Comparison of hemoglobin levels by HemoCue301+ and Sysmex KX-21N at University of Gondar Hospital, Northwest Ethiopia, 2020.

BACKGROUND: Automated hematology analyzers deliver accurate and reliable hemoglobin measurement but they are expensive to afford for most of the developing countries like Ethiopia. Point of care hemoglobin analyzer like HemoCue301+ has potential to alleviate such problems. The main aim of this study was to compare the hemoglobin concentration measured by HemoCue301+ with the Sysmex KX-21N method at University of Gondar Com-prehensive Specialized Hospital, Gondar, Ethiopia, 2020. METHODS: A hospital based cross-sectional study with convenient sampling technique was employed from November to December 2020. Institutional ethics approval was obtained prior to sample utilization. A total of 147 specimens were analyzed by HemoCue301+ and Sysmex KX-21N hematology analyzer to compare the hemoglobin concentration measured by the two methods. Paired sample t-test and Bland-Altman plot were used to arrive at conclusions. SPSS version 20 and MedCalc software were used for analysis of the data. RESULTS: The paired sample t-test indicated the mean difference of the two measurements was 0.08299 with a standard deviation of 0.82332 and t-test: 1.222 at 146 degrees of freedom. There was no significant difference between the two measurements with a p-value of 0.224. The concordance correlation coefficient of the two methods was 0.956 (95% CI: 0.940 - 0.968, p < 0.0001). From the Bland-Altman plot, the limit of agreement was -1.50 - 1.70 g/dL with the mean difference of 0.08299 (95% CI: -0.05121 - 0.2172). CONCLUSIONS: There was no significant difference in the hemoglobin measurement by the HemoCue and Sysmex KX-21N (coef = -0.127, 95% CI: -0.379 - 0.634). The HemoCue301+ may be used interchangeably with Sysmex-KX-21N automated hematology analyzers.

Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia. METHODS: Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg's Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. RESULTS: A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections. CONCLUSION: The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.

Anemia as a risk factor for tuberculosis: a systematic review and meta-analysis.

BACKGROUND: Tuberculosis is a major public health problem caused by Mycobacterium tuberculosis, occurring predominantly in population with low socioeconomic status. It is the second most common cause of death from infectious diseases. Tuberculosis becomes a double burden among anemic patients. Anemia increases an individual's susceptibility to infectious diseases including tuberculosis by reducing the immunity level. Therefore, the purpose of this study was to determine whether anemia is a risk factor for tuberculosis. METHOD: Relevant published articles were searched in electronic databases like PubMed, Google Scholar, EMBASE, and Cochrane Library using the following MeSH terms: risk factor, predictors, tuberculosis, TB, Anaemia, Anemia, hemoglobin, Hgb, and Hb. Articles written in the English, observational studies conducted on the incidence/prevalence of tuberculosis among anemic patients, or papers examined anemia as risk factors for tuberculosis were included. From those studies meeting eligibility criteria, the first author's name, publication year, study area, sample size and age of participants, study design, and effect measure of anemia for tuberculosis were extracted. The data were entered using Microsoft Excel and exported to Stata version 11 for analysis. The random-effects model was applied to estimate the pooled OR and HR, and 95% CI. The sources of heterogeneity were tested by Cochrane I-squared statistics. The publication bias was assessed using Egger's test statistics. RESULTS: A total of 17 articles with a 215,294 study participants were included in the analysis. The odd of tuberculosis among anemic patients was 3.56 (95% CI 2.53-5.01) times higher than non-anemic patients. The cohort studies showed that the HR of tuberculosis was 2.01 (95% CI 1.70-2.37) times higher among anemic patients than non-anemic patients. The hazard of tuberculosis also increased with anemia severity (HR 1.37 (95% CI 0.92-2.05), 2.08 (95% CI 1.14-3.79), and 2.66 (95% CI 1.71-4.13) for mild, moderate, and severe anemia, respectively). CONCLUSION: According to the current systematic review and meta-analysis, we can conclude that anemia was a risk factor for tuberculosis. Therefore, anemia screening, early diagnose, and treatment should be provoked in the community to reduce the burden of tuberculosis.

Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis.

BACKGROUND: Tuberculosis (TB) and HV have been intertwined and makeup a deadly human syndemic worldwide, especially in developing countries like Ethiopia. Previous studies have reported different TB incidences and its association with CD4+ T cell counts among HIV positive patients in Ethiopia. Thus, the goal of this meta-analysis was, first, to determine pooled incident TB among adult HIV positive patients, and second, to assess the association between incident TB and baseline CD4+ T cell count strata's. METHODS: We searched PubMed, Cochrane library, Science Direct and Google scholar databases from June 1 to 30, 2018. The I2 statistics and Egger's regression test was used to determine heterogeneity and publication bias among included studies respectively. A random effects model was used to estimate pooled incident TB and odds ratio with the respective 95% confidence intervals using Stata version 11.0 statistical software. RESULTS: A total of 403 research articles were identified, and 10 studies were included in the meta-analysis. The pooled incident TB among adult HIV infected patients in Ethiopia was 16.58% (95% CI; 13.25-19.91%). Specifically, TB incidence in Pre-ART and ART was 17.16% (95% CI; 7.95-26.37%) and 16.24% (95% CI; 12.63-19.84%) respectively. Moreover, incident TB among ART receiving patients with baseline CD4+ T cell count < and > 200 cells/mm3 was 28.86% (95% CI; 18.73-38.98%) and 13.7% (95% CI; 1.41-25.98%) correspondingly. The odds of getting incident TB was 2.88 (95% CI; 1.55-5.35%) for patients with baseline CD4+ T cell count < 200 cells/mm3 compared to patients with baseline CD4+ T cell count > 200 cells/mm3. CONCLUSION: High incident TB among adult HIV positive patients was estimated, especially in patients with CD4+ T cell count < 200 cells/mm3. Therefore, Early HIV screening and ART initiation, as well as strict compliance with ART and increasing the coverage of TB preventive therapy to more risky groups are important to prevent the problem. TRIAL REGISTRATION: Study protocol registration: CRD42018090802.

Circulating MicroRNAs in Multiple Myeloma: a Literature Review.

Multiple myeloma is a tumour of antibody-secreting plasma cells characterized by clonal expansion and accumulation of monotypic plasma cells in the bone marrow. It is an incurable malignant neoplasm accounting for 10% all hematological malignancies. Globally, the annual percentage of new cancer cases and deaths attributed to multiple myeloma is estimated at about 0.8% and 1%, respectively. Furthermore, its global incidence ranges from 0.5 - 12/100,000 population. It causes hypercalcemia, renal insufficiency, anemia, thrombocytopenia, leucopenia, bone lesions, bone fractures, spinal stenosis, and endorgan damages. This neoplasm occurs due to a complex cytogenetic and chromosomal aberrations. These aberrations affect the expression and functions of microRNAs. Abnormal expression of these microRNAs plays an important role in the pathogenesis and angiogenesis of multiple myeloma and could have a potential role in the diagnosis, prognostic stratification, and treatment of multiple myeloma. This review aimed at summarising the expression of microRNAs and the implication of their dysregulation in the pathogenesis, diagnosis, and treatment of multiple myeloma.

Neonatal Iron: Factors Influencing its Level and Associated Complications - a Review Article.

BACKGROUND: Iron is an essential micronutrient which plays a significant role, particularly vital for early brain growth and function. Maternal iron condition influences the iron status of neonates since iron transferred from the mother is the only source for fetal iron. A depletion in iron as a result of rapid growth leads to iron deficiency which is common in neonates. Although there are inconsistencies with regard to the normal reference ranges for neonatal iron level, the current review summarized literature to provide compressive information about neonatal iron status and factors that influence its level. METHODS: This is a narrative review on the basis of relevant literatures mainly on neonatal iron from peer-reviewed journals. Electronic databases such as PubMed, PMC, Scopus, Science Direct, Google scholar, Google, and Yahoo were used to retrieve relevant literatures using key terms like "newborn iron, neonatal iron, iron overload, maternal factors, complication, iron level and neonates" separately and in combination. RESULTS: Several factors had been postulated as factors associated with neonatal iron status. The current review figured out that maternal obesity, gestational diabetes mellitus, preterm delivery, placental transferrin receptor, inappropriate iron supplementation, use of iron fortified formula, uses of recombinant erythropoietin therapy, smoking, maternal iron deficiency anemia, umbilical cord clamping, and transfusion are the major factors which can influence neonatal iron level. These factors may have either positive or negative effects on neonatal iron level. Both iron deficiency and iron overload at some stage in the fetal development or at early stage of neonatal development cause abnormal functions of multiple organ system of neonates and subsequently contributed to neonatal and childhood morbidity and mortality. CONCLUSIONS: By one and other means insufficient, late and extra maternal iron supplementation, early and delayed umbilical cord clamping have negative effects on the iron level of neonates. Therefore, careful prenatal and antenatal follow-up need to be strengthened with due emphasis for maternal iron assessment.

Assessment of hematological parameters of petrol filling workers at petrol stations in Gondar town, Northwest Ethiopia: a comparative cross-sectional study.

BACKGROUND: Petrol is the non-specific term for petroleum which is used for inside combustion of engines. Petrol filling workers are highly vulnerable to occupational exposure to these harmful substances which lead to hemato-toxicity and blood disorders such as leukemia, aplastic anemia, and dysplastic bone marrow. Thus, this study was aimed to assess hematological parameters of petrol filling workers in Gondar town, Northwest Ethiopia. METHODS: A comparative cross-sectional study was conducted from January to March 2019 in Gondar town, Northwest Ethiopia. A total of 110 study participants comprising 55 study groups and 55 controls group were recruited by a convenient sampling technique. Socio-demographic data were collected using a structured questionnaire, and 3 ml of venous blood was collected for the determination of hematological parameters. The data were entered into Epi info 7.2.0.1 and analyzed by SPSS version of 20. Mean, standard deviation, median, and interquartile ranges were used to present the data. Independent t test and Mann-Whitney U test were used to compare the mean or median difference between parametric and non-parametric hematological parameters, respectively. Moreover, Pearson product-moment and Spearman's rank-order bivariable correlations analyses were used to describe the correlation between hematological parameters and duration of exposure to petrol. A P value of ≤ 0.05 was considered statistically significant. RESULTS: The study revealed that mean red blood cell count and hemoglobin level as well as the median hematocrit, mean cell hemoglobin concentration, platelet count, absolute lymphocytes count, and red cell distribution width values of petrol filling workers showed a significant increment compared with the control group. On the other hand, the mean cell hemoglobin value of petrol filling workers showed a significant decrement compared with healthy controls. Moreover, the duration of exposure to petrol showed a significant positive correlation with red blood cell count and mean cell hemoglobin concentration; however, a significant negative correlation was observed with mean cell volume. CONCLUSION: This study showed that the majority of hematological parameters of petrol filling workers showed an increment compared with healthy controls which might be associated with exposure to petrol chemicals. However, further longitudinal study with a larger sample size should be conducted to explore the impact of petrol exposure on hematopoiesis.

Immunological status and virological suppression among HIV-infected adults on highly active antiretroviral therapy.

BACKGROUND: World Health Organization (WHO) recommends that viral load ([VL) is a primary tool that clinicians and researchers have used to monitor patients on antiretroviral therapy (ART), an antiviral drug against retroviruses. Whereas, CD4 cell counts can only be used to monitor clinical response to ART in the absence of VL testing service. Therefore, this study is aimed to assess the level of immunological status and virological suppression, and identify associated factors among human immunodeficiency virus ([HIV)-infected adults who were taking antiretroviral drugs of combination regimen know as highly active antiretroviral therapy (HAART). METHODS: A hospital-based cross-sectional study was conducted at the University of Gondar comprehensive specialized referral hospital from February to April 2018. A total of 323 adult participants on HAART were selected using a systematic random sampling technique and enrolled into the study. Blood samples for viral load determination and CD4 cell count were collected. Binary logistic regression analysis was used to determine factors associated with immunologic status and virological suppression in HIV patients on HAART. Odds ratio with 95% CI was used to measure the strength of association. RESULTS: Virological suppression (VL level < 1000 copies/ml) was found in 82% (95% CI 77.7, 86.1) of study participants, and it has been associated with CD4 cell count between 350 and 499 cells/mm3 (adjusted odds ratio (AOR) = 2.56; 95% CI 1.14, 5.75) and > 499 cells/mm3 (AOR = 7.71; 95% CI 3.48, 17.09) at VL testing and current age > 45 years old (AOR = 5.99; 95% CI 2.12, 16.91). Similarly, favorable immunological status (≥ 400 cells/mm3 for male and ≥ 466 cells/mm3 for female) was observed in 52.9% (95% CI 47.4, 58.8) of the study participants. Baseline CD4 cell count of > 200 cells/mm3, age at enrollment of 26 through 40 years old, and urban residence were significantly associated with favorable immunological status. CONCLUSION: Though the majority of HIV-infected adults who were on HAART had shown viral suppression, the rate of suppression was sub-optimal according to the UNAIDS 90-90-90 target to help end the AIDS pandemic by 2020. Nonetheless, the rate of immunological recovery in the study cohort was low. Hence, early initiation of HAART should be strengthened to achieve good virological suppression and immunological recovery.

The Role of Reticulocyte Hemoglobin Content for Diagnosis of Iron Deficiency and Iron Deficiency Anemia, and Monitoring of Iron Therapy: a Literature Review.

BACKGROUND: The diagnosis of iron deficiency anemia is still complicated and most of the tests have drawbacks. Bone marrow examination, the gold standard for the diagnosis of iron deficiency and iron deficiency anemia, is a painful, invasive, and costly procedure. Other methods are also used to diagnose iron deficiency and iron deficiency anemia; soluble transferrin receptor, serum iron, serum ferritin, and transferrin saturation are most common biomarkers of iron status that are frequently affected by inflammation, chronic diseases, and in the normal aging process (except soluble transferrin receptor). All are less available compared to complete blood count with reticulocyte hemoglobin content (CHr). Reticulocytes have a normal life span of one or two days in the circulation. CHr is a good indication of iron availability and an early marker of iron deficient erythropoiesis which can be obtained readily using automated blood cell analyzers. Therefore, the main objective of the current review is to assess the role of CHr for diagnosis of iron deficiency, iron deficiency anemia, and monitoring of iron therapy. METHODS: Studies published in English were searched using the National Library of Medicine, PubMed, and Google scholar databases. RESULTS: According to this review, CHr has a moderate sensitivity and specificity for diagnosing iron deficiency, and is less affected by inflammation than serum iron, transferrin saturation, and ferritin and is an early predictor of treatment response. It is used in screening of iron deficiency, diagnosis of iron deficiency anemia, and diagnosis of functional iron deficiency anemia in acute or chronic diseases or inflammation. CHr is also important in treatment monitoring. It is useful for early measurement of response to iron therapy, increasing within days of the initiation of iron therapy. It helps monitoring of intravenous iron supplementation, recombinant human erythropoie¬tin therapy, and oral iron therapy in hemodialysis and non-hemodialysis patients, and children. CONCLUSIONS: It is easy to analyze, less time consuming, and less expensive than bone iron examination and iron biochemical tests. However, there is no standardized cutoff point and different researchers use varying cutoff values which affects its accuracy in diagnosing iron deficiency and it should therefore be standardized. Moreover, since CHr can be affected with any conditions that cause iron restricted erythropoiesis, further analysis may be needed.

Hematological Indices of Pregnant Women at the University of Gondar Referral Hospital, Northwest Ethiopia: a Comparative Cross-Sectional Study.

BACKGROUND: Pregnancy is a natural physiological variation as a result of hormonal and metabolic changes. Worldwide a large proportion of women are expected to die each year as a result of pregnancy complication related to hematological profile alterations. Therefore, this study is aimed at assessing hematological indices of pregnant in comparison with non-pregnant women. METHODS: A comparative cross-sectional study was conducted among pregnant and non-pregnant women at the University of Gondar Hospital, from February to April 2015. A blood sample was collected from 139 pregnant and 139 age-matched non-pregnant women using systematic random sampling technique. Data analysis was made using SPSS version 20. Level of significance was analyzed using independent t-test and Mann-Whitney U test. A p-value ≤ 0.05 was considered statistically significant. RESULTS: In this study, pregnant women had significantly higher WBC count [(7.08 ± 2.07 vs. 5.77 ± 1.85) x 109/L], MCV [(93.16 ± 3.44 vs. 90.74 ± 4.12) fL], MCHC [(30.40 ± 1.19 vs. 29.47 ± 1.46) pg], Neutrophil count [(4.73 ± 1.86 vs. 3.06 ± 1.47) x 109/L], Lymphocyte count [(1.65 ± 0.41 vs. 1.2 ± 0.54) x 109/L], RDW [(49.35 ± 2.9 vs. 46.37 ± 2.73) fL], PDW [(14.02 ± 0.6 vs. 13.12 ± 0.19) fL], and MPV [(10.49 ± 0.95 vs. 10.06 ± 1.18) fL] compared with controls. The RBC count [(4.55 ± 0.38 vs. 5.14 ± 0.53) x 1012/L], Hb [(13.73 ± 0.96 vs. 15.30 ± 1.074) g/dL], Hct [(42.14 ± 2.55 vs. 47.16 ± 3.36)%], and Platelets [(196.07 ± 48.88 vs. 249.36 ± 62.73) x 109/L] were significantly lower among pregnant women compared to the control group, respectively. This study also indicated that there was a significant difference in MCV, MCH, platelet count, absolute lymphocyte count and RDW across the three trimes-ters of pregnancy. CONCLUSIONS: This study found a statistically significant difference in the majority of hematological indices between pregnant and non-pregnant women. Trimesters of pregnancy have an influence on some hematological indices. This study provides baseline data for basic hematological indices changes, and it is vital especially in the antenatal care assessment to avoid pregnancy-related adverse outcomes.

The Role of Neutrophil to Lymphocyte Count Ratio in the Differential Diagnosis of Pulmonary Tuberculosis and Bacterial Community-Acquired Pneumonia: a Cross-Sectional Study at Ayder and Mekelle Hospitals, Ethiopia.

BACKGROUND: The differential diagnosis of pulmonary tuberculosis and bacterial community-acquired pneumonia is often a challenging phenomenon. The neutrophil to lymphocyte count ratio, a suitable indicator of inflammation, has been demonstrated to be a useful biomarker for predicting bacteremia. The main aim this study is to evaluate the role of neutrophil to lymphocyte count ratio in the differential diagnosis of pulmonary tuberculosis and bacterial Community-Acquired Pneumonia at Ayder and Mekelle hospitals, Mekelle, Ethiopia. METHODS: A hospital based cross-sectional study was conducted from February to May 2017 on a total of 146 patients at Ayder and Mekelle hospitals. After taking written informed consent, study participants were interviewed for a detailed history and 5 mL of blood was collected for hematological analysis. Pulmonary tuberculosis was diagnosed by using Ziehl-Neelsen and Gene X-pert. Community acquired pneumonia was diagnosed using sputum culture. Student's t-test, Pearson's chi-square test, and receiver operating characteristics curve analysis were used. A p-value < 0.05 was considered statistically significant. RESULTS: The neutrophil to lymphocyte count ratio and eythrocyte sedimentation rate were significantly higher in pulmonary tuberculosis patients than bacterial community-acquired pneumonia patients. Neutrophil to lymphocyte count ratio and eythrocyte sedimentation rate with cutoff values of ≥ 2.72 and ≥ 39, respectively, showed the highest area under the curve (AUC = 0.69; 95% CI: 0.62, 0.77). CONCLUSIONS: Neutrophil to lymphocyte count ratio and eythrocyte sedimentation rate together at a time with their respective cutoff values gave a 69% accuracy in differentiating pulmonary tuberculosis from bacterial community-acquired pneumonia. Therefore, neutrophil to lymphocyte count ratio and erythrocyte sedimentation rate can be used in differentiating pulmonary tuberculosis from PTB patients from bacterial Community-acquired pneumonia, especially in resource-limited settings.

Under nutrition, maternal anemia and household food insecurity are risk factors of anemia among preschool aged children in Menz Gera Midir district, Eastern Amhara, Ethiopia: a community based cross-sectional study.

BACKGROUND: In Ethiopian, the prevalence of anemia among preschool aged children widely varied across regions. Since anemia adversely affects the cognitive and physical development of the children, it is important to determine its burden for implementing appropriate measurements. Therefore, this study was aimed at determining the anemia prevalence and associated factors among preschool aged children. METHOD: A community based cross-sectional study was conducted on a total of 432 preschool children in Menz Gera Midir district from January to May, 2017. A multi stage sampling procedure was applied to select the target groups. Hemocue analyzer for Haemoglobin determination; anthropometric measurements for assessment nutritional status, structured questionnaires for socio-demographic and economic variables were used for data collection. The morphological appearance of red blood cell was assessed microscopically to determine type of anemia. Descriptive statistics were employed to summarize the data and binary logistic regression was used for inferential statistics. A p value less than 0.05 was considered as statistically significant. RESULT: The overall prevalence of anemia was 123 (28.5%); of which 38 (30.9%) and 85 (69.1%) were moderate and mild, respectively. Morphologically about 50.4, 37.4 and 12.2% were microcytic hypochromic, normocytic normochromic and macrocytic anemias, respectively. Child age 6-11 months (COR: 5.67, 95% CI: 2.2, 14.86), child age 12-23 months (COR: 5.8, 95% CI: 2.3, 14.7), wasting (COR: 3.5, 95% CI: 1.2, 9.8), stunting (COR: 3.8, 95% CI: 1.92, 7.77), underweight (COR: 2.12, 95% CI: 1.07, 4.38), MUAC measurement below 13 cm (COR: 5.6, 95% CI: 2.83, 11.15), household headed by female (COR: 3.24, 95% CI: 1.1, 9.63), maternal anemia (COR: 4, 95% CI: 2.2, 7.23) and household food insecurity (COR: 2.12, 95% CI: 1.09, 4.12) were significantly associated with anemia. CONCLUSION: The prevalence of anemia among the children was found to be high and associated with child age group, child nutritional status, house hold headed by female, maternal anemia and household food insecurity. Further studies on nutritional anemia, community based nutritional education, iron supplementation to children at risk should be promoted.

Prevalence and determinants of stunting and wasting among public primary school children in Gondar town, northwest, Ethiopia.

BACKGROUND: Undernutrition among school age children has an impact on their health, cognition, and educational achievement. Therefore, this study aimed to assess the prevalence and associated factors of stunting and wasting among school age children in Gondar town, northwest, Ethiopia. METHODS: An institution-based cross-sectional study was done among school children aged 6-14 years. Data on socio-demographic, nutritional and dietary status of children were collected using structured questionnaire. Anthropometric measurements were carried out to determine the status of stunting and wasting. Data were entered into Epi-Info version 3.5.3 and transferred to SPSS version 20 for further analysis. Bivariable and multivariable logistic regression models were fitted to identify associated factors of stunting and wasting. Both crude odds and adjusted odds ratios with 95% CI were used to measure the strength of associations. In the multivariable analysis, variables with < 0.05 p-values were considered statistically significant. RESULTS: A total of 523 school age children were with the median age of 12 (10-13 inter quartile range) years participated in the study. The overall prevalence of stunting and wasting among primary school children was 241(46.1%; 95% CI: 42.3, 50.3) and 47 (9%; 95% CI: 6.7, 11.7), respectively. Child age (AOR = 1.9, 95% CI: 1.29, 2.80), public tab/yard water source (AOR = 2.22; 95%CI: 1.46, 3.39), DDS < 4 (AOR = 1.89 95%CI: 1.08, 3.30), tea drinking habit (AOR = 0.46, 95%CI: 0.27, 0.80) and anemia (AOR = 1.72 95%CI: 1.05, 2.83) were significant predictors of stunting. Moreover, child age (AOR = 3.91; 95% CI: 1.62, 9.44), maternal/care-givers' age ≤ 34 (AOR = 0.34; 95%CI: 0.16, 0.71), maternal education (AOR = 2.55; 95%CI: 1.15, 5.65), family poverty (AOR = 3.23; 95% CI: 1.30, 7.93) and alcohol consumption (AOR = 2.93; 95%CI: 1.16, 7.42) were found significantly associated with wasting. CONCLUSION: Stunting and wasting were then major problems among school age children. Child age, water source for dinking, DDS < 4 and anemia resulted in stunting. On the other hand, child age, maternal education and age, family poverty and alcohol drinking were risk factors for wasting. Therefore, launching community based nutritional education programs, implementing school feeding and strengthening economic level of the communities are essential to reduce the problems.

Syphilis and human immunodeficiency virus infections among pregnant women attending antenatal care clinic of Gondar family guidance association, Northwest Ethiopia: implication for prevention of mother to child transmission.

BACKGROUND: Sexually transmitted infections constitute a major public health problem worldwide. Syphilis and HIV infections cause various adverse pregnancy outcomes. Therefore, the aim of this study was to determine the seroprevalence of HIV and syphilis infections among pregnant women at Gondar Family Guidance Association clinic, northwest Ethiopia. METHODS: A retrospective study was conducted using sociodemographic and laboratory data obtained from registration books of Gondar Family Guidance Association clinic from January 2011 to April 2015. A binary logistic regression model was fit to identify factors associated with HIV and syphilis infections. Odds ratios with 95% confidence intervals were calculated to determine the strength of association between factors associated with HIV and syphilis infections. A p-value ≤0.05 was considered statistically significant. RESULTS: A total of 3504 pregnant women were included in the study from January 2011 to April 2015. The seroprevalence of HIV, and syphilis were 145 (4.1%) and 66(1.9%), respectively. Twenty-three (0.66%) women were co-infected. Age group 20-29 years (AOR: 3.86; 95% CI: 1.36-10.89), age group ≥30 years (AOR: 6.08; 95% CI: 2.04-18.14) compared to age < 20 year, and HIV-infection (AOR: 14.6; 95% CI: 8.49-25.18) were significantly associated with syphilis infection. There was a decline in trend seroprevalence of HIV from 5.2% in 2011 to 2.1% in 2015; and decline in syphilis seroprevalence from 2.6% in 2011 to 1.6% in 2015 but not statistically significant. CONCLUSION: The data showed that syphilis and HIV infections are still critical public health concerns among pregnant women. Screening of all pregnant women for these infections is valuable. Further community-based studies to identify risk factors are necessary.

Haematological and immunological reference intervals for adult population in the state of Amhara, Ethiopia.

OBJECTIVE: Reference intervals (RIs) currently being used in Ethiopia are derived from western populations. Thus, this study aimed to establish locally derived haematological and immunological RIs. METHOD: The study was conducted in Amhara State, Ethiopia with a total of 967 (55.2% males) participants. 56.9% of males and 43.1% of females were eligible for haematological and immunological RI determination. A non-parametric test was used for the determination of upper (97.5th percentile) and lower (2.5th percentile) reference interval limits with 95% CI. The Harris and Boyd Rule was used to determine the need of partitioning of reference intervals based on gender. RESULT: The established 95% reference intervals (2.5th-97.5th percentile) were: for WBC: 3-11.2 × 109 /l; for platelet: 90-399 × 109 /l; for RBC: 4-6 × 1012 /l for males and 3.5-5.6 × 1012 /l for females; for haemoglobin: (Hgb) 12-18.9 g/dl for males and 10.7-17.5 g/dl for females; for PCV: 35.7-55.3% for males and 32.2-50.1% for females; for CD4: 400-1430 × 109 /l for males and 466-1523 × 109 /l for females; for CD4 percentage: 18-49.1% for males and 21.3-52.9% for females; for MCV: 81-100 fl; for MCH: 25.3-34.6 pg; MCHC: 28.8-36.9%; for RDW: 11.6-15.4% and for MPV: 8-12.3 fl. Males had significantly higher RBC, Hgb and PCV than females. CD4 counts and CD4 percentage were significantly higher in females. CONCLUSION: The reference intervals established in this study differ from others and thus should be used for the interpretation of laboratory results in diagnosis and safety monitoring in clinical trials in Amhara.

Human blood platelets and viruses: defense mechanism and role in the removal of viral pathogens.

Platelets are small non-nucleated cell fragments and the second most abundant cell that play crucial role in managing vascular integrity and regulating hemostasis. Recent finding shows, beyond its hemostatic function platelets also play a main role in fighting against pathogen including viruses. With their receptors, platelet interacts with viral pathogen and this interaction between platelets and viral pathogens result in activation of platelets. Activated platelet releases different molecules that have antiviral activity including kinocidins and other platelet microbicidal peptides. In addition, activated platelet has antiviral role by different mechanism including; phagocytosis of viral pathogen, produce reactive oxygen species and interact with and activate other immune cells. In other side, antiplatelet treatments are one of defending mechanism of viral pathogen. This narrative review summarizes what is known regarding the role of human platelets in fighting viral pathogen.

Schistosoma mansoni and soil-transmitted helminths among preschool-aged children in Chuahit, Dembia district, Northwest Ethiopia: prevalence, intensity of infection and associated risk factors.

BACKGROUND: Intestinal schistosomiasis and soil-transmitted helminthiasis are the major public health problems globally. Compared with any other age group, pre-school aged children and school-aged children are the most exposed. There are few studies showing the burden of intestinal schistosomiasis, and soil-transmitted helminthiasis among pre-school aged children in Ethiopia. Hence, this study aimed to assess the prevalence of schistosoma mansoni and soil-transmitted helminths and associated risk factors among preschool aged children of Chuahit and surrounding Kebeles, Northwest Ethiopia. METHODS: A community based cross sectional study was conducted from February 2 to March 27 2015. Four hundred one preschool-aged children were included in the study by using two stage cluster sampling technique. Pretested structured questionnaire was employed to collected data via face-to-face interview technique. A single stool specimen was collected, and a portion of the sample was processed by Kato Katz method. RESULTS: Of the total children, 141 (35.2 %) harbored one or more intestinal helminthes. Schistosoma mansoni was found in 45 (11.2 %) of preschool age children. Ascaris lumbricoides was the predominant isolate, 77 (19.2 %) followed by S. mansoni, 45 (11.2 %). The least parasites isolated were Tania species, 2 (0.5 %). After adjusting for other variables, being mothers who did not have the habit of washing hands after toilet (AOR = 7.3, 95%CI: 2.97-17.95), being occupationally housewife mothers (AOR = 8.9, 95%CI: 2.27-25.4), using protected spring water as a main family source of water (AOR = 3.9, 95%CI: 1.2-12.3) and child habit of not wearing shoe (AOR = 1.91, 95%CI: 1.01-3.64) were significantly associated with high prevalence of soil-transmitted helminthiasis among preschool-age children in Chuahit. CONCLUSION: The current study showed that relatively higher level of STH and S. mansoni among preschool-aged children in Chuahit. This finding calls for a need of public health education, promotion of women education and provision of safe water to reduce the burden of soil-transmitted intestinal helminthiasis and schistosomiaisis.

Assessment of hematology laboratory performance in the total testing process using quality indicators and sigma metrics in the northwest of Ethiopia: A cross-sectional study.

Background and Aims: Assuring laboratory quality by minimizing the magnitude of errors is essential. Therefore, this study aimed to assess hematology laboratory performance in the total testing process using quality indicators and sigma metrics. Methods: A cross-sectional study was conducted from April to June 2022. The study included a total of 13,546 samples. Data on included variables were collected using a checklist. Descriptive statistics were used to present the overall distribution of errors. Binary logistic regression models were applied. Furthermore, using a Sigma scale, the percentage of errors was converted to defects per million opportunities to assess laboratory performance. Finally, the defect per million opportunities was converted to a sigma value using a sigma calculator. Results: Of the 13,546 samples and corresponding requests, the overall error rate was 123,296/474,234 (26%): 93,412/47,234 (19.7%) pre-analytical, 2364/474,234 (0.5%) analytical, and 27,520/474,234 (5.8%) post-analytical. Of the overall errors, 93,412/123,296 (75.8%), 2364/123,296 (1.9%), and 27,520/123,296 (22.3%) were pre-analytical, analytical, and post-analytical errors, respectively. The overall sigma value of the laboratory was 2.2. The sigma values of the pre-analytical, analytical, and post-analytical phases were 2.4, 4.1, and 3.1, respectively. The sample from the inpatient department and collected without adherence to the standard operating procedures (SOPs) had a significantly higher (p < 0.05) rejection rate as compared to the outpatient department and collected with adherence to SOPs, respectively. In addition, an association between prolonged turnaround times and manual recording, inpatient departments, and morning work shifts was observed. Conclusion: The current study found that the overall performance of the laboratory was very poor (less than three sigma). Therefore, the hospital leadership should change the manual system of ordering tests and release of results to a computerized system and give need-based training for all professionals involved in hematology laboratory sample collection and processing.

Blood specimen rejection rate in clinical laboratory: A systematic review and meta-analysis.

Background: Clinical laboratory errors have a great impact on patient safety and treatment. Although specimen rejections result in longer turnaround times and increased health-care costs, different studies present inconsistent findings. Therefore, the study aimed to determine the pooled prevalence of blood specimen rejection in clinical laboratory. Methods: Electronic databases including MEDLINE, PubMed, EMBASE, HINARI, Cochrane Library, Google Scholar, and Science Direct were comprehensively searched. Articles were screened and the data extracted independently by authors. Publication bias was checked by funnel-plots and Egger's statistical test. Pooled prevalence was estimated using a random-effects model. The I2 statistical test were performed to assess heterogeneity. The possible sources of heterogeneity were analyzed through subgroup and sensitivity analysis. Results: Total of 26 articles with 16,118,499 blood sample requests were included in the meta-analysis. The pooled prevalence of blood specimen rejection in the clinical laboratory was 1.99% (95% CI: 1.73, 2.25). Subgroup analysis showed that, the highest prevalence of specimen rejection was observed in Asia [2.82% (95%CI: 2.21, 3.43)] and lowest in America [0.55% (95%CI: 0.27, 0.82)]. The leading cause of blood specimen rejection in clinical laboratories were clotted specimen (32.23% (95%CI: 21.02, 43.43)), hemolysis (22.87% (95%CI: 16.72, 29.02)), insufficient volume (22.81% (95%CI: 16.75, 28.87)), and labelling errors (7.31% (95%CI: 6.12, 8.58)). Conclusion: The pooled prevalence of blood specimen rejection rate is relatively high especially in developing regions. Therefore, proper training for specimen collectors, compliance with good laboratory practices specific to specimen collection, transportation, and preparation is required to reduce the rejection rate.

Role of RNA Splicing Mutations in Diffuse Large B Cell Lymphoma.

Ribonucleic acid splicing is a crucial process to create a mature mRNA molecule by removing introns and ligating exons. This is a highly regulated process, but any alteration in splicing factors, splicing sites, or auxiliary components affects the final products of the gene. In diffuse large B-cell lymphoma, splicing mutations such as mutant splice sites, aberrant alternative splicing, exon skipping, and intron retention are detected. The alteration affects tumor suppression, DNA repair, cell cycle, cell differentiation, cell proliferation, and apoptosis. As a result, malignant transformation, cancer progression, and metastasis occurred in B cells at the germinal center. B-cell lymphoma 7 protein family member A (BCL7A), cluster of differentiation 79B (CD79B), myeloid differentiation primary response gene 88 (MYD88), tumor protein P53 (TP53), signal transducer and activator of transcription (STAT), serum- and glucose-regulated kinase 1 (SGK1), Pou class 2 associating factor 1 (POU2AF1), and neurogenic locus notch homolog protein 1 (NOTCH) are the most common genes affected by splicing mutations in diffuse large B cell lymphoma.