-skin contact in sub-Saharan Africa: prevalence and predictors

Introduction

Skin-to-skin contact is an evidence-based intervention that signifies a situation whereby a newborn is positioned directly on the mother’s abdomen or chest in order for them to have direct ventral-to-ventral skin contact. The act of skin-to-skin contact begins immediately after delivery to about 23 hours afterwards. Evidence shows that skin-to-skin contact is important in improving child health outcomes. Nevertheless, evidence on its prevalence and predictors in sub-Saharan Africa (SSA) remains sparse. The study, therefore, estimated the prevalence of skin-to-skin contact between mothers and their newborns, as well as its predictors.

Methods

Using data from the recent Demographic and Health Survey conducted between 2015 and 2020 from 17 countries in SSA, we included 131 094 women who gave birth in the last 5 years preceding the survey in the final analysis. We used percentages to summarise the prevalence of skin-to-skin contact. Multilevel logistic regression analysis was used to determine the predictors of skin-to-skin contact. Adjusted odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were used to present the results of the regression analysis.

Results

Approximately 42% (41.7 to 42.2) of mothers practiced newborn skin-skin contact. The highest prevalence was found in Benin (75.1% (74.1 to 76.0)) and the lowest prevalence in Nigeria (11.7% (11.2 to 12.1)). The likelihood of skin-to-skin contact was higher among women covered by health insurance, those who delivered in health facilities, those in the richest wealth index, women who attended 1–3 antenatal care (ANC) visits and four or more ANC visits, and those with secondary or higher education. The odds of skin-to-skin contact was low among women who delivered by caesarean section (adjusted OR=0.15; 95% CI 0.13 to 0.16).

Conclusion

Considering that less than half of the surveyed women practiced skin-to-skin contact, it is expedient for intensification of advocacy and strict supervision of the practice within the included countries. Informal educational programmes can also be rolled out through various media platforms to sensitise the public and healthcare providers on the need for skin-to-skin contact. These will help maximise the full benefits of skin-to-skin contact and expedite prospects of achieving the Sustainable Development Goal targets 3.1 and 3.2.

Protective Effects of Quercetin on Clothianidin-Induced Liver Damage in the Rat Model

Clothianidin (CTD) is a member of the neonicotinoid group of insecticides. This study was performed to determine the effect of quercetin on clothianidin-induced liver injury (CTD) in rats. Rats were randomly assigned to a normal control (saline), a CTD control-treated group (20 mg/kg) every 3 days for 21 days, and CTD + quercetin-treated groups (2.5, 5, and 10 mg/kg) for 35 days intraperitoneally. Enzyme activity, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), was measured by spectrophotometry in serum samples by an automatic biochemical analyzer using commercial kits. Total antioxidant capacity (TAC), malondialdehyde (MDA), and nitrate-nitrite were measured in homogeneous liver tissue samples of animals. A significant increase in ALT and AST enzyme activity was observed in the CTD group in comparison with that of the control groups. In the clothianidin + quercetin (10 mg/kg) group, the ALT and AST enzyme levels decreased compared to the clothianidin control group significantly (P < 0.05). The MDA value of the liver increased in the clothianidin-treated group compared to that of the control groups (P < 0.05). Decreased tissue TAC level was observed in the CTD-treated group in comparison with that of the control groups (P < 0.05). The MDA level of the liver decreased in the clothianidin + quercetin (10 mg/kg) group compared to that of the CTD control group (P < 0.05). Quercetin significantly raised the level of TAC in the liver tissue of the clothianidin + quercetin (10 mg/kg) treated group compared to that of the clothianidin control group (P < 0.05). Liver nitrate-nitrite measurement showed a significant increase in the clothianidin group compared to that of the normal control group (P < 0.05). Nitrate-nitrite level in the liver was decreased in clothianidin + quercetin (10 mg/kg) compared to that of the clothianidin control group significantly (P < 0.05). Histopathological investigation revealed that contact to the CTD induced tissue disorganization and inflammatory cell infiltration, but minor histopathological alterations in the liver tissues of rats treated with CTD and quercetin (10 mg/kg) were detected.

If we build it, will they come? Results of a quasi-experimental study assessing the impact of maternity waiting homes on facility-based childbirth and maternity care in Zambia

INTRODUCTION

Maternity waiting homes (MWHs) aim to increase access to maternity and emergency obstetric care by allowing women to stay near a health centre before delivery. An improved MWH model was developed with community input and included infrastructure, policies and linkages to health centres. We hypothesised this MWH model would increase health facility delivery among remote-living women in Zambia.

METHODS

We conducted a quasi-experimental study at 40 rural health centres (RHC) that offer basic emergency obstetric care and had no recent stockouts of oxytocin or magnesium sulfate, located within 2 hours of a referral hospital. Intervention clusters (n=20) received an improved MWH model. Control clusters (n=20) implemented standard of care. Clusters were assigned to study arm using a matched-pair randomisation procedure (n=20) or non-randomly with matching criteria (n=20). We interviewed repeated cross-sectional random samples of women in villages 10+ kilometres from their RHC. The primary outcome was facility delivery; secondary outcomes included postnatal care utilisation, counselling, services received and expenditures. Intention-to-treat analysis was conducted. Generalised estimating equations were used to estimate ORs.

RESULTS

We interviewed 2381 women at baseline (March 2016) and 2330 at endline (October 2018). The improved MWH model was associated with increased odds of facility delivery (OR 1.60 (95% CI: 1.13 to 2.27); p<0.001) and MWH utilisation (OR 2.44 (1.62 to 3.67); p<0.001). The intervention was also associated with increased odds of postnatal attendance (OR 1.55 (1.10 to 2.19); p<0.001); counselling for family planning (OR 1.48 (1.15 to 1.91); p=0.002), breast feeding (OR 1.51 (1.20 to 1.90); p<0.001), and kangaroo care (OR 1.44 (1.15, 1.79); p=0.001); and caesarean section (OR 1.71 (1.16 to 2.54); p=0.007). No differences were observed in household expenditures for delivery.

CONCLUSION

MWHs near well-equipped RHCs increased access to facility delivery, encouraged use of facilities with emergency care capacity, and improved exposure to counselling. MWHs can be useful in the effort to increase delivery at advanced facilities in areas where substantial numbers of women live remotely.

TRIAL REGISTRATION NUMBER

NCT02620436.

Prevalence of elevated liver enzymes and its relationship with type 2 diabetes mellitus in North Indian adults

Background

Non-alcoholic fatty liver disease (NAFLD) also referred as metabolic as metabolic (dysfunction) associated fatty liver disease. Type 2 diabetes mellitus (T2DM) is a major cause in progression of NAFLD and non-alcoholic steatohepatitis (NASH). The aim of the present study is to assess the activity of liver enzymes in T2DM in North Indian population.

Method

This was a cross-sectional descriptive study clinic-based study in patients with T2DM. A total of 612 participants (226 healthy controls and 386 T2DM) were recruited. Body mass index (BMI), activity of liver enzymes including alanine and aspartate aminotransferase (ALT, AST) along with alkaline phosphatase (ALP) was measured. Fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) along with total protein (TP) and albumin were also measured. Quantitative variables were expressed as mean ± SD, while qualitative variables as frequencies (%). Pearson/Spearman correlation test, unpaired t-test, Chi-squared test was used to assess the correlation, association and significant differences between study groups respectively. A P-value of < .05 was set as statistically significant. The Statistical Package for Social Sciences (SPSS) ® Statistics, version 23 (IBM SPSS Statistics, Armonk, NY) was used to for analysis of data.

Results

The study was conducted on 386 T2DM patients, and out of 386 patients, 139 (36.01%) were male (P < .000) and 247 (63.98%) were female. The mean age of the T2DM patients was 46.4 ± 13.6 years, while healthy individuals have mean age of 39.2 ± 12.0 years (P < .000). It was observed that the activity of AST in T2DM is comparable with the healthy persons (P = .060). While the level of ALT, total bilirubin and ALP in T2DM is significantly higher compared to healthy control (P < .000). On average, 62.53% of T2DM subjects and 32% of participants of healthy subjects had abnormal liver enzymes activity.

Conclusion

The present study has revealed widely co-existent derangements in liver function tests (LFTs) in the diabetic population of North India. A detailed workup in such patients may be helpful in timely diagnosis and treatment. Moreover, early detection and management of abnormal liver parameters in T2DM would help minimize liver-related morbidity and mortality.

When and how do adolescent girls in Japan become aware of premenstrual symptoms from menarche? A cross-sectional study among senior high school students

OBJECTIVE

To investigate the interval from menarche to the onset of premenstrual symptoms and its relationship with menarche age.

DESIGN

Cross-sectional school-based survey.

SETTING

Urban areas of Sendai, the largest city in northeastern Japan.

PARTICIPANTS

1422 female Japanese 10th-12th grade senior high school students participated in the survey.

MAIN OUTCOME MEASURES

The time of awareness of premenstrual symptoms, and the interval from menarche to the onset of premenstrual symptoms.

RESULTS

1290 students had menstruation and completed the whole survey. The median age at menarche was 12 years (IQR: 11-13 years). The prevalence of self-reported premenstrual symptoms was 49%. The median age at which students became aware of premenstrual symptoms was 15 years (IQR: 14-16 years). The median time from the onset of menarche to awareness of premenstrual symptoms was 2 years. This time was negatively correlated with menarche age (ρ=-0.47, p<0.001). A Cox proportional hazards regression analysis revealed that early menarche was significantly associated with a lower cumulative risk of developing premenstrual symptoms (OR: 0.73 (95% CI 0.58 to 0.91)).

CONCLUSIONS

High school students in Japan began experiencing premenstrual symptoms at around 15 years old, and within 2 years of menarche. This study suggested that social factors other than hormonal factors, such as early menarche, might be associated with the onset of premenstrual symptoms.

Experimental and molecular predictions of the adjuvanticity of snail mucin on hepatitis B vaccine in albino mice

Although aluminum-containing adjuvants are widely used in human vaccination due to their excellent safety profile, they exhibit low effectiveness with many recombinant antigens. This study investigated the adjuvanticity of snail mucin with recombinant Hepatitis B Vaccine (rHBsAg). Twenty-five (25) female mice distributed unbiasedly into 5 groups were used in the study and were administered different rHBsAg/Mucin formulation at 7 days intervals. Blood samples were collected a day following the administration for analysis. The results of liver function and body weight analysis were indications that snail mucin had no adverse effect on the mice. The treatment group (administer mucin and rHBsAg) showed significantly (P<0.05) higher mean titres of anti-HBsAg antibodies when compared with the negative controls and the positive control administered with two doses of rHBsAg after the boost doses (day 28). Furthermore, a comparable immune response to positive control administered with three doses rHBaAG was recorded. In silico prediction, studies of the protein-protein interaction of a homology modelled snail mucus protein and HBsAg gave an indication of enhanced HBV antigen-antibody interaction. Therefore, this study has shown that snail mucin possesses some adjuvant properties and enhances immune response towards rHBsAg vaccine. However, there is a need for further molecular dynamics studies to understand its mechanism of action.

Maternal depression and loss of children under the one-child family planning policy in China: a cross-sectional study of 300 000 women

OBJECTIVES

This study aims to explore the association between maternal depression and the loss of the only child under the family-planning (FP) policy.

DESIGN

Cross-sectional data from a Chinese population-based study were analysed.

SETTING

Population from 10 (5 rural and 5 urban) areas in China.

PARTICIPANTS

Around 300 000 females were included in the study. The FP group was defined as women with one or two live births. Those with no surviving child were classified into the loss-of-only-child group. The non-FP group included women who had more than two live births. Logistic regression was used to assess the relationship between major depressive disorder (MDD) and family types, after stratification and adjustment.

OUTCOME

MDD was assessed using the Composite International Diagnostic Inventory.

RESULTS

The odds of MDD are 1.42 times higher in the FP group in general (OR=1.42, 95% CI: 1.28 to 1.57), as opposed to the non-FP group. In particular, the odds of MDD are 1.36 times greater in the non-loss-of-only-child group (OR=1.36, 95% CI: 1.21 to 1.51) and 2.80 (OR=2.80, 95% CI: 0.88 to 8.94) times greater in the loss-of-only-child group, compared with the non-FP group. The associations between FP groups and MDD appeared to be stronger in the elderly population, in those who were married, less educated and those with a higher household income. The association was found progressively stronger in those who lost their only child.

CONCLUSIONS

People in the FP group, especially those who lost their only child, are more susceptible to MDD than their counterparts in the non-FP group. Mental health programmes should give special care to those who lost their only child and take existing social policies and norms, such as FP policies, into consideration.

Factors affecting anaemia among women of reproductive age in Nepal: a multilevel and spatial analysis

OBJECTIVE

The main objective of this study was to explore the factors affecting anaemia among women of reproductive age (WRA) in Nepal using spatial and multilevel epidemiological analysis.

DESIGN

This cross-sectional study analysed data from the 2016 Nepal Demographic and Health Survey. Spatial analysis was performed using ArcGIS software V.10.8 to identify the hot and cold spots of anaemia among WRA (15-49 years). Data were analysed using multilevel mixed-effect logistic regression analysis.

SETTING

Nepal.

PARTICIPANTS

A total of 6414 WRA were included in the analysis.

MAIN OUTCOME MEASURE

Anaemia defined by WHO as haemoglobin level less than 120 g/L in non-pregnant women and less than 110 g/L in pregnant women.

RESULTS

The spatial analysis showed that statistically significant hotspots of anaemia were in the southern Terai region (four districts in province 1, eight districts in province 2, one district in Bagmati province, two districts in province 5 and one district in Sudurpaschim province) of Nepal. At the individual level, women who underwent female sterilisation (adjusted OR, aOR: 3.61, 95% CI 1.10 to 11.84), with no education (aOR: 1.99, 95% CI: 1.17 to 3.39), and from middle socioeconomic class families (aOR: 1.65, 95% CI: 1.02 to 2.68) were more likely to be anaemic, whereas, older women (>35 years) (aOR: 0.51, 95% CI: 0.26 to 0.97) and those women who were using hormonal contraceptives (aOR: 0.63, 95% CI: 0.43 to 0.90) were less likely to be anaemic. At the community level, women from province 2 (aOR=2.97, 95% CI: 1.52 to 5.82) had higher odds of being anaemic.

CONCLUSION

WRA had higher odds of developing anaemia, and it varied by the geographical regions. Nutrition-specific and nutrition-sensitive interventions can be tailored based on the factors identified in this study to curb the high burden of anaemia.

A Survey of implementation status of child nutrition surveillance systems, registry systems and information systems: a scoping literature review protocol

INTRODUCTION

Child malnutrition in all forms is known globally as the leading cause of poor health. Planning and solving this challenge require sources that collect data accurately. Nutrition surveillance systems (NSS), nutrition registry systems (NRS) and nutrition information systems (NIS) collect and analyse data on nutrition status. Unfortunately, these systems only exist in a few countries. The methods that these systems use significantly differ and their effectiveness is also scarcely researched. This scoping literature review aimed to conduct a survey on NSS, NRS and NIS that collect data on children's nutrition at national and international levels, along with their attributes.

METHODS AND ANALYSIS

The methods and analyses of this scoping review follow the Arksey and O'Malley's methodology. This scoping literature review will be conducted in five stages based on this method. (1) The main research question and subquestions are identified. (2) Relevant studies are extracted. In this step, we will search electronic databases including PubMed, Scopus and ISI Web of Science. A manual search will also be performed in Google Scholar, grey literature, and the websites of organisations such as WHO, UNICEF, Centers for Disease Control and Prevention, National Health Service, International Food Policy Research Institute, Food and Agriculture Organization, Food and Nutrition Technical Assistance, United Nations World Food Programme, and United Nations System Standing Committee on Nutrition. (3) Extracted studies are separately reviewed by two reviewers based on inclusion and exclusion criteria, and eligible studies are then selected. A third reviewer resolves disagreements. (4) A checklist is developed to extract the features. Data of included systems are separately extracted and entered into a checklist by two reviewers. A third reviewer then resolves any disagreement. (5) Data are summarised and analysed and are presented in tables and figures.

DISCUSSION

This scoping literature review provides strong evidence of the status of systems that collect data on the status of child nutrition. This evidence can help select best practices which can be applied to develop future systems. It can also be a positive step towards achieving an integrated system.

Role of Caspase-1 in the Pathogenesis of Inflammatory-Associated Chronic Noncommunicable Diseases

Caspase-1 is the first and extensively studied inflammatory caspase that is activated through inflammasome assembly. Inflammasome is a cytosolic formation of multiprotein complex that aimed to start inflammatory response against infections or cellular damages. The process leads to an auto-activation of caspase-1 and consequent maturation of caspase-1 target molecules such as interleukin (IL)-1β and IL-18. Recently, the role of caspase-1 and inflammasome in inflammatory-induced noncommunicable diseases (NCDs) like obesity, diabetes mellitus (DM), cardiovascular diseases (CVDs), cancers and chronic respiratory diseases have widely studied. However, their reports are distinct and even they have reported contrasting role of caspase-1 in the development and progression of NCDs. A few studies have reported that caspase-1/inflammasome assembley has a protective role in the initiation and progression of these diseases through the activation of the noncanonical caspase-1 target substrates like gasdermin-D and regulation of immune cells. Conversely, others have revealed that caspase-1 has a direct/indirect effect in the development and progression of several NCDs. Therefore, in this review, we systematically summarized the role of caspase-1 in the development and progression of NCDs, especially in obesity, DM, CVDs and cancers.