International border malaria transmission in the Ethiopian district of Lare, Gambella region: implications for malaria spread into South Sudan.

BACKGROUND: Despite notable progress in the control and prevention of malaria in the Horn of Africa, the disease continues to cause significant morbidity and mortality in various regions of Ethiopia, and elsewhere in the region. The transmission of malaria is affected by genetic, sociocultural, and ecological factors. Lare is an Ethiopian district adjacent to the Ethio-South Sudan border, in Gambella region. The region currently has the highest prevalence of malaria in Ethiopia. This study assesses the burden and spatiotemporal patterns of disease transmission, including the effect of climatic factors on the occurrence of malaria, across an international border crossing. This understanding can assist in crafting informed programmatic and policy decisions for interventions. METHODS: This study was conducted in Lare district, Southwest Ethiopia, a temperate zone. A retrospective descriptive analysis was conducted using clinical service data collected between 2011 and 2021 from the 9 health facilities of the district. Both clinically diagnosed patients and those identified using microscopy and rapid diagnostic testing (RDT) were included in the study. Additionally, climate data was incorporated into analyses. Examples of analyses include malaria burden, positivity rate, incidence, species frequency, and an ANOVA to assess inter-annual case number and meteorological factor variation. RESULTS: Between 2011 and 2021, a total of 96,616 suspected malaria cases were tested by microscopy or RDT, and 39,428 (40.8%) of these cases were reported as positive. There were 1276 patients admitted with 22 deaths recorded. There were further more significant fluctuations in positivity rates across years, the highest being 74.5% in 2021. Incidence varied from 18.0% in 2011 to 151.6% in 2016. The malaria parasite species most detected was Plasmodium falciparum, followed by a smaller proportion of Plasmodium vivax. The greatest proportions of P. falciparum cases were observed in 2018 and 2019, at 97.4% and 97.0% prevalence, respectively. There was significant seasonal variation in case number, the highest observed in July through September of each year. Climatic conditions of annual rainfall, temperature and humidity favored the increment of malaria cases from June until October. CONCLUSION: The study shows that the burden, i.e. morbidity and mortality (with fluctuating patterns) of malaria are still significant public health problems and can pose serious consequences in the district. This has implication for cross-border malaria transmission risk due to considerable border crossings. The predominant cause of the disease is P. falciparum, which causes severe complications in patients. The district has to prepare to deal with such complications for better patient care and outcomes.

The effect of interpersonal psychotherapy on quality of life among breast cancer patients with common mental health disorder: a randomized control trial at Tikur Anbessa Specialized Hospital.

PURPOSE: To determine the effect of interpersonal psychotherapy on anxiety, depression, and quality of life among breast cancer patients with mental health disorders at Tikur Anbessa Specialized Hospital, Ethiopia. METHODS: A two-arm parallel randomized controlled trial study was conducted among 114 (n = 57 intervention, and n = 57 control group) breast cancer patients with common mental health disorder at the oncology center of Tikur Anbessa Specialized Hospital. The hospital anxiety and depression measurement scale was used to assess depression and anxiety disorder and a 30-item quality of life questionnaire was used to assess the quality of life. General linear model analysis was done, confounding factors were controlled, and p < 0.05 was used to declare statistical significance. RESULTS: Patients in the intervention group showed a significant improvement in the anxiety (coefficient - 3.68; 95% CI - 5.67, - 1.69; p < 0.001), depression (coefficient - 3.22; 95% CI - 4.7, - 1.69; p < 0.001), physical functioning (coefficient 10.55; 95% CI 3.13, 17.98; p = 0.006), health-related quality of life (coefficient 21.85; 95% CI 14.1, 29.59; p < 0.001), insomnia (coefficient - 19.56; 95% CI - 31.87, - 7.25; p = 0.002), and fatigue (coefficient - 11.37; 95% CI - 21.49, - 1.24; p = 0.028) respectively. CONCLUSIONS: The adapted Ethiopian version of interpersonal psychotherapy had improved anxiety, depression, and some domains of health-related quality of life. Hence, health programmers should consider incorporating it as a treatment option in oncology centers. TRIAL REGISTRATION NUMBER: PACTR202011629348967 granted on 20 November 2020 which was retrospectively registered.

In Vivo Antimalarial Activity of 80% Methanol and Aqueous Bark Extracts of Terminalia brownii Fresen. (Combretaceae) against Plasmodium berghei in Mice.

BACKGROUND: Despite a substantial scientific progress over the past two decades, malaria continues to be a worldwide burden. Evergrowing resistance towards the currently available antimalarial drugs is a challenge to combat malaria. Medicinal plants are a promising source of new drugs to tackle this problem. Thus, the present study aimed at evaluating the antiplasmodial activity of Terminalia brownii in Plasmodium berghei infected mice. METHODS: A 4-day suppressive test was employed to evaluate the antimalarial effect of 80% methanol and aqueous bark extracts of T. brownii against P. berghei in Swiss albino mice. RESULTS: The in vivo acute toxicity test indicated that both extracts of T. brownii against p < 0.001) compared to negative control. The maximum level of chemosuppression (60.2%) was exhibited at 400 mg/kg dose of 80% methanol extract. Moreover, the 80% methanol extract showed a significant (p < 0.001) compared to negative control. The maximum level of chemosuppression (60.2%) was exhibited at 400 mg/kg dose of 80% methanol extract. Moreover, the 80% methanol extract showed a significant (. CONCLUSION: The present study indicated that hydromethanolic and aqueous bark extracts of T. brownii possess a promising antimalarial activity, with higher effect exhibited by the hydromethanolic extract.T. brownii against.