Association of fruit and vegetable intake with predicted 10-year cardiovascular disease risk among hypertensive patients in Addis Ababa, Ethiopia: a cross-sectional study

OBJECTIVE

In low-income countries, such as Ethiopia, few studies have evaluated the risk of cardiovascular disease (CVD) among hypertensive patients. We assessed the 10-year CVD risk of hypertensive patients.

DESIGN

This cross-sectional study was part of a larger survey conducted in Addis Ababa. The 10-year CVD risk was calculated using the Framingham Risk Score (FRS) algorithm based on seven sex-specific risk factors as well as a country-specific Globorisk score. Fruits and vegetables (FV) consumption, salt intake and stress levels were measured with 24-hour dietary recall, INTERSALT equation and Cohen's Perceived Stress Scale, respectively. A multiple linear regression model was fitted to explore the association.

SETTING

Addis Ababa, Ethiopia, 2021.

PARTICIPANTS

A sample of 191 patients diagnosed with hypertension.

OUTCOME MEASURES

Predicted 10-year cardiovascular risk of hypertensive patients.

RESULTS

A total of 42.4%, 27.7% and 29.8% of hypertensive patients were at low, moderate and high CVD risks, respectively. The majority (80.1%) of patients consumed inadequate FV, 95.7% consumed salt >5 g/day and 58.1% had moderate to high-stress levels. There was a substantial agreement between the FRS and Globorisk prediction models (weighted kappa 0.77). In the unadjusted model, FV consumption (>450 g/day) and total fruit intake in the highest tertile were associated with 14.2% and 6.7% lower CVD risk, respectively. After adjusting for lifestyle factors, increasing FV intake from 120 to 450 g/day was significantly related to 11.1%-15.2% lower CVD risk in a dose-response manner. Additionally, total fruit, but not total vegetable intake in the highest tertile, was significantly associated with decreased CVD risk.

CONCLUSION

We found a high prevalence of CVD risk among hypertensive patients. High FV consumption was inversely associated with CVD risk. This suggests that patients should be advised to increase FV intake to minimise CVD risk.

Prevalence of Dyslipidemia among School-Age Children and Adolescents in Addis Ababa, Ethiopia

Objective Lipid abnormalities during childhood might be associated with a higher risk of atherosclerosis development in adulthood. In Ethiopia, there were no data on this area. The present work was aimed at assessing the lipid profile abnormalities among children and adolescents aged between 5 and 17 years, in Addis Ababa, Ethiopia.

Materials and Methods The present school-based cross-sectional study was done from March 2019 to October 2019 in the capital city, Addis Ababa. A total of 504 students were randomly recruited for this study. The total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein-cholesterol levels were determined using the Cobas c501 automated chemistry analyzer. The prevalence of lipid abnormalities was described in percentages. Bivariate and multivariate analyses were performed, and data with p-value less than 0.05 was considered statistically significant.

Results Dyslipidemia in at least one of the lipid profiles was observed in 322 (63.9%) school children, whereas only one of the participants had an abnormality in all four lipid profile tests. The prevalence of total cholesterol 200 mg/dL or higher, low-density lipoprotein 130 mg/dL or higher, high-density lipoprotein less than 40 mg/dL, and triglycerides 130 mg/dL or higher was in 14 (2.8%), 16 (3.2%), 294 (58.4%), and 46 (19.1%) participants, respectively.

Conclusion In the current work, the majority of the study participants had a normal lipid profile except increased prevalence of a reduced concentration of high-density lipoprotein-cholesterol. The overall prevalence of serum lipid abnormalities was 63.9%. Serum lipid levels did not show significant differences with sex, age, fasting habits, or obesity.

Establishment of Reference Intervals for Serum Protein Electrophoresis of Apparently Healthy Adults in Addis Ababa, Ethiopia

Background

Even though several factors affect reference intervals (RIs), company-derived values are currently in use in many laboratories worldwide. However, few or no data are available regarding serum proteins RIs, especially in resource-limited countries such as Ethiopia.

Objective

To establish RIs for serum protein electrophoresis of apparently healthy adults in Addis Ababa, Ethiopia.

Methods

A cross-sectional study was conducted on a total of 297 apparently healthy adults from April to October 2019 in four selected sub-cities (Akaki, Kirkos, Arada, and Yeka) of Addis Ababa, Ethiopia. Laboratory analysis of collected samples was performed using the Capillarys 2 Flex Piercing analyzer, while statistical analysis was conducted using SPSS version 23 and Med-Calc software. The Mann–Whitney test was used to check partitions. A non-parametric method of reference range establishment was performed as per CLSI guideline EP28A3C.

Results

The established RIs were: albumin 53.83–64.59%, 52.24–63.55%; alpha-1 globulin 3.04–5.40%, 3.44–5.60%; alpha-2 globulin 8.0–12.67%, 8.44–12.87%; and beta-1 globulin 5.01–7.38%, 5.14–7.86%. Moreover, the albumin to globulin ratios were 1.16–1.8 and 1.09–1.74 for males and females, respectively. The combined RIs for beta-2 globulin and gamma globulin were 2.54–4.90% and 12.40–21.66%, respectively.

Conclusion

The established reference interval for serum protein fractions revealed gender-specific differences, except for beta-2 globulin and gamma globulin.

Beyond hemoglobin: uncovering iron deficiency and iron deficiency anemia using serum ferritin concentration among pregnant women in eastern Ethiopia: a community-based study

BACKGROUND

Although the high burden of anemia among pregnant women in low-resource settings like Ethiopia is well documented, evidence is scarce on the underlying causes using biochemical tests. Therefore, this study assessed the iron status and factors associated with iron deficiency (ID) using serum ferritin concentration among pregnant women in Haramaya district, eastern Ethiopia.

METHODS

A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. The serum ferritin (SF) concentration was measured in the National Biochemical Laboratory of Ethiopia on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer using the electro-chemiluminescence (ECL) method and standard procedures. A log-binomial regression analysis identified variables associated with iron deficiency, and defined as serum ferritin concentration < 15 μg/L (per the World Health Organization recommendation in developing countries). An adjusted risk ratio (aRR), and a 95% confidence interval (CI), were used to report associations. Finally, the p-value < 0.05 was the cut-off point for the significant association.

RESULTS

A total of 446 pregnant women with a mean age of 24.78 (+ 5.20) were included in the study. A total of 236 (52.91%; 95% CI: 48.16-57.63) had iron deficiency. The overall prevalence of anemia and iron deficiency anemia (IDA) was 45.96% (95% CI: 41.32-50.71) and 28.03% (95% CI: 21.27-32.44), respectively. The risk of iron deficiency was more likely among women with low dietary diversity (aRR = 1.36; 95% CI = 1.07-1.72) and those who skipped meals (aRR = 1.29; 95% CI = 1.05-1.57), but less among women who had antenatal care (aRR = 0.73 (95% CI = 0.61-0.88).

CONCLUSION

More than half of the pregnant women in eastern Ethiopia had iron deficiency. Improving dietary diversity, meal frequency, and prenatal follow-up is essential to improve the high burden of ID and the adverse effect on pregnant women and the fetus. Moreover, a prospective study comparing maternal and perinatal outcomes among these spectra-iron depletion, ID, and IDA-is crucial for understanding their impact on maternal and perinatal mortality and morbidity.

Comparison of Selected Clinical Chemistry Assay Results by two Analyzers: Cobas 6000 (c501) and Cobas Integra 400 Plus

BACKGROUND

Comparison of assay results is very important for having a comparable backup analyzer to provide a quality laboratory service without interruption. Even though, several factors affect assay results by different instruments, little or no data is available regarding assay results comparison between Cobas 6000 (c501) and Cobas integra 400 plus in the study area. Thus, the present study was aimed to compare assay results of two fully auto-mated clinical chemistry analyzers: Cobas 6000 (c501) and Cobas Integra 400 Plus at the National Clinical Chemistry Reference Laboratory of Ethiopian Public Health Institute, Addis Ababa, Ethiopia.

METHODS

The assay results for the 20 selected clinical chemistry parameters were obtained from 52 randomly selected samples on Cobas 6000 (c501) and Cobas integra 400 plus. Statistical analysis was done using Med-Calc software. The 2019 CLIA proposed acceptance limits for proficiency testing were used to check bias or difference obtained from correlation and regression analysis.

RESULTS

Assay results comparison revealed almost perfect data correlations among all selected clinical chemistry parameters: Albumin, ALP, ALT, Alpha-amylase (AMYL), AST, Direct bilirubin, Total bilirubin, Total cholesterol, Creatine kinase, Creatine kinase MB-subunit, Creatinine, GGT, Glucose, HDLC4, LDH, Phosphate, Total Protein, Triglycerides, Uric acid, and Urea, on both analyzers with coefficient of determination (R2) ranging from 98.9% to 99.99% and coefficient of correlation (r) ranging from 99.4% to 100%, depicting the precision and reliability of assay results, standardization, and system equivalency. Moreover, the calculated bias/difference is lower than both CLIA total allowable error and CLIA allowable error.

CONCLUSIONS

In summary, regression/correlation analysis and calculated bias or difference revealed almost equivalent data representation of both analyzers as per the CLIA standard, thus showing that both fully automated analyzers are standardized and properly calibrated to be used simultaneously and inter-changeably as the main and back up analyzers for selected clinical chemistry parameters analyzed at the clinical chemistry reference laboratory.

Sub-chronic toxicity of ethanol leaf extract of Syzygium guineense on the biochemical parameters and histopathology of liver and kidney in the rats

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Long-term use of Syzygium guineense leaf extract reduced the food intake and weight gain in rats.

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The serum level of liver and kidney enzymes of rats was increased by the treatment of high dose of Syzygium guineense leaf.

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Use of Syzygium guineense leaf extract showed hypoglycemic effect in rats.

Background

Syzygium guineense Wall. leaf is being used as a traditional medicine against hypertension and diabetes mellitus. Unlike its efficacy, the safety profile of this plant upon long-term administration has not been investigated yet. Therefore, this study investigated the sub-chronic toxicity of S. guineense leaves in rats.

Methods

Wistar albino rats, 10/sex/group were randomly assigned into four groups. Group I-III respectively received 250, 500, and 1000 mg/kg of body weight of 70 % ethanol extract ofS. guineense leaves for 90 consecutive days. Group IV (control) received distilled water. Throughout the experiment, clinical observations were carried out, food intake and weight of the rats also were measured. Finally, different biochemical parameters, organ weight, and histopathology of liver and kidneys were evaluated.

Results

Administration of 70 % ethanol extract ofS. guineense leaves decreased food intake and body weight gain of the test animals. Rats treated with 1000 mg/kg of S. guineense extract showed significantly increased serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase levels. Serum urea levels also increased in female rats treated with 500 and 1000 mg/kg body weight of S. guineense. Moreover, the blood glucose level of rats treated with 1000 mg/kg body weight was significantly decreased compared to the control group. However, the histology of the liver and kidneys were not significantly altered by any of the doses administered.

Conclusion

Administration ofS. guineense in rats at a dose of 1000 mg/kg body weight affected the food consumption, weight gain, and serum levels of liver and kidney enzymes suggesting that S. guineense intake at high doses may be toxic. Therefore, liberal consumption of S. guineense leaves should be taken curiously and cautiously.