Spatial Modelling of Risk Factors for Malaria Prevalence in SNNP Regional State,Ethiopia

BackgroundMalaria is one of the most severe public health problems worldwide with 300 to 500 million cases and about one million deaths reported to date of which 90% were from world health organization (WHO) Sub Saharan Africa (SSA) countries. The purpose of this study was to explore the spatial distribution of malaria parasite prevalence (MPP) among districts of Southern Nations Nationalities and Peoples Regional State (SNNRS) in Ethiopia by using 2011 malaria indicator survey (MIS) data collected for 76 districts and to model its relationship with different covariates.MethodExploratory spatial data analysis (ESDA) was conducted followed by implementation of spatial lag model (SLM) and spatial error model (SEM) in GeoDa software. Queen contiguity second order type of spatial weight matrix was applied in order to formalize spatial interaction among districts.ResultsFrom ESDA, we found positive spatial autocorrelation in malaria prevalence rate. Hot spot areas for MPP were found in the eastern and southeast parts of the region. Relying on specification diagnostics and measures of fit, SLM was found to be the best model for explaining the geographical variation of MPP. SLM analysis demonstrated that proportion of households living in earth/local dung plastered floor house, proportion of households living under thatched roof house, average number of rooms/person in a given district, proportion of households who used anti-malaria spray in the last 12 months before the survey, percentage household using mosquito nets and average number of mosquito nets/person in a given district have positive and statistically significant effect on spatial distribution of MPP across districts of SNNPRS. Percentage of households living without access to radio and television has negative and statistically significant effect on spatial distribution of MPP across districts of MPP.ConclusionMalaria is spatially clustered in space. The implication of the spatial clustering is that, in cases where the decisions on how to allocate funds for interventions needs to have spatial dimension.     

Clinical Characteristics and Outcomes of Patients with COVID-19 Infection and Acute Ischemic Stroke at Eka Kotebe General Hospital in Addis Ababa,Ethiopia

BackgroundAcute ischemic stroke has been reported to occur in a significantly higher number of COVID-19 patients as compared to healthy controls with variable proposed pathophysiologic mechanisms. To our knowledge, sufficient data regarding this subject is lacking in Ethiopia and the African continent at large. In this case series, we report the clinical characteristics and management of 5 cases with COVID-19 infection and acute ischemic stroke to shed light on the diagnostic and therapeutic challenges in resource-limited setups.MethodsThis is a case series including data collected from the medical records of 5 participants with confirmed RT-PCR positive COVID-19 infection and radiologically confirmed acute ischemic stroke, admitted at Eka Kotebe General Hospital Intensive Care Unit (ICU) in Addis Ababa, Ethiopia from June 10, 2020, to November 04, 2020.ResultsCryptogenic stroke was documented in 4/5 participants included in this series with the most common vascular risk factors identified for stroke being hypertension and diabetes mellitus. The median time from onset of COVID-19 symptoms to the identification of stroke was 07 days. Two fifth of the participants in this series died during their ICU admission with the immediate cause of deaths reported to be related to the severe COVID-19 infection but not stroke.ConclusionCryptogenic stroke was documented in 4/5 patients in this series despite the presence of vascular risk factors for other stroke subtypes. The overall prevalence, subtypes, and outcomes of stroke in COVID-19 patients in Ethiopia and the African continent as a whole needs additional research to elucidate the local burden of the disease and define the predominant pathophysiologic mechanisms for stroke in COVID-19 in the region.     

Changing hygiene behaviours: a cluster-randomized trial,Ethiopia

ObjectiveTo determine whether a water, sanitation and hygiene intervention could change hygiene behaviours thought to be important for trachoma control.MethodsWe conducted a cluster-randomized trial in rural Ethiopia from 9 November 2015 to 5 March 2019. We randomized 20 clusters to an intervention consisting of water and sanitation infrastructure and hygiene promotion and 20 clusters to no intervention. All intervention clusters received a primary-school hygiene curriculum, community water point, household wash station, household soap and home visits from hygiene promotion workers. We assessed intervention fidelity through annual household surveys.FindingsOver the 3 years, more wash stations, soap and latrines were seen at households in the intervention clusters than the control clusters: risk difference 47 percentage points (95% confidence interval, CI: 41–53) for wash stations, 18 percentage points (95% CI: 12–24) for soap and 12 percentage points (95% CI: 5–19) for latrines. A greater proportion of people in intervention clusters reported washing their faces with soap (e.g. risk difference 21 percentage points; 95% CI: 15–27 for 0–5 year-old children) and using a latrine (e.g. risk difference 9 percentage points; 95% CI: 2–15 for 6–9 year-old children). Differences between the intervention and control arms were not statistically significant for many indicators until the programme had been implemented for at least a year; they did not decline during later study visits.ConclusionThe community- and school-based intervention was associated with improved hygiene access and behaviours, although changes in behaviour were slow and required several years of the intervention.     

Cardioprotective Effects of Nicorandil,a Mitochondrial Potassium Channel Opener against Doxorubicin‐Induced Cardiotoxicity in Rats

Doxorubicin is a chemotherapeutic drug used to treat solid and haematopoietic tumours. Its use is limited by a major side effect of cardiotoxicity. It was reported that doxorubicin‐induced cardiotoxicity is mediated through oxidative stress coupled with impaired NO bioavailability and NF‐κB activation. Nicorandil, a mitochondrial ATP‐dependent potassium (K_ATP) channel opener, was reported to be cardioprotective on ischaemic myocardium. However, the effect of nicorandil against doxorubicin‐induced cardiotoxicity has not yet been clarified. Accordingly, six groups of rats were used. The first three groups were injected with vehicle, nicorandil (3 mg/kg) orally and doxorubicin (a single intraperitoneal injection of 20 mg/kg), respectively. Group four was treated with nicorandil, whereas group five was treated with glibenclamide and then nicorandil starting 2 days before doxorubicin and continued for five consecutive days. Group six was treated with glibenclamide alone. At the end of the experiment, the rats were killed. Cardiac enzyme indexes were measured in serum. Heart tissues were processed for determination of nitrite/nitrate, NF‐κB protein expression, glutathione (GSH), lipid peroxide (TBARS) levels and superoxide production. In addition to body‐weight reduction, doxorubicin produced cardiotoxicity as indicated from the increase in lactate dehydrogenase (LDH), creatine kinase (CK) activities, TBARS, superoxide production, NF‐κB expression and caspase‐3 activity. Moreover, doxorubicin decreased GSH and nitrite/nitrate levels. Histopathological examination of doxorubicin‐treated hearts revealed degenerative changes. On the other hand, nicorandil protected cardiac tissues against doxorubicin cardiotoxicity as demonstrated from normalization of cardiac biochemical and oxidative stress parameters and amelioration of histopathological changes. Glibenclamide, a blocker of the K_ATP channel, reversed most of the cardiac effects of nicorandil.