Immunohematological reference ranges for adult Ethiopians

A cross-sectional survey was carried out with 485 healthy working adult Ethiopians who are participating in a cohort study on the progression of human immunodeficiency virus type 1 (HIV-1) infection to establish hematological reference ranges for adult HIV-negative Ethiopians. In addition, enumeration of absolute numbers and percentages of leukocyte subsets was performed for 142 randomly selected HIV-negative individuals. Immunological results were compared to those of 1,356 healthy HIV-negative Dutch blood donor controls. Immunohematological mean values, medians, and 95th percentile reference ranges were established. Mean values were as follows: leukocyte (WBC) counts, 6.1 x 10(9)/liter (both genders); erythrocyte counts, 5.1 x 10(12)/liter (males) and 4.5 x 10(12)/liter (females); hemoglobin, 16.1 (male) and 14.3 (female) g/dl; hematocrit, 48.3% (male) and 42.0% (female); platelets, 205 x 10(9)/liter (both genders); monocytes, 343/microl; granulocytes, 3, 057/microl; lymphocytes, 1,857/microl; CD4 T cells, 775/microl; CD8 T cells, 747/microl; CD4/CD8 T-cell ratio, 1.2; T cells, 1, 555/microl; B cells, 191/microl; and NK cells, 250/microl. The major conclusions follow. (i) The WBC and platelet values of healthy HIV-negative Ethiopians are lower than the adopted reference values of Ethiopia. (ii) The absolute CD4 T-cell counts of healthy HIV-negative Ethiopians are considerably lower than those of the Dutch controls, while the opposite is true for the absolute CD8 T-cell counts. This results in a significantly reduced CD4/CD8 T-cell ratio for healthy Ethiopians, compared to the ratio for Dutch controls.     

Indications of the Protective Role of Natural Killer Cells in Human Cutaneous Leishmaniasis in an Area of Endemicity

The role of natural versus acquired immunity to Leishmania aethiopica infection in humans is the focus of our studies. We found in previous studies that mononuclear cells from nonexposed healthy Swedish donors responded to Leishmania antigen stimulation by proliferation and gamma interferon production. The main cell type responding was CD3⁻ CD16/56⁺ natural killer (NK) cells. These findings led us to suggest that the potential to produce a rapid, nonacquired NK cell response may be a protective phenotype. In order to test this hypothesis, an area in Ethiopia where Leishmania is endemic was selected, and peripheral blood mononuclear cells were obtained from individuals who had lived in the area most of their lives but had no evidence of past or present leishmaniasis. Their responses were compared with those of confirmed leishmaniasis patients from the same region with active lesions or cured leishmaniasis lesions. Cells from these donors were stimulated in vitro with L. aethiopica antigen. Responses were measured by proliferation, cytokine production, and phenotype analysis by fluorescence-activated cell sorting. The association of NRAMP1 alleles with the studied phenotype and susceptibility to L. aethiopica-induced leishmaniasis was also evaluated. The results show that Leishmania antigens can induce NK cell and CD8⁺-T-cell responses in vitro. This is clearly seen in proliferating cells from the cured (immune) individuals and the apparently protected controls from the area of endemicity. It contrasted with the reactivity of the patients, where some NK proliferation was coupled with enhanced CD4⁺-T-cell proliferation. We conclude from these observations that NK cells and CD8⁺ cells proliferating in response to Leishmania stimulation are involved in protection from and healing of (Ethiopian) cutaneous leishmaniasis; however, such mechanisms appear to be unrelated to the NRAMP1 host resistance gene.     

37℃凝血温度下正常人和哮喘患者血清ECP水平的测定

室温（２０℃）是广泛接受的血清ＥＣＰ测定凝血温度，但存在一些问题。设想体温３７℃可能是血清ＥＣＰ测定的有效凝血温度。为此，对６８例急性发作的哮喘患者在３７℃凝血温度下血清ＥＣＰ水平进行分析，比较凝血温度分别为２０℃和３７℃时同一患者血样本的ＥＣＰ水平变化，结果发现３７℃下哮喘患者血清ＥＣＰ水平（５０．９±３．１８μｇ／Ｌ）显著高于正常对照（１７．２７±１．３６μｇ／Ｌ，Ｐ＜０．０１）。在６８例病人中，３７℃凝血下有２８人血清ＥＣＰ水平高于正常值，而２０℃凝血下只有１７人血清ＥＣＰ水平高于正常值，两者间存在显著差异（Ｐ＜０．０５）。３７℃凝血温度下血清ＥＣＰ水平与哮喘症状计分显著相关（ｒ＝０．７７，Ｐ＜０．０１）。此外，尚测定了３７℃凝血温度下１０１位１０～５０岁的健康人血清ＥＣＰ水平，结果显示３７℃下正常人血清ＥＣＰ水平的几何均数是１７．８１μｇ／Ｌ，血清ＥＣＰ水平的正常值为７０μｇ／Ｌ以下（９５％的可信限）。本研究表明，在血清ＥＣＰ的测定中设凝血温度为３７℃不仅是有效、简化的方法，而且还可减少哮喘患者血清ＥＣＰ水平的假阴性。     

北柴胡适生地分析及数值区划研究

采用生物适生地分析系统,对北柴胡的适宜产地进行数值区划,并与资源普查结果相比较,以探索药材产地适宜性区划的现代方法。结果发现以北京延庆为基点,以水热距为距离和分级指标,得出了北柴胡全国的783个适宜产地,主要分布在纬度27．5-54．2°,经度75．17-134．17°之间,其中1级适宜产地的分布范围为纬度35．22-44．47°,经度102．33-124．05°之间,主要在山西、陕西、河北的北部,内蒙的中南部及辽宁的西南部,该结果与我国北柴胡的自然分布产区非常相似。结果表明采用生物适生地分析系统,结合柴胡资源调查资料,可以较好地对北柴胡的适宜产地进行数值分级区划。     

IRS-1的表达和泛素化在KKAy及C57BL/6J小鼠糖尿病发展过程中的意义

目的:探讨胰岛素受体底物-1(IRS-1)蛋白表达和泛素化水平在糖尿病发展过程中的作用。方法:20只8周龄C57BL/6J小鼠随机分为正常对照组(正常饲料喂养,n=10)和胰岛素抵抗组(高脂饲料喂养,n=10)。8周龄KKAy小鼠8只,高脂饲料喂养,为2型糖尿病组。检测各组小鼠体重、血糖和血胰岛素水平。12周后免疫印迹检测各组动物肝组织IRS-1的表达量,同时采用剥离免疫印迹法检测肝组织IRS-1的泛素化水平。结果:高脂喂养12周后C57BL/6J小鼠出现胰岛素抵抗,KKAy小鼠出现肥胖和糖尿病。2型糖尿病组IRS-1的表达显著低于正常对照组和胰岛素抵抗组(P<0.05),而IRS-1的泛素化水平则显著高于胰岛素抵抗组(P<0.05),与对照组无显著性差异(P>0.05)。结论:2型糖尿病时IRS-1的表达下调,IRS-1泛素化水平增加是导致胰岛素信号转导障碍的重要原因。     

Ixodid ticks infesting cattle in three agroecological zones in central Oromia: species composition,seasonal variation,and control practices

A cross-sectional study was conducted to determine the species, prevalence, and seasonal variation of ticks on cattle in central Oromia. In addition, questionnaire survey was used to assess the control practices of ticks in central Oromia. During the study period from August 2008 through April 2009, a total of 10,440 adult ixodid ticks were collected from a total of 918 cattle (153 cattle during dry and wet seasons from each of three agroecologies) in three agroecological zones during wet and dry seasons. A total of seven species of ixodid ticks belonging to four genera were identified during the wet period, whereas similar numbers of genera but six species of ixodid ticks were recorded during the dry season. Amblyomma, Boophilus, Rhipicephalus, and Hyalomma tick genera were identified during the two seasons. Five different species of ticks were identified from the highland altitude. Significantly (p?<?0.05) higher proportion of Boophilus decoloratus (88.2 %) was identified during the wet season, Hyalomma truncatum (1.5 %) was with the least proportion. Rhipicephalus evertsi evertsi (50.8 %) was the most abundant during the dry period, whereas Hyalomma marginatum rufipes (5 %) was with smallest proportion. In the midland, a total of six species of ticks were identified. Significantly (p?<?0.05) higher proportion of Amblyomma variegatum (76.6 %) than the other species was recorded during the wet season in the midland. But Rhipicephalus pulchellus (0.05 %) was collected with the lowest proportion. R. e. evertsi (46.3 %) was the most abundant tick species during the dry season, whereas R. pulchellus (0 %) was with lowest proportion. In the lowland, a total of seven species of ticks during the wet and six during the dry season were identified. A significantly (p?<?0.05) higher proportion of A. variegatum (30.3 %) was recorded during the wet season, whereas R. pulchellus (1.4 %) was identified with the lowest proportion in the lowland. R. e. evertsi (24.8 %) was the most abundant tick species during the dry season in the lowland, but R. pulchellus (0 %) was with the lowest proportion during the same season in the lowland. Results of the study revealed that the highest mean total tick burden was recorded during the early rainy season than the dry season from the end of March to April. And the lowest mean tick count was recorded during the early dry and the late dry season during December and February, respectively. The overall tick count across seasons showed significant variation (F?=?114 and p?=?0.000). The questionnaire survey on the tick control practices has revealed that (90 %) diazinon and (57.3 %) cypermethrin were the commonly used acaricides with a frequency of one to three times per year during the peak of tick infestation. In conclusion, this study demonstrated that ixodid ticks occur with high prevalence and burden and still play major roles in reducing productivity of cattle and cause health problems of cattle in central Oromia. Further studies on the role of ticks in the transmission of pathogens to cattle, other animals, and zoonotic pathogens to man in Oromia are urgently needed.     

Evaluation and characterization of tumor lysis syndrome before and after chemotherapy among pediatric oncology patients in Tikur Anbessa specialized hospital,Addis Ababa,Ethiopia

Background

Tumor lysis syndrome (TLS) is a life-threatening emergency disorder, caused by an abrupt release of intracellular metabolites after tumor cell death. It is characterized by a series of metabolic manifestations, especially hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. The aim of this study was to evaluate and characterize the incidence of tumor lysis syndrome among pediatric oncology patients before and after treatment.

Methods

Hospital based prospective cohort study was conducted for 6 months on 61 newly diagnosed pediatric oncology patients. Socio-demographic data was collected by interview administered questionnaire. Patients were followed and the physical diagnosis, imaging and laboratory results were interpreted by senior physicians. Data was entered to and analyzed by SPSS version 23.

Results

Among 61 pediatric oncology patients 39(63.9%) were males. The mean (±SD) age of the pediatric patients was 6.39 (±?3.67) years ranging from 2 months to 14 years. 29.5% of patients were found to have TLS. There were 11.5% and 18.0% of laboratory TLS (LTLS) and clinical TLS (CTLS) cases respectively. There were72.2% spontaneous and 27.8% treatment induced TLS cases with 23% and 21.3% cases of hyperuricemia and 4.9% and 6.6% cases of hyperkalemia incidence before and after treatment respectively. Only two patients died, in the study period, due to TLS.

Conclusion

There was high incidence of TLS irrespective of socio-demographic variation among study participants, suggesting that children with cancer are at risk of developing TLS. As TLS is a life-threatening complication of malignancies, early identification of patients at risk and reducing morbidity and mortality is crucially important.

     

Prevalence and correlates of dyslipidemia in HIV positive and negative adults in Western Kenya: A cross-sectional study

There is increasing morbidity and mortality from cardiovascular diseases (CVD) in sub-Saharan Africa (SSA). Dyslipidemia is a well-known CVD risk factor which has been associated with human immunodeficiency virus (HIV) infection and its treatment in high-income countries. Studies in SSA that have examined the relationship between HIV and dyslipidemia have reported mixed results. In this study, we sought to determine the prevalence of dyslipidemia in HIV positive and negative adults (>=30 years old) and evaluate for association in Western Kenya with a higher prevalence expected among HIV positive individuals.HIV positive adults receiving antiretroviral therapy (ART) and HIV negative individuals seeking HIV testing and counseling services were recruited into a cross-sectional study. Demographic and behavioral data and fasting blood samples were collected. Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Associations between baseline demographic and clinical variables and dyslipidemia were analyzed using logistic regression.A total of 598 participants, 300 HIV positive and 298 HIV negative adults were enrolled. Dyslipidemia data was available for 564 (94%) participants. In total, 267 (47%) had dyslipidemia. This was not significantly different between HIV positive and HIV negative individuals (46% vs 49%, P = .4). In a multivariate analysis including both HIV positive and negative individuals, adults 50 to 59 years of age had a 2-fold increased risk of dyslipidemia (Odds ratio [OR] 2.1, 95% confidence interval (1.2–3.5) when compared to 30 to 39-years-old participants. Abdominal obesity (OR 2.5), being overweight (OR 1.9), and low fruit and vegetable intake (OR 2.2) were significantly associated with dyslipidemia. Among HIV positive participants, time since HIV diagnosis, ART duration, use of (PI) protease inhibitor-based ART, viral load suppression, current cluster of differentiation (CD4) count and nadir CD4 did not have significant associations with dyslipidemia.The prevalence of dyslipidemia is high in Western Kenya, with nearly half of all participants with lipid abnormalities. Dyslipidemia was not significantly associated with HIV status, or with HIV-specific factors. Older age, being overweight, abdominal obesity, and low fruit and vegetable intake were associated with dyslipidemia and may be targets for public health interventions to lower the prevalence of dyslipidemia and CVD risk in sub-Saharan Africa.