Integrated Prevalence Assessment of Wuchereria bancrofti and Onchocerca volvulus in Three Co-Endemic Districts of Gambella Region, Ethiopia

Lymphatic filariasis (LF) and onchocerciasis (OV) are among the neglected tropical diseases (NTD) targeted for elimination in Ethiopia. We used a transmission assessment survey (TAS-1) to evaluate the serological status of OV in three co-endemic districts in Gambella simultaneously. During May and June 2019, blood samples were collected from 6- to 7-year-old children who were randomly selected through standard community-based TAS methodology. Children were tested for both circulating filarial antigen (CFA) for LF via filariasis test strip and for Onchocerca volvulus 16 (Ov16) antibody for OV via laboratory-based ELISA. A total of 3,377 children from 150 villages in the three districts were tested; 1,823 (54.0%) were male. All three districts had CFA results below the critical threshold for stopping LF mass drug administration (MDA). In contrast, 40 children (1.2%) were positive for Ov16 antibody, well above the WHO's OV stop MDA threshold of 0.1%. The integrated assessment indicated two programmatic decisions: stop MDA for LF and continue MDA for OV. Accordingly, albendazole MDA was discontinued in the districts but ivermectin MDA continued. This integrated assessment showed that a random sample for TAS can give important information about OV transmission status in co-endemic areas.

Half-time evaluation of a new 4-year Ph.D. program in nursing and midwifery at the University of Gondar, Ethiopia

A new four-year Ph.D. programme in nursing and midwifery, the first of its kind in Ethiopia, was started in 2018/2019 at the University of Gondar when eight doctoral students in nursing and midwifery entered the program. We who have been involved see this as an appropriate time to evaluate what has been accomplished to date and to look toward future possibilities. Our aim in carrying out such an evaluation and presenting our findings is in part to determine if similar programs might be developed in other similar settings and in part to learn what modifications to the present program might be considered. The key elements of a questionnaire survey with closed and open response alternatives were based on the content, structure and learning outcomes of the home university Ph.D. programme as described in the curriculum. The questionnaire responses captured changes that would be needed to maintain a fully satisfactory programme that blends onsite instruction and online access to faculty resulting in a twenty-first century blended Ph.D. programme. Improved dialogue between the home university faculty and the external supervisors is needed. The programme can provide a career pathway that midwifery and nursing educators can follow in their own country rather than having to leave to study in another country. The findings provide insight into the feasibility of extending similar Ph.D. programmes to other parts of East Africa and with the SDG 5 in mind with an increased focus on women leadership. The justification for this initiative is to meet the need for more nursing and midwifery faculty who can provide quality midwifery and nursing education in East African countries. Retention of these professionals will help to deal with the shortage of healthcare personnel and will provide better care for the general population.

Multivariate analysis for yield and yield-related traits of sesame (Sesamum indicum L.) genotypes

Sesame production under irrigation is limited in Ethiopia because of in availability of high yielding varieties, inadequate and inefficient irrigation schemes, and insignificant awareness of producers. This study, comprising 13 sesame genotypes, was conducted around Humera and Werer during 2018 and 2019 under irrigation. The design was randomized completely block design with three replications and the objectives were to develop high yielding genotypes and identify important agronomic traits. Multivariate statistical methods like Additive Main Effect and Multiplicative Interaction (AMMI) model, Principal Component Analysis, Cluster and factor analyses were used. The genotypes (6.22%), environments (42.62) and Genotype × Environment Interactions (25.09%) were statistically (p < 0.001) significant for the agronomic traits. The grain yield in each observation varied from 383 kg/ha to 2044 kg/ha and the grand mean yield was 820.19 kg/ha. The highest mean yield was recorded from G12 (948.6 kg/ha) followed by G4 (938.9 kg/ha) while the lowest was recorded from G8 (703.1 kg/ha). G1, G4, G12, G5, G8, G11 and G13 are identified as unstable genotypes while G2, G3, G6, and G9 are stable genotypes. The genotypes were grouped in to four clusters and cluster-II was characterized as the high yielding cluster and it was also associated with grain yield, pods per plant, branches per plant and thousand seed weight. Branches per plant, pods per plant and thousand seed weight may be most determinant and crucial in developing high yielding sesame varieties. This finding recommends that G4 and G6 are desirable genotypes and can be used for irrigation production.

The Galabat-Metema cross-border onchocerciasis focus: The first coordinated interruption of onchocerciasis transmission in Africa

Background

Onchocerciasis transmission across international borders is not uncommon, yet a coordinated cross border stops mass drug administration (MDA) decision has not been documented.

Methods/Principle findings

The Galabat-Metema focus involves neighboring districts on the border between Sudan and Ethiopia. Mass drug administration (MDA) was provided once and subsequently twice per year in this focus, with twice-per-year beginning in Ethiopia’s Metema subfocus in 2016 and in the Sudan’s Galabat subfocus in 2008. Ov16 ELISA-based serosurveys were conducted in 6072 children under 10 years of age in the Metema subfocus in 2014, and 3931 in the Galabat in 2015. Between 2014 and 2016, a total of 27,583 vector Simulium damnosum flies from Metema and 9,148 flies from Galabat were tested by pool screen PCR for Onchocerca volvulus O-150 DNA. Only 8 children were Ov16 seropositive (all in the Metema subfocus); all were negative by skin snip PCR. The upper limit of the 95% confidence interval (UCL) for Ov16 seropositive was <0.1% for the overall focus and 0.14 positive fly heads per 2000 (UCL = 0.39/2000). However, an entomological ‘hotspot’ was detected on the Wudi Gemzu river in Metema district. The hotspot was confirmed when 4 more positive fly pools were found on repeat testing in 2017 (1.04 L3/2000 flies (UCL = 2.26/2000). Information exchange between the two countries led to stopping MDA in a coordinated fashion in 2018, with the exception of the hotspot at Wudi Gemzu, where MDA with ivermectin was increased to every three months to hasten interruption of transmission.

Conclusion

Coordinated stop MDA decisions were made by Sudan and Ethiopia based on data satisfying the World Health Organization’s criteria for interruption of onchocerciasis transmission. Definitions of entomological ‘hotspots’ and buffer zones around the focus are proposed.

Onchocerciasis is a vector-borne tropical disease caused by the parasitc worm, Onchocerca volvulus. The vector is Simulium flies that breed in fast flowing rivers and streams. The infection can cause skin disease and loss of vision, giving risk to the common name of ‘river blindness’ for the condition. Ivermectin (Mectizan) mass drug administration (MDA) given at high coverage for many years can interrupt transmission such that MDA can eventually be stopped. The present paper provides highlights of onchocerciasis transmission interruption in the first known coordinated international cross border focus with ivermectin MDA program in Africa, where 99% of the global onchocerciasis burden exists. This focus known as Galabat-Metema is shared between Ethiopia and Sudan, both of which have established a nationwide policy for elimination of onchocerciasis. The paper provides the history of MDA in the border area and the results leading a coordinated end to MDA in the focus in 2017.

Proportion of medication error reporting and associated factors among nurses: a cross sectional study

BACKGROUND

A medication error (ME) is any preventable event that may cause or lead to inappropriate medication use or patient harm. Voluntary reporting has a principal role in appreciating the extent and impact of medication errors. Thus, exploration of the proportion of medication error reporting and associated factors among nurses is important to inform service providers and program implementers so as to improve the quality of the healthcare services.

METHODS

Institution based quantitative cross-sectional study was conducted among 397 nurses from March 6 to May 10, 2015. Stratified sampling followed by simple random sampling technique was used to select the study participants. The data were collected using structured self-administered questionnaire which was adopted from studies conducted in Australia and Jordan. A pilot study was carried out to validate the questionnaire before data collection for this study. Bivariate and multivariate logistic regression models were fitted to identify factors associated with the proportion of medication error reporting among nurses. An adjusted odds ratio with 95% confidence interval was computed to determine the level of significance.

RESULT

The proportion of medication error reporting among nurses was found to be 57.4%. Regression analysis showed that sex, marital status, having made a medication error and medication error experience were significantly associated with medication error reporting.

CONCLUSION

The proportion of medication error reporting among nurses in this study was found to be higher than other studies.

[Pregnancy in adolescence: maternal-fetal prognosis]

The adolescent's pregnancy is not rare. In the clinical view the maternal prognosis is better than the foetal which is reserved. In fact the rate of prematurity, intra uterin under development, genetous malformation and perinatality death is increased. In the psychosocial view, these pregnancies occurs problems specially the relationship between mother and child and real social break of these adolescents.

Murine oncostatin M stimulates mouse synovial fibroblasts in vitro and induces inflammation and destruction in mouse joints in vivo

Oncostatin M (OSM) is a multifunctional cytokine, a member of the interleukin-6/leukemia inhibitory factor (IL-6/LIF) family, that can regulate a number of connective-tissue cell types in vitro including cartilage and synovial tissue-derived fibroblasts, however its role in joint inflammation in vivo is not clear. We have analyzed murine OSM (muOSM) activity in vitro and in vivo in mouse joint tissue, to determine the potential role of this cytokine in local joint inflammation and pathology. The effects of muOSM and other IL-6/LIF cytokines on mouse synovial fibroblast cultures were assessed in vitro and showed induction of monocyte chemotactic protein-1, interleukin-6, and tissue inhibitor metalloproteinase-1, as well as enhancement of colony growth in soft agarose culture. Other IL-6/LIF cytokines including IL-6, LIF, or cardiotrophin-1, did not have such effects when tested at relatively high concentrations (20 ng/ml). To assess effects of muOSM in articular joints in vivo, we used recombinant adenovirus expressing muOSM cDNA (AdmuOSM) and injected purified recombinant virus (10(6) to 10(8) pfu) intra-articularly into the knees of various mouse strains. Histological analysis revealed dramatic alterations in the synovium but not in synovium of knees treated with the control virus Ad-dl70 or knees treated with Adm-IL-6 encoding biologically active murine IL-6. AdmuOSM effects were characterized by increases in the synovial cell proliferation, infiltration of mononuclear cells, and increases in extracellular matrix deposition that were evident at day 4, but much more marked at days 7, 14, and 21 after administration. The synovium took on characteristics similar to pannus and appeared to contact and invade cartilage. Collectively, these results provide good evidence that OSM regulates synovial fibroblast function differently than other IL-6-type cytokines, and can induce a proliferative invasive phenotype of synovium in vivo in mice on overexpression. We suggest that OSM may contribute to pathology in arthritis.

The effect of "superactive" charcoal and magnesium citrate solution on blood ethanol concentrations and area under the curve in humans

Eleven healthy males between 21 and 37 years of age were enrolled into a non-randomized crossover study comparing superactive charcoal (SAC) given after ethanol administration. After receiving 0.6 gm/kg ethanol orally (95% V/V diluted in orange juice), blood was sampled at 0, 0.5, 1.0, 1.5, 2.0, 3.0, and 4.0 hours. Area under the curve (AUC) was calculated and the highest ethanol level was recorded. After a minimum of 1 week washout, the volunteers ingested an identical ethanol dose but in addition received 60 grams of SAC and 300 ml of 5.8% magnesium citrate solution 1 and 3 hours post ingestion. The data was compared using the paired t-test with p less than 0.05 considered significant. Nine volunteers completed the study. Volunteers had difficulty ingesting the full second 60 gram SAC dose. The AUC (mean 1184 mcg x hr/ml) and highest ethanol concentrations (mean 46.3 mg/dl) for the control group were not significantly greater than in the SAC group (mean AUC 1167 mcg x hr/ml and highest ethanol concentration of 49.0 mg/dl). The ethanol concentration in the SAC group was significantly less than control only at 2.0 hours (31.6 mg/dl vs 36.6 mg/dl, p less than 0.01). The peak ethanol concentration in the SAC group occurred at 1.0 hours in 7 of 9 volunteers, while in the control group, peak concentration occurred randomly between 0.5 and 2.0 hours. We conclude SAC in the dose used is not effective in decreasing AUC, highest ethanol concentration, and blood ethanol levels when given 1 and 3 hours after ethanol ingestion.