Long-term serologic follow-up of blood donors with biologic false reactivity on an anti-human T-cell lymphotropic virus Types I and II chemiluminescent immunoassay and implications for donor management

BACKGROUND: This study reports the results of the long‐term serologic follow‐up of blood donors who gave an index biologic false‐reactive (BFR) result on an anti‐human T‐lymphotropic virus Types I and II (HTLV‐I and ‐II) chemiluminescent immunoassay (ChLIA). STUDY DESIGN AND METHODS: All allogeneic whole‐blood and apheresis donors who gave an index BFR result on a HTLV‐I and ‐II ChLIA between May 10, 1997, and December 31, 2004, were included in the study. Donors were followed up for an additional 2 years until December 31, 2006. RESULTS: A total of 332 donors gave an index BFR donation during the study period. Donors were divided into five groups based on results of donations subsequent to the index BFR donation: 89 (26.8%) donors gave only nonreactive donations subsequent to the index BFR result, 56 (16.9%) donors gave only BFR donations, 43 (13.0%) gave one or more subsequent BFR donations before giving only nonreactive donations, 59 (17.8%) donors gave intermittent BFR and nonreactive donations, and 85 (25.6%) donors gave no further donations during the study period. The estimated mean duration of biologic false reactivity from the time of the index BFR donation in donors who gave only a single BFR result was 7.0 (1.4‐42.75) months and 23.3 (4.1‐92.25) months in those donors who gave several BFR results before giving nonreactive donations. Modeling of the data indicated that notification and deferral of donors after two consecutive BFR donations would result in the deferral of 143 of 332 (43.1%) of donors with an index BFR result while allowing donors to give three BFR results would reduce the number of deferred donors to 74 of 332 (22.3%). CONCLUSION: The results of this study indicate that although biologic false reactivity is usually transient, the time for resolution is variable. Allowing donors to give two or three BFR results before notification and deferral is one strategy that would substantially reduce the number of donors requiring deferral.     

Knowledge and use of medicinal plants by people around Debre Libanos monastery in Ethiopia

The study was conducted around Debre Libanos monastery from October 2005 to June 2006. A total of 250 villagers, 13 monks and 3 nuns were interviewed using semistructured questionnaire on the knowledge and use of medicinal plants. The informant consensus factor (ICF) and the fidelity level (FL) of the species were determined. Eighty medicinal plant species were reported. The average medicinal plant reported by a female is 1.67+/-0.33 and a male is 5.77+/-0.71 with significant difference between them (alpha=0.05, p=0.023). The ICF values demonstrated that local people tend to agree more with each other in terms of the plants used to treat 'Mich' and headache (0.69) and intestinal illness and parasites (0.68) but a much more diverse group of plants are cited to treat problems related to rabies (0.14) and unidentified swelling and cancer (0.11). The FL values are also similar to ICF values. The knowledge of the villagers close to the monastery is found to be higher than those distant from the monastery and the correlation between Abichu and Telaye (r=0.970, alpha=0.05, p=0.001), and Zegamel and Doreni (r=0.745, alpha=0.05, p=0.027) is significant indicating the relationships between the number of plants reported by the informants and the distance from the monasteries to the villages. This study was not able to determine the knowledge difference between the villagers and the monastery dwellers because the monks and nuns were not willing to give information on the knowledge and use of medicinal plants. This may result in the long run in loss of local knowledge in the surrounding area and the country at large for preparation of pharmacologically effective remedies.     

In vitro antitrypanosomal activity of Moringa stenopetala leaves and roots.

The leaves and the root extracts of Moringa stenopetala were tested in vitro against trypomastigotes of Trypanosoma brucei, Trypanosoma cruzi and L. donovani amastigotes. The fresh root wood ethanol extract and the dried leaves acetone extract were found to be active against T. brucei with an ED(50) value of 9.2 microg/mL and 10.0 microg/mL respectively. All the other extracts were inactive against all the tested parasite forms.     

Vaccination coverage survey versus administrative data in the assessment of mass yellow fever immunization in internally displaced persons--Liberia, 2004

Yellow fever (YF) is a mosquito-borne vaccine-preventable disease with high mortality. In West Africa, low population immunity increases the risk of epidemic transmission. A cluster survey was conducted to determine the effectiveness of a mass immunization campaign using 17D YF vaccine in internally displaced person (IDP) camps following a reported outbreak of YF in Liberia in February 2004. Administrative data of vaccination coverage were reviewed. A cluster sample size was determined among 17,384 shelters using an 80% vaccination coverage threshold. A questionnaire eliciting demographic information, household size, and vaccination status was distributed to randomly selected IDPs. Data were analyzed to compare vaccination coverage rates of administrative versus survey data. Among 87,000 persons estimated living in IDP camps, administrative data recorded 49,395 (57%) YF vaccinated persons. A total of 237 IDPs were surveyed. Of survey respondents, 215 (91.9%, 95% CI 88.4-95.4) reported being vaccinated during the campaign and 196 (83.5%, 95% CI 78.6-88.5) possessed a valid campaign vaccination card. The median number of IDPs living in a shelter was 4 (range, 1-8) and 69,536 persons overall were estimated to be living in IDP camps. Coverage rates from a rapid survey exceeded 90% by self-report and 80% by evidence of a vaccination card, indicating that the YF immunization campaign was effective. Survey results suggested that administrative data overestimated the camp population by at least 20%. An emergency, mop-up vaccination campaign was avoided. Coverage surveys can be vital in the evaluation of emergency vaccination campaigns by influencing both imminent and future immunization strategies.     

Adverse birth outcomes and associated factors among mothers who delivered in Bale zone hospitals,Oromia Region,Southeast Ethiopia

ObjectiveAdverse birth outcomes, which include stillbirth, preterm birth, low birthweight, congenital abnormalities, and stillbirth, are the leading cause of neonatal and infant mortality worldwide. We assessed adverse birth outcomes and associated factors among mothers who gave birth in Bale zone hospitals, Oromia, Southeast Ethiopia.MethodsWe used systematic random sampling in this cross-sectional study. We identified factors associated with adverse birth outcomes using bivariate analysis and multivariable logistic regression analysis.ResultsThe proportion of adverse birth outcomes among participants was 21%. Of 576 births, 70 (12.2%) were low birthweight, 49 (8.5%) were preterm birth, 45 (7.8%) were stillbirth, and 18 (3.1%) infants had congenital anomalies. Inadequate antenatal care (adjusted odds ratio [AOR] = 6.58, 95% confidence interval [CI] 3.25–13.32), multiple pregnancy (AOR  =  4.74, 95% CI 1.55–14.45), premature rupture of membranes in the current pregnancy (AOR = 2.31, 95% CI 1.26–4.21), hemoglobin level  < 11 g/dL (AOR = 3.22, 95% CI 1.85–5.58), and mid-upper arm circumference less than 23 cm (AOR = 5.93, 95% CI 3.49–10.08) were all significantly associated with adverse birth outcomes.ConclusionsApproximately one in five study participants had adverse birth outcomes. Increasing antenatal care uptake, ferrous supplementation during pregnancy, and improving the quality of maternal health services are recommended.     

Isolation and antimicrobial drug susceptibility pattern of bacterial pathogens from pediatric patients with otitis media in selected health institutions,Addis Ababa,Ethiopia: a prospective cross-sectional study

Background

Otitis media is inflammation of the middle ear and tympanic membrane, which often occurs after an acute upper respiratory tract infection. It is the most common episode of infection in children and the second most important cause of hearing loss affecting 1.23 billion people, thus ranked fifth global burden of disease with a higher incidence in sub-Saharan Africa. Thus, the aim of this study was to determine the isolation rate of bacterial pathogens from pediatric patients with otitis media.

Methodology

Institutional based cross-sectional study was conducted from January 2013–June 2014 in Addis Ababa among 210 pediatrics patients. Demographic, clinical and associated factors data was obtained in face to face interview with guardians/parents by 5 trained nurse data collectors using structured questionnaire. Middle ear drainage swab was collected following all aseptic procedures and transported to the microbiology laboratory. Culture and Antimicrobial sensitivity test were performed according to the standards. The data quality was assured by questionnaire translation, retranslation and pretesting. Reference strains were used as a positive and negative control for biochemical tests, and culture results were cross checked. Data was checked for completeness, consistency and then entered into Epi Info v3.5.1 and analyzed by SPSS v20. Data interpretation was made using graphs, tables, and result statements.

Result

A total of 196 middle ear drainage swab samples were analyzed from pediatric patients and of those 95 (48.5%) samples were positive for pathogenic organisms. The major isolate was S. aureus (15.8%) followed by P. aeruginosa (10.9%), Viridians streptococcus (9.9%), S. pneumoniae (8.9%) and S. pyogenes (7.9%). Upper respiratory tract infection history and living in the rural area have shown significant association with the isolation of pathogenic organism, (p-value?=?0.035) and (p-value?=?0.003) respectively. Most of the isolates show a high level of resistance to Trimethoprim-Sulfamethoxazole, Penicillin G, Ampicillin, Amoxicillin, and Chloramphenicol.

Conclusion

S. aureus and P. aeruginosa are the most common pathogens that contribute to otitis media as well most of the isolates show a high level of resistance to commonly used drugs to treat otitis media. Therefore, culture and susceptibility testes have paramount importance for the better management of otitis media and drug-resistant infections.

     

Impact of temperature and precipitation on propagation of intestinal schistosomiasis in an irrigated region in Ethiopia: suitability of satellite datasets

Objective To assess the suitability of satellite temperature and precipitation datasets for investigating the dependence of Schistosoma mansoni disease transmission on meteorological conditions in an irrigated agricultural region in Ethiopia. Methods Data used were monthly number of patients infected with S. mansoni and seeking treatment at the local hospital, monthly maximum air temperature from a local weather station, monthly average land surface temperature from MODIS satellite data, monthly total precipitation from a local rain gauge and precipitation estimates from four widely used satellite products, namely, TMPA 3B42RT, TMPA 3B42, CMORPH and PERSIANN. The number of patients was used as proxy for vector abundance. Results Temperature and precipitation play a role in the transmission of S. mansoni disease. There is a weak but significant positive correlation between monthly maximum air temperature derived from a meteorological station (or average land surface temperature derived from MODIS satellite product) and the number of patients in the same month. There is a significant negative correlation between monthly precipitation volume (derived from rain gauge or satellite data) and number of patients at lags of 1 and 2 months. Conclusion Satellite temperature and precipitation products provide useful information to understand and infer the relationship between meteorological conditions and S. mansoni prevalence.