Risk factors for placental malaria and associated adverse pregnancy outcomes in Rufiji,Tanzania: a hospital based cross sectional study

BackgroundPrevention and treatment of malaria during pregnancy is crucial for reduction of malaria in pregnancy and its adverse outcomes. The spread of parasite resistance to Sulphadoxine-Pyrimethamine (SP) used for Intermittent Preventive Treatment for malaria in pregnancy (IPTp), particularly in East Africa has raised concerns about the usefulness and the reliability of the IPTp regimen. We aimed to assess the effectiveness of two doses of SP in treating and preventing occurrence of adverse pregnancy outcomes.MethodologyThe study was an analytical cross sectional study which enrolled 350 pregnant women from Kibiti Health Centre, South Eastern Tanzania. Structured questionnaires were used to obtain previous obstetrics and medical history of participants and verified by reviewing antenatal clinic cards. Maternal placental blood samples for microscopic examination of malaria parasites were collected after delivery. Data was analyzed for associations between SP dosage, risk for PM and pregnancy outcome. Sample size was estimated based on precisionResultsPrevalence of placental maternal (PM) was 8% among pregnant women (95%CI, 4.4–13.1%). Factors associated with increased risk of PM were primigravidity (P<0.001) and history of fever during pregnancy (P= 0.02). Use of at least 2 doses of SP for IPTp during pregnancy was insignificantly associated with reducing the risk PM (P=0.08), low birth weight (P=0.73) and maternal anemia (P=0.71) but associated significantly with reducing the risk of preterm birth (P<0.001).ConclusionTwo doses of SP for IPTp regime are ineffective in preventing and treating PM and adverse pregnancy outcome. Hence a review to the current IPTp regimen should be considered with possibility of integrating it with other malaria control strategies.     

Longitudinal study of bad dreams in preschool-aged children: prevalence, demographic correlates, risk and protective factors

STUDY OBJECTIVES: To (1) clarify the epidemiology of bad dreams in children and investigate risk and protective factors related to (2) the child's sleep, (3) parental sleep-enabling practices, and (4) the child's temperament. DESIGN: Longitudinal with 6 time points from 5 months to 6 years. SETTING: Subjects' homes. PARTICIPANTS: Representative sample of 987 children in the Province of Quebec. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Longitudinal logistic regression analysis models with primary endpoints of presence or absence of parent-rated bad dreams at 29 months, 41 months, 50 months, 5 years, and 6 years and predictor variables of demographic characteristics, parent ratings of child's sleep characteristics, parental sleep-enabling practices (e.g., cosleeping), and child's psychological characteristics at 5 and 17 months (anxiousness, temperament). Mothers' ratings indicated lower than expected prevalence of frequent bad dreams (1.3% to 3.9%). Demographic correlates of bad dreams were high family income, absence of siblings at 29 months, and a non-immigrant mother. The best predictor at 41 and 50 months was the presence of bad dreams the preceding year, whereas at 5 and 6 years, it was their earlier presence at 29 months. Early protective factors were parental practices favoring emotional nurturance after night awakenings (29 and 41 months); early risk factors were sleep-onset emotional nurturance (29 months), difficult temperament (5 months), and anxiousness (17 months). CONCLUSIONS: Bad dreams in preschoolers are less prevalent than thought but, when present, are trait-like in nature and associated with personality characteristics measured as early as 5 months. A stress-diathesis model may best account for the observed pattern of predictive factors.     

HTLV‐1 and ‐2 in a first‐time blood donor population in Northeastern Brazil: Prevalence,molecular characterization,and evidence of intrafamilial transmission

Independent epidemiology for respective human T‐cell lymphotropic virus (HTLV) types 1 and 2 is little known in blood donors in Brazil, where screening for HTLV‐1/2 is mandatory at blood banks, but no testing to confirm/differentiate these viruses. Therefore, this study aims to assess the prevalence of HTLV‐1 and ‐2 in a first‐time blood donor population in Northeastern Brazil and to carry out molecular characterization of respective isolates. A cross‐sectional study was conducted at the State Blood Bank in Piauí. Samples were screened for anti–HTLV‐1/2 by enzyme immunoassay, and reactive samples were confirmed using a line immunoassay and polymerase chain reaction (PCR). Of 37 306 blood donors, 47 were anti–HTLV‐1/2 reactive by enzyme immunoassay. After confirmed by line immunoassay, 22 were positive for HTLV‐1 (0.59 per 1000; 95% CI: 0.38‐0.87), 14 were positive for HTLV‐2 (0.37 per 1000; 95% CI: 0.21‐0.61), 1 was indeterminate, and the remaining donors were negative. The HTLV‐1 infection was also confirmed by PCR in all anti–HTLV‐1‐positive samples, and sequencing classified these isolates as belonging to the Transcontinental (A) subgroup of the Cosmopolitan (1a) subtype. Of 14 anti–HTLV‐2‐positive samples, 11 were also PCR positive, which belonged to subtype a (HTLV‐2a/c). In addition, 38 family members of 5 HTLV‐1‐ and 3 HTLV‐2‐infected donors were analyzed. Familial transmission of HTLV‐1 and ‐2 was evidenced in 3 families. In conclusion, in Northeastern Brazil, where HTLV‐1 and ‐2 are endemic, counseling blood donor candidates and their families might play a key role in limiting the spread of these viruses.     

Associations between body shape,body adiposity and other indices: a case study of hypertension in Chinese children and adolescents

Abstract

Background: A Body Shape Index (ABSI) and the Body Adiposity Index (BAI) are used to quantify body shape for adults. However, only a few studies have been conducted confirming whether ABSI or BAI is a better index for predicating hypertension and pre-hypertension in Chinese children and adolescents.

Aim: To estimate scaling exponents for using ABSI with Chinese children and adolescents, comparing body shape indices used for predicting hypertension and pre-hypertension and determine which obesity indices can serve as predictors.

Subjects and methods: Data from children and adolescents aged 7–17?years in the 2011 Chinese Health and Nutrition Survey were analysed. Partial correlation analysis and receiver operating characteristics analysis were applied.

Results: The area under curve (AUC) values for all the predictors are better for differentiating hypertension than pre-hypertension. Body Mass Index (BMI) gave the largest AUC in both children and adolescents. ABSI and ABSI-(C) (ABSI for Chinese children and adolescents) were unable to differentiate hypertension or pre-hypertension in the population. BAI could only differentiate pre-hypertension in girls aged 7–12?years (AUC = 0.353, p?<?0.05).

Conclusion: ABSI, ABSI-(C) and BAI are not more associated with hypertension or pre-hypertension than BMI, waist circumference and waist-to-height ratio in Chinese children and adolescents.     

The lack of effect of benzalkonium chloride on the cilia of the nasal mucosa in patients with perennial allergic rhinitis: a combined functional, light, scanning and transmission electron microscopy study

Background Controversy still exists about the effect of 0.02% benzalkonium chloride (BKC). a preservative in many nasal sprays, on human nasal epithelium in vivo. Objective To determine the safety of BKC by assessing its effect on the function and morphology of cilia of human nasal epithelium. Methods A single-centre, double-blind nasal biopsy study in 22 patients with perennial allergic rhinitis, receiving fluticasone propionate aqueous nasal spray (FPANS) containing BKC. BKC plus placebo or placebo alone for 6 weeks. Before, at two weekly intervals during treatment and 2 weeks after treatment ceased an indigocarmine saccharine transport time (ICST) was performed. Results ICST results did not significantly vary between the groups. There was no statistical relationship between the number of ciliated cells present and the treatment the patients received. Scanning and transmission electron microscopy examination showed no effects of BKC. Conclusion Despite reports of its ciliostatic effects in vitro. BKC did not have such an effect when it was applied for 6 weeks (with/without fluticasone propionale) to the nasal mucosa of perennial allergic rhinitis patients in vivo.