Progression of clinical tuberculosis is associated with a Th2 immune response signature in combination with elevated levels of SOCS3

In this study, we explored the local cytokine/chemokine profiles in patients with active pulmonary or pleural tuberculosis (TB) using multiplex protein analysis of bronchoalveolar lavage and pleural fluid samples. Despite increased pro-inflammation compared to the uninfected controls; there was no up-regulation of IFN-γ or the T cell chemoattractant CCL5 in the lung of patients with pulmonary TB. Instead, elevated levels of IL-4 and CCL4 were associated with high mycobacteria-specific IgG titres as well as SOCS3 (suppressors of cytokine signaling) mRNA and progression of moderate-to-severe disease. Contrary, IL-4, CCL4 and SOCS3 remained low in patients with extrapulmonary pleural TB, while IFN-γ, CCL5 and SOCS1 were up-regulated. Both SOCS molecules were induced in human macrophages infected with Mycobacterium tuberculosis in vitro. The Th2 immune response signature found in patients with progressive pulmonary TB could result from inappropriate cytokine/chemokine responses and excessive SOCS3 expression that may represent potential targets for clinical TB management.     

Is the legal framework by itself enough for successful WHO code implementation? A case study from Ethiopia

Since 2016, Ethiopia has passed several proclamations and directives to regulate the promotion of commercial breastmilk substitute (BMS). Ethiopia's market potential will undoubtedly be the gravitating point for international infant formula companies due to growing urbanization, purchasing power, population, and the relatively low use of BMS to‐date. The aim of this review is to assess the strengths and weaknesses of the existing laws, standards, and monitoring documents used to regulate the marketing of BMSs in Ethiopia and make future recommendations. The study findings highlighted that the regulation on marketing are comprehensive and strong to limit the promotion of infant formula. On the other hand, the regulation on marketing of follow‐up formulas, complementary foods, and growing‐up milk by manufacturers and distributors, media houses, and communication and advertisement agencies are underregulated, especially with regards to the international 69.9 regulation. The monitoring and enforcement of the existing marketing regulations remain limited in the absence of a formal coordination mechanism. Several violations of the national BMS regulations were observed. Forty‐one percent of mothers reported observing the BMS advertising and logos were detected in 36% of health facilities assessed. In 100% of cases, the infant formula labels contained violations. As the lead national authority mandated to regulate food safety, the Ethiopian Food and Drug Authority needs to update its regulations related to the marketing of BMS to fill the loopholes and revise the national law in line with the international code of marketing of BMSs to protect breastfeeding.     

Homing defects of B cells in HIV-1 infected children impair vaccination responses

Background

Successful vaccinations rely on antibody responses. Chemokine receptors play an important role in B cell homing to differentiation niches. We assessed CXCR4, CXCR5 and CCR6 expression on B cells during HIV-1 infection and relate it to antibody responses against a HBV vaccine.

HIV/AIDS risk perception and behavior of college students of the Metekel Zone,Benishangul Gumuz regional state,Ethiopia

Sexual and reproductive health problems are the main causes of death, disability and disease among young people in the world, particularly in Africa. The objective of this study was to assess human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) risk perception and behavior, and factors associated with risk perception, among college students of the Metekel Zone, Ethiopia. An institutional-based cross-sectional study design was used. The data were collected using a pretested and self-administered questionnaire, were entered into EPI INFO version 6 and exported into Statistical Package of Social Sciences (SPSS) version 16 for analysis. Variables with p < 0.02 in the bivariate logistic regression were entered to multivariate logistic regression and variables with p < 0.05 were considered as statistically significant. Three hundred and eighty-eight students were participated. Total 43% of respondents (50.70% males and 34.10% females) had had sex. About 48.81% of the sexually active respondents reported that they had had sexual intercourse with two or more partners. About 16.49% of study participants perceived themselves at risk of getting HIV/AIDS and the most frequently, cited reasons for perceiving oneself at risk were having sex without a condom, having multiple sexual partners and having sex with commercial sex workers (CSW). Chewing khat (adjusted OR = 3.54, 95% CI: 1.45?8.63); being willing to undergo voluntary counseling and testing (VCT) (adjusted OR = 4. 30, 95% CI: 1.09?16.88); having seen a person infected/dead of HIV (adjusted OR = 4.23, 95% CI: 1.36?13.13) and having multiple sexual partners (adjusted OR = 6.10, 95% CI: 2.40?15.44) were significantly associated with HIV risk perception. The risk perception of HIV/AIDS among the college students was low despite their involvement in different risky sexual behaviors. The government should use mass media techniques, such as television, radio, mobile services and posters to spread information on HIV transmission prevention among college students, especially information on the importance of condom use, minimizing the number of sexual partners and VCT. College administrations need to disseminate information through special lectures, and group discussions about khat chewing, HIV/AIDS and VCT.     

Prevalence and associated factors of khat use among university students in the University of Gondar,northwest Ethiopia

Habitual khat use has negative psychological, social, sexual, and economic consequences. Therefore, this study was aimed to assess the prevalence of khat use and associated factors among university students in the University of Gondar. Institution-based cross-sectional study was conducted from February to September 2011. Multistage sampling techniques were used to select the study participants. Anonymous self-administered questionnaire was used to collect the data. Epi Info and SPSS softwares were used to enter and analyze the data. Binary logistic regression was used to identify the determinant factors. Independent two-sample “t” test was employed to compare academic performance between khat chewers and non-chewers. Odds ratio with 95% confidence interval was used to assess the strength of the association. P-value <0.05 was considered statistically significant. The current prevalence of khat chewing was 16.4%. Sex, place of upbringing, alcohol use, cigarette smoking, and history of family and friends related chewing khat were statistically associated with khat chewing habit. The prevalence of khat chewing was found moderate and had not any influence on academic performance. Targeted and consistent counseling by a close controller and guidance is recommended as a direct in-campus intervention to tackle this habit.     

Incidence of human rabies exposure and associated factors at the Gondar Health Center,Ethiopia: a three-year retrospective study

Background

Rabies is one of the oldest known and most feared human diseases. Epidemiological studies provide basic information about the burden of the disease and underline the importance of prevention and control interventions. However, there have been limited studies conducted regarding the incidence of rabies and associated factors in Ethiopia, in general, and in this study area, in particular. Therefore, the aim of this study was to assess the incidence of human rabies exposure and associated factors at the Gondar Health Center, Ethiopia.

Methods

A retrospective cross-sectional study was conducted at the Gondar Health Center where post-exposure prophylaxis (PEP) for rabies was available for the whole population in the North Gondar Zone catchment area. Data of human rabies exposure cases between 2011 and 2013 were collected from the rabies PEP registration book using data abstraction sheets. The data was entered and analyzed using SPSS version 16 statistical software.

Result

A total of 261 cases of human rabies exposure were reported to the Gondar Health Center from 2011 to 2013. The sex and age specific distribution showed that the majority of these cases were among males (142/226, 62.8%) and children under 15 years of age (87/226, 38.5%). A predominant number of cases were observed in individuals from rural areas (161/220, 73.2%), and during fall and winter seasons (67/222, 30.18%). A significant number of people exposed to rabies (23.2%) came to the health center for PEP two or more weeks after the injury. The incidence of human rabies exposure cases was 4.6, 2.61, and 1.27 per 100, 000 population in 2011, 2012, and 2013, respectively. Being male and living in an urban setting were found to be risk factors for human rabies exposure in 2011.

Conclusion

A significant number of human rabies exposure cases were reported to the Gondar Health Center. Being male and living in an urban setting were found to be associated with rabies exposure. A community-based follow-up study is recommended to more accurately estimate the incidence of human rabies exposure.

Electronic supplementary material

The online version of this article (doi:10.1186/2049-9957-4-3) contains supplementary material, which is available to authorized users.     

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.     

Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, North West of Ethiopia: A community - based cross sectional study

Background

Under-5 mortality is a major public health challenge in developing countries. It is essential to identify determinants of under-five mortality (U5M) childhood mortality because these will assist in formulating appropriate health programmes and policies in order to meet the United Nations MDG goal. The objective of this study was to develop a predictive model and identify maternal, child, family and other risk factors associated U5M in Nigeria.

Methods

Population-based cross-sectional study which explored 2008 demographic and health survey of Nigeria (NDHS) with multivariable logistic regression. Likelihood Ratio Test, Hosmer-Lemeshow Goodness-of-Fit and Variance Inflation Factor were used to check the fit of the model and the predictive power of the model was assessed with Receiver Operating Curve (ROC curve).

Results

This study yielded an excellent predictive model which revealed that the likelihood of U5M among the children of mothers that had their first marriage at age 20-24 years and ?? 25 years declined by 20% and 30% respectively compared to children of those that married before the age of 15 years. Also, the following factors reduced odds of U5M: health seeking behaviour, breastfeeding children for > 18 months, use of contraception, small family size, having one wife, low birth order, normal birth weight, child spacing, living in urban areas, and good sanitation.

Conclusions

This study has revealed that maternal, child, family and other factors were important risk factors of U5M in Nigeria. This study has identified important risk factors that will assist in formulating policies that will improve child survival.