The frequency of an IL-18-associated haplotype in Africans

Variation within the gene for the proinflammatory cytokine interleukin (IL)-18 has been associated with inter-individual differences in levels of free protein and disease risk. We investigated the frequency of function-associated IL18 gene haplotypes in an extensive sample (n=2357) of African populations from across the continent. A previously identified five tagging SNP (single-nucleotide polymorphism) haplotype (here designated hGTATA), known to be associated with lower levels of IL-18, was observed at a frequency of 27% in a British population of recent European ancestry, but was found at low frequency (<8%) or completely absent in African populations. Potentially protective variants may, as a consequence, be found at low frequency in African individuals and may confer a difference in disease risk.     

Multiple correspondence analysis as a tool for analysis of large health surveys in African settings

Background

More than two thirds of the total population of Ethiopia is estimated to be at risk of malaria. Therefore, malaria is the leading public health problem in Ethiopia.

Objective

To investigate the determinants of malaria Rapid Diagnosis Test (RDT) result and the association between socio-economic, demographic and geographic factors.

Method

The study used data from household cluster malaria survey which was conducted from December 2006 to January 2007. A total of 224 clusters of about 25 households each were selected from the Amhara, Oromiya and Southern Nation Nationalities and People (SNNP) regions of Ethiopia. A multiple correspondence analysis was used to jointly analyse malaria RDT result, socio-economic, demographic and geographic factors.

Results

The result from multiple correspondence analysis shows that there is association between malaria RDT result and different socio-economic, demographic and geographic variables.

Conclusion

There is an indication that some socio-economic, demographic and geographic factors have joint effects. It is important to confirm the association between socio-economic, demographic and geographic factors using advanced statistical techniques.     

Modelling CD4 counts before and after HAART for HIV infected patients in KwaZulu-Natal South Africa

BackgroundThis study aims to make use of a longitudinal data modelling approach to analyze data on the number of CD4+cell counts measured repeatedly in HIV-1 Subtype C infected women enrolled in the Acute Infection Study of the Centre for the AIDS Programme of Research in South Africa.MethodologyThis study uses data from the CAPRISA 002 Acute Infection Study, which was conducted in South Africa. This cohort study observed N=235 incident HIV-1 positive women whose disease biomarkers were measured repeatedly at least four times on each participant.ResultsFrom the findings of this study, post-HAART initiation, baseline viral load, and the prevalence of obese nutrition status were found to be major significant factors on the prognosis CD4+ count of HIV-infected patients.ConclusionEffective HAART initiation immediately after HIV exposure is necessary to suppress the increase of viral loads to induce potential ART benefits that accrue over time. The data showed evidence of strong individual-specific effects on the evolution of CD4+ counts. Effective monitoring and modelling of disease biomarkers are essential to help inform methods that can be put in place to suppress viral loads for maximum ART benefits that can be accrued over time at an individual level.     

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.     

Ribosomal RNA evidence of ocular Chlamydia trachomatis infection following 3 annual mass azithromycin distributions in communities with highly prevalent trachoma

Twelve trachoma-hyperendemic communities were treated with 3 annual mass azithromycin distributions. Children aged 0-9 years were monitored 1 year following the third treatment. An RNA-based test detected ocular chlamydial infection in more children than did a DNA-based test (6.9% vs 4.2%), and in a larger number of communities (8 vs 7).     

Prevalence and associated factors of treatment failure among HIV/AIDS patients on HAART attending University of Gondar Referral Hospital Northwest Ethiopia

Background

The initiation of highly active antiretroviral therapy (HAART) plays a significant role in the clinical management of HIV infected people by preventing morbidity and mortality. This benefit becomes, the most terrible when treatment failure develops. Thus, this research aims to assess the prevalence and associated factors of treatment failure among HIV/AIDS patients on HAART attending University of Gondar Referral Hospital Northwest Ethiopia.

Results

Patients on ART with a minimum of 6?months and up to 12?years of treatment were being enrolled. The prevalence of treatment failure, immunological failure and virological failure among people living with HIV/AIDS attending University of Gondar referral hospital were 20.3, 13.2, and 14.7%, respectively. Patients who had no formal education (Adjusted odds ratio (AOR): 3.8; 95% CI, 1.05–13.77), primary level education (AOR: 4.2; 95% CI, 1.16–15.01) and duration on ART <?6?years (AOR: 2.1; 95%CI, 1.12–3.81) were a significant risk factor. However, initial adult regimen D4T?+? 3TC+ EFV (AOR: 0.025; 95% CI, 0.002–0.36), AZT +3TC?+?NVP (AOR: 0.07; 95% CI, 0.01–0.71), AZT?+? 3TC?+?EFV (AOR: 0.046; 95% CI, 0.004–0.57) andTDF+3TC?+?EFV (AOR: 0.04; 95% CI, 0.004–0.46) were significantly protective for treatment failure.

Conclusions

Timely and early identification of associated factors and monitoring antiretroviral therapy treatment failure should be done to enhance the benefit and to prevent further complication of the patients. It is preferable to initiate ART using any one of the following ART regimens: AZT +3TC?+?NVP, AZT?+?3TC?+?EFV and TDF?+?3TC?+?EFV to prevent treatment failure. Since the prevalence of this treatment failure and its associated factor may be different from other ART centers and community in Ethiopia, further national representative institutional based cross-sectional researches are needed across all ART centers of Ethiopia in order to determine the prevalence of treatment failure and its associated factors.