human papillomavirus (HPV) is the most common sexually transmitted virus in the world. Prevalence of infection differs, with highest rates reported in sub-Saharan African, including the country of ...Tanzania. In pregnancy, the hormonal changes and immune changes seem to facilitate HPV persistence, increasing the cancer risk and the risk of vertical transmission towards the placenta and the fetus. The burden of HPV infection is still high despite multiple screening and detection test available. The AmpFire® HPV assay is a novel nucleic acid isothermal amplification with real-time fluorescence detection assay that can test simultaneously 15 high-risk HPV. This nested cohort study aims to contribute evidence on the prevalence of HPV infection and persistence across two time points among pregnant women in Pemba island, Tanzania.
vaginal swabs that were previously collected during pregnancy were stored in eNAT buffer (n
=385 and n
=187) and were tested with AmpFire® screening assay, for simultaneous detection of the HPV 16, 18 and other high-risk HPV genotypes 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68.
the AmpFire® HPV assay detected an 11% and 6% high-risk HPV prevalence at the two time points among pregnant women in Pemba island, consecutively. For the 133 women whose samples were tested at both time points, the persistence rate of high-risk HPV was 64%.
novel isothermal HPV assay, such as the AmpFire®, might be feasible to use in low-income regions.
Preterm birth is the leading cause of neonatal deaths in low middle-income countries (LMICs), yet there exists a paucity of high-quality data from these countries. Most modelling estimates are based ...on studies using inaccurate methods of gestational age assessment. We aimed to fill this gap by measuring the population-based burden of preterm birth using early ultrasound dating in five countries in South-Asian and sub-Saharan Africa.
We identified women early in pregnancy (<20 weeks based on last menstrual period) by home visits every 2-3 months (except in Zambia where they were identified at antenatal care clinics) in 5 research sites in South-Asia and sub-Saharan Africa between July 2012 and September 2016. Trained sonographers performed an ultrasound scan for gestational age dating. Women were enrolled if they were 8-19 weeks pregnant on ultrasound. Women <8 weeks were rescheduled for repeat scans after 4 weeks, and identified women were followed through pregnancy until 6 weeks postpartum. Site-specific rates and proportions were calculated and a logistic regression model was used to predict the risk factors of preterm birth.
Preterm birth rates ranged from 3.2% in Ghana to 15.7% in Pakistan. About 46% of all neonatal deaths occurred among preterm infants, 49% in South Asia and 40% in sub-Saharan Africa. Fourteen percent of all preterm infants died during the neonatal period. The mortality was 37.6% for early preterm babies (<34 weeks), 5.9% for late preterm babies (34 to <37 weeks), and 1.7% for term babies (37 to <42 weeks). Factors associated lower gestation at birth included South-Asian region (adjusted mean difference (Adj MD) = -6.2 days, 95% confidence interval (CI) = -5.5, -6.9), maternal morbidities (Adj MD = -3.4 days, 95% CI = -4.6, -2.2), multiple pregnancies (Adj MD = -17.8 days, 95% CI = -19.9,-15.8), adolescent pregnancy (Adj MD = -2.7 days, 95% CI = -3.7, -1.6) and lowest wealth quintile (Adj MD = -1.3 days, 95% CI = -2.4, -0.3).
Preterm birth rates are higher in South Asia than in sub-Saharan Africa and contribute to 49% and 40% of all neonatal deaths in the two regions, respectively. Adolescent pregnancy and maternal morbidities are modifiable risk factors associated with preterm birth.
Drug-resistant tuberculosis (DR-TB) is a serious public health of concern. We present the management of multidrug-resistant (MDR)-TB with skin reaction in Zanzibar in a patient who had prior exposure ...to anti-TB drugs. The reaction developed 4 months later, following MDR-TB treatment, stopped when the drug was withdrawn, and reappeared when reintroduced. Close monitoring is important in managing DR-TB cases, and an active DR-TB safety, monitoring, and management is required to detect, monitor, and manage adverse events timely.
The protective effect of biochanin A (BCA) on the histopathology, immunohistochemistry, and biochemistry of thioacetamide (TAA)-induced liver cirrhosis in vivo was investigated. There was a ...significant reduction in liver weight and hepatocyte propagation, with much lower cell injury in rat groups treated with BCA (25 mg/kg and 50 mg/kg) following a TAA induction. These groups had significantly lower levels of proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA). The liver homogenates showed increased antioxidant enzyme activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), as well as decreased malondialdehyde (MDA) levels. The serum biomarkers associated with liver function, namely alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyl transaminase (GGT), returned to normal levels, comparable to those observed in both the normal control group and the reference control group. Taken together, the normal microanatomy of hepatocytes, the inhibition of PCNA and α-SMA, improved antioxidant enzymes (SOD, CAT, and GPx), and condensed MDA with repairs of liver biomarkers validated BCA’s hepatoprotective effect.
Objective: The United Arab Emirates (UAE), with its characteristic local population, geography, and history, presents several risk factors for cardiovascular diseases (CVDs) in obese individuals. ...Obesity and its associated complications, including diabetes, atherogenic dyslipidemia, and CVDs leading to significant health risks. In the present study, "Youths" defined as young people between 18 and 22 years. We assessed dyslipidemia, inflammation, and oxidative stress biomarker levels and their association with endothelial dysfunction (ED) in both overweight/obese and normal weight youths of UAE. Methods: There were 160 youths with overweight/obese (BMI greater than or equal to 25 kg/m.sup.2) patients and healthy age- and sex-matched normal weight (BMI less than or equal to 24.9 kg/m.sup.2) as controls participated in this study. The anthropometric data and blood samples were collected to assess the biomarkers for dyslipidemia, inflammation, oxidative stress, ED from all the youths. Results: The overall mean age and male-to-female ratio were 20+ or -1.5years and 1.0:1.2, respectively. There was statistically significant difference in HDL-C (p<0.001), triglycerides (TG) (p<0.001), ApoA (p=0.002), ApoB/ApoA ratio (p=0.009) between the overweight/obese and normal weight youths. Among, inflammatory markers: hs-CRP, IL-6, TNF-alpha also showed significant p<0.001 and oxidative stress markers: DNA/RNA Damage, catalase and nitric oxide (NO) showed significant p<0.001 between groups. Spearman correlation of ED markers with lipid profile markers showed Vitamin C levels positively correlated with HDL-C (p<0.001) and negatively correlated with glucose (p<0.001). ICAM-1showed significant negative correlation with HDL-C (p<0.01) and ApoA (p<0.001) but positive correlation with TG (p<0.01) and HbA1c (p<0.001) among groups. Spearman correlation of ED markers with inflammatory/oxidative stress biomarkers showed Vitamin C levels negatively correlated with ferritin (p < 0.001), NO (p < 0.001), GGT (p < 0.001), and ALT (p < 0.001) levels. The ICAM-1showed significant positive correlation with hs-CRP (p < 0.01), IL-6 (p < 0.001), TNF-alpha (p < 0.01), GGT (p < 0.05), and ALT (p < 0.05) in both groups. Conclusion: This study revealed a strong link between the biomarkers of dyslipidemia, inflammation, and oxidative stress with ED in overweight/obese patients. This study might be used to predict future cardiovascular events in this population. Keywords: dyslipidemia, inflammation, oxidative stress, endothelial dysfunction, obesity, youth
The combination antimalarial therapy of artemisinin-naphthoquine (ART-NQ) was developed as a single-dose therapy, aiming to improve adherence relative to the multiday schedules of other artemisinin ...combination therapies. The pharmacokinetics of ART-NQ has not been well characterized, especially in children. A pharmacokinetic study was conducted in adults and children over 5 years of age (6 to 10, 11 to 17, and ≥18 years of age) with uncomplicated malaria in Tanzania. The median weights for the three age groups were 20, 37.5, and 55 kg, respectively. Twenty-nine patients received single doses of 20 mg/kg of body weight for artemisinin and 8 mg/kg for naphthoquine, and plasma drug concentrations were assessed at 13 time points over 42 days from treatment. We used nonlinear mixed-effects modeling to interpret the data, and allometric scaling was employed to adjust for the effect of body size. The pharmacokinetics of artemisinin was best described by one-compartment model and that of naphthoquine by a two-compartment disposition model. Clearance values for a typical patient (55-kg body weight and 44.3-kg fat-free mass) were estimated as 66.7 L/h (95% confidence interval CI, 57.3 to 78.5 L/h) for artemisinin and 44.2 L/h (95% CI, 37.9 to 50.6 L/h) for naphthoquine. Nevertheless, we show via simulation that patients weighing ≥70 kg achieve on average a 30% lower day 7 concentration compared to a 48-kg reference patient at the doses tested, suggesting dose increases may be warranted to ensure adequate exposure. (This study has been registered at ClinicalTrials.gov under identifier NCT01930331.).
The Arabian Tahr Arabitragus jayakari is endemic to the Hajar Mountains of Oman and the United Arab Emirates in the southeast of the Arabian Peninsula and is categorized as Endangered on the IUCN Red ...List of Threatened Species. Lack of scientific research from areas of its occurrence has been a challenge in determining its basic ecological aspects such as current distribution range, population status, and abundance. In the present study, we report a new distribution record for the Arabian Tahr from the Hatta Mountain Conservation Area in the Dubai Emirate through camera trap images. A total of 442 images (44 events) were obtained using three camera traps on 564 trap nights between March and December 2016. About 90% of the Arabian Tahr captures were recorded between 1100 and 1600 hr, indicating diurnal activity. This new occurrence record of the Arabian Tahr from this area is considered of high significance as it will drive in more studies and incentives towards the conservation and management of the species and the area as a whole.