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Yang Y, Gao L, Shen F, Miao J, Liu H. A cross-sectional analysis of the relationship between ischemic stroke and uric acid in young people in highland areas. Front Endocrinol (Lausanne) 2024; 14:1325629. [PMID: 38274224 PMCID: PMC10808705 DOI: 10.3389/fendo.2023.1325629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024] Open
Abstract
Objective To investigate the relationship between serum uric acid (SUA) levels and ischemic stroke in young patients in the Ganzi Tibetan plateau area. Methods A cross-sectional survey was undertaken from January 2020 to June 2023 involving young patients (age: 15-45 years) diagnosed with ischemic stroke. The survey was conducted at the Department of Internal Medicine of the People's Hospital of Derong County, Ganzi Prefecture. The participants underwent a comprehensive assessment, including questionnaire surveys, physical examinations, laboratory tests, and head computed tomography (CT) examinations. Based on the tertiles of serum uric acid (SUA) levels, the patients were stratified into three groups. Furthermore, stroke severity was classified into mild (1-4 points), moderate (5-15 points), and severe (>15 points) categories using the National Institute of Health Stroke Scale. Results The severe stroke group exhibited higher levels of age, glucose, systolic blood pressure, serum triglyceride, low-density lipoprotein cholesterol, and serum uric acid (SUA) compared to the mild stroke group (P < 0.05). Furthermore, the likelihood of male sex, advanced age, smoking, and a family history of stroke, diabetes mellitus, and heart disease were significantly elevated in the severe stroke group compared to the moderate stroke group (P < 0.05). Multivariate logistic regression analysis conducted on young adults residing in highland areas revealed a significant association between SUA levels and the risk of stroke. Conclusion Elevated SUA levels serve as a distinct risk factor for the development of a major stroke in young patients in highland areas. At SUA levels of 320.56 mol/L, the risk of a moderate-to-severe stroke is noticeably elevated.
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Affiliation(s)
- Yifan Yang
- Department of Neurology, the Affiliated Hospital of Southwest Jiaotong University & The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
| | | | | | | | - Hua Liu
- Department of Neurology, the Affiliated Hospital of Southwest Jiaotong University & The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
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Ha TV, Nguyen AMT, Nguyen HST. Self-medication practices among Vietnamese residents in highland provinces. J Multidiscip Healthc 2019; 12:493-502. [PMID: 31456640 PMCID: PMC6620316 DOI: 10.2147/jmdh.s211420] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 05/16/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Monitoring self-medication practice, which refers to individuals using medicine without instructions of physicians, is critical to control its harmful effects. However, in Vietnam, evidence about self-medication among individuals in highland areas is constrained. This study examined self-medication practice among residents living in highland areas in Vietnam and determined associated factors. Materials and methods: A cross-sectional study was performed in five highland provinces with 1000 individuals. Information about individual and household's socioeconomic status and self-medication practice in the last 12 months was surveyed. Multivariate logistic and Poisson regressions were used to identify associated factors with self-medication. Results: 83.3% reported self-medication in the last 12 months, with the mean times of self-medication being 4.5 times (SD=4.1). Female (OR=0.62, p<0.01), ethnic minorities, higher number of members having health insurance in family (OR=0.82, p<0.01) and higher annual household income (OR=0.78, p<0.05) were associated with the lower likelihood of "Only buy medicines at pharmacy stores when having illness in the last 12 month". Moreover, people who were females (OR=0.59, p<0.05), white-collar worker (OR=0.25, p<0.01) and had higher number of children in the family (OR=0.68, p<0.05) were less likely to practice self-medication. People who were ethnic minorities, white-collar worker (Coef.=-0.32, p<0.01) and higher number of members having health insurance in family had lower times of self-medication in the last 12 months compared to other groups. Meanwhile, individuals having higher number of members in the family (Coef.=0.07, p<0.01) and higher annual household income (Coef.=0.08, p<0.01) had highertimes of self-medication in the last 12 months. Conclusion: Residents in highland areas in Vietnam had a considerably high 12-month prevalence of self-medication. Medical products quality management and self-medication guideline are potential to maximize the effects of self-medication. Moreover, promoting the use of health insurance should also be concerned as a solution to address this issue.
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Affiliation(s)
- Thuy Van Ha
- Department of Health Insurance, Ministry of Health of Vietnam, Hanoi 100000, Vietnam
| | - An Mai Thi Nguyen
- Department of Planning and Financing, Ministry of Health of Vietnam, Hanoi 100000, Vietnam
| | - Ha Song Thi Nguyen
- Department of Pharmacoeconomics and Management, Hanoi University of Pharmacy, Hanoi 100000, Vietnam
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Cividini A, Simčič M, Stibilj V, Vidrih M, Potočnik K. Changes in fatty acid profile of Bovec sheep milk due to different pasture altitude. Animal 2019; 13:1111-8. [PMID: 30309404 DOI: 10.1017/S1751731118002598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Sheep rearing on mountain pastures is an ancestral tradition in northwestern Slovenia. The indigenous Bovec sheep are widespread there and are well adapted to the rough Alpine rearing conditions. Every year, after weaning, the sheep start grazing in the lowlands (L) and then gradually move to mountain pastures, and finally, to the highland (H) pastures of the Alps. Grazing positively affects the fatty acid (FA) composition in sheep milk fat with increased availability of polyunsaturated FA (PUFA) in grass, and subsequently, in milk. Consequently, the objective of this work was to study the FA profile in sheep milk during grazing in four geographical areas in the Alps. A total of 15 ewes of the Bovec sheep breed were randomly selected and milk samples from these ewes were taken at four different pasture locations that differed with regard to altitude: the L pasture location at an altitude of 480 m, the mountain pastures (M1 and M2) at altitudes of 1100 to 1300 m and 1600 to 1900 m, respectively, and the H pastures at altitudes of 2100 to 2200 m. Milk samples from the ewes were taken during the grazing season from April to September. The chemical and FA composition of the milk samples from each pasture location were determined. There were significant differences in the concentrations of FA among the L, M1, M2 and H milk samples. We observed decreases of the concentrations of saturated FA (SFA) in milk from L to H pastures. The concentration of α-linolenic FA, monounsaturated FA (MUFA), PUFA and n-3 PUFA in milk were increased significantly with pasture altitude. The n-6/n-3 PUFA ratio was reduced by the change of pasture altitude with the lowest value at the M1 pasture (1.5). The concentrations of total SFA decreased significantly and was lowest at the L pasture. Our results underline the importance of the effect of grazing in the Alpine region associated with pasture altitude on the FA profile of sheep milk. The first variation in FA concentration in sheep milk occurred between L and M1, although it was more evident on H pastures in the Alpine mountains. Changes of the FA profile in sheep milk due to pasture altitude were related to variation in FA concentration in the pasture and the botanical composition of the pasture location.
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Wanjala CL, Kweka EJ. Impact of Highland Topography Changes on Exposure to Malaria Vectors and Immunity in Western Kenya. Front Public Health 2016; 4:227. [PMID: 27790610 PMCID: PMC5063849 DOI: 10.3389/fpubh.2016.00227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 09/29/2016] [Indexed: 11/13/2022] Open
Abstract
Background It is almost an axiom that in the African highlands (above 1,500 m) transmission of Plasmodium falciparum is limited primarily by low ambient temperature and that small changes in temperature could result in temporary favorable conditions for unstable transmission within populations that have acquired little functional immunity. The pattern of malaria transmission in the highland plateau ecosystems is less distinct due to the flat topography and diffuse hydrology resulting from numerous streams. The non-homogeneous distribution of larval breeding habitats in east African highlands obviously affects Anopheles spatial distribution which, consequently, leads to heterogeneous human exposure to malaria. Another delicate parameter in the fragile transmission risk of malaria in the highlands is the rapid loss of primary forest due to subsistence agriculture. The implication of this change in land cover on malaria transmission is that deforestation can lead to changes in microclimate of both adult and larval habitats hence increase larvae survival, population density, and gametocytes development in adult mosquitoes. Deforestation has been documented to enhancing vectorial capacity of Anopheles gambiae by nearly 100% compared to forested areas. Method The study was conducted in five different ecosystems in the western Kenya highlands, two U-shaped valleys (Iguhu, Emutete), two V-shaped valleys (Marani, Fort Ternan), and one plateau (Shikondi) for 16 months among 6- to 15-year-old children. Exposure to malaria was tested using circumsporozoite protein (CSP) and merozoite surface protein immunochromatographic antibody tests. Malaria parasite was examined using different tools, which include microscopy based on blood smears, rapid diagnostic test based on HRP 2 proteins, and serology based on human immune response to parasite and vector antigens have been also examined in the highlands in comparison with different topographical systems of western Kenya. Results The results suggested that changes in the topography had implication on transmission in highlands of western Kenya and appropriate diagnosis, treatment, and control tool needed to be considered accordingly. Both plateau and U-shaped valley found to have higher parasite density than V-shaped valley. People in V-valley were less immune than in plateau and U-valley residents. Conclusion Topography diversity in western Kenya highlands has a significant impact on exposure rates of human to malaria vectors and parasite. The residents of V-shaped valleys are at risk of having explosive malaria outbreaks during hyper-transmission periods due to low exposure to malaria parasite; hence, they have low immune response to malaria, while the U-shaped valleys have stable malaria transmission, therefore, the human population has developed immunity to malaria due to continuous exposure to malaria.
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Affiliation(s)
- Christine Ludwin Wanjala
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Medical Laboratory Sciences, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Eliningaya J Kweka
- Mosquito Section, Division of Livestock and Human Diseases Vector Control, Tropical Pesticides Research Institute, Arusha, Tanzania; Department of Medical Parasitology and Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Kweka EJ, Kimaro EE, Munga S. Effect of Deforestation and Land Use Changes on Mosquito Productivity and Development in Western Kenya Highlands: Implication for Malaria Risk. Front Public Health 2016; 4:238. [PMID: 27833907 PMCID: PMC5080343 DOI: 10.3389/fpubh.2016.00238] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 10/12/2016] [Indexed: 11/30/2022] Open
Abstract
Background African highlands were known to be free of malaria for the past 50 years. However, the ever growing human population in the highlands of Africa has led to the deforestation and land coverage changes to create space for more land for cultivation, grazing, and house construction materials needs. This has lead to the creation of suitable breeding habitats, which are in open places. Decrease of canopy and forest cover has led to increased temperature both in outdoors and indoors in deforested areas. This increased temperature has resulted in the shortening of developmental stages of aquatic stages of mosquitoes and sporogony development in adult mosquitoes. Method Assessment of the effects of deforestation and land coverage changes (decrease), which leads to temperature changes and subsequently increases survivorship of adults and sporogony development in adult mosquitoes’ body was gathered from previous data collected from 2003 to 2012 using different analysis techniques. Habitats productivity, species dynamics and abundance, mosquitoes feeding rates, and sporogony development are presented in relation to temperature changes. Results The effects of temperature rise due to land cover changes in highlands of western Kenya on larval developmental rates, adult sporogony developments, and malaria risk in human population were derived. Vector species dynamics and abundance in relation to land use changes have been found to change with time. Conclusion This study found that, land cover changes is a key driver for the temperature rise in African highlands and increases the rate of malaria vectors Anopheles gambiae ssp., An. Funestus, and An. arabiensis colonizing the highlands. It has also significantly enhanced sporogony development rate and adult vector survival and therefore the risk of malaria transmission in the highlands.
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Affiliation(s)
- Eliningaya J Kweka
- Mosquito Section, Division of Livestock and Human Diseases Vector Control, Tropical Pesticides Research Institute, Arusha, Tanzania; Department of Medical Parasitology and Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Epiphania E Kimaro
- Mosquito Section, Division of Livestock and Human Diseases Vector Control, Tropical Pesticides Research Institute , Arusha , Tanzania
| | - Stephen Munga
- Centre for Global Health Research, Kenya Medical Research Institute , Kisumu , Kenya
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Lynch CA, Bruce J, Bhasin A, Roper C, Cox J, Abeku TA. Association between recent internal travel and malaria in Ugandan highland and highland fringe areas. Trop Med Int Health 2015; 20:773-80. [PMID: 25689689 PMCID: PMC5006858 DOI: 10.1111/tmi.12480] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the association between travel (recency of travel, transmission intensity at destination compared to origin and duration of travel) and confirmed malaria in Uganda. METHODS Health facility-based case-control study in highland (~2200 m), and highland fringe (~1500 m) areas with adjustment for other covariates. RESULTS In the highland site, patients who had travelled to areas of higher transmission intensity than their home (origin) areas recently were nearly seven times more likely to have confirmed malaria than those who had not (OR 6.9; P = 0.01, 95% CI: 1.4-33.1). In the highland fringe site, there was also a statistically significant association between travel and malaria (OR 2.1; P = 0.04, 95% CI: 1.1-3.9). CONCLUSIONS For highland areas, or areas of low malaria transmission, health authorities need to consider internal migrants when designing malaria control programs. Control interventions should include information campaigns reminding residents in these areas of the risk of malaria infection through travel and to provide additional mosquito nets for migrants to use during travel. Health authorities may wish to improve diagnosis in health facilities in highland areas by adding travel history to malaria case definitions. Where routine monitoring data are used to evaluate the impact of interventions on the malaria burden in highland areas, health authorities and donors need ensure that only cases from the local area and not 'imported cases' are counted.
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Affiliation(s)
- Caroline A. Lynch
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jane Bruce
- Faculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
| | - Amit Bhasin
- Faculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
| | - Cally Roper
- Faculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jonathan Cox
- Faculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
| | - Tarekegn A. Abeku
- Faculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
- Malaria ConsortiumLondonUK
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Woyessa A, Deressa W, Ali A, Lindtjørn B. Evaluation of CareStart™ malaria Pf/Pv combo test for Plasmodium falciparum and Plasmodium vivax malaria diagnosis in Butajira area, south-central Ethiopia. Malar J 2013; 12:218. [PMID: 23805822 PMCID: PMC3700775 DOI: 10.1186/1475-2875-12-218] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 06/24/2013] [Indexed: 11/17/2022] Open
Abstract
Malaria is a major public health problem in Ethiopia. Plasmodium falciparum and Plasmodium vivax co-exist and malaria rapid diagnostic test (RDTs) is vital in rendering parasite-confirmed treatment especially in areas where microscopy from 2008 to 2010 is not available. CareStartTM Malaria Pf/Pv combo test was evaluated compared to microscopy in Butajira area, south-central Ethiopia. This RDT detects histidine-rich protein-2 (HRP2) found in P. falciparum, and Plasmodium enzyme lactate dehydrogenase (pLDH) for diagnosis of P. vivax. The standard for the reporting of diagnostic accuracy studies was complied. Among 2,394 participants enrolled, 10.9% (n=87) were Plasmodium infected (household survey) and 24.5% (n=392) health facility-based using microscopy. In the household surveys, the highest positivity was caused by P. vivax (83.9%, n=73), P. falciparum (15.0%, n=13), and the rest due to mixed infections of both (1.1%, n=1). In health facility, P. vivax caused 78.6% (n=308), P. falciparum caused 20.4% (n=80), and the rest caused by mixed infections 1.0% (n=4). RDT missed 9.1% (n=8) in household and 4.3% (n=17) in health facility-based surveys among Plasmodium positive confirmed by microscopy while 3.3% (n=24) in household and 17.2% (n=208) in health facility-based surveys were detected false positive. RDT showed agreement with microscopy in detecting 79 positives in household surveys (n=796) and 375 positives in health centre survey (n=1,598).RDT performance varied in both survey settings, lowest PPV (64.3%) for Plasmodium and P. falciparum (77.2%) in health centres; and Plasmodium (76.7%) and P. falciparum (87.5%) in household surveys. NPV was low in P. vivax in health centres (77.2%) and household (87.5%) surveys. Seasonally varying RDT precision of as low as 14.3% PPV (Dec. 2009), and 38.5% NPV (Nov. 2008) in health centre surveys; and 40-63.6% PPV was observed in household surveys. But the influence of age and parasite density on RDT performance was not ascertained. Establishing quality control of malaria RDT in the health system in areas with low endemic and where P. falciparum and P. vivax co-exist is recommendable. CareStartTM RDT might be employed for epidemiological studies that require interpreting the results cautiously. Future RDT field evaluation against microscopy should be PCR corrected.
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Affiliation(s)
- Adugna Woyessa
- Ethiopian Health & Nutrition Research Institute, P. O. Box 1242, Addis Ababa, Ethiopia
| | - Wakgari Deressa
- School of Public Health, College of Health Sciences, Addis Ababa University, P. O. Box 9086, Addis Ababa, Ethiopia
| | - Ahmed Ali
- School of Public Health, College of Health Sciences, Addis Ababa University, P. O. Box 9086, Addis Ababa, Ethiopia
| | - Bernt Lindtjørn
- Centre for International Health, University of Bergen, Bergen, Norway
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Abstract
Recent epidemics of Plasmodium falciparum malaria have been observed in high-altitude areas of East Africa. Increased malaria incidence in these areas of unstable malaria transmission has been attributed to a variety of changes including global warming. To determine whether the reemergence of malaria in western Kenya could be attributed to changes in meteorologic conditions, we tested for trends in a continuous 30-year monthly malaria incidence dataset (1966-1995) obtained from complete hospital registers at a Kenyan tea plantation. Contemporary monthly meteorologic data (1966-1995) that originated from the tea estate meteorologic station and from global climatology records were also tested for trends. We found that total hospital admissions (malaria and nonmalaria) remained unchanged while malaria admissions increased significantly during the period. We also found that all meteorologic variables showed no trends for significance, even when combined into a monthly suitability index for malaria transmission. We conclude that climate changes have not caused the highland malaria resurgence in western Kenya.
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Affiliation(s)
| | - Simon I. Hay
- University of Oxford, Oxford, U.K
- Kenya Medical Research Institute/Wellcome Trust Collaborative Programme, Nairobi, Kenya
| | | | | | - Robert W. Snow
- University of Oxford, Oxford, U.K
- Kenya Medical Research Institute/Wellcome Trust Collaborative Programme, Nairobi, Kenya
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