Simple learning tools to improve clinical laboratory practical skills training

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Podoconiosis and soil-transmitted helminths (STHs): double burden of neglected tropical diseases in Wolaita zone, rural southern Ethiopia

Background Both podoconiosis and soil-transmitted helminth (STH) infections occur among barefoot people in areas of extreme poverty; however, their co-morbidity has not previously been investigated. We explored the overlap of STH infection and podoconiosis in Southern Ethiopia and quantified their separate and combined effects on prevalent anemia and hemoglobin levels in podoconiosis patients and health controls from the same area. Methods and Principal Findings A two-part comparative cross-sectional study was conducted in Wolaita zone, southern Ethiopia. Data were collected from adult patients presenting with clinically confirmed podoconiosis, and unmatched adult neighborhood controls living in the same administrative area. Information on demographic and selected lifestyle factors was collected using interviewer-administered questionnaires. Stool samples were collected and examined qualitatively using the modified formalin-ether sedimentation method. Hemoglobin level was determined using two different methods: hemoglobinometer and automated hematology analyzer. A total of 913 study subjects (677 podoconiosis patients and 236 controls) participated. The prevalence of any STH infection was 47.6% among patients and 33.1% among controls (p<0.001). The prevalence of both hookworm and Trichuris trichiura infections was significantly higher in podoconiosis patients than in controls (AOR 1.74, 95% CI 1.25 to2.42, AOR 6.53, 95% CI 2.34 to 18.22, respectively). Not wearing shoes and being a farmer remained significant independent predictors of infection with any STH. There was a significant interaction between STH infection and podoconiosis on reduction of hemoglobin level (interaction p value = 0.002). Conclusions Prevalence of any STH and hookworm infection was higher among podoconiosis patients than among controls. A significant reduction in hemoglobin level was observed among podoconiosis patients co-infected with hookworm and ‘non-hookworm STH’. Promotion of consistent shoe-wearing practices may have double advantages in controlling both podoconiosis and hookworm infection in the study area

Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

Introduction: Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods: A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results: There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion: Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures were recommended.Key words: Logistics management information system, stock outs, laboratory commoditie

Magnitude and determinants of stunting in children underfive years of age in food surplus region of Ethiopia: The case of West Gojam Zone

Background: Child malnutrition is a major public health problem in Ethiopia. Surprisingly, the highest level of stunting is found in food surplus areas of the country. Objective: To identify the determinants of stunting in food surplus areas of West Gojam Zone. Method: A community based cross-sectional survey was conducted on 622 mother-child pairs of 0-59 month old children in Mecha and Wenberma Woredas of West Gojam Zone, Northern Ethiopia between May and June 2006. The study investigated the differential impact of demographic and socio-economic factors, health related factors and dietary factors on stunting among under-five children. Both bivariate analysis and multivariate analysis (logistic regression model) were used to identify the determinants of under-five stunting. Results: The analyses revealed that 43.2 (12.0-17.6) 95% CI percent of the children under age five were suffering from chronic malnutrition, 14.8 (39.3-47.1) 95% CI percent were acutely malnourished and 49.2 (45.3-53.1) 95% CI percent were found to be under-weight. The main contributing factors for under-five stunting were found to be sex of the child, child’s age, diarrhea episode, deprivation of colostrum, duration of breastfeeding, pre-lacteal feeds, type of food, age of introduction of complementary feeding and method of feeding. Conclusion: The findings of this study led to the realization that inappropriate feeding practice is the principal risk factor which brought about nutritional deprivation among under-five children in food surplus areas of Ethiopia. Thus, the importance of appropriate feeding during infancy and childhood cannot be overstated even in food surplus areas. The high prevalence of malnutrition in the study area points out the need to revisit the impression held by many people that malnutrition is not a problem in food surplus areas. Development and implementation of preventive policies aimed at addressing child malnutrition should also consider food surplus areas of the country. [Ethiop. J. Health Dev. 2009;23(2):98-106

Oral health awareness, practices and status of patients with diabetes attending a tertiary health institution in Nigeria

Background: Despite the reported increasing prevalence of diabetes mellitus, very few studies have documented report on oral health awareness and oral health conditions of individuals with diabetes mellitus from our environment. Thus this study aimed at assessing the oral health awareness, practices and status of individuals with diabetes mellitus attending a tertiary health facility in Nigeria.Methods: A cross sectional survey of 143 patients with diabetes attending the medical outpatients' clinic of the hospital. Information was obtained from participants using pretested structured questionnaires and oral examination. Tests of associations were determined using Chi-square and student t test.Results: One-fifth (20.3%) of the respondents were aware of good oral health preventing oral diseases in diabetes. Thirty-five (24.5%) knew that diabetes could worsen oral health condition and only 3 (2.1%) could correctly explain the association between diabetes and oral health conditions. Forty-three (30.1%) had participated in an oral health education program focused on diabetes and oral health. The majority (88.6%) had calculus accumulation while none had a healthy periodontium.Conclusion: Oral health awareness, practices and status of patients with diabetes were poor in our environment. Thus, these individuals need to be better informed of the relationship between oral health and diabetes.Keywords: Oral disease; diabetes; awareness; oral health educatio

Larvicidal effects of Jatropha curcas L. against Anopheles arabiensis (Diptera: Culicidea)

Crude and column chromatographic fractions of methanol leaf extract of Jatropha curcas were tested for their larvicidal activities against laboratory reared late third instar larvae of Anopheles arabiensis. Crude methanol leaf extract of J .curcas had similar larvicidal activity to 0.5 ppm Temephos (positive control) at test concentrations ranging from 125 -1000 ppm while column chromatographic fractions (F1 and F2 ) of the crude methanol leaf extract of J.curcas showed similar larvicidal activities to 0.5 ppm Temephos at 62.5 and 125 ppm test concentrations. Column chromatographic fraction three (F3) showed similar larvicidal activity to 0.5 ppm Temephos at 125 ppm test concentration. The LC50 and LC90 values of crude methanol leaf extract of J.curcas were found to be 92.09 and 241.09 ppm, respectively. Toxic activities of column chromatographic fraction one (F1) (LC50=28.65 ppm; LC90 = 49.20 ppm) were nearly equal to that of column chromatographic fraction two [F2] (LC50= 30.40 ppm; LC90 = 49.80 ppm). Least toxicity on the test larvae was observed by column chromatographic fraction three [F3] (LC50 = 80.70 ppm; LC90 = 123.70 ppm). Thus, the larvicidal activity of crude methanol leaf extract was not due to the synergistic effects of its fractions. Further studies are recommended to identify larvicidal active ingredients from the active column chromatographic fractions of crude methanol leaf extract of J. curcas. Key words: Malaria vector control, Anopheles arabiensis, Botanical larvicides J. curca