Risk factors associated with oesophageal malignancy among Ethiopian patients: a case control study

Background: The incidence of Oesophageal cancer is increasing worldwide. Genetics, obesity, smoking, and alcohol consumption are among the known risk factors for this deadly cancer.  Although Oesophageal cancer was noted to be common in Arsi and Bale regions of Ethiopia, the risk factors predisposing to this cancer have not yet been identified or reported to the best of our knowledge. The main objective of this study was to identify the risk factors associated with oesophageal cancer among the study population.Methods: A case-control study where volunteer adult patients aged 18 and above with diagnosis of oesophageal cancer (cases) and non-esophageal cancer patients (controls) were included was conducted in 2015 in Addis Ababa. The patients with dysphagia were referred to Adera Medical and Gastroenterology center from various regions of the country for Endoscopy. Patient data on socio-demographic and socio-economic variables, family history of similar illness and dietary history were collected using a pre specified questionnaire Patients’ clinical features, Endoscopic diagnosis and histology reports were retrieved from patients chart. Data were entered and analyzed using SPSS version 20 software. Frequency tables and figures were used to describe cases and controls. Odds ratio and 95% confidence interval were used to establish the strength and the significance of the association between independent and outcome (development of Esophageal Cancer) variables, respectively.Results: A total of 215 patients were diagnosed to have esophageal cancer at the center during April 1,2014 through March 31, 2015. A total of 115 (55%)of cases were females with a mean age of 50 years while 96 (45%) were males with a mean age of 55 years. Most of the patients were Muslim farmers from rural Arsi and Bale regions of the country where consumption of hot wheat porridge is very common as staple diet. Majority had mid esophageal mass lesion followed by distal and proximal lesions, in 45%, 34%, and 21% of the patients, respectively. Most (88%) of the patients had Esophageal squamous cell cancer (SCC) while the rest 12% had adenocarcinoma on histologic diagnosis.Conclusion: Oesophageal cancer was noted to be more common among the farmers from Arsi and Bale regions of the country. Consumption of hot porridge for long time was noted to be significantly associated with having oesophageal cancer among the farmers from the two regions possibly due to the thermal effect, which could lead to dysplasia and later cancer.Keywords: Oesophageal cancer, Risk factors, Ethiopi

Whole genome sequencing characterization of Slovenian carbapenem-resistant Klebsiella pneumoniae, including OXA-48 and NDM-1 producing outbreak isolates

Objectives The first hospital outbreak of carbapenemase-producing Enterobacteriaceae in Slovenia occurred in 2014-2016. Whole genome sequencing was used to analyse the population of carbapenem-resistant Klebsiella pneumoniae collected in Slovenia in 2014-2017, including OXA-48 and/or NDM-1 producing strains from the outbreak. Methods A total of 32 K. pneumoniae isolates were analysed using short-read sequencing. Multilocus sequence typing and core genome multi-locus sequence typing were used to infer genetic relatedness. Antimicrobial resistance markers, virulence factors, plasmid content and wzi types were determined. Long-read sequencing was used for six isolates for detailed analysis of plasmids and their possible transmission. Results Overall, we detected 10 different sequence types (STs), the most common being ST437 (40.6%). Isolates from the initial outbreak belonged to ST437 (12/16) and ST147 (4/16). A second outbreak of four ST15 isolates was discovered. A new ST (ST3390) and two new wzi types (wzi-556, wzi-559) were identified. blaOXA-48 was found in 17 (53.1%) isolates, blaNDM-1 in five (15.6%), and a combination of blaOXA-48/NDM-1 in seven (21.9%) isolates. Identical plasmids carrying blaOXA-48 were found in outbreak isolates sequenced with long-read sequencing technology. Conclusions Whole genome sequencing of Slovenian carbapenem-resistant K. pneumoniae isolates revealed multiple clusters of STs, two of which were involved in the first hospital outbreak of carbapenem producing K. pneumoniae in Slovenia. Transmission of the plasmid carrying blaOXA-48 between two STs was likely to have occurred. A previously unidentified second outbreak was also discovered, highlighting the importance of whole genome sequencing in detection and/or characterization of hospital outbreaks and surveillance of drug-resistant bacterial clones

PEMBUATAN FILTER AIR SEDERHANA & PENGUJIAN KUALITAS AIR

Penelitian ini bertujuan untuk membuat filter air sederhana dan menguji kualitas fisik dan kimia air yang di filter. Metode penelitian yang digunakan adalah metode deskriptif untuk menganalisis sampel air dan metode eksperimen untuk membuat filter air sederhana. Parameter yang diukur adalah derajat keasaman (pH), total partikel terlarut (TDS), kadar garam/salinitas, daya hantar listrik (DHL), turdibity/kekeruhan dan total padatan tersuspensi (TSS). Berdasarkan hasil pengujian menggunakan bahan dan alat diatas terjadi perubahan pada air yang di filtrasi pada satu kali penyaringan. Partikel dari air kotor disaring dengan lapisan kerikil kecil diawal untuk menyaring kotoran kasar lalu diikuti dengan penyaringan kotoran halus dengan pasir. Setelah pasir terdapat lapisan sabut kelapa yang berfungsi sebagai penyaring kotoran halus lalu di beri lagi lapisan pasir lagi, kemudian lapisan sabut kelapa yang juga sama-sama untuk menyaring kotoran halus. Lalu berikutnya terdapat lapisan tawas yang berfungsi untuk mengendapkan partikel. Hasil pengujian air menunjukkan bahwa sampel air yang di filter memiliki nilai pH 4,7, nilai salinitas 5,51 ppm, nilai TDS 7,31 mg/L, nilai konduktivitas 11,10 μS/cm, nilai turdibity 28,1 NTU dan nilai TSS 933 mg/L.This research aims to make a simple water filter and test the physical and chemical quality of the filtered water. The research method used is a descriptive method to analyze water samples and an experimental method to make a simple water filter. The parameters measured are the degree of acidity (pH), total dissolved particles (TDS), salt content/salinity, electrical conductivity (DHL), turbidity/turbidity and total suspended solids (TSS). Based on the test results using the materials and tools above, there were changes in the filtered water during one filtering session. Particles from dirty water are filtered with a layer of small gravel initially to filter out coarse dirt, followed by filtering fine dirt with sand. After the sand there is a layer of coconut fiber which functions as a filter for fine dirt, then another layer of sand is added, then a layer of coconut fiber which also filters fine dirt. Then next there is a layer of alum which functions to settle the particles. The water test results showed that the filtered water sample had a pH value of 4.7, a salinity value of 5.51 ppm, a TDS value of 7.31 mg/L, a conductivity value of 11.10 μS/cm, a turdibity value of 28.1 NTU and a TSS 933 mg/L

Factors associated with never treatment and acceptability of mass drug administration for the elimination of lymphatic filariasis in Guyana, 2021

Guyana remains one of four countries in the Americas endemic for lymphatic filariasis (LF). Elimination of LF requires repeated annual mass drug administration (MDA) with sufficient levels of coverage for success. This study assesses the acceptability and never treatment of LF MDA using data from a routine assessment survey in 2021. A subset of individuals, over 20 years of age (n = 2498), were selected to receive an expanded questionnaire to examine factors associated with acceptability and never treatment. Assessed factors include respondent demographics, knowledge, risk perceptions of LF, and opinions on the MDA programme. The majority (73%) of those with scores above the acceptability threshold (score ≥22.5) reported participating in MDA two or more times. Factors strongly and positively associated with scoring above the acceptability threshold include beliefs in importance of participation in MDA for their community (aOR = 2.8, 95%CI (1.1-7.2)), perception of importance of LF treatment (6.9 (3.2-14.7)), receiving treatment in 2021 (2.9 (1.5-5.4)), and the number of self-reported times taking treatment for LF (2.2 (1.1-4.4)). Ten percent of respondents participated in the MDA for the first time in 2021, while 15% reported never treatment during any round of LF MDA. Three factors were statistically associated with participation in MDA across the two levels of the models (level 1: took LF treatment once versus never, and level 2: took LF treatment twice versus never) included: 1) scoring above the acceptability threshold (aOR = 6.2, 95%CI(3.8-10.0)), 2) self-reported importance of participation in MDA for their community (7.1 (2.9-17.8)), and 3) personal beliefs that they should take LF treatment even if they are not sick (2.6 (1.7-3.9)). As Guyana moves closer to LF elimination, these results provide further insight and understanding into programmatic results and could inform further action following MDA activities-particularly if an approach is needed to address never treatment during MDA

Substance use and its predictors among undergraduate medical students of Addis Ababa University in Ethiopia

<p>Abstract</p> <p>Background</p> <p>Substance use remains high among Ethiopian youth and young adolescents particularly in high schools and colleges. The use of alcohol, <it>khat </it>and tobacco by college and university students can be harmful; leading to decreased academic performance, increased risk of contracting HIV and other sexually transmitted diseases. However, the magnitude of substance use and the factors associated with it has not been investigated among medical students in the country. This study was conducted to determine the prevalence of substance use and identify factors that influenced the behavior among undergraduate medical students of Addis Ababa University in Ethiopia.</p> <p>Methods</p> <p>A cross-sectional study using a pre-tested structured self-administered quantitative questionnaire was conducted in June 2009 among 622 medical students (Year I to Internship program) at the School of Medicine. The data were entered into Epi Info version 6.04d and analyzed using SPSS version 15 software program. Descriptive statistics were used for data summarization and presentation. Differences in proportions were compared for significance using Chi Square test, with significance level set at p < 0.05. Multivariate logistic regression analyses were used to assess the magnitude of associations between substance use and socio-demographic and behavioral correlates.</p> <p>Results</p> <p>In the last 12 months, alcohol was consumed by 22% (25% males vs. 14% females, p = 0.002) and <it>khat </it>use was reported by 7% (9% males vs. 1.5% females, p < 0.001) of the students. About 9% of the respondents (10.6% males vs. 4.6% females, p = 0.014) reported ever use of cigarette smoking, and 1.8% were found to be current smokers. Using multiple logistic regression models, being male was strongly associated with alcohol use in the last 12 months (adjusted OR = 2.14, 95% CI = 1.22-3.76). Students whose friends currently consume alcohol were more likely to consume alcohol (adjusted OR = 2.47, 95% CI = 1.50-4.08) and whose friends' use tobacco more likely to smoke (adjusted OR = 3.89, 95% CI = 1.83-8.30). <it>Khat </it>use within the past 12 months was strongly and positively associated with alcohol consumption (adjusted OR = 15.11, 95% CI = 4.24-53.91). Similarly, ever use of cigarette was also significantly associated with alcohol consumption (adjusted OR = 8.65, 95% CI = 3.48-21.50).</p> <p>Conclusions</p> <p>Concordant use of alcohol, <it>khat </it>and tobacco is observed and exposure to friends' use of substances is often implicated. Alcohol consumption or <it>khat </it>use has been significantly associated with tobacco use. While the findings of this study suggest that substance use among the medical students was not alarming, but its trend increased among students from Year I to Internship program. The university must be vigilant in monitoring and educating the students about the consequences of substance use.</p

The role of hemodialysis machines dedication in reducing Hepatitis C transmission in the dialysis setting in Iran: A multicenter prospective interventional study

BACKGROUND: Hepatitis C virus (HCV) infection is a significant problem among patients undergoing maintenance hemodialysis (HD). We conducted a prospective multi-center study to evaluate the effect of dialysis machine separation on the spread of HCV infection. METHODS: Twelve randomly selected dialysis centers in Tehran, Iran were randomly divided into two groups; those using dedicated machines (D) for HCV infected individuals and those using non-dedicated HD machines (ND). 593 HD cases including 51 HCV positive (RT-PCR) cases and 542 HCV negative patients were enrolled in this study. The prevalence of HCV infection in the D group was 10.1% (range: 4.6%– 13.2%) and it was 7.1% (range: 4.2%–16.8%) in the ND group. During the study conduction 5 new HCV positive cases and 169 new HCV negative cases were added. In the D group, PCR positive patients were dialyzed on dedicated machines. In the ND group all patients shared the same machines. RESULTS: In the first follow-up period, the incidence of HCV infection was 1.6% and 4.7% in the D and ND group respectively (p = 0.05). In the second follow-up period, the incidence of HCV infection was 1.3% in the D group and 5.7% in the ND group (p < 0.05). CONCLUSIONS: In this study the incidence of HCV in HD patients decreased by the use of dedicated HD machines for HCV infected patients. Additional studies may help to clarify the role of machine dedication in conjunction with application of universal precautions in reducing HCV transmission

Assessing factors influencing communities' acceptability of mass drug administration for the elimination of lymphatic filariasis in Guyana.

BACKGROUND: Guyana is one of four countries in the Latin American Region where lymphatic filariasis (LF) remains endemic. In preparation for the introduction of a new triple drug therapy regimen (ivermectin, diethylcarbamazine, and albendazole (IDA)) in 2019, an acceptability study was embedded within sentinel site mapping in four regions to assess mass drug administration (MDA) coverage and compliance, acceptability, and perceptions about treatment and disease. The results from this survey would inform the rollout of IDA in Guyana in 2019. METHODS: Data collection for the study occurred in August 2019, using a validated questionnaire administered by trained enumerators. Across all regions, a total of 1,248 participants were sampled by the Filarial Mapping team. Four-hundred and fifty-one participants aged over 18 years were randomly selected for participation in an expanded acceptability questionnaire. All data were captured in Secure Data Kit (SDK). RESULTS: Acceptability was measured using a mean acceptability score. Unadjusted mean scores ranged from 24.6 to 29.3, with 22.5 as the threshold of acceptability. Regional variation occurred across many indicators of interest: self-rated understanding about LF, mechanisms of LF transmission, LF drug safety and history of treatment during MDA. Region IV (Georgetown) recorded higher knowledge about LF, but lower compliance and acceptability. Number of pills was not perceived as a concern. CONCLUSION: Acceptability of MDA was good across all four regions under study. Results from this study set a baseline level for key indicators and acceptability, from which the acceptability of IDA can be measured. Regional variations across indicators suggest that localized approaches should be considered for social mobilization and MDA delivery to capture these contextual differences