HIV and intestinal parasites in adult TB patients in a teaching hospital in Northwest Ethiopia

The level of HIV infection and intestinal parasitoses among TB patients was assessed in a hospital-based cross-sectional study involving 257 patients in Gondar, Ethiopia. In TB patients, our study reported co-infection with HIV (52.1%) and intestinal parasites (40.9%) The high prevalence of HIV and intestinal parasites indicates an increased morbidity inTB patients and emphasized the importance of continued HIV sero-surveillance, stool analysis and treatment.     

Comparison of an rRNA-based and DNA-based nucleic acid amplification test for the detection of Chlamydia trachomatis in trachoma

BACKGROUND/AIM: The World Health Organisation (WHO) hopes to achieve global elimination of trachoma, still the leading cause of preventable blindness worldwide, in part through mass antibiotic treatment. DNA-based nucleic acid amplification tests (NAATs) are currently used to evaluate the success of treatment programmes by measuring the prevalence of C trachomatis infection. Some believe that newer ribosomal RNA (rRNA)-based tests may be much more sensitive since bacterial rRNA is present in amounts up to 10 000 times that of genomic DNA. Others believe that rRNA-based tests are instead less sensitive but more specific, due to the presence of dead or subviable organisms that the test may not detect. This study compares an rRNA-based test to a DNA-based test for the detection of ocular C trachomatis infection in children living in trachoma-endemic villages. METHODS: An rRNA-based amplification test and DNA-based polymerase chain reaction (PCR) were performed on swab specimens taken from the right upper tarsal conjunctiva of 56 children aged 0-10 years living in two villages in Amhara, Ethiopia. RESULTS: The rRNA-based test detected ocular C trachomatis infection in 35 (63%) subjects compared with 22 (39%) detected by PCR (McNemar's test, p = 0.0002). The rRNA-based test gave positive results for all subjects that were positive by PCR, and also detected infection in 13 (23%) additional subjects. CONCLUSION: The rRNA-based test appears to have significantly greater sensitivity than PCR for the detection of ocular chlamydial infection in children in trachoma-endemic villages. Using the rRNA-based test, we may be able to detect infection that was previously missed with PCR. Past studies using DNA-based tests to assess prevalence of infectious trachoma following antibiotic treatment may have underestimated the true prevalence of infection.     

Guillain-Barré Syndrome Associated with SARS CoV-2 Infection: Case Report

BackgroundSince the outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV2) in December 2019, there have been some case reports of Coronavirus disease 19 (COVID 19) associated Guillain-Barré Syndrome (GBS). GBS is an inflammatory polyradiculoneuropathy associated with numerous viral and bacterial infections. Here we describe the case of an Ethiopian man with a typical clinical and electrophysiological manifestation of GBS.Case PresentationA 70-year-old male presented with four days history of progressive and ascending bilateral limbs weakness which end up with respiratory failure. He had an antecedent headache, loss of appetite, and generalized fatigue. Electrophysiological studies showed Acute Motor and Sensory Axonal Neuropathy whereas and cerebrospinal fluid analysis revealed albuminocytologic dissociation with positive preintubation SARS CoV2 test. He was treated with supportive care and recovered successfully.ConclusionThis case illustrates one of the few occasions when patients with mild COVID-19 develop severe neurologic manifestations. Seemingly, early identification and management can improve clinical outcomes. We would like to emphasize the need to consider screening for SARS CoV-2 in patients presenting with GBS.     

Evaluation of Community-Based Trichiasis Surgery in Northwest Ethiopia

Background

Surgery to correct trachomatous trichiasis (TT) is recommended to prevent blindness caused by trachoma. This study evaluated the outcomes of community-based trichiasis surgery with absorbable sutures, conductd in Amhara Regional State, Ethiopia.

Methods

A simple random sample of 431 patients was selected from surgical campaign records of which 363 (84.2%) were traced and enrolled into the study. Participants were interviewed and examined for trichiasis recurrence, complications of TT surgery and corneal opacity. Multilevel logistic regression models were used to explore the associations between trichiasis recurrence, corneal opacity and explanatory variables at the eye level.

Results

The prevalence of trichiasis recurrence was 9.4% (95% Confidence Interval [CI] 6.6–12.8) and corneal opacity was found in 14.3% (95% CI 10.9–18.3) of the study participants. The proportion of participants with complications of TT surgery was: granuloma 0.6% (95% CI 0.1–2.0); lid closure defects 5.5% (95% CI 3.4–8.4) and lid notching 16.8% (95% CI 13.1–21.1). No factors were identified for trichiasis recurrence. Corneal opacity was associated with increased age (Ptrend=0.001), more than 12 months post surgery (OR=2.7; 95%CI 1.3–5.6), trichiasis surgery complications (OR=2.9; 95%CI 1.4–5.9) and trichiasis recurrence (OR=2.5; 95%CI 1.0–6.3).

Conclusion

Prevalence of recurrent trichiasis and granuloma were lower than expected but higher for lid closure defects and lid notching. The majority of the participants reported satisfaction with the trichiasis surgery they had undergone. The findings suggest that recurrence of trichiasis impacts on the patients'' risk of developing corneal opacity but longitudinal studies are required to confirm this.     

Dysglycemia in Critically Ill Children Admitted to Jimma Medical Centre,Southwest Ethiopia

BackgroundAbnormal blood glucose level is one of the most frequently encountered problems in children with severe illnesses. However, its magnitude and outcome have rarely been determined in Ethiopia. We aimed to determine the magnitude, associated factors and outcome of dysglycemia in critically ill children admitted to Jimma Medical Center.MethodsProspective longitudinal study was conducted on children aged 28 days to 14 years admitted with critical illnesses at the different units of the Department of Pediatrics and Child Health of Jimma Medical Center, Southwest Ethiopia, from June to August 2019. Data were collected by trained medical personnel using structured questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) windows version 20.0. Dysglycemia was considered whenever the child had a random blood sugar >150mg/dl or <45mg/dl.ResultDysglycemia was seen at admission in 139/481, 28.9% children; 24 (5.0%) had hypoglycemia whereas 115 (23.9%) had hyperglycemia. The factors associated with dysglycemia at admission were severe acute malnutrition (p=002, AOR=3.09, CI=1.18,7.77), impaired mental status (p=0.003, AOR=4.63, CI=1.68, 12.71), place of residence (p=0.01, AOR=1.85, CI=1.15–2.96) and presence of diarrhea on date of admission. Among the children who had dysglycemia at admission, 16/139, 11.5% died.ConclusionDysglycemia is a common problem in critically ill children in the setting. Blood glucose level should be determined for all critically ill children, and routine empirical administration of dextrose should be minimized since most of the children with dysglycemia had hyperglycemia than hypoglycemia.     

In vitro anthelmintic activity of crude extracts of five medicinal plants against egg-hatching and larval development of Haemonchus contortus

Ethnopharmacological relevance

Senna occidentalis, Leonotis ocymifolia, Leucas martinicensis, Rumex abyssinicus, and Albizia schimperiana are traditionally used for treatment of various ailments including helminth infection in Ethiopia.

Materials and Methods

In vitro egg hatch assay and larval development tests were conducted to determine the possible anthelmintic effects of crude aqueous and hydro-alcoholic extracts of the leaves of Senna occidentalis, aerial parts of Leonotis ocymifolia, Leucas martinicensis, Rumex abyssinicus, and stem bark of Albizia schimperiana on eggs and larvae of Haemonchus contortus.

Results

Both aqueous and hydro-alcoholic extracts of Leucas martinicensis, Leonotis ocymifolia and aqueous extract of Senna occidentalis and Albizia schimperiana induced complete inhibition of egg hatching at concentration less than or equal to 1 mg/ml. Aqueous and hydro-alcoholic extracts of all tested medicinal plants have shown statistically significant and dose dependent egg hatching inhibition. Based on ED₅₀, the most potent extracts were aqueous and hydro-alcoholic extracts of Leucas martinicensis (0.09 mg/ml), aqueous extracts of Rumex abyssinicus (0.11 mg/ml) and Albizia schimperiana (0.11 mg/ml). Most of the tested plant extracts have shown remarkable larval development inhibition. Aqueous extracts of Leonotis ocymifolia, Leucas martinicensis, Albizia schimperiana and Senna occidentalis induced 100, 99.85, 99.31, and 96.36% inhibition of larval development, respectively; while hydro-alcoholic extracts of Albizia schimperiana induced 99.09 inhibition at the highest concentration tested (50 mg/ml). Poor inhibition was recorded for hydro-alcoholic extracts of Senna occidentalis (9%) and Leonotis ocymifolia (37%) at 50 mg/ml.

Conclusions

The overall findings of the current study indicated that the evaluated medicinal plants have potential anthelmintic effect and further in vitro and in vivo evaluation is indispensable to make use of these plants.     

Experience of surgical therapy in 72 patients with thoracic hydatidosis over a 10-year period

OBJECTIVE: This review aims to evaluate retrospectively 72 patients diagnosed to have thoracic hydatid disease and treated surgically in Tikur Anbessa Hospital between December 1993 and November 2003. DESIGN: Retrospective Analysis hospital records. SETTINGS: Tikur Anbessa Hospital, Department of Surgery, Medical Faculty, Addis Ababa University, Addis Ababa, Ethiopia. PATIENTS AND METHODS: Medical records and Operation theater registers of seventy-two Patients operated on for Thoracic hydatidosis were evaluated retrospectively. Chest Roentgenogram was the main diagnostic tool used Main surgical techniques employed were evacuation in 44 (52.4%) cysts, cystotomy in 30 (35.7%) cysts, and enucleation in 10 (12%) cysts. Additional palliative procedures (such as pericystectomy and Capitonnage) and radical procedures (such as resection of the lung) were also employed. RESULTS: forty of the patients were male and thirty-two female with a mean age of 31.4 years. The most Common presenting symptoms were cough in 60 (83.3%) patients, expectoration in 47 (65.3%) patients and chest pain in 38 (52.8%) patients. Chest radiography revealed a round opacity or shadow in 58 (80.6%) patients. All patients were treated surgically. The mean hospital stay was 38.3 days. Major postoperative Complications occurred in 12 (16.9%) patients; pneumonia, pleural effusion and prolonged air leak were the complications in order of their frequency. There was one postoperative death and one recurrence at 6-months follow-up period. CONCLUSION: Surgical excision of pulmonary hydatidosis with maximum preservation of lung parenchyma is possible in the majority of patients and should remain the mainstay of surgical treatment.     

Synthesis and antiprotozoal activity of 1,2,3,4-tetrahydro-2-thioxopyrimidine analogs of combretastatin A-4

Eighteen 1,2,3,4-tetrahydro-2-thioxopyrimidine analogs (5a?Cj, 6a?Ce, and 7a?Cc) of combretastatin A-4 were synthesized with the objective of discovering compounds capable of controlling the growth of Trypanosoma?lewisii, Leishmania?tarantole, Plasmodium?falciparum, and Giardia?lamblia. Even though the target compounds demonstrated differential cytotoxicity against mammalian cancer cells, with IC₅₀ values ranging from 0.5 to >100???M, the range of activity against Trypanosoma, Leishmania, and Plasmodium, and to a good extent for Giardia, was narrow. The IC₅₀ values of ??active?? compounds against the parasites ranged from about 10???? to slightly greater than 50???M. Specifically, compounds 5a, 5g, 5h, 6c, 7a, and 7c were not cytotoxic against mammalian cancer cells (IC₅₀?>?100???M) but showed good activity against the parasites, except Giardia (e.g., compounds 6c and 7a), suggesting that these compounds may act in a similar mechanism in parasites. Compounds 5f and 6b were previously shown to promote microtubule depolymerization in mammalian cells.