Introduction
Co-morbid depression is common in people with tuberculosis (TB) but little is known about the course over time.
Objectives
Our objectives were to determine the level of remission and ...factors associated with failure to remit in depressive symptom scores in people with TB undergoing treatment in primary care facilities in Ethiopia.
Methods
We assessed 648 people with newly diagnosed TB for depressive symptoms using Patient Health Questionnaire (PHQ-9) at the time of starting anti-TB medication, and again at two and six months. Remission was defined as more than 50% reduction in baseline depressive symptom scores. We analyzed factors associated with failure of depressive symptom score to remit at the end of the follow up using multilevel mixed-effects logistic regression by taking individuals as nested within 14 health institutions. Adjustment was made for socio-demographic characteristics, baseline depression score, stigma, type of TB, outcome of TB treatment, perceived severity of TB, substance use, perceived social support, substance use, and HIV status.
Results
Compared to the baseline, the mean PHQ-9 scores declined at two months (Hedge’s G: 0.82; 95%CI: 0.71, 0.94) and six months (Hedge’s G: 1.20; 95%CI: 1.08, 1.33). However, depressive symptom scores failed to remit in 176 (33.1%) of the 532 people with TB who completed the follow up. . Stigma (AOR: 2.23; 95%CI: 1.09, 4.55), older age (AOR: 2.2; 95%CI: 1.13, 4.29), and treatment completion without a bacteriological proof of cure (treatment complete as compared to treatment cure) (AOR: 2.47; 95%CI: 1.37, 4.48) were independent predictors of failure of depressive symptom score to remit. Surprisingly, baseline lower depressive symptom score was more persistent than higher baseline depressive symptom score (AOR: 2.93; 95%CI: 1.56, 5.47).
Conclusions
In one-third of people with newly diagnosed TB, baseline depressive symptom scores did not remit after full course of TB treatment. TB treatment guidelines require in-built mental health component. Studies are required to understand course of depression beyond six months and effective interventions in this population.
Disclosure of Interest
None Declared
TVET plays a significant role in human resource development and, as a result, in a society’s progress and prosperity. The study is aiming at identifying the key factors influencing students’ academic ...success at polytechnic colleges. The study’s target population was regular Bahir Dar Polytechnic College students in the 2019/2020 academic year. Stratified random sampling was employed to conduct a cross-sectional survey of 536 participants. The author employed SPSS version 25 and WinBUGS 1.4 for quantitative data analysis. Bayesian logistic regression was used to model the factors that significantly influence TVET students’ academic achievement. Gender, age, family monthly income, study hours, stimulant use during the study, English language proficiency, EGSECE score, previous perceptions of TVET, teacher satisfaction, and field of study placement satisfaction were identified as factors that significantly influenced TVET students’ academic achievements. Being female, having a low family income, studying for a shorter period, using stimulants while studying, having a low English language proficiency, having a low EGSECE result, having a negative perception of TVET, and having low satisfaction with field of study were all linked to lower academic achievement in this study. According to the findings, students should spend more time in learning and consume fewer stimulants during their studies. The Ministry of Education should modify the TVET curriculum to aid students in improving their English language skills. Teachers in TVET should also receive ongoing capacity-building training. Finally, rather than imposing norms and limits (in terms of student achievement), TVET colleges should respect students’ free choice of training sector (department).
IntroductionChild mortality rates remain high in sub-Saharan Africa, including Ethiopia. We are conducting a cluster randomised control trial in the Gondar zone of the Amhara region to determine the ...impact of pairing Orthodox priests with community health workers, known locally as the Health Development Army (HDA), on newborns’ nutritional status, early illness identification and treatment, and vaccination completeness.Ensuring intervention efficacy with scientific rigour is essential, but there are often delays in adopting evidence into policy and programmes. Here, we present a protocol for conducting parallel implementation research alongside an efficacy study to understand intervention implementability and scalability. This will help develop a scale-up strategy for effective elements of the intervention to ensure rapid implementation at scale.Methods and analysisWe will conduct a stakeholder analysis of key implementation stakeholders and readiness surveys to assess their readiness to scale up the intervention. We will conduct semistructured interviews and focus group discussions with stakeholders, including HDA members, health workers, Orthodox priests, and caregivers, to determine the core intervention elements that need to be scaled, barriers and facilitators to scaling up the intervention in diverse sociocultural settings, as well as the human and technical requirements for national and regional implementation. Finally, to determine the financial resources necessary for sustaining and scaling the intervention, we will conduct activity-based costing to estimate implementation costs from the provider’s perspective.Ethics and disseminationThe study received approval from the University of Gondar Institutional Review Board (approval no: VP/RTT/05/1030/2022) and the University of Washington Human Subjects Division (approval no: STUDY00015369). Participants will consent to participate. Results will be disseminated through workshops with stakeholders, local community meetings, presentations at local and international conferences, and journal publications. The study will provide evidence for factors to consider in developing a scale-up strategy to integrate the intervention into routine health system practices.
Background. Many people living with HIV in South Africa (SA) are not aware of their seropositive status and are diagnosed late during the course of HIV infection. These individuals do not obtain the ...full benefit from available HIV care and treatment services. Objectives. To describe the prevalence of late presentation for HIV care among newly diagnosed HIV-positive individuals and evaluate sociodemographic variables associated with late presentation for HIV care in three high-burden districts of SA. Methods. We used data abstracted from records of 8 138 newly diagnosed HIV-positive individuals in 35 clinics between 1 June 2014 and 31 March 2015 to determine the prevalence of late presentation among newly diagnosed HIV-positive individuals in selected highprevalence health districts. Individuals were categorised as ‘moderately late’, ‘very late’ or ‘extremely late’ presenters based on specified criteria. Descriptive analysis was performed to measure the prevalence of late presentation, and multivariate regression analysis was conducted to identify variables independently associated with extremely late presentation. Results. Overall, 79% of the newly diagnosed cases presented for HIV care late in the course of HIV infection (CD4+ count ≤500 cells/ μL and/or AIDS-defining illness in World Health Organization (WHO) stage III/IV), 19% presented moderately late (CD4+ count 351 - 500 cells/μL and WHO clinical stage I or II), 27% presented very late (CD4+ count 201 - 350 cells/μL or WHO clinical stage III), and 33% presented extremely late (CD4+ count ≤200 cells/μL and/or WHO clinical stage IV) for HIV care. Multivariate regression analysis indicated that males, non-pregnant women, individuals aged >30 years, and those accessing care in facilities located in townships and inner cities were more likely to present late for HIV care. Conclusions. The majority of newly diagnosed HIV-positive individuals in the three high-burden districts (Gert Sibande, uThukela and City of Johannesburg) presented for HIV care late in the course of HIV infection. Interventions that encourage early presentation for HIV care should be prioritised in SA and should target males, non-pregnant women, individuals aged >30 years and those accessing care in facilities located in inner cities and urban townships.
Immunoglobulin (IgG) has the ability to suppress the Ab response against the Ag to which it binds. Although the mechanism remains unclear, this phenomenon has physiological relevance and is used ...clinically in Rh prophylaxis. As suppression works well in mice lacking the inhibitory FcγRIIB, the two most likely explanations are that IgG masks epitopes and/or that IgG increases the clearance of Ag. In the present study, mice were immunized with sheep red blood cells (SRBC) to which the hapten 5-iodo-4-hydroxyl-3-nitrophenacetyl (NIP) was conjugated at high or low density and the ability of IgG anti-NIP to suppress the Ab response to NIP and SRBC was assayed. Only the NIP-specific response was suppressed when mice were immunized with SRBC-NIPlow, whereas both NIP- and SRBC-specific responses were suppressed when SRBC-NIPhigh was used. This is best explained by epitope masking; at high epitope density, IgG also blocks neighbouring epitopes from recognition by B cells. We also examined the effects of IgG-mediated suppression on T-cell responses directly in vivo. While IgG anti-SRBC administered with sheep red blood cells ovalbumin (SRBC-OVA) almost completely suppressed the anti-SRBC and anti-OVA Ab responses, the OVA-specific T-cell response was still 50% of that observed in control mice. This is probably the result of decreased Ag exposure as IgG-bound SRBC were cleared faster from the bloodstream and were found at lower concentration in the spleen than unbound SRBC. These results suggest that both Ag clearance and epitope masking occurs during IgG-mediated suppression, but that under physiological circumstances epitope masking is the predominant mechanism.
The intention of this review is to assess the impact of anthropogenic activities on the biodiversity of Lake Abijata. The lake was established as a National Park, together with Lakes Shalla and ...Chitu, to conserve water birds. It has high pH and electrical conductivity and is hypersaline. It presents an inhospitable limnochemical environment that limits biodiversity, although there are organisms adapted to these hostile conditions. The biodiversity of the lake is threatened by anthropogenic activities. Deforestation, expansion of agriculture, livestock, soda ash extraction and upstream irrigation led to a drop in water level and surface area, a change in physico-chemical and biological conditions, and a general deterioration in ecosystem condition. The phytoplankton community structure has switched from populations of Arthrospira fusiformis to non-Arthrospira fusiformis, zooplankton communities have moved towards small-bodied rotifers, such as Brachionus, Filinia and Lecane spp., the fishery has totally collapsed and birds, such as lesser flamingoes (Phoeniconaias minor Geoffroy) and great white pelicans (Pelecanus onocrotalus), have migrated to nearby lakes. These ecological changes over the past years point to the need for a new conservation and management plan to restore the ecosystem's health. A few recommendations are given for lake management as mechanisms to protect the ecosystem.
Antibodies administered in vivo together with the antigen they are specific for can regulate the immune response to that antigen. This phenomenon is called antibody‐mediated feedback regulation and ...has been known for over 100 years. Both passively administered and actively produced antibodies exert immunoregulatory functions. Feedback regulation can be either positive or negative, resulting in >1000‐fold enhancement or >99% suppression of the specific antibody response. Usually, the response to the entire antigen is up‐ or downregulated, regardless of which epitope the regulating antibody recognizes. IgG of all isotypes can suppress responses to large particulate antigens like erythrocytes, a phenomenon used clinically in Rhesus prophylaxis. IgG suppression works in mice lacking the known Fc‐γ receptors (FcγR) and a likely mechanism of action is epitope masking. IgG1, IgG2a and IgG2b administered together with soluble protein antigens will enhance antibody and CD4+ T‐cell responses via activating FcγR, probably via increased antigen presentation by dendritic cells. IgG3 as well as IgM also enhance antibody responses but their effects are dependent on their ability to activate complement. A possible mechanism is increased B‐cell activation caused by immune complexes co‐crosslinking the B‐cell receptor with the complement‐receptor 2/CD19 receptor complex, known to lower the threshold for B‐cell activation. IgE‐antibodies enhance antibody and CD4+ T‐cell responses to small soluble proteins. This effect is entirely dependent on the low‐affinity receptor for IgE, CD23, the mechanism probably being increased antigen presentation by CD23+ B cells.
The roots of
have been used traditionally for the management of wound in different regions of Ethiopia. Despite the presence of several claims and in vitro studies regarding its role in wound ...healing, no scientific studies have been conducted so far. Therefore, this study aims to scientifically evaluate the wound healing activities of the crude extract and solvent fractions of the roots of
in Swiss albino mice.
The dried root powder of
was extracted using 80% methanol by maceration technique. This was then fractionated with chloroform, ethyl acetate, and water. These extracts were formulated as ointment at 5% and 10% concentration by using simple base. Acute dermal toxicity was performed on mice. The wound healing potential was evaluated using excision, incision, and burn wound models.
In excision wound, 10% and 5% of crude extract ointment provided a significant (P<0.001) percentage of contraction starting from day 4 and day 6 onwards respectively. Moreover, the rate of epithelialization was significantly (P<0.001) improved in 10% crude extract. In burn wound, 10% and 5% crude extract showed significant (P<0.001) wound contraction starting from day 4 and 8 onwards respectively. In both excision and burn wounds, a moderate concentration of fibroblast proliferation and collagen deposition was observed on the 10% crude extract. The 5% and 10% aqueous and ethyl acetate fractions produced a significant (P<0.001) percentage of wound contraction and shortening of epithelialization at different time points compared to simple ointment.
The results of this study demonstrated that the 80% methanolic crude extract, aqueous and ethyl acetate fractions of
root have wound healing potential which assimilates its traditional use.
Objectives
People living with disability are more vulnerable to dental caries and have a high decayed, missed, and filled permanent teeth (DMFT) index and untreated dental disease than nondisabled ...individuals. In Ethiopia, there is a dearth of information on the oral health status of the disabled population. Hence, this study aimed to determine the prevalence of dental caries and its predictors among special needs school students in the Amhara region, Ethiopia.
Methods
An institution‐based cross‐sectional study was done on special needs school students in the Amhara region from November 2020 to April 2021. The study participants were recruited using a simple random sampling technique using a computer random generator. Data collection was done using the World Health Organization oral health survey tool. Data entry was done using Epi‐data 4.6 and analyzed using SPSS 26. A logistic regression model was used to identify the possible predictors of dental caries.
Results
Four hundred and forty‐three students with a mean age of 15.8 ± 3.8 were included in the study. The prevalence of dental caries was 41.5% (95% confidence interval CI: 36.3, 46.0) in permanent dentition with a mean DMFT score of 1.3 ± 1.6. The prevalence of dental caries in primary dentition was 23.1% (95% CI: 11.9, 32.1) with a mean decayed, missed, and filled primary teeth (dmft) score of 1.9 ± 0.2.
Being 7–12 years old (adjusted odds ratios AOR = 3.6, 95% CI: 1.6, 8.3), lower grade level (AOR = 2.4, 95% CI:1.3,4.4), poor oral hygiene status (AOR = 2.5, 95% CI: 1.3, 4.8), and lack of parental support during tooth brushing (AOR = 2.2, 95% CI: 1.2, 4.1) were independent predictors of dental caries.
Conclusions
A significant amount of special needs school students in the study area had dental caries. Age, grade level, oral hygiene status, and lack of parent support during tooth brushing were independent predictors of dental caries.
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