Oogenesis in the terrestrial hermit crab Coenobita clypeatus (decapoda,anomura). I. Previtellogenic oocytes

Ultrastructural study of previtellogenic oocytes found in cystlike clusters scattered throughout the length of the bilobed ovary of the hermit crab Coenobita clypeatus shows a high nuclear:cytoplasm ratio. Large, round nuclei containing synaptinemal complexes serve as good temporal markers for identification of previtellogenic oocytes. The cytoplasm contains many smooth-membraned vesicles filled with granules and probably of nuclear origin. In addition to its complement of Golgi complexes, endoplasmic reticulum, mitochondria, and free ribosomes, the cytoplasm also contains stacks of annulate lamellae, a feature not previously described for decapod oocytes. Typically, the previtellogenic oocyte with its accumulation of ribosomes has the appearance of a nonsynthetic cell preparing to go through a metabolic transition.     

The Economic Burden of Meningitis to Households in Kassena-Nankana District of Northern Ghana

Objective

To estimate the direct and indirect costs of meningitis to households in the Kassena-Nankana District of Ghana.

Methods

A Cost of illness (COI) survey was conducted between 2010 and 2011. The COI was computed from a retrospective review of 80 meningitis cases answers to questions about direct medical costs, direct non-medical costs incurred and productivity losses due to recent meningitis incident.

Results

The average direct and indirect costs of treating meningitis in the district was GH¢152.55 (US$101.7) per household. This is equivalent to about two months minimum wage earned by Ghanaians in unskilled paid jobs in 2009. Households lost 29 days of work per meningitis case and thus those in minimum wage paid jobs lost a monthly minimum wage of GH¢76.85 (US$51.23) due to the illness. Patients who were insured spent an average of GH¢38.5 (US$25.67) in direct medical costs whiles the uninsured patients spent as much as GH¢177.9 (US$118.6) per case. Patients with sequelae incurred additional costs of GH¢22.63 (US$15.08) per case. The least poor were more exposed to meningitis than the poorest.

Conclusion

Meningitis is a debilitating but preventable disease that affects people living in the Sahel and in poorer conditions. The cost of meningitis treatment may further lead to impoverishment for these households. Widespread mass vaccination will save households'' an equivalent of GH¢175.18 (US$117) and impairment due to meningitis.     

High Compliance with Newborn Community-to-Facility Referral in Eastern Uganda:.An Opportunity to Improve Newborn Survival

Background

Seventy-five percent of newborn deaths happen in the first-week of life, with the highest risk of death in the first 24-hours after birth.WHO and UNICEF recommend home-visits for babies in the first-week of life to assess for danger-signs and counsel caretakers for immediate referral of sick newborns. We assessed timely compliance with newborn referrals made by community-health workers (CHWs), and its determinants in Iganga and Mayuge Districts in rural eastern Uganda.

Methods

A historical cohort study design was used to retrospectively follow up newborns referred to health facilities between September 2009 and August 2011. Timely compliance was defined as caretakers of newborns complying with CHWs’ referral advice within 24-hours.

Results

A total of 724 newborns were referred by CHWs of whom 700 were successfully traced. Of the 700 newborns, 373 (53%) were referred for immunization and postnatal-care, and 327 (47%) because of a danger-sign. Overall, 439 (63%) complied, and of the 327 sick newborns, 243 (74%) caretakers complied with the referrals. Predictors of referral compliance were; the newborn being sick at the time of referral- Adjusted Odds Ratio (AOR) = 2.3, and 95% Confidence-Interval (CI) of [1.6 - 3.5]), the CHW making a reminder visit to the referred newborn shortly after referral (AOR =1.7; 95% CI: [1.2 -2.7]); and age of mother (25-29) and (30-34) years, (AOR =0.4; 95% CI: [0.2 - 0.8]) and (AOR = 0.4; 95% CI: [0.2 - 0.8]) respectively.

Conclusion

Caretakers’ newborn referral compliance was high in this setting. The newborn being sick, being born to a younger mother and a reminder visit by the CHW to a referred newborn were predictors of newborn referral compliance. Integration of CHWs into maternal and newborn care programs has the potential to increase care seeking for newborns, which may contribute to reduction of newborn mortality.