Correction to: Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study.

Following publication of the original article [1], we have been notified that the name of one author was spelled incorrectly as Kidanemariam Berhe, when the correct spelling is Kidanemaryam Berhe.

Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study.

BACKGROUND: The incidence of premature rupture of membranes ranges from about 5% to 10% of all deliveries. A woman with premature rupture of membranes is at risk of intra-amniotic infection, postpartum infection, endometritis, and death. A neonate born from premature rupture of membranes mother is at high risk of respiratory distress syndrome, sepsis, intraventricular hemorrhage and death. Little is known regarding the risk factors in Ethiopia. Therefore, this study was conducted to identify risk factors of premature rupture of membranes among pregnant women admitted to public hospitals in Mekelle city, Tigray, Ethiopia. METHODS: Hospital based unmatched case control study design was implemented on 240 samples (160 controls and 80 cases) from pregnant mothers admitted to public hospitals in Mekelle city from February - April/2016. Data was collected by interviewer administered Structured questionnaire and checklist. Binary logistic regression model was used to see the association between dependent and independent variables and multivariable logistic regression was used to identify the independent predictors of premature rupture of membranes. RESULTS: A total of 160 controls and 80 cases were enrolled in the study. Multivariable logistic regression showed that history of abortion [AOR 3.06 (CI: 1.39, 6.71)], history of PROM [AOR 4.45 (CI: 1.87, 10.6)], history of caesarean section [AOR 3.15(CI: 1.05, 9.46)] and abnormal vaginal discharge in the index pregnancy [AOR 3.31(CI: 1.67, 6.56)] were positively associated with premature rupture of membranes. CONCLUSIONS: Past obstetric history and risks in the index pregnancy have an association with premature rupture of membranes. The finding of the study suggests early identification and treatment of genitourinary infection.

Correction to: Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study.

Following publication of the original article [1], the author reported that his name was misspelled. The original article has been corrected.Incorrect name: Gidiom GebrehetCorrect name: Gdiom Gebreheat.

Effects of Toxoplasma gondii genotype and absence of host MAL/Myd88 on the temporal regulation of gene expression in infected microglial cells.

The majority of strains of Toxoplasma gondii belong to three distinct clonal lines known as types I, II, and III. The outcome of the immune response to infection is influenced by the parasite strain type. The goal of this study was to examine differences in the kinetics of gene expression in microglial cells infected with types I, II, or III of T. gondii. In addition, a requirement for the integrity of host Toll-like receptor (TLR) signaling in parasite-mediated changes in gene expression was evaluated. Wild type murine microglial cells infected with T. gondii displayed different kinetic patterns of pro-inflammatory cytokine expression that were dependent on the parasite strain type. In general, types II and III elicited higher sustained responses compared to type I which induced fluctuating patterns of cytokine gene expression. Contrary to this, differences in the induction of anti-apoptotic gene expression were minimal among the different type strains throughout infection. Experiments with cells lacking the TLR adaptor molecules MAL and Myd88 showed a dependency on these factors for the pro-inflammatory response but not the anti-apoptotic response. The results show that the outcome of gene expression in T. gondii-infected microglial cells is dependent on the parasite strain type in a time-dependent manner and is selective to particular subsets of genes. The induction of an anti-apoptotic response by T. gondii infection in the absence of TLR signaling reflects a complex level of modulation of host functions by the parasite.

The microbial and physical quality of recycled gloves.

Plastic surgical gloves reprocessed at the Kenyatta National Hospital (KNH) were tested for microbiological and physical quality, using standard, disposable, factory sterilised surgical gloves as reference. The microbiological tests were carried out using slightly modified British Pharmacopoeia method. The tests to check on the physical integrity of the gloves were designed in our laboratories. A total of 48 pairs of each group were tested. 41.67% of the reprocessed gloves and 12.5% of the reference glove failed sterility test, whereas 47.9% of the former and 0% of the latter had physical defects. These results show significant difference in the microbiological and physical quality of the reprocessed and reference gloves. The reprocessing of plastic surgical gloves is therefore, potentially dangerous and it is strongly recommended that it is discontinued at all levels of health-care institutions.

The neutralizing capacity and sodium content of antacid brands on the Kenyan market.

Seventeen brands of antacid products available on the Kenya market were investigated for their acid neutralising capacity and sodium content. Thirteen tablet products gave neutralising capacity per tablet of between 4.7 to 14.12 mMol hydrochloric acid. The neutralising capacities for the suspensions ranged between 11.97 to 34.32 mMol hydrochloric acid for 10ml suspension. The lowest neutralising capacities were obtained for products based on compound magnesium trisilicate and higher capacities for those containing magaldrate, or magnesium hydroxide or magnesium carbonate in combination with other ingredients. The fastest rate of neutralization was obtained with preparations containing carbonates and the lowest by compound magnesium trisilicate. The sodium content for the preparations was between < 0.001 mEq to 0.732 mEq sodium per minimum recommended dose. The study shows a high degree of variation in both the acid neutralising capacities and the sodium content of the different brands investigated.

Response of falciparum malaria to chloroquine and three second line antimalarial drugs in a Kenyan coastal school age population.

Ambulatory rural school children in the Mombasa area with P. falciparum parasitaemia were examined and randomly assigned to treatment with one of three second-line antimalarials--amodiaquine, pyrimethamine/sulphadoxine (P/SD) and pyrimethamine/sulfalene (P/SL). Clinical signs and parasitaemia were followed daily for the first week and on days 14 and 28. WHO Mark II schizont inhibition tests were performed for all the above 3 drugs and chloroquine. The total number of cases was 73. The mean parasite density was 142.1 +/- 207; 102.7 +/- 166; 82.74 +/- 93 parasites per 300 WBC for amodiaquine, P/SD, and P/SL, respectively. In vitro tests showed a chloroquine resistance rate of 60% and no resistance to all of the second line drugs. Also, all children treated successfully cleared their parasitaemia with mean clearance rates of 2.05 +/- 0.57; 1.86 +/- 0.47; 2.05 +/- 0.50 days for amodiaquine, P/SD and P/SL, respectively. Even though, no difference in the effectiveness between the second line drugs used was found, reinfection rates as depicted by day 28 parasitaemia differed--amodiaquine 16%; P/SD 0%; and P/SL4.35%. This difference could be attributed to the difference in the pharmacokinetic properties of the drugs.

PIP: In Kenya, in May-June 1990, clinicians screened 728 primary school children in Mazeras, a coastal village, for Plasmodium falciparum parasitemia and randomly assigned them to receive 1 of 3 second-line antimalarials (amodiaquine, pyrimethamine/sulfadoxine [P/SD], and pyrimethamine/sulfalene [P/SL] to treat malaria. Laboratory personnel at the Coast Provincial General Hospital conducted WHO Mark II schizont inhibition tests for all 3 antimalarials and chloroquine. The clinicians followed the children every day for the first week and at 2 and 4 weeks. 10.44% (76) of the children had falciparum malaria (=or 40 asexual parasites/300 WBC). 3 were lost to follow-up, so 73 children were part of the in vivo study. Prior to treatment, mean parasite densities were 142.1/300 WBC for the amodiaquine group, 102.7/300 WBC for the P/SD group, and 82.74/300 WBC for the P/SL group. The mean clearance time for 2.05 days for amodiaquine, 1.86 days for P/SD, and 2.05 days for P/SL. By day 14, none of the children had parasitemia and no differences in mean body temperatures existed. On day 28, 16% of the children in the amodiaquine group and 4.35% of those in the P/SL group were reinfected compared to none in the P/SD group (p .05). Differences in the pharmacokinetic properties of these second line antimalarials may account for the difference in reinfection rates. 60% of the isolates were resistant to chloroquine. None were resistant to the second line drugs. Isolates were highly sensitive to both P/SD and P/SL. These findings show the need for the Kenyan Ministry of Health to reexamine chloroquine as a treatment for falciparum malaria in areas of confirmed high chloroquine resistance.

Pharmacokinetics of albendazole in children with hydatid disease.

The pharmacokinetics of albendazole were investigated in five children who were hospitalized at the Kenyatta National Hospital for the treatment of hydatid disease. Unchanged albendazole was below detectable level in plasma. The major metabolite present was albendazole sulphoxide. In one of the patients, the concentration of albendazole sulphone in plasma was significantly high, whereas in the other four children, only trace amounts were detected. Maximum concentrations of albendazole sulphoxide in these five children were variable and generally higher than those reported in adults by other workers. Other pharmacokinetic parameters were comparable to those found in other studies.

A comparative study of the neutralising capacity of eight brands of antacids.

Eight brands of antacid tablets commonly available in the private market in Kenya were subjected to in-vitro tests for neutralizing capacity. The neutralizing capacity per gram and per tablet of the products was compared. The neutralizing capacity in millilitres of 0.1 M HC1 per gram ranged from 103.10 for Gelusil to 225.13 for Maalox, with others ranging between +/- 18.1% and -12% about the average. The neutralizing capacity per tablet ranged from 64.90 ml for Magnesium trisilicate Co tablets B.P. to 263.15 ml for Maalox, with the others ranging between +/- 24.9% and -33.1% about the average. This shows high variation in the neutralizing capacities of the different brands available especially in relations to the neutralizing capacities per tablet due to the high variation in the tablet weight.