Incidence of malaria among children living near dams in northern Ethiopia: community based incidence survey

ObjectiveTo assess the impact of construction of microdams on the incidence of malaria in nearby communities in terms of possibly increasing peak incidence and prolonging transmission.DesignFour quarterly cycles of malaria incidence surveys, each taking 30 days, undertaken in eight at risk communities close to dams paired with eight control villages at similar altitudes but beyond flight range of mosquitoes.SettingTigray region in northern Ethiopia at altitudes of 1800 to 2225 m.SubjectsAbout 7000 children under 10 years living in villages within 3 km of microdams and in control villages 8-10 km distant.ResultsOverall incidence of malaria for the villages close to dams was 14.0 episodes/1000 child months at risk compared with 1.9 in the control villages—a sevenfold ratio. Incidence was significantly higher in both communities at altitudes below 1900 m.ConclusionsThere is a need for attention to be given to health issues in the implementation of ecological and environmental development programmes, specifically for appropriate malaria control measures to counteract the increased risks near these dams.

Key messages

• Environmental development may have important effects on the epidemiology of vector borne diseases such as malaria
• This may be particularly important where disease transmission is unstable—for example, in highland areas
• Children in villages near recently constructed microdams in northern Ethiopia had a significantly increased risk of malaria
• It seems that this irrigation development programme is leading to increased malaria transmission across a range of altitudes and seasons
• Intersectoral collaboration is necessary in development projects that may affect communities both positively and negatively

     

Development of an early biomarker for the ovarian liability of selective estrogen receptor modulators in rats

Selective estrogen receptor modulators (SERMs) have the potential to treat estrogen sensitive diseases such as uterine leiomyoma and endometriosis, which are prevalent in reproductive age women. However, SERMs also increase the risk of developing ovarian cysts in this population, a phenomenon that is not seen in postmenopausal women. It is believed that current SERMs partially block estradiol's ability to downregulate gonadotropin-releasing hormone (GnRH) secretion from the hypothalamus thereby interfering with estradiol's negative feedback, leading to increased ovarian stimulation by gonadotropins, and cyst formation. It has been postulated that a SERM with poor brain exposure would have less negative effect on the HPO axis, therefore reducing the risk of developing ovarian cysts. In order to test this hypothesis, we identified an early marker of SERM-dependent ovarian effects: upregulation of Cyp17a1 mRNA. SERMs known to cause ovarian cysts upregulate Cyp17a1 after only 4 days of dosing and suppression of the HPO axis prevented this regulation, indicating that ovarian expression of Cyp17a1 was secondary to SERM's effect on the brain. We then characterized three SERMs with similar binding affinity and antagonist effects on the uterus for their relative brain/plasma exposure and ovarian effects. We found that the degree of brain exposure correlated very well with Cyp17a1 expression.     

Sequence analysis in the 23S rDNA region of Mycobacterium tuberculosis and related species

We sequenced a 516 base pair segment in the 23S rRNA gene of 54 Mycobacterium tuberculosis isolates, 52 of which were clinical isolates from Ethiopia. Sequence polymorphism was observed with 19 of the 54 strains; the polymorphic sites occurred in less than 2% (9/516) of the total sequence positions. The sequence variations represented base pair substitutions (14/23), insertions (9/23) or both (1/23). Insertions occurred at one site only, whereas substitutions were observed in various regions of the gene. There was no relation between mutational sites and drug susceptibility. However, using information from the GenBank database, comparison between the 23S rDNA sequences of M. tuberculosis and the corresponding sequences of other mycobacteria and of related non-mycobacterial species revealed considerable variation, suggesting that this region may provide a target for rapid detection and identification of mycobacteria both at the genus or species level.     

Factors associated with exclusive breastfeeding practices among mothers in Goba district,south east Ethiopia: a cross-sectional study

Background

Exclusive breastfeeding is defined as feeding infants only breast milk, be it directly from breast or expressed, with no addition of any liquid or solids apart from drops or syrups consisting of vitamins, mineral supplements or medicine, and nothing else. Several studies have shown that exclusive breastfeeding for the first six months plays a great role in preventing morbidity and mortality. However, in Ethiopia a large portion of infants are not exclusively breastfed according to the infant feeding recommendations. Understanding the factors that influence exclusive breastfeeding is crucial to promoting the practice. This study was carried out to identify factors predicting exclusive breastfeeding among mothers in Bale Goba district, south east Ethiopia.

Methods

A community-based cross-sectional study was conducted from March to February 2010 involving both quantitative and qualitative data. A total of 608 mothers were selected randomly. A convenience sampling technique was used to generate the qualitative data. The qualitative data were analyzed using thematic frameworks. A multivariable logistic regression analysis was used to identify independent predictors of exclusive breastfeeding after controlling for background variables.

Results

The prevalence of exclusive breastfeeding in the last 24?hours preceding the survey was 71.3%. The median duration of exclusive breastfeeding was three months and mean frequency of breastfeeding was six times per day. Being unemployed [AOR: 10.4 (95% CI: 1.51, 71.50)] and age of infants of less than two months [AOR: 5.6 (95% CI: 2.28, 13.60)] were independently associated with exclusive breastfeeding.

Conclusions

A large proportion of infants are not exclusively breastfed during the first 6?months, despite what is recommended in the national and global infant and young child feeding (IYCF) guidelines. Employed mothers were less likely to practice exclusive breastfeeding, implying the need for promoting workplace breastfeeding practices and creating an enabling environment for exclusive breastfeeding. Extensions of maternity leave up to the first six month of child’s age to achieve optimal level of exclusive breastfeeding practices should also be looked into as an alternative solution.

     

Magnitude and correlates of intimate partner violence against women and its outcome in Southwest Ethiopia

Background

Intimate Partner Violence (IPV) is a major public health problem with serious consequences. This study was conducted to assess the magnitude of IPV in Southwest Ethiopia in predominantly rural community.

Methods

This community based cross-sectional study was conducted in May, 2009 in Southwest Ethiopia using the World Health Organization core questionnaire to measure violence against women. Trained data collectors interviewed 851 ever-married women. Stata version 10.1 software and SPSS version 12.0.1 for windows were used for data analysis.

Result

In this study the life time prevalence of sexual or physical partner violence, or both was 64.7% (95%CI: 61.4%–67.9%). The lifetime sexual violence [50.1% (95% CI: 46.7%–53.4%)] was considerably more prevalent than physical violence [41.1% (95%:37.8–44.5)]. A sizable proportion [41.5%(95%CI: 38.2%–44.8%)] of women reported physical or sexual violence, or both, in the past year. Men who were controlling were more likely to be violent against their partner.

Conclusion

Physical and sexual violence is common among ever-married women in Southwest Ethiopia. Interventions targeting controlling men might help in reducing IPV. Further prospective longitudinal studies among ever-married women are important to identify predictors and to study the dynamics of violence over time.     

Sodium stibogluconate (SSG) & paromomycin combination compared to SSG for visceral leishmaniasis in East Africa: a randomised controlled trial

Background

Alternative treatments for visceral leishmaniasis (VL) are required in East Africa. Paromomycin sulphate (PM) has been shown to be efficacious for VL treatment in India.

Methods

A multi-centre randomized-controlled trial (RCT) to compare efficacy and safety of PM (20 mg/kg/day for 21 days) and PM plus sodium stibogluconate (SSG) combination (PM, 15 mg/kg/day and SSG, 20 mg/kg/day for 17 days) with SSG (20 mg/kg/day for 30 days) for treatment of VL in East Africa. Patients aged 4–60 years with parasitologically confirmed VL were enrolled, excluding patients with contraindications. Primary and secondary efficacy outcomes were parasite clearance at 6-months follow-up and end of treatment, respectively. Safety was assessed mainly using adverse event (AE) data.

Findings

The PM versus SSG comparison enrolled 205 patients per arm with primary efficacy data available for 198 and 200 patients respectively. The SSG & PM versus SSG comparison enrolled 381 and 386 patients per arm respectively, with primary efficacy data available for 359 patients per arm. In Intention-to-Treat complete-case analyses, the efficacy of PM was significantly lower than SSG (84.3% versus 94.1%, difference = 9.7%, 95% confidence interval, CI: 3.6 to 15.7%, p = 0.002). The efficacy of SSG & PM was comparable to SSG (91.4% versus 93.9%, difference = 2.5%, 95% CI: −1.3 to 6.3%, p = 0.198). End of treatment efficacy results were very similar. There were no apparent differences in the safety profile of the three treatment regimens.

Conclusion

The 17 day SSG & PM combination treatment had a good safety profile and was similar in efficacy to the standard 30 day SSG treatment, suggesting suitability for VL treatment in East Africa.

Clinical Trials Registration

www.clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00255567","term_id":"NCT00255567"}}NCT00255567     

Identification of genomic regions associated with inbreeding depression in Holstein and Jersey dairy cattle

Background

Inbreeding reduces the fitness of individuals by increasing the frequency of homozygous deleterious recessive alleles. Some insight into the genetic architecture of fitness, and other complex traits, can be gained by using single nucleotide polymorphism (SNP) data to identify regions of the genome which lead to reduction in performance when identical by descent (IBD). Here, we compared the effect of genome-wide and location-specific homozygosity on fertility and milk production traits in dairy cattle.

Methods

Genotype data from more than 43 000 SNPs were available for 8853 Holstein and 4138 Jersey dairy cows that were part of a much larger dataset that had pedigree records (338 696 Holstein and 64 049 Jersey animals). Measures of inbreeding were based on: (1) pedigree data; (2) genotypes to determine the realised proportion of the genome that is IBD; (3) the proportion of the total genome that is homozygous and (4) runs of homozygosity (ROH) which are stretches of the genome that are homozygous.

Results

A 1% increase in inbreeding based either on pedigree or genomic data was associated with a decrease in milk, fat and protein yields of around 0.4 to 0.6% of the phenotypic mean, and an increase in calving interval (i.e. a deterioration in fertility) of 0.02 to 0.05% of the phenotypic mean. A genome-wide association study using ROH of more than 50 SNPs revealed genomic regions that resulted in depression of up to 12.5 d and 260 L for calving interval and milk yield, respectively, when completely homozygous.

Conclusions

Genomic measures can be used instead of pedigree-based inbreeding to estimate inbreeding depression. Both the diagonal elements of the genomic relationship matrix and the proportion of homozygous SNPs can be used to measure inbreeding. Longer ROH (>3 Mb) were found to be associated with a reduction in milk yield and captured recent inbreeding independently and in addition to overall homozygosity. Inbreeding depression can be reduced by minimizing overall inbreeding but maybe also by avoiding the production of offspring that are homozygous for deleterious alleles at specific genomic regions that are associated with inbreeding depression.

Electronic supplementary material

The online version of this article (doi:10.1186/s12711-014-0071-7) contains supplementary material, which is available to authorized users.     

COVID-19 and indirect health implications in Africa: Impact,mitigation measures,and lessons learned for improved disease control

Seth Inzaule and co-authors discuss implications of the COVID-19 pandemic for health in African countries.

Summary points

• Coronavirus Disease 2019 (COVID-19) and the mitigation measures taken to limit its spread have significantly disrupted other essential health services in Africa. This disruption has threatened the control of major high-burden diseases such as HIV, tuberculosis (TB), and malaria as well as the prevention of maternal and child mortality.
• While the 2020 WHO global reports for HIV, TB, and malaria show progress in control of these diseases in African countries, there are still significant gaps in meeting the global targets. Similarly, modeling studies predict that most African countries are unlikely to meet the Sustainable Development Goals (SDGs) 2030 targets for reductions in maternal and child mortality under the current rate of progress.
• Prediction models and emerging empirical data indicate that the implemented mitigation measures against COVID-19 such as travel restrictions and lockdowns as well as the repurposing of health resources and suspension of prevention programs such as immunizations will lead to an increase in new infections and deaths, significantly reversing the gains achieved in the control of these health challenges.
• A more comprehensive COVID-19 response that minimizes indirect deaths is therefore warranted in Africa. These include implementing WHO recommendations that limit contact with the clinic where possible, such as multimonths drug dispensing, self-testing, virtual platforms for case management, community- and home-based prevention, and care services such as home distribution of test kits, vaccines, treatment, and mosquito nets.
• This is in addition to ensuring effective implementation of COVID-19 infection prevention and control measures in healthcare facilities including providing healthcare workers with personal protective equipment and prioritizing them for COVID-19 immunization.
• There is also a need to incorporate aggressive recovery plans to reverse the lost gains in disease control efforts and put African countries back on course toward achieving the global targets. This includes leveraging on the wider COVID-19 response enablements such as the increased political will and global solidarity funding efforts to support a more comprehensive response that accounts for the indirect public health effects of the pandemic.

     

Predicting seasonal habitat suitability for the critically endangered African wild ass in the Danakil,Ethiopia

The African wild ass (Equus africanus) is the most endangered wild equid in the world and is listed as a Critically Endangered (CR) on the IUCN Red list. Today, only relict populations remain in Ethiopia and Eritrea. The current Ethiopian population persists in the Danakil Desert at a very low density. Wildlife managers need to identify the extent of the remaining suitable habitat and understand human–wildlife interactions for appropriate conservation strategies. This study employed the maximum entropy model (Maxent) to determine suitable habitat and seasonal distribution of African wild ass in the Danakil Desert of Ethiopia. Field surveys were conducted four times annually, twice during the wet season and twice during the dry season, for 2 years. Field data and predictor variables were separated into the dry and wet seasons, and models were generated for each season independently. Distance from water, distance from settlements, herbaceous cover and slope were the best predictors of suitable habitat for both dry and wet seasons. Evaluations of model performances were high with area under the curve (AUC) values of 0.94 and 0.95 for the dry and wet seasons, respectively. Our results will be critical for identifying the available suitable habitat that should be conserved to safeguard this species from extinction.