Co-infection of Onchocerca volvulus and intestinal helminths in indigenous and migrant farmers in southwest Ethiopia

A cross-sectional survey on onchocerciasis and intestinal helminthic infections was conducted in two villages around the town of Teppi, south-west of Ethiopia on a total of 308 subjects of which 180 indigenous and 128 migrant settlers aged 10 years and above who lived in the area for at least 5 years. Of the total study subjects, 65% were males. The majority (64%) of the study subjects were in the age range of 21-40 years. The results of stool and skin snip examinations for ova/parasite and microfilaria revealed that, 62% (190) and 81% (248) of the study subjects were positive for intestinal parasites and microfilariderma respectively. Fifty percent (154) of the total subjects in the two villages had both onchocerciasis and intestinal helminthic infections. However, 80% (94/118) of the stool negative subjects also had onchocerciasis indicating that onchocercal skin infection has no significant influence on the acquisition of intestinal helminthic infections or vice versa [(relative risk 1.04, 95% CI 0.91, 1.18) P > 0.05]. Sixty-five percent (161/248) of the total skin snip positive individuals had microfilarial load of > 10 mf/mg of skin snip. The proportion of multiple infections with 2 or more intestinal helminthes was recorded in 51% (96/190) of individuals positive for intestinal parasitosis. There was a significant (x2 = 8.41, P < 0.005) difference in the onchocerciasis infection rate among indigenous (88%) and migrant (75%). No direct association was observed between onchocerciasis and intestinal parasitosis in the two study groups (indigenous and migrant settlers). The public health significance of coexistence of the two diseases, and the need for intensive control measures are discussed.     

Onchocerciasis among school children in Kafa, South West Ethiopia

A cross-sectional survey was undertaken to determine the magnitude, manifestations, and practices related to Onchocerciasis on 1337 students of six junior secondary schools of Kafa Zone in January 1993. Information on symptoms of the disease and the frequency of common practices that would bring the subjects to the breeding sites was collected by interview, while physical measurements and clinical examination was used to collect data on visual acuity, nutritional status and objective manifestations of the disease. Skin snip from both gluteal areas was examined to determine the microfilarial rate and density of infection, while nutritional status using Body Mass Index for Age (BMI-for Age), and visual impairment following the standard procedures was categorized. The majority, 1179 (88.2%) of the subjects, were aged 15 years and less of which males constituted 54.5% (728). The overall microfilarial carrier rate was 15.6% (95% CI = 13.7-17.6%) while the density of infection was 1.4 mf/mg skin snip. The prevalence and density of infection varied significantly among the twelve aggregates of villages identified based on the similarity of the ecological feature and contiguity of home address of the students. Males had significantly higher rate and density of infection but the difference by age was not significant. The prevalence of infection was significantly higher among the students who had reported frequent bathing, swimming, fishing and collecting firewood at/or near the rivers identified as the probable breeding sites of the vector, while there was no statistically significant association between infection and washing clothes, fetching water or crossing over the rivers. Groin lymph nodes enlargement, photophobia and itching were the leading symptoms complained by the infected subjects. However, only itching and the objective features related to the cutaneous Onchocerciasis were significantly associated to the infection. Visual acuity didn't differ among positive and negative subjects. Nutritional status was significantly associated with Onchocercal infection. Based on these findings recommendations are given on the areas of intervention and further study.     

Knowledge and attitudes towards antiretroviral therapy among factory workers participating in a cohort on HIV and AIDS, Addis Ababa, Ethiopia

This study investigates barriers that may pose a threat to a successful implementation of an antiretroviral treatment (ART) program in Ethiopia. As prelude to the provision of ART among factory workers participating in a cohort study on HIV and AIDS in Ethiopia, we measured knowledge and attitudes towards several aspects of ART and provided an educational intervention. The proportion of participants having good knowledge on issues concerning adherence was found reasonably good (67.7%), concerning the benefit of ART was intermediate (37.7%) and concerning eligibility was very low (16.8%). Knowledge concerning eligibility improved somewhat after the provision of the educational intervention. Only one third of HIV infected persons discloses their HIV status to their partner. Several aspects that could impact adherence to ART will be discussed, such as ART knowledge, social support, willingness to take ART, and disclosure of serostatus, taking the cohort study site into account. Results indicate a tremendous need to educate cohort participants before and during introduction of ART. Efforts to increase knowledge of ART, and especially knowledge of eligibility criteria to start ART, seem warranted, as well as encouragement to identify social support and disclose HIV serostatus, as these factors directly impact the success of an ART program.     

Incidence of Healthcare-Associated Infections (HAIs) and the adherence to the HAIs’ prevention strategies in a military hospital in Alkharj

BackgroundHealthcare-associated infections (HAI) are considered one of the most common adverse events in health care service provision. In order to prevent the occurrence of HAIs, it is important to implement several prevention strategies.ObjectivesThis study aims to determine the incidence of healthcare-associated infections in a military hospital in Alkharj and the adherence to the HAIs’ prevention strategies.MethodsThis study included exporting data for all infected cases confirmed by the infection disease specialists in 2019. The data were collected from the reports that were written by infection control unit and infectious disease department.ResultsThe rate of healthcare associated infections (HAIs) in 2019 was 0.43% of total patient admissions. The rate of central line associated bloodstream infections in 2019 was 1.15 per 1000 central line days. The rate of catheter associated urinary tract infections in 2019 was 1.00 per 1000 catheter days. The rate of ventilator associated pneumonia in 2019 was 2.11 per 1000 ventilator days and the rate of surgical site infections in 2019 was 0.41 %.ConclusionThe rate of overall healthcare-associated infections (HAI) was low. The compliance rate of health care workers to preventive measures that control HAIs was generally high but there was a need for more awareness particularly regarding personal protective equipment and hand hygiene. So it is important to attend more awareness activities and workshops particularly regarding personal protective equipment and hand hygiene. Furthermore, infection control unit and infectious disease department in the hospital should support the robust HAI prevention programs.Keyword: Healthcare-associated infections, HAIs, Nosocomial infections, Prevention strategies     

Dimethoate absorption: A complementary in vitro and in vivo assessment

This work attempts to evaluate dermal exposure (DE) of farm workers to dimethoate after 4 h of routine application to a lemon plantation. Dimethoate was measured on the workers’ clothes as well as in stratum corneum (SC) and in saliva. In vitro permeation tests (IVPT) were performed through rat, pig and human skin and pig buccal, esophageal and sublingual mucosas. The mean of dimethoate DE was 342.19 ± 487.14 mg/d, the percentage of toxic dose per hour was higher than the other pesticides, and the SC penetration factors ranged between 0.5 and 14.81 and 0.05–53.96 % for back of neck and arms respectively. In the supporting IVPT study, dimethoate absorption through human skin was 14.75 % and the default value in the absence of experimental data for this product is 70%. These results show that in family farming the deficiency of correct clothing during the application of pesticides leaves workers more vulnerable.     

Evaluating the genotoxic effects of workers exposed to lead using micronucleus assay, comet assay and TCR gene mutation test

To evaluate the genotoxic effects of lead (Pb) exposure, 25 workers in a workplace producing storage battery were monitored for three genetic end-points using micronucleus (MN) assay, comet assay and TCR gene mutation test. Twenty-five controls were matched with workers according to age, gender and smoking. The air Pb concentration in the workplace was 1.26 mg/m(3). All subjects were measured for Pb concentration of blood by atom absorption spectrophotometry. The mean Pb concentration of blood in workers (0.32 mg/l) was significantly higher than that in controls (0.02 mg/l). The results of MN test showed that the mean micronuclei rate (MNR) and mean micronucleated cells rate (MCR) in workers were 9.04+/-1.51 per thousand and 7.76+/-1.23 per thousand, respectively, which were significantly higher than those (2.36+/-0.42 per thousand and 1.92+/-0.31 per thousand) in controls (P<0.01). It was found in the comet assay that the mean tail length (MTL) of 25 workers and 25 controls were 2.42+/-0.09 and 1.02+/-0.08 microm, respectively, there was significant difference between workers and controls for MTL (P<0.01), also the difference of the mean tail moment (MTM) between workers (0.85+/-0.05) and controls (0.30+/-0.09) was very significant (P<0.01). However, in TCR gene mutation assay Mfs-TCR of workers and controls were 1.69+/-0.15 x 10(-4) and 1.74+/-0.17 x 10(-4), respectively, there was no significant difference between workers and controls (P>0.05). The results of our study indicated that the genetic damage was detectable in 25 workers occupationally exposed to lead.     

Levels of doses to radiological workers in Ethiopia: 1977-1988

During the period 1977 to 1988, a total of 10,494 Eastman Kodak Type 2 film badges and 19,236 Vinten lithium fluoride thermoluminescence dosimeters (TLDS) were delivered to medical workers in Ethiopia of which 5,135 (48.93%) film badges and 19,177 (99.69%) TLDS were evaluated. The annual average occupational doses to the workers were estimated to be 1.44 and 4.51 mSv with corresponding collective dose equivalents of 0.29 and 4.51 man-Sv respectively. Comparisons of doses to similar workers in different countries were compiled from the literature. Based on the TLD results and the 1977 International Commission on Radiological Protection (ICRP) risk coefficients it is estimated that the occurrence of extra fatal and non-fatal cancer cases is in the order of 74 per million radiological workers per year. The hereditary defects expected are 18 and 36 cases in the next two and in all future generations respectively. During these periods, the number of institutions monitored rose from 35 to 88 while the workers monitored increased from 100 to 450.     

Antiparasitic activity of risedronate in a murine model of acute Chagas' disease

We report the results of a study on the activity of the farnesyl-pyrophosphate synthase inhibitor risedronate (Ris) in a murine model of acute Chagas' disease. This compound displays rapid, cytocidal activity in vitro against Trypanosoma cruzi, but its in vivo activity had not been investigated previously. A murine model of acute Chagas' disease was used, in which experimental animals were infected with 10(3) trypomastigotes and intravenous treatment was started 24 h post-infection. In this model, Ris, at doses as low as 1 mg/kg per day given for 7 days, induced > 90% reductions in parasitaemia and increased very significantly (P = 0.001) the survival of treated animals. Higher doses (up to 10 mg/kg per day) led to further reductions in parasitaemia and mortality, with no deleterious effects on weight gain and general physical condition of the treated animals. There was no relapse of parasitaemia after discontinuation of treatment, suggesting trypanocidal, rather than trypanostatic, activity. This interpretation was confirmed by the almost complete disappearance of amastigote nests in the hearts of treated animals. However, no parasitological cures were observed in infected animals that received the bisphosphonate, probably due to the short treatment period. Taken together, these results indicate that Ris could be a useful lead compound for the development of new drugs effective against Chagas' disease.     

Helicobacter pylori infection in patients with upper gastrointestinal symptoms in Arba Minch Hospital: southwestern Ethiopia.

A prospective study was conducted to determine the frequency of occurrence of Helicobacter pylori infection in outpatients presenting with upper gastro intestinal symptoms to Arba Minch Hospital over a one year period. Four hundred and forty four patient, 309 males and 135 females, underwent upper gastro intestinal fiberoptic endoscopy between March 1989 and April 1990. The age range was 14 to 75 years (mean = 35). All 444 patients were examined and tested for infection. Sixty per cent had abnormal endoscopy results. The major endoscopic findings were gastritis in 23% and peptic ulcer disease in 20% of the patients. To identify H. pylori infection, 2 biopsy specimens were taken from the greater curve of the gastric antral mucosa of all patients. The specimens were examined using the urease diagnostic test and Loeffler Methylene Blue stain. Infection was considered present when either of the tests were positive. Infection by H. pylori was found in 324 patients (73%). Among the 173 patients without endoscopic findings, 63% had infection. Of 271 patients with abnormal endoscopic findings, 79% were infected. The results of this study show that H. pylori infection is a common finding in patients with upper gastrointestinal symptoms in Ethiopia. There is a higher prevalence of infection among patients with endoscopic findings. Thus the management of patients with upper gastro-intestinal symptoms in Ethiopia should take H. pylori infection into consideration.     

Novel 2,5-disubstituted-1,3,4-oxadiazoles as anti-inflammatory drugs

Objective:

1,3,4-oxadiazole ring is a versatile moiety with a wide range of pharmacological properties. The present work deals with the synthesis and evaluation of the anti-inflammatory activity of two novel 2,5-disubstituted-1,3,4-oxadiazoles (OSD and OPD).

Materials and Methods:

Carrageenan-induced rat hind paw edema was employed as an acute model of inflammation. For evaluating sub-acute anti-inflammatory activity, carrageenan-induced inflammation in rat air pouch was employed. Complete Freund''s adjuvant-induced arthritis in rats was used as a model of chronic inflammation. To evaluate in vitro anti-inflammatory activity, lipopolysaccharide (LPS)-stimulated RAW264.7 cells were used.

Results:

OSD (100 mg/kg) reduced carrageen-induced paw edema by 60%, and OPD (100 mg/kg) produced a modest 32.5% reduction. OSD also reduced leukocyte influx and myeloperoxidase in carrageenan-induced rat air pouch model. In complete Freund''s adjuvant-induced arthritis model, both OSD and OPD (200 mg/kg for 14 days) reduced paw edema and NO levels. In LPS-stimulated RAW264.7 cells, OSD and OPD inhibited formation of nitric oxide and reactive oxygen species, with OPD showing a better activity in comparison to OSD.

Conclusions:

OSD was the better of the two compounds in in vivo models of inflammation. The o-phenol substitution at position 2 of oxadiazole ring in OSD may be responsible for its better in vivo anti-inflammatory activity. The ability of the compounds to inhibit LPS-induced pro-inflammatory mediator release suggests an anti-inflammatory mechanism targeting LPS-TLR4-NF-κB signalling pathway, which needs to be explored in detail. The disparate efficacy in vitro and in vivo also requires in-depth evaluation of the pharmacokinetics of these novel oxadiazoles.KEY WORDS: Inflammation, myeloperoxidase, oxadiazole     

Cold hands after exposure to arsenic or vibrating tools: effects of ketanserin on finger blood pressure and skin temperature

The effect of ketanserin, a serotonin 5-HT2 receptor inhibitor, on the cold-provoked vasospasm in arsenic workers was examined by measuring the finger systolic pressure (FSP). After injection of 10 mg ketanserin the skin temperature and the FSP of the cooled finger increased significantly. Prolonged oral treatment with ketanserin, 2 X 40 mg per day, did not significantly influence the skin temperature or FSP during local cooling in arsenic workers or patients with primary or vibration-induced Raynaud's phenomenon. The effect of ketanserin intravenously indicates that serotonin is involved in the mechanism behind vasospasm of arsenic workers in the same way as it is known to be in patients with primary and vibration-induced Raynaud's phenomenon.     

Incidence of Healthcare-Associated Infections (HAIs) and the adherence to the HAIs’ prevention strategies in a military hospital in Alkharj

BackgroundHealthcare-associated infections (HAI) are considered one of the most common adverse events in health care service provision. In order to prevent the occurrence of HAIs, it is important to implement several prevention strategies.ObjectivesThis study aims to determine the incidence of healthcare-associated infections in a military hospital in Alkharj and the adherence to the HAIs’ prevention strategies.MethodsThis study included exporting data for all infected cases confirmed by the infection disease specialists in 2019. The data were collected from the reports that were written by infection control unit and infectious disease department.ResultsThe rate of healthcare associated infections (HAIs) in 2019 was 0.43% of total patient admissions. The rate of central line associated bloodstream infections in 2019 was 1.15 per 1000 central line days. The rate of catheter associated urinary tract infections in 2019 was 1.00 per 1000 catheter days. The rate of ventilator associated pneumonia in 2019 was 2.11 per 1000 ventilator days and the rate of surgical site infections in 2019 was 0.41 %.ConclusionThe rate of overall healthcare-associated infections (HAI) was low. The compliance rate of health care workers to preventive measures that control HAIs was generally high but there was a need for more awareness particularly regarding personal protective equipment and hand hygiene. So it is important to attend more awareness activities and workshops particularly regarding personal protective equipment and hand hygiene. Furthermore, infection control unit and infectious disease department in the hospital should support the robust HAI prevention programs.     

替吉奥联合伊立替康一线治疗晚期结直肠癌的前瞻性临床观察

目的：观察替吉奥联合伊立替康一线治疗术后复发或转移的晚期结直肠癌的疗效和安全性。方法：42例无手术指征的晚期结直肠癌患者,未接受姑息化疗,接受以下方案作为一线化疗：替吉奥40mg/m2,2次/d,口服,d1～d9;伊立替康180mg/m2,静脉滴注, d1;14d为1个周期（IRIS方案）。对患者进行密切观察和随访。结果：有40例可评价疗效,中位化疗周期数8（4～12）,部分缓解14例,稳定22例,疾病进展4例,有效率为45.0%,疾病控制率为90%。中位无进展生存期（PFS）为6.5个月（1.5～10.0个月）。主要毒副作用有皮肤色素沉着、消化道反应和骨髓抑制,多为I～II度,III度以上毒性发生率为7.1%,无治疗相关性死亡。结论：替吉奥联合伊立替康一线治疗晚期结直肠癌,应用方便,近期疗效与目前标准方案相当,毒副反应可耐受。     

Synergic enhancing-effect of DEET and dodecylamine on the skin permeation of testosterone from a matrix-type transdermal delivery system

The synergic in vitro skin permeation enhancing-effect of N,N-diethyl-m-toluamide (DEET) and dodecylamine was investigated in order to develop a novel non-scrotal matrix-type transdermal delivery system of testosterone (TS). When DEET was loaded in DuroTak^® 87-2510 together with 2% TS and 3% dodecylamine, the in vitro rat skin permeation rate of TS synergistically increased as DEET concentration increased up to 0.5%. No further increase in permeation was observed thereafter and a plateau was observed up to 3.8% DEET. Moreover, compared to 0.5% DEET concentration, the addition of 3.8% of DEET in combination with 3% dodecylamine and 6% TS further increased the permeation rate of TS, and the maximum permeation rate of 11.21 μg/cm²/h was achieved. The in vitro skin permeation rates of TS from a transdermal delivery system of DuroTak^® 87-2510 containing 6% TS, 3% dodecyamine, and 3.8% DEET were in the following order: hairless mouse skin > rat skin > human cadaver skin. Assuming that a system with a surface area of 60 cm² is applied, the human cadaver skin permeation rate of 5.74 μg/cm²/h achieved in this study can be interpreted as being equivalent to delivering ～ 8.?27?mg of TS per day. Considering that the commercially available product (Testoderm^®TTS) for non-scrotal skin of the same surface area is designed to administer 5?mg of TS per day, the new formulation could maintain therapeutic plasma concentration of TS at a smaller surface area of 40 cm².     

Clinical and parasitological aspects of Bancroftian filariasis in Hale, northeast Tanzania

OBJECTIVES: To document the endemicity characteristic of Bancroftian filariasis and to validate the effect of blood sampling time adjustment method on microfilarial intensity in relation to sex and age. DESIGN: Community based cross sectional survey. SETTING: Four rural communities in Hale area, Muheza district, northeast Tanzania. SUBJECTS: A sample of 1,025 inhabitants aged one year and above. MAIN OUTCOME MEASURES: Chronic clinical manifestations (elephantiasis and hydrocele), microfilarial prevalence as well as crude and time adjusted microfilarial geometric mean intensity (GMI). RESULTS: Clinically, 6.9% of examined individuals had elephantiasis and 28.5% males aged 15 years and above had hydrocele. Prevalence of Wuchereria bancrofti infection was 31.8%, with females and males showing a microfilarial rate of 32.1% and 31.5% respectively. Both the clinical manifestations and microfilarial prevalence increased with age. The GMI among microfilarial positive individuals for the crude microfilaraemia was 1,122 or 1,175 mf/ml of blood after adjustment of the sample to the expected level if it had been collected at peak hour. In different age and sex groups, the adjusted microfilarial GMI was slightly higher but exhibited a similar pattern to crude microfilaraemia count suggesting that time of blood sampling has similar effect on each age and sex group.     

Antifilarial Effect of a Combination of Botanicals from Acacia auriculiformis and Centella asiatica on Canine Dirofilariasis

A mixture (1:1) of the ethanol extracts from the leaves of Centella asiatica and the funicles of Acacia auriculiformis was administered orally to pariah dogs naturally infected with Dirofilaria immitis at 0.04 mg/g body weight/d for 45 days. Two triterpenoid saponins, acaciaside A and B, isolated from the funicles of A. auriculiformis were combined with the leaf ethanol extract from C. asiatica (1:1) and tested at 0.04 mg/g body weight/d for 45 days on microfilaraemic dogs. There was an initial fluctuation in the microfilarial (mf) count in the blood following treatment with the mixture of crude extracts, and then the mf density decreased up to 99%. This suppression lasted for 120 days. When treated with the saponins mixed with the C. asiatica ethanol extract, there was an 86% reduction in mf density 30 days after the last date of treatment, and 68% reduction was maintained 120 days after the treatment.     

吉非替尼一线治疗老年晚期非小细胞肺癌疗效观察

目的：评价吉非替尼治疗非小细胞肺癌的疗效和毒副作用。方法：52例非小细胞肺癌患者,均未接受过一线治疗。治疗方案为吉非替尼250mg,qd,单药口服,每月1次胸腹部CT评价疗效。结果：52例患者中2例达完全缓解（CR）,11例部分缓解（PR）,20例稳定（SD）,全组有效率（CR＋PR）为25.0%,疾病控制率（CR＋PR＋SD）为63.5%。腺癌组有效率为31.3%,疾病控制率为71.9%;非腺癌组有效率为15.0%,疾病控制率为50.0%,二者之间差异有统计学意义（P〈0.05）。常见的毒副作用为皮疹和腹泻,Ⅰ、Ⅱ度不良反应皮疹（42.3%）和腹泻（26.9%）未见间质性肺病和常见的血液学毒性出现。结论：吉非替尼对于老年晚期非小细胞肺癌有较好的有效性和安全性。     

Laboratory and clinical studies on cefdinir in pediatric field

Clinical trials of cefdinir (CFDN) in pediatric infections were carried out. Results are summarized as follows. 1. Mean half-lives of CFDN in serum in children when administered on an empty stomach were 1.24 hours (3 mg/kg per os) and 1.85 hours (6 mg/kg per os). 2. Mean 8 hour urinary excretion rates of CFDN were 19.0% (3 mg/kg/per os) and 10.5% (6 mg/kg per os). 3. CFDN was administered to 28 children with various infections: 12 patients with tonsillitis, 8 with bronchitis, 2 with pneumonia, 4 with urinary tract infections, 1 staphylococcal scalded skin syndrome and 1 with impetigo. The overall efficacy rate was 89.3%. 4. Diarrhea was noted in 1 patient. Abnormal laboratory test values encountered were eosinophilia in 2 patients, thrombocytosis in 1.     

维A酸维生素C棕榈酸酯泡囊的体外释放、经皮渗透和皮肤贮留研究

目的研究维生素C棕榈酸酯泡囊作为维A酸载体时,主药的体外释放、经皮渗透和皮肤贮留情况。方法采用Franz扩散池测定维A酸从载体中的释放速度,扩散池与供给池之间为纤维素膜（截留分子量8000～14000）,扩散池面积为2.92cm^2。体外透皮试验用小鼠、大鼠或兔子背部皮肤替代半透膜。在体外透皮试验完结后,取下皮肤,剪碎匀浆,用50%异丙醇-生理盐水提取,提取液处理后用HPLC测定药物浓度。结果结果表明维A酸释放速率和累积经皮渗透量大于市售乳膏,同时具有较高的皮肤贮留量。结论维生素C棕榈酸酯泡囊作为维A酸载体有助于增加局部药物浓度。     

维A酸贴剂的体外透皮扩散研究

目的:研究自制的维A酸贴剂的体外透皮扩散率及在皮肤内的蓄积量。方法:按《中国药典》2005年版规定测定含量均匀度,以酸性异丙醇为溶剂,在波长352nm处测定维A酸,用透皮扩散仪测定透皮贴剂与市售维A酸乳膏对小鼠皮的扩散率及皮肤内的蓄积量。结果:贴剂的含量均匀度合格;测定的平均回收率为97.99%。测得含量为9.73mg/片,为标示量的97.3%;贴剂的扩散率虽低于乳膏,但皮肤内的蓄积量明显高于乳膏。结论:该贴剂能使药物蓄积于皮肤内,有利于提高对皮肤病的疗效和降低毒性,值得进一步开发。