Protein Identification of Venoms of the African Spitting Cobras, Naja mossambica and Naja nigricincta nigricincta.

Cobra snakes, including Naja mossambica and Naja nigricincta nigricincta, are one of the major groups of snakes responsible for snakebites in southern Africa, producing significant cytotoxicity and tissue damage. The venom of N. mossambica has been briefly characterised, but that of N. n. nigricincta is not reported. The current study identifies the venom proteins of N. mossambica and N. n. nigricincta. This is achieved using sodium dodecyl sulphate (SDS)-polyacrylamide gel eletrophroresis (PAGE), followed by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Most of the proteins were less than 17 kDa in both snakes. N. mossambica was found to have 75 proteins in total (from 16 protein families), whereas N.n. nigricincta had 73 (from 16 protein families). Of these identified proteins, 57 were common in both snakes. The proteins identified belonged to various families, including the three-finger toxins (3FTx), Cysteine-rich secretory proteins (CRiSP), Phospholipase A2 (PLA2) and Venom metalloproteinase M12B (SVMP). The current study contributes to the profile knowledge of snake venom compositions, which is of fundamental value in understanding the proteins that play a major role in envenomation.

Bone health of the Ovahimba people of north-western Namibia in the context of urbanization and a change of the sociocultural environment.

The prevalence of osteoporosis in Sub-Saharan African (SSA) countries is low, however, as urbanization takes root, it is predicted that bone health will decrease dramatically. The bone health of the semi-nomadic Ovahimba people of Namibia was investigated in the context of urbanization and changes of the sociocultural environment. Furthermore, data on bone health in SSA countries is scarce; there exists no ethnic-specific reference group for people of black origin. Included in the study were 98 urban and rural living Ovahimba people. Quantitative ultrasound was performed, sunrise/sunset saliva cortisol concentrations was measured and a questionnaire was conducted. There was no significant difference in the QUS parameters, however, after adjustment for confounders, SOS and SI differed significantly. The saliva cortisol concentrations differed significantly. After adjustment for confounders, saliva cortisol was significantly negatively correlated to SOS (r= -0.27, p = 0.021) giving an indication for an association between cortisol concentration and QUS parameters. The urban group furthermore showed a nutritional transition. Even though the bone health of the Ovahimba is very good, first signs of the adverse effects of urbanization were detected. Beside changes of lifestyle, this may be attributed to an increased cortisol exposure of the Ovahimba people living in an urban environment due to an increased psychosocial stress.

Alterations of cortisol homeostasis may link changes of the sociocultural environment to an increased diabetes and metabolic risk in developing countries: a prospective diagnostic study performed in cooperation with the Ovahimba people of the Kunene region/northwestern Namibia.

CONTEXT: Diabetes mellitus is increasingly affecting Africa. OBJECTIVE: Urbanization of the Ovahimba people in Namibia is associated with an increased prevalence of disorders of glucose metabolism, and may thus be attributed to changes of cortisol homeostasis. DESIGN: A prospective, cross-sectional, diagnostic study was applied. SETTING: The study was conducted in the field. Location of the Diabetes Epidemic: Africa and Namibia. PARTICIPANTS: Ovahimba people: group 1 "urban" n = 60, 42 females, 46.3 ± 11.3 years (town); group 2 "rural" n = 63, 44 females, 51.1 ± 12.0 years (seminomadic). INTERVENTIONS: oGTT, sunrise and sunset saliva cortisol, metabolic parameters, questionnaire. MAIN OUTCOME MEASURE: The prevalence of disorders of glucose metabolism (DM, IGT, IFT). RESULTS: The prevalence of disorders of glucose metabolism differed significantly: urban group n = 17(28.3%) vs rural group n = 8(12.7%) (P = 0.04). The saliva cortisol concentrations also differed significantly: sunrise 0.34 ± 0.18 vs 0.12 ± 0.15 µg/dL, sunset 0.18 ± 0.20 vs 0.07 ± 0.09 µg/dL, area under the curve 6.16 ± 3.48 vs 2.28 ± 2.56 µg/dL * 24 h (all P < 0.001). Further metabolic parameters were unfavorably changed in the urban group: hip circumference (P < 0.001), waist circumference (P < 0.001), body mass index (P = 0.014), systolic BP at rest (P < 0.001), diastolic BP at rest (P = 0.002), systolic BP after exercise (P < 0.001), heart rate after exercise (P = 0.007), fasting glucose (P < 0.001), 2-h-glucose by OGTT (P = 0.002), triglycerides (P = 0.04), HDL-cholesterol (P = 0.014), prevalence of the metabolic syndrome (P < 0.001). Physical activity was higher in the rural group, and intake of fast food and sweets were higher in the urban group. CONCLUSIONS: Urbanization of the Ovahimba people is associated with an increasing prevalence of disorders of glucose metabolism and other unfavorable metabolic parameters. Besides changes of lifestyle, this may be attributed to an increased cortisol exposure of the Ovahimba people living in an urban environment.

Prevalence of tobacco use in Eritrea: results from a noncommunicable disease risk factor survey.

The prevalence of noncommunicable diseases in Eritrea is increasing. Tobacco use is a recognized risk factor for most of these diseases, especially cardiovascular disease. No data have been published on tobacco use in Eritrea. The present study sought to establish the prevalence of tobacco smoking in Eritrea. The World Health Organization STEPwise approach was used for the survey, conducted in 2004 on a random national sample size of 2,460 subjects (response rate = 93.7%). The prevalence of tobacco smoking in the general population was 8.1%; the prevalence was 15% among men, compared with 0.6% among women. Prevalence rates were higher in those older than 45 years of age. The prevalence of tobacco smoking was higher among Muslims (11.4%) than Orthodox Christians (5.8%), and among alcohol drinkers (10.2%) than nondrinkers (6.6%). The majority of tobacco users (89.3%) used commercially available cigarettes. A study on knowledge, attitudes, and practices regarding tobacco use is needed to determine the behavioral factors leading to tobacco smoking among the vulnerable groups.

Roll back malaria--an African success story in Eritrea.

BACKGROUND: High morbidity and mortality from malaria in Africa prompted the Abuja Declaration by African Heads of State in 2000. The goal set in the declaration for 2010 was to reduce malaria mortality by 50%. Countries were therefore expected to ensure that 60% of people suffering from malaria had access to treatment, that 60% of those at risk received intermittent prophylaxis, and that 60% of people in high-risk groups were using insecticide-treated nets (ITNs) by 2005. In 1999 Eritrea introduced malaria policies, strategies and multi-level interventions targeting households, communities and health facilities. OBJECTIVES: To assess Eritrea's progress towards meeting the Abuja Declaration goal, targets and key determinants. METHODS: A retrospective study was undertaken using data from the Health Management Information System (HMIS) and reports of annual reviews. Correlation and regression analysis were used to assess associations between selected variables. RESULTS: The incidence rate for malaria decreased from 6000/100000 in 1998 to 1100/100000 in 2003, representing > 80% decline in morbidity. The cumulative number of ITNs distributed increased from 50000 in 1998 to 685000 in 2003. The ITN impregnation rate increased from 15% to > 70% during the same period. Indoor residual spraying increased from 7444 kg to 41157 kg of insecticide in 2004 resulting in the protected population increasing from 117017 to 244315 respectively. The number of health workers recruited and trained rose from 936 to 4118. There was a strong correlation between the malaria incidence rate, distribution of ITNs (R2 = 0.76) and the total number of health workers trained (R2 = 0.72). The association was consistent in regression analysis (beta = -0.05, p = 0.03 for ITNs, and beta = -0.249, p = 0.05 for trained health workers). CONCLUSION: Within 5 years Eritrea met the Abuja Declaration objectives through multiple vector-control methods, case management and surveillance.

Prevalence of noncommunicable diseases in Zimbabwe: results from analysis of data from the National Central Registry and Urban Survey.

The disease burden from noncommunicable diseases (NCDs) in Africa is rapidly increasing based on projections from a limited number of reports. In the absence of national health surveys in Zimbabwe, all data nationally generated between 1990 and 1997 were analyzed. From 1990 to 1997, prevalence rates (expressed per 100,000 people) of hypertension increased from 1000 to 4000, rates of diabetes increased from 150 to 550, and rates of cerebrovascular accidents (CVA) increased from 5 to 15. The case fatality rate (CFR) for CVA decreased substantially during the period of study, implying improved case management of the disease, while the CFR for most other diseases did not change significantly throughout the study period. The observation of increased prevalence of some NCDs during the study period was corroborated by findings from a blood pressure survey subsequently conducted in an urban environment of Zimbabwe, which revealed a hypertension (blood pressure > or =140/90 mm Hg) prevalence of 35% in women and 24% in men. In spite of the limitations of the centrally generated hospital-based data, its analysis is still valuable. Countries are therefore encouraged to utilize this easily accessible resource for policy formulation and resource mobilization.

A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and 2004: the effect of combination of control methods.

BACKGROUND: Malaria is a huge public health problem in Africa that is responsible for more than one million deaths annually. In line with the Roll Back Malaria initiative and the Abuja Declaration, Eritrea and other African countries have intensified their fight against malaria. This study examines the impact of Eritrea's Roll Back Malaria Programme: 2000-2004 and the effects and possible interactions between the public health interventions in use. METHODS: This study employed cross-sectional survey to collect data from households, community and health facilities on coverage and usage of Insecticide-Treated Nets (ITNs), Indoor Residual Spraying (IRS), larvicidal activities and malaria case management. Comparative data was obtained from a similar survey carried out in 2001. Data from the Health Management Information System (HMIS) and reports of the annual assessments by the National Malaria Control Programme was used to assess impact. Time series model (ARIMA) was used to assess association. RESULTS: In the period 2000-2004, approximately 874,000 ITNs were distributed and 13,109 health workers and community health agents were trained on malaria case management. In 2004, approximately 81% households owned at least one net, of which 73% were ITNs and 58.6% of children 0-5 years slept under a net. The proportion of malaria cases managed by community health agents rose from 50% in 1999 to 78% in 2004. IRS coverage increased with the combined amount of DDT and Malathion used rising from 6,444 kg, in 2000 to 43,491 kg, in 2004, increasing the population protected from 117,017 to 259,420. Drug resistance necessitated regimen change to chloroquine plus sulfadoxine-pyrimethamine. During the period, there was a steep decline in malaria morbidity and case fatality by 84% and 40% respectively. Malaria morbidity was strongly correlated to the numbers of ITNs distributed (beta = -0.125, p < 0.005) and the amount (kg) of DDT and Malathion used for IRS (beta = -2.352, p < 0.05). The correlation between malaria case fatality and ITNs, IRS, population protected and annual rainfall was not statistically significant. CONCLUSION: Eritrea has within 5 years attained key Roll Back Malaria targets. ITNs and IRS contributed most to reducing malaria morbidity.

Emerging non-communicable disease epidemic in Africa: preventive measures from the WHO Regional Office for Africa.

The World Health Organization Regional Office for Africa (WHO AFRO) commissioned a study to compile and analyze published reports on non-communicable diseases (NCDs) in Africa to build evidence on the burden of NCDs in the region. Anecdotally, little information or literature was available on this subject. The objective of the study was to establish the status of NCDs in Africa by using published sources of information. A literature search was done through MEDLINE/PubMed and Google to identify studies that reported on prevalence rates of NCD risk factors. The study confirmed that information on NCDs in Africa was lacking. The prevalence of hypertension was found to be rapidly increasing, from 3% in rural areas to > 30% in some urban settings. In some populations, hypertension prevalence rates were higher in women than in men while the opposite was true in others. Most people with hypertension were not aware of their condition, and of those who were on treatment, < 20% had optimal control. The prevalence of diabetes mirrored that of hypertension, from < 1% in some rural areas to > 20% in some selected populations and racial groupings in urban settings. The predominant type was type 2 diabetes, which accounted for > 80% of all cases in some reports and tended to present later in life. The prevalence of tobacco smoking also varied across the continent, from < 1% in rural women to 50% in some urban men. Recent studies based on analysis of hospital-based information have documented NCD trends that were similar to prevalence data generated from national risk factor surveys. NCD risk factors such as hypertension and diabetes are increasing in Africa.