Ectoparasites of goats in three agroecologies in central Oromia, Ethiopia

A cross-sectional study was conducted to determine the prevalence and risk factors for ectoparasites infestation in 979 goats in three agroecologies in central Oromia, Ethiopia from October 2009 through April 2010. The results of the study showed that of the total goats examined 487 (49.7 %) of them were infested with one or more ectoparasites. The ectoparasites identified were (16.5 %) Linognathus spp., 8.8 % Sarcoptes, 5 % Ctenocephalides spp. 11.8 % Amblyomma variegatum, 5.9 % Rhipicephalus evertsi evertsi, 4.3 % Rhipicephalus pravus, 1.6 % Boophilus decoloratus, 1.8 % Rhipicephalus sanguineus, 1.3 % Rhipicephalus praetextatus, and 0.4 % Hyalomma truncatum. Statistically significant (OR?=?0.477, p?=?0.000) difference was observed in prevalence of Linognathus stenopsis among highland, lowland and midland. Significantly higher prevalence of tick infestation in the lowland than both the midland and highland agroecology was recorded. The risk of tick infestations in lowland and midland was 2.841 and 5.635 times, respectively, higher than in highlands. Age-related variation was not observed in the prevalence of both Linognathus and tick infestations in examined goats. Significantly (OR?=?7.864, p?=?0.000) higher prevalence of sarcoptic mange in the lowland than the midland was observed. Goats in lowland were 7.864 times at higher risk for sarcoptic mange than those in the midlands. Sex-related variation in the prevalence of ectoparasites was never recorded in goats. Significantly higher prevalence of sarcoptic mange (OR?=?0.266, p?=?0.000) and Ctenocephalides spp. (OR?=?2.430, p?=?0.005) on young than adult goats was recorded. The logistic regression results showed statistically significant difference in prevalence of tick infestations (OR?=?0.565, p?=?0.000) and sarcoptic mange (OR?=?0.582, p?=?0.003) between goats with poor and good body condition. Further studies on role of ectoparasites in transmission of diseases to goats, comparative prevalence and load, and the importance of goats as alternative hosts in different agroecology and management systems in Ethiopia are recommended so as to design applicable control program in the country. Furthermore, the threat of ectoparasites on overall productivity of goats and the tanning industry warrants detail studies and urgent control intervention.     

Effect of fructose on blood pressure: a systematic review and meta-analysis of controlled feeding trials

Concerns have been raised about the adverse effect of fructose on blood pressure. International dietary guidelines, however, have not addressed fructose intake directly. A systematic review and meta-analysis was conducted to assess the effect of fructose in isocaloric exchange for other carbohydrates on systolic, diastolic, and mean arterial blood pressures. Studies were identified using Medline, Embase, and Cochrane databases (through January 9, 2012). Human clinical trials of isocaloric oral fructose exchange for other carbohydrate sources for ≥7 days were included in the analysis. Data were pooled by the generic inverse variance method using random-effects models and expressed as mean differences with 95% CI. Heterogeneity was assessed by the Q-statistic and quantified by I(2). Study quality was assessed using the Heyland Methodological Quality Score. Thirteen isocaloric (n=352) and 2 hypercaloric (n=24) trials met the eligibility criteria. Overall, fructose intake in isocaloric exchange for other carbohydrates significantly decreased diastolic (mean difference: -1.54 [95% CI: -2.77 to -0.32]) and mean arterial pressure (mean difference: -1.16 [95% CI: -2.15 to -0.18]). There was no significant effect of fructose on systolic blood pressure (mean difference: -1.10 [95% CI: -2.46 to 0.44]). The hypercaloric fructose feeding trials found no significant overall mean arterial blood pressure effect of fructose in comparison with other carbohydrates. To confirm these results, longer and larger trials are needed. Contrary to previous concerns, we found that isocaloric substitution of fructose for other carbohydrates did not adversely affect blood pressure in humans.     

Mediators of socioeconomic inequalities in dietary behaviours among youth: A systematic review

Children and adolescents with a lower socioeconomic position have poorer dietary behaviours compared to their counterparts with a higher socioeconomic position. A better understanding of the mechanisms behind such socioeconomic inequalities is vital to identify targets for interventions aimed at tackling these inequalities. This systematic review aimed to summarize existing evidence regarding the mediators of socioeconomic differences in dietary behaviours among youth. A systematic literature search of MEDLINE, Embase, PsycINFO, and Web of Science databases yielded 20 eligible studies. The dietary behaviours included in the reviewed studies were the intake of fruit and vegetables, sugar‐sweetened beverages, unhealthy snacks/fast food and breakfast. The consistent mediators of the effects of socioeconomic position on dietary behaviours among youth were: self‐efficacy, food preferences and knowledge at the intrapersonal level; and availability and accessibility of food items at home, food rules and parental modelling at the interpersonal level. Few studies including mediators at the organisational, community or policy levels were found. Our review found several modifiable factors at the intrapersonal and interpersonal levels that could be targeted in interventions aimed at combating inequalities in dietary behaviours among youth. Rigorous studies exploring organisational, community and policy level mediators are warranted.     

Parasitological,serological and clinical evidence for high prevalence of podoconiosis (non‐filarial elephantiasis) in Midakegn district,central Ethiopia

Objective To determine whether the elephantiasis in Midakegn district, central Ethiopia, is filarial or non‐filarial (podoconiosis) using serological, parasitological and clinical examinations, and to estimate its prevalence. Methods At house‐to‐house visits in 330 randomly selected households, all household members who had elephantiasis were interviewed and clinically examined at the nearby health centre to confirm the presence of elephantiasis, check the presence of scrotal swelling and rule out the other causes of lymphoedema. A midnight blood sample was obtained from each participant with elephantiasis for microscopic examination of Wuchereria bancrofti microfilaria. A daytime blood sample was obtained from half of the participants for serological confirmation using the immuno‐chromatographic test card. Results Consistent with the features of podoconiosis, none of the elephantiasis cases had consistently worn shoes since childhood; 94.3% had bilateral swelling limited below the level of the knees; no individual had thigh or scrotal elephantiasis; parasitological test for microfilariae and serological tests for W. bancrofti antigen were negative in all samples. The prevalence of the disease was 7.4% and it peaked in the third decade of life, the most economically active age. Conclusion Midakegn District has a high prevalence of podoconiosis and no filarial elephantiasis. Prevention, treatment and control of podoconiosis must be among the top priorities of public health programmes.     

Comparison of Paracheck Pf® test with conventional light microscopy for the diagnosis of malaria in Ethiopia

ObjectiveTo assess the accuracy of Paracheck Pf® in reference to the conventional light microscopy.MethodsA total of 400 patients visiting Awash, Methara and Ziway malaria centers were simultaneously screened with both light microscopy and Paracheck Pf® for the presence of Plasmodium falciparum (P. falciparum) malaria.ResultsOf the 190 samples that were negative by light microscope, the Paracheck Pf® showed 11 false positive and 179 true negative results, and from a total of 210 samples positive by light microscope, Paracheck Pf® accurately diagnosed 200 true malaria cases. Taking the light microscopy as a standard test for malaria, the sensitivity, specificity, positive predictive value and negative predictive value of Paracheck Pf® is 95.2% [cofidence interval (CI)=92.4–97.1], 94.2% (CI=91.1–96.3), 94.8% (CI=92.0–96.7) and 94.7% (CI=91.6–96.8), respectively.ConclusionsParacheck Pf® showed good sensitivity and specificity for the diagnosis of P. falciparum malaria, and fulfill the world health organization (WHO) recommendation that requires the sensitivity of rapid diagnostic tests (RDTs) to be greater than 95%. Therefore, Paracheck Pf® can be used as an alternative to the Giemsa stain light microscopy in resource poor set ups.     

Relapsing fever in children--demographic, social and clinical features.

Louse-borne relapsing fever (LBRF) is an acute febrile illness endemic Ethiopia. To date reports of childhood LBRF are few. The demographic, social and clinical features of eighty children with LBRF admitted to Ethio-Swedish Children's Hospital, Addis Abeba between 1989 and 1991 is presented. The mean age of patients was 8.8 years (range 4 months to 15 years). The male to female ratio was 1.2:1. Seventy-seven (97%) patients came from Addis Abeba. They came from poor families living in overcrowded homes. Fever, headache, right upper quadrant pain, chills and rigors were common symptoms. Fever and hepatosplenomegaly were common signs. Three drug regimens were used in the treatment of patients. A combination of penicillin and tetracycline, chloramphenicol alone and erythromycin alone, all given for 3 days. There was only one death. The literature on LBRF in adults is reviewed and the results are compared (1).     

Modeling Complex Disease with Demographic and Environmental Covariates and a Candidate Gene Marker

We randomly chose replicates 28 and 29 of the simulated data sets of Genetic Analysis Workshop 12 to model the dependence of affection status on covariates, quantitative traits, and genes using all living pedigree members. First we explored the relationship of affection status to demographic and environmental factors using logistic regression and the Cox proportional hazards models. In the second stage of our analyses the generalized transmission disequilibrium test (GTDT) was applied to nuclear families with at least two affected siblings to select single markers and high‐risk alleles, which were tested in the population association analyses including all pedigree members. Multiple logistic regression models were fitted to investigate the joint contributions of genetic and nongenetic factors and a block‐recursive modeling approach was adopted to study inherent hierarchical dependence structure in the data. We found that allele 2 on marker 35 of chromosome 6 is associated with higher risk compared with the other 3 alleles of this marker. In addition to this significant genetic effect, age at exam and four of the five quantitative traits (QT1, QT2, QT4, and QT5) had a significant association with the disease. Our results were obtained without knowledge of the true disease generating models. © 2001 Wiley‐Liss, Inc.     

Teaching invasive perinatal procedures: assessment of a high fidelity simulator-based curriculum.

OBJECTIVE: Learning curves pose a difficult problem in the teaching of technical skills: how do you teach procedural skills without compromising patients' health? A simulator-based curriculum has been designed to minimize the risks to patients undergoing amniocentesis by shifting the learning curve away from patients and into the laboratory. This study evaluated the effectiveness of a high-fidelity simulator-based curriculum in improving the performance of amniocentesis by obstetric trainees. DESIGN: Thirty trainees received a course on the practice of amniocentesis. The curriculum consisted of a lecture, a syllabus, and a hands-on training session with the simulator. Pre- and post-training performance were evaluated with two rating scales. Training and performance evaluation were completed using the same simulator. The effectiveness of the simulator-based workshop and the effect of year of training were assessed using a two-way analysis of variance. RESULTS: Performance scores improved from a mean score of 55% to 94% using checklist scoring and from 57% to 88% using global ratings. The two-way analysis of variance revealed a significant effect of training (F1,60 = 43.57; P < 0.001) accounting for 45% of the variance in scores, and a significant effect of experience level (F2,60 = 9.16; P < 0.001) accounting for 25% of the variance in scores. CONCLUSIONS: A comprehensive curriculum based on a high-fidelity simulator was effective at improving skills demonstrated on the simulator. The challenge remains to establish that skills acquired on a simulator are transferable to the clinical setting.     

Salivary and Serum Antibody Response Against Neisseria meningitidis After Vaccination With Conjugate Polysaccharide Vaccines in Ethiopian Volunteers

Meningococcal conjugate vaccines induce serum antibodies crucial for protection against invasive disease. Salivary antibodies are believed to be important for hindering meningococcal acquisition and/or clearance of established carriage. In this study, we measured salivary IgA and IgG antibodies induced by vaccination with a monovalent serogroup A conjugate vaccine or a tetravalent A, C, W and Y conjugate vaccine, in comparison with antibody levels in serum. Saliva and serum samples from Ethiopian volunteers (1–29 years) collected before and eight times on a weekly basis after receiving the serogroup A conjugate vaccine, the tetravalent serogroup A, C, W and Y conjugate vaccine, or no vaccine (control group), were analysed using a multiplex microsphere immunoassay for antibody detection. Serogroup‐specific IgG antibody levels in saliva increased significantly after vaccination with both vaccines. The monovalent serogroup A vaccine also induced an increase in salivary IgA antibodies. A strong correlation between serogroup‐specific IgG antibodies in saliva and serum, and a somewhat lower correlation for IgA, was observed for all serogroups. There was also a strong correlation between specific secretory IgA and IgA antibodies in saliva for all serogroups. Meningococcal conjugate vaccines are able to elicit salivary antibodies against serogroup A, C, W and Y correlating with antibody levels in serum. The strong correlation between saliva and serum antibody levels indicates that saliva may be used as a surrogate of systemic antibody responses.