Health care seeking behavior for depression in Northeast Ethiopia: depression is not considered as illness by more than half of the participants

Background

Depression is one of the most disabling and chronic mental illnesses. Despite its high burden, many people suffering from depression did not perceive that they had a treatable illness and consequently most of them did not seek professional help. The aim of this study was to assess the level of professional help-seeking behavior and associated factors among individuals with depression.

Methods and materials

The community-based cross-sectional study was conducted among residents of Dessie, Northeast Ethiopia. First, 1165 residents were screened for depression using patient health questionnaire and then 226 individuals who were screened positive for probable depression were interviewed with General Help-Seeking Questionnaire to assess the professional help-seeking behavior of participants with depression. Major associated variables were identified using logistic regression with 95% confidence interval (CI), and variables with a p value less than 0.05 were considered statistically significant.

Results

Among the total participants with depressive symptoms, only 25.66% of them did seek professional help. Being female [adjusted odds ratio (AOR)?=?2.769, 95% CI (1.280, 5.99)], current alcohol drinking [AOR?=?2.74, 95% CI (1.265, 5.940)], co-morbid medical-surgical illness [AOR?=?4.49, 95% CI (1.823, 11.071)], perceiving depression as illness [AOR?=?2.44, 95% CI (1.264, 4.928)], having moderate depressive symptoms [AOR?=?2.54, 95% CI (1.086, 5.928)] and moderately severe depressive symptoms [AOR?=?7.67, 95% CI (2.699, 21.814)] were significantly associated with help seeking behavior of participants.

Conclusions

Level of professional help-seeking behavior is as low as previous studies in different countries. The severity of depressive symptoms, co-morbidity of medical–surgical illness, current drinking of alcohol, being female, and perceiving depression as illness were significantly associated with professional help-seeking behavior for depressive symptoms. Working on mental health literacy in the community is important to increase help-seeking behavior.

     

Severe malaria in the under-fives--clinical featrues, management and outcome in a district hospital

A prospective hospital based study on severe malaria in under-five children was carried out over a period of one year in a district hospital of Ethiopia to determine the case fatality rate (CFR), factors contributing for high mortality, health seeking behaviour of the care takers, direct cost and feasibility of operating the WHO treatment guidelines at a district level. One hundred and one children aged between 6 and 59 months fulfilling the criteria of severe malaria have been recruited in the study and treated according to WHO guidelines. The most frequently encountered clinical manifestations of severe malaria were prostration and hypoglycaemia, the prevalence being 28.7% respectively. The over all case fatality rate of severe malaria was 11.9%. Cerebral malaria was the only isolated form of severe malaria with high CFR (OR=5.06, 95%CI 1.01-25.1). The hospital CFR of severe anaemia was 16.7%, which could have been reduced by provision of safe blood transfusion. Most of the children (80.2%) presented to the hospital in more than 24 hours after the onset of the illness. Forty seven percent of children received drugs at home and in 96% of the cases it was antimalarial drugs. The antimalarial drug treatment (dose/duration) was adequate in 71%. Children receiving appropriate anti-malaria treatment at home show a tendency towards a lower CFR. The total direct cost per disease episode ranged from USD 13.75 to 27.5. Eighty five percent of the direct cost was due to expenditures in the hospital. Implementation of the management protocol based on the WHO guidelines has required substantial input of resources. Major constraints noted were related to availability of safe blood andfollow-up after discharge. The study provides useful information for improved case management of severe malaria thereby reduce mortality of the under-five children due to severe malaria.     

Comfort Evaluation of Wearable Functional Textiles

Wearable E-textile systems should be comfortable so that highest efficiency of their functionality can be achieved. The development of electronic textiles (functional textiles) as a wearable technology for various applications has intensified the use of flexible wearable functional textiles instead of wearable electronics. However, the wearable functional textiles still bring comfort complications during wear. The purpose of this review paper is to sightsee and recap recent developments in the field of functional textile comfort evaluation systems. For textile-based materials which have close contact to the skin, clothing comfort is a fundamental necessity. In this paper, the effects of functional finishing on the comfort of the textile material were reviewed. A brief review of clothing comfort evaluations for textile fabrics based on subjective and objective techniques was conducted. The reasons behind the necessity for sensory evaluation for smart and functional clothing have been presented. The existing works of literature on comfort evaluation techniques applied to functional fabrics have been reviewed. Statistical and soft computing/artificial intelligence presentations from selected fabric comfort studies were also reviewed. Challenges of smart textiles and its future highlighted. Some experimental results were presented to support the review. From the aforementioned reviews, it is noted that the electronics clothing comfort evaluation of smart/functional fabrics needs more focus.     

Development of Stainless Steel Yarn with Embedded Surface Mounted Light Emitting Diodes

The integration of electronic components in/onto conductive textile yarns without compromising textile qualities such as flexibility, conformability, heat and moisture transfer, and wash resistance is essential to ensuring acceptance of electronic textiles. One solution is creating flexible and stretchable conductive yarns that contain tiny surface-mounted electronic elements embedded at the fiber level. The purpose of this work was to manufacture and subsequently evaluate the physical features and electromechanical properties of stainless steel yarn with light-emitting surface mounted devices (SMDs) embedded in it. The SMDs were successfully integrated into a conductive stainless steel yarn (SS) by inserting crimp beads and creating a bond through hot air soldering machines, resulting in what we call an E-yarn. The relationship curves between gauge length and electrical resistance, and the relationship curves between conductive yarn elongation and electrical resistance, were explored experimentally. The results of the analysis demonstrated that E-yarn had a lower tensile strength than the original electrically-conductive SS yarn. The effects of the washing cycle on the conductivity of the E-yarn were also investigated and studied. The results showed that E-yarns encapsulated at the solder pad by heat shrink tube still functioned well after ten machine wash cycles, after which they degraded greatly.     

Health care seeking among pulmonary tuberculosis suspects and patients in rural Ethiopia: a community-based study

Background  

Health care seeking is a dynamic process that is influenced by socio-demographic, cultural and other factors. In Ethiopia, there are limited studies regarding the health seeking behaviour of tuberculosis (TB) suspects and TB patients. However, a thorough understanding of patients' motivation and actions is crucial to understanding TB and the treatment of disease. Such insights would conceivably help to reduce delay in diagnosis, improve treatment adherence and thereby reduce transmission of TB in the community. The objective of this study was to describe and analyze health care seeking among TB suspects and pulmonary TB (PTB) cases in a rural district of the Amhara Region in Ethiopia.     

Role of PD-1 and its ligand, B7-H1, in early fate decisions of CD8 T cells

Expression of the PD-1 receptor on T cells has been shown to provide an important inhibitory signal that down-modulates peripheral effector responses in normal tissues and tumors. Furthermore, PD-1 up-regulation on chronically activated T cells can maintain them in a partially reversible inactive state. The function of PD-1 in the very early stages of T-cell response to antigen in vivo has not been fully explored. In this study, we evaluate the role of PD-1 and its 2 B7 family ligands, B7-H1 (PD-L1) and B7-DC (PD-L2), in early fate decisions of CD8 T cells. We show that CD8 T cells specific for influenza hemagglutinin (HA) expressed as a self-antigen become functionally tolerized and express high levels of surface PD-1 by the time of their first cell division. Blockade of PD-1 or B7-H1, but not B7-DC, at the time of self-antigen encounter mitigates tolerance induction and results in CD8 T-cell differentiation into functional cytolytic T lymphocytes (CTLs). These findings demonstrate that, in addition to modulating effector functions in the periphery, B7-H1:PD-1 interactions regulate early T-cell-fate decisions.     

Daratumumab,bortezomib, cyclophosphamide and dexamethasone in newly diagnosed and relapsed multiple myeloma: LYRA study

This United States community study evaluated the combination of daratumumab, bortezomib, cyclophosphamide and dexamethasone (D-VCd) in newly diagnosed multiple myeloma (NDMM) and relapsed multiple myeloma (RMM). Patients received 4–8 induction cycles of bortezomib 1·5 mg/m², cyclophosphamide 300 mg/m² and dexamethasone 40 mg weekly. Intravenous daratumumab 16 mg/kg was administered as approved except for a split-first dose in Cycle 1. Eligible patients underwent autologous stem cell transplantation. All patients received ≤12 daratumumab maintenance doses monthly. Eighty-six NDMM and 14 RMM patients received ≥1 treatment dose. In NDMM patients, very good partial response or better (≥VGPR) and overall response rates after 4 induction cycles were 44% (primary endpoint) and 79%, respectively, and 56% and 81% at end of induction. The 12-month progression-free survival (PFS) rate was 87%. Efficacy was also observed in RMM patients. Fatigue (59%) and neutropenia (13%) were the most frequent treatment-emergent adverse event (TEAE) and grade 3/4 TEAE, respectively. Infusion reactions occurred in 54% of patients, primarily during the first dose, and were mild (2% grade 3). The first 2 daratumumab infusions were 4·5 and 3·8 h (median). Overall, D-VCd was well tolerated, split-first daratumumab dosing was feasible, the ≥VGPR rate after 4 cycles was 44% and the 1-year PFS rate was 87%.