COVID-19 vaccination knowledge, attitudes and practices among residents of Bosnia and Herzegovina during the third wave of COVID-19 outbreak.

Background: Bosnia and Herzegovina hasn't still developed and started any vaccination programs to contain the current COVID-19 outbreak and prevent further spreading and death from this disease. The aim of this study was to assess current knowledge, attitudes and practices towards COVID-19 vaccination during the third wave of the outbreak when the healthcare system is facing a collapse and to create a paradigm for developing vaccination programs in the country. Methods: his cross-sectional study was conducted by an anonymous online questionnaire based on a Congo study and Center for Disease Control and Prevention facts regarding COVID-19 vaccination during the third wave of the COVID-19 outbreak in the country. Results: In total, 570 subjects, mostly female 474 (83.1%), with a high school degree or lower 230 (40.3%), married 305 (53.5%), engaged in intellectual labor 302 (53.0%), from urban environment 531 (93.1%) and with a mean age of 35.28±11.35, were included in the study. The mean COVID-19 vaccination knowledge test score was 11.29±1.91. Being single (OR= 1.88, 95% 1.20-2.94) or in a relationship (OR=1.87, 95% 1.12-3.11), being engaged in intellectual labor (OR=1.59, 95% CI 1.06-2.37) and having a Master's degree or higher (OR=1.65, 95% CI 1.10-2.46) were associated with higher knowledge test scores. Only 264 (46.3%) subjects agreed that COVID-19 vaccination programs will prevail in a battle versus COVID-19 and only 36 (6.3%) were currently vaccinated against COVID-19. Higher knowledge regarding COVID-19 and its vaccination was determined as an independent predictor for vaccinating itself against COVID-19 (OR=23.09, 95% CI 11.94-44.68), as well as respecting socio-epidemiological measures such as avoidance of crowded places (OR=2.07, 95% CI 1.28-3.35) and wearing face mask (OR=6.95, 95% CI 2.07-23.29). Conclusions: Our study shows that Bosnia and Herzegovina population has poor knowledge, relatively pessimistic attitudes and a very low vaccinal rate against COVID-19 during the third wave of the outbreak which promotes COVID-19 vaccination hesitancy and further COVID-19 spreading and death toll. By activating proper socioepidemiological measures and educating population about COVID-19 and COVID-19 vaccination, as well as vaccination against COVID-19, the current situation could be changed.

Patterns of energy drinks consumption in leisure, sports and academic activities among a group of students attending University of Sarajevo, Bosnia and Herzegovina.

BACKGROUND: Energy drinks (EDs) are non-alcoholic beverages that contain caffeine and other ingredients, marketed for their actual or perceived effects as stimulants, energizers and performance enhancers. The aim of this pilot study was to evaluate patterns of EDs consumption in leisure, sports, and academic activities over the last year among a group of pregraduate students of the University of Sarajevo, Bosnia and Herzegovina. STUDY DESIGN: A cross-sectional study conducted by an online questionnaire-based survey. METHODS: An anonymous questionnaire was mainly based on a Consortium Nomisma-Areté questionnaire [background information and consumer profile, general EDs consumption practices and reasons; alcohol mixed with EDs (AmEDs) consumption, EDs consumption in sports, consumption of other caffeinated beverages], and an additional part to evaluate EDs consumption during academic activities. RESULTS: Out of 812 respondents from 22 faculties (participation rate of 23%), mean age 21.37 ± 1.98 years, 498 (61.7%) reported EDs consumption over the last year. Three main reasons for EDs consumption were to stay awake (58.2%), to enjoy the taste (46.8%), and to boost energy (38.0%). Energy drinks were mainly consumed less than once a month (70.5%), most frequently during academic activity (50.4%), less frequently mixed with alcohol for relaxation (21.5%), and only rarely in association with sports or other physical activity (10%). Drinking coffee (OR = 2.022; 95% CI 1.416-2.830; p < 0.001) and being a higher year student (OR = 0.723; 95% CI 0.639-0.819; p < 0.001) were independent predictors for EDs consumption; being single and living with parents (OR = 17.138; 95% CI 1.328-221.528; p = 0.030) for consumption of AmEDs; and being a man (OR = 2.251; 95% CI 1.493-3.392; p < 0.001) and living in urban environment (OR = 1.193; 95% CI 1.125-3.251; p = 0.017) for consuming EDs in association with sports or other physical activity. CONCLUSION: Based on these preliminary data and taking low participation rate into account, EDs consumption seems not to be alarming among university students in our region. EDs are most frequently consumed during academic activity, less frequently mixed with alcohol for relaxation, and only rarely in association with sports or other physical activity. However, as EDs are increasingly aggressively promoted and easily accessible, the larger study is warranted to provide more reliable and up to date conclusions, and if necessary, to inform measures preventing health risks associated with EDs consumption.

Cattle breeding, trypanosomosis prevalence and drug resistance in Northern Togo.

African Animal Trypanosomosis (AAT) is a major disease of cattle in Togo and its control is essentially based on chemotherapy. However, because of excessive use of trypanocides during the past decades, chemo-resistance in the parasites has developed. In order to assess the current situation of AAT and resistance to trypanocidal drugs in Northern Togo, a study was conducted on cattle from December 2012 to August 2013 in the regions of Kara and Savanes. An initial cross-sectional survey was carried out in 40 villages using the Haematocrit Centrifugation Technique (HCT). Out of these, 5 villages with a trypanosome prevalence of >10% were selected for a block treatment study (BT) with diminazene diaceturate (DA: 3.5mg/kg for a 14-day follow-up) and isometamidium chloride (ISM: 0.5mg/kg for a 28-day follow-up). Positive blood samples collected during the parasitological surveys and an equivalent number of negatives were further analyzed by PCR-RFLP for trypanosome species confirmation and molecular diagnosis of resistance to DA in Trypanosoma congolense. The results from 1883 bovine blood samples confirmed a high overall trypanosome prevalence of 10.8% in Northern Togo. PCR-RFLP revealed that T. congolense is the dominant pathogenic trypanosome species (50.5%) followed by T. vivax (27.3%), and T. brucei (16.2%). The BT showed varying levels of treatment failures ranging from 0 to 30% and from 0 to 50% for DA and for ISM respectively, suggesting the existence of resistant trypanosome populations in the study area. Our results show that AAT still represents a major obstacle to the development of cattle husbandry in Northern Togo. In areas of high AAT risk, a community-based integrated strategy combining vector control, rational use of trypanocidal drugs and improving the general condition of the animals is recommended to decision makers.

Drug quality analysis through high performance liquid chromatography of isometamidium chloride hydrochloride and diminazene diaceturate purchased from official and unofficial sources in Northern Togo.

Trypanocidal drugs remain the most accessible and thus commonly used means of controlling tsetse transmitted animal African trypanosomosis. In Togo, trypanocides are sold on official as well as unofficial markets, but the quality of these trypanocides is undocumented so a drug quality assessment study was conducted from May 2013 to June 2014. Trypanocides supplied by European, Indian and Chinese pharmaceutical companies and sold on official and unofficial markets in Togo were purchased. In total fifty-two trypanocides were obtained, 24 of these samples from official markets and 28 from unofficial markets made up of a total of 36 diminazene diaceturate and 16 isometamidium chloride hydrochloride samples. The samples were analysed in the reference laboratory of the OIE (World Organisation for Animal Health), Laboratory for the Control of Veterinary Medicines (LACOMEV) in Dakar which uses galenic testing and high performance liquid chromatography (HPLC) testing as standard reference analysis methods. The results revealed a high proportion of trypanocides of sub-standard quality on the Togolese market: 40% were non-compliant to these quality reference standards. All of the HPLC non-compliant samples contained lower amounts of active ingredient compared to the concentration specified on the packaging. Non-compliance was higher in samples from the unofficial (53.57%) than from the official markets (25%; p=0.04).The main drug manufacturers, mostly of French origin in the study area, supply quality drugs through the official legal distribution circuit. Products of other origins mostly found on illegal markets present a significantly lower quality.

Estradiol and weight are covariates of paracetamol clearance in young women.

AIM: Paracetamol clearance differs between pregnant and non-pregnant women and between women with or without specific oral contraceptives (OCs). However, an association between female sex hormones and paracetamol clearance has never been explored. METHODS: In total, 49 women at delivery, 8 female control subjects without OC use, historical data of 14 women taking OCs, and 15 postpartum observations with and without OCs were pooled to explore covariates of paracetamol clearance. All received a single intravenous 2-gram paracetamol dose, and blood samples were collected up to 6 h after dosing. High-performance liquid chromatography was used to quantify paracetamol. The area under the curve to time infinity (AUC0-∞) was determined and clearance (l/h·m(2)) was calculated by dose/ AUC0-∞. In addition, estradiol and progesterone were quantified by ELISA with electro-chemiluminescence. RESULTS: Median paracetamol clearance at delivery was significantly higher when compared to postpartum or non-pregnant women (11.9 vs. 6.42 and 8.4 l/h·m(2), at least p < 0.05), while an association between paracetamol clearance and estradiol was observed (R = 0.494, p < 0.0001). In non-pregnant subjects, there was no impact of OC exposure on paracetamol clearance. Multiple regression revealed a linear association (Radj = 0.41, p < 0.001) between paracetamol clearance and weight (p = 0.0462) and estradiol (p < 0.0001). CONCLUSION: Estradiol and weight in part explain the variation in paracetamol clearance in young women.

Weight, pregnancy and oral contraceptives affect intravenous paracetamol clearance in young women.

OBJECTIVES: Because of the extensive variability in paracetamol clearance in young women, published data were pooled with newly collected observations in search of covariates of paracetamol pharmacokinetics (PK) within this specific population. SUBJECTS AND METHODS: PK estimates and clinical characteristics [pregnant, weight, exposure to oral contraceptives (OC)] in young women following IV loading dose (2 g paracetamol) were pooled, using a non-compartmental linear disposition model in individual time-concentration profiles. Data were reported by median and range. Rank correlation was used to link clearance (l/h) to weight, Mann Whitney U test to compare clearance (l/h.m-2) between subgroups (pregnant, OC exposure). Finally, a multiple regression model with clearance (l/h) in all women and all non-pregnant women was performed. RESULTS: Based on 73 paracetamol PK estimates, a 8-fold variability in clearance (range 7.1-62.2 l/h) was documented, in part explained by a correlation (r2=0.36) between clearance (l/h) and weight. Clearance (l/h and l/h.m-2) and distribution volume (l) at delivery (n=36) were higher compared to non-pregnant observations. In non-pregnant women, women on OC (n=20) had a higher paracetamol clearance (l/h.m-2) compared to women (n=17) not on OC (p = 0.023). Weight (p = 0.0043) and pregnancy (p = 0.02) were independent variables (r=0.56) of paracetamol clearance (l/h). In non-pregnant women, weight (p = 0.009) and OC exposure (p = 0.03) were independent variables (r=0.51). CONCLUSIONS: Weight, pregnancy and OC result in higher clearance of IV paracetamol in young women. Besides compound specific relevance, these findings also unveil covariates of drug metabolism in young women.

Deletion in the gene BruAb2_0168 of Brucella abortus strains: diagnostic challenges.

Three Brucella abortus strains were isolated from joint hygromas from cows in northern Togo. Two deletions in the 5' side of the gene BruAb2_0168 were identified. As this gene is used for species identification, these deletions have consequences for diagnostic procedures. Multiple locus variable number of tandem repeat (VNTR) analysis was therefore performed for species identification. The strains showed unique VNTR profiles, providing some of the first genotypic data from West Africa. More molecular and epidemiological data are needed from the region, in order to better understand transmission patterns and develop suitable diagnostic assays.

Pharmacokinetics of intravenous ketorolac following caesarean delivery.

BACKGROUND: Drug disposition is altered by pregnancy and the peripartum period but data on intravenous ketorolac pharmacokinetics following caesarean delivery have not been previously reported. METHODS: At the end of caesarean delivery, women received an intravenous bolus of ketorolac tromethamine 30 mg (immediate postpartum, Group IP). Plasma samples were collected at 1, 2, 4, 6 and 8h. A similar pharmacokinetic study was repeated in a subgroup of these women 4-5 months after delivery (late postpartum, Group LP) and in a group of unrelated, healthy non-pregnant female volunteers (controls, Group C). A non-compartmental linear disposition model was applied to analyse individual ketorolac time-concentration profiles. Results at delivery were compared with controls using unpaired or paired statistics as appropriate. Covariates of pharmacokinetic estimates at delivery were examined. RESULTS: Thirty-nine women were studied at caesarean delivery, of whom eight were re-evaluated 4-5 months later. In addition, eight volunteers were studied. Clearance in Group IP was higher compared to Groups LP and C (2.11 vs. 1.43 and 1.07 L/h·m(2) respectively, P<0.05). Volume of distribution was also increased in Group IP compared to Groups LP and C (0.24 vs. 0.16 and 0.17 L/kg respectively, P<0.05). No significant covariates of pharmacokinetic estimates, including gestational age, preterm vs. term, twin vs. singleton and maternal co-morbidity, were seen in Group IP. CONCLUSIONS: Ketorolac clearance and distribution volume are significantly increased following caesarean delivery. These data provide pharmacokinetic estimates on which to base studies on post caesarean analgesia.

Cefazolin plasma protein binding and its covariates in neonates.

Cefazolin (CFZ) is highly and saturably bound to human serum albumin (HSA) in adults. We aim to describe CFZ protein binding and its covariates in neonates. In neonates to whom intravenous CFZ (50 mg/kg) was administered prior to a surgical procedure, total and unbound CFZ plasma concentrations (mg/l) were determined at 0.5, 2, 4 and 8 h after CFZ administration. Linear and multiple regression analyses were used to document covariates of unbound CFZ fraction. The Wilcoxon signed-rank test was used for the paired analysis of unbound CFZ fractions. In 40 patients with a median weight of 2,767 (range 830-4,200) g and a postmenstrual age (PMA) of 39 (25-45) weeks, 131 samples were collected. The median unbound CFZ fraction was 0.39 (0.10-0.73). Linear regression of unbound CFZ fraction versus unbound CFZ plasma concentration (R (2) = 0.39) had a slope significantly different from zero (p < 0.001). In a multiple regression analysis, albuminaemia, total CFZ concentration, indirect bilirubinaemia and PMA resulted in an R (2) value of 0.496. The median unbound CFZ fraction at the peak concentration (0.46, range 0.28-0.69) was significantly higher compared to the trough level (0.36, range 0.17-0.73) (p < 0.001). The between- and within-patient saturability of CFZ plasma protein binding were documented in neonates. The median unbound CFZ fraction in neonates is higher than in adults and depends partly on albuminaemia, total CFZ concentration, indirect bilirubinaemia and PMA. Integration of CFZ protein binding in future pharmacokinetic/pharmacodynamic research is warranted in order to optimise neonatal CFZ dosing. We recommend protein binding assessment in the neonatal pharmacokinetic evaluation of highly protein-bound or clinically relevant drugs.

Pharmacokinetics of a loading dose of intravenous paracetamol post caesarean delivery.

BACKGROUND: The postpartum period affects drug disposition, but data of intravenous paracetamol loading dose pharmacokinetics immediately following caesarean delivery have not yet been reported. METHODS: Immediately following caesarean delivery, women received a 2-g loading dose of intravenous paracetamol. Plasma samples were collected at 1, 2, 4 and 6 h. Individual pharmacokinetics were calculated assuming a linear one-compartment model with instantaneous input and first-order output. Data were reported using median and range. RESULTS: Twenty-eight patients undergoing caesarean delivery were recruited (age 31.5 [20-42] years, weight 79 [57-110] kg, body surface area 1.9 [1.5-2.4]m(2)). Median paracetamol plasma concentrations after 1, 2, 4 and 6 h were 22.5, 15.25, 7.9, and 3.9 mg/L respectively. Paracetamol clearance was 20.3 (11.8-62.8) L/h or 10.9 (7-23.8)L/hm(2), distribution volume 58.3 (42.9-156) L or 0.72 (0.52-1.56) L/kg. CONCLUSION: Pharmacokinetics of intravenous paracetamol have been estimated following caesarean delivery. Although limited to a loading dose shortly after surgery, the results are clinically relevant since this is the first description in this patient population. These data provide evidence on which to base further integrated pharmacokinetic/pharmacodynamic studies in peripartum analgesia.

Paracetamol and ketorolac pharmacokinetics and metabolism at delivery and during postpartum.

During pregnancy, changes in renal elimination, body composition and metabolic activity occur. Since these important alterations in physiology also affect drug disposition, pregnancy warrants a focused approach. Despite these differences, even commonly administered drugs have not undergone pharmacokinetic evaluation in pregnant women or at delivery. This is also true for analgesics routinely administered by anesthesiologists during pregnancy or at delivery, like intravenous (i.v.) paracetamol or ketorolac. We report on our observations on i.v. paracetamol and ketorolac disposition following cesarean delivery to illustrate the feasibility of such focused studies and the impact of pregnancy on drug disposition. The clinical relevance of these observations are subsequently discussed, and some future research directions are suggested.

Individual fluctuations in efficacy of febantel against Muellerius capillaris in goats.

One hundred and eighty-seven dairy goats originating from 7 farms in western France were treated individually with febantel (probenzimidazole drug) at a dose rate of 5 mg/kg in spring 1991. Individual faecal samples were collected on d 0, 7 and 21 post-treatment and processed for counting first stage larvae of Muellerius capillaris (LPG: larvae per gram of faeces). Eggs of digestive tract strongyles were also counted on d 0 and 7 (EPG: eggs per gram of faeces). Blood samples were taken on d 0 to assess pepsinogen concentration related to abomasal damage caused by strongyle infection. The individual characteristics of the goats were recorded. The procedure was repeated on the same animals in autumn 1991. The faecal larval count reduction (FLCR) was mainly related to farm and season: farm 1 in the spring and farm 6 in the autumn showed a higher proportion of high responder (HR) goats (FLCR > 80%), whereas farm 3 exhibited a lower proportion of HR goats in the autumn. On the other hand, the characteristics of the goats (breed, physiological status, age, weight, presence or absence of wattles and horns) as well as the initial level of parasitism (LPG, EPG and pepsinogen concentration) all had a role which was limited or zero on the variability of response to treatment. Goats could not be individually categorized according to their response level because the FLCR values obtained in the spring were not repeated in the autumn, suggesting that other environmental parameters could be involved.

Between goat-farm biological variability of the nematode Muellerius capillaris first-stage larvea. Influence of anthelmintic treatment.

Seven dairy-goat farms from the centerwest of france were investigated for morphology and ecology of first-stage larvae (L1) of Muellerius capillaris before and after treatment of goats with febantel, a probenzimidazole anthelmintic. The lengths, survivals at 20 and -20 degrees C, and infectivity of L1 to intermediate host Helix aspersa, were different between farms. The between farms differences in survivals were reduced after treatment of goats with febantel. The observed between farm differences in L1 did not seem to be related to farm characteristics (intensity of treatments, susceptibility to febantel, and intermediate host species).

Variability in susceptibility to anthelmintics of the lungworm Muellerius capillaris first-stage larvae. Relationship to dairy-goat farms and previous exposure to febantel treatment.

Seven dairy-goat farms, located in central, western France, were studied in order to assess the variability in susceptibility of the lungworm Muellerius capillaris first-stage larvae (L1) to 3 different anthelmintics in relation to farm origin, by means of motility tests. The motility tests were performed by mixing larval suspensions with pyrantel (PYR), thiabendazole (TBZ) or ivermectin (IVE) solutions (3 concentrations x 3 incubation durations). The same anthelmintic tests were repeated 7 and 21 d after febantel (probenzimidazole) treatment of the goats. Before the treatment of goats, the average ratio (x 100) of L1 motility compared with control were very different for the 3 anthelminthics: 44, 30 and 59, respectively for TBZ, PYR and IVE. The ratios of L1 motility were the same at days 7 and 21 after the treatment of goats. The susceptibility of L1 to anthelmintics varied a great deal from 1 farm to another when goats had not been previously treated, whereas L1s from the same farms were the same after treatment of goats. The occurrence of different motilities of L1 with the anthelmintic tests from 1 farm to another should be related to the existence of different populations of M capillaris. The L1 motilities were reduced after anthelmintic treatment of goats suggesting a temporary effect on populations of M capillaris females shedding L1.