Mortality and its predictors among human immunodeficiency virus-infected children younger than 15 years receiving antiretroviral therapy in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Despite antiretroviral treatment (ART), the human immunodeficiency virus (HIV) continues to pose a considerable health burden in resource-poor countries. This systematic review and meta-analysis aimed to determine the pooled incidence density of mortality and identify potential predictors among HIV-infected children receiving ART, from studies conducted in various parts of Ethiopia. METHODS: A comprehensive database search was made in Excerpta Medica, PubMed, Web of Science, African Journals Online, Google Scholar, and Scopus. We reported results following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. Excel Spreadsheet and STATA Version 14 software were used for data abstraction and meta-analysis, respectively. Statistical heterogeneity among studies was assessed using I2 statistics. Meta-regression and subgroup analysis were performed to further explore the sources of statistical heterogeneity. Moreover, publication bias and a leave-out-one sensitivity analysis were performed. RESULTS: Twenty-two articles involving 8,731 participants met inclusion criteria and were included. The pooled incidence density of mortality was 3.08 (95% confidence interval (CI), 2.52 to 3.64) per 100 child years. Predictors of mortality were living in rural areas (hazard ratio (HR), 2.18 [95% CI, 1.20 to 3.98]), poor adherence to ART (HR, 2.85 [ 95% CI, 1.39 to 5.88]), failure to initiate co-trimoxazole preventive therapy (HR, 2.16 [95% CI, 1.52 to 3.07]), anemia (HR, 2.28 [95% CI, 1.51 to 3.45]), opportunistic infections (HR, 1.52 [ 95% CI, 1.15 to 2.00]), underweight (HR, 1.74 [95% CI, 1.26 to 2.41]), wasting (HR, 2.54 [95% CI, 1.56 to 4.16]), stunting (HR, 2.02 [95% CI, 1.63 to 2.51]), World Health Organization classified HIV clinical stages III and IV (HR, 1.71 [95% CI, 1.42 to 2.05]), and Nevirapine-based regimens (HR, 3.91 [95% CI, 3.09 to 4.95]). CONCLUSIONS: This study found that the overall mortality rate among HIV-infected children after ART initiation was high. Therefore, high-level commitment and involvement of responsible caregivers, healthcare providers, social workers, and program managers are of paramount importance to identify these risk factors and thus enhance the survival of HIV-infected children receiving ART.

Seroprevalence of hepatitis c virus infection among blood donors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Blood transfusion is one of the routine therapeutic interventions in hospitals that can be lifesaving. However, this intervention is related to several transfusion-related infections. Hepatitis C viral infection is one of the most common causes of transfusion-related hepatitis. Subsequently, this systematic review and meta-analysis was aimed to estimate the seroprevalence of hepatitis C virus infection among blood donors in Ethiopia. METHODS: PubMed, Google Scholar, Health InterNetwork Access to Research Initiative (HINARI), Excerpta Medica database (EMBASE), and Cochrane library, the web of science, African journal of online (AJOL), and Google Scholar was searched. The data were extracted using Microsoft Excel and analyzed by using STATA version 14. Publication bias was checked by funnel plot, contour-enhanced funnel plots, trim and fill analysis and more objectively through Egger's regression test, with P <  0.05 considered to indicate potential publication bias. The heterogeneity of studies was checked using I2 statistics. Pooled analysis was conducted using a weighted inverse variance random-effects model. Subgroup analysis was done by region and study period. A sensitivity analysis was employed. RESULT: A total of 25 studies with 197,172 study participants were used to estimate the seroprevalence of hepatitis c virus among blood donors. The overall seroprevalence of hepatitis C virus was 0.819% (95% CI: 0.67-0.969; I2 = 92.3%). Regional sub-group analysis showed that the pooled prevalence of hepatitis c virus infection among blood donors found to be 0.563% in Somali, 1.08% in Oromia, 0.847% in Amhara, and 0.908% in south nations nationalities and peoples region. CONCLUSION: The pooled seroprevalence of hepatitis C virus infection among blood donors in Ethiopia found to be low. Moreover, there should be systematic strategies that enhance donor screening and retention of safe regular donors.

Maternal satisfaction towards childbirth Service in Public Health Facilities at Adama town, Ethiopia.

BACKGROUND: Maternal satisfaction towards childbirth service is related to the quality of care. Promotion of patient satisfaction is essential for preventing patient anxiety, promoting treatment adherence, preventing disease, and health promotion. This study was aimed at assessing the satisfaction and associated factors among mothers who visit public health facilities in Adama town for childbirth service. METHODS: An institution based cross-sectional study design was conducted at public health facilities in Adama town from June 01 to June 30, 2018. Four hundred seventy-seven mothers were selected using a systematic random sampling method. Bivariate and multivariate logistic regressions were conducted to identify predictors of maternal satisfaction towards childbirth service by considering p-value less than 0.05. RESULTS: The study revealed that 357 (74.8%) were satisfied with the services. Factors which showed a significant association with satisfaction were 25-34 age group (AOR; 2.026, 95%CI:1.056,3.887), no formal education (AOR;2.810, 95%CI;1.085,7.278), planned childbirth (AOR; 1.823,95%CI;1.024,3.246), wait time of less than 1 h (AOR;11.620,95%CI;3.619,37.309) and wait time of one to 2 h (AOR;19.620, 95%CI;2.349,68.500). CONCLUSION: Three-quarters of the mothers were satisfied with childbirth services. Age, educational status, reason for visit and wait time were found to have a significant association with maternal satisfaction of childbirth services.

Molten globule-like partially folded state of Bacillus licheniformis α-amylase at low pH induced by 1,1,1,3,3,3-hexafluoroisopropanol.

Effect of 1,1,1,3,3,3-hexafluoroisopropanol (HFIP) on acid-denatured Bacillus licheniformis α -amylase (BLA) at pH 2.0 was investigated by far-UV CD, intrinsic fluorescence, and ANS fluorescence measurements. Addition of increasing HFIP concentrations led to an increase in the mean residue ellipticity at 222 nm (MRE 222 nm) up to 1.5 M HFIP concentration beyond which it sloped off. A small increase in the intrinsic fluorescence and a marked increase in the ANS fluorescence were also observed up to 0.4 M HFIP concentration, both of which decreased thereafter. Far- and near-UV CD spectra of the HFIP-induced state observed at 0.4 M HFIP showed significant retention of the secondary structures closer to native BLA but a disordered tertiary structure. Increase in the ANS fluorescence intensity was also observed with the HFIP-induced state, suggesting exposure of the hydrophobic clusters to the solvent. Furthermore, thermal denaturation of HFIP-induced state showed a non-cooperative transition. Taken together, all these results suggested that HFIP-induced state of BLA represented a molten globule-like state at pH 2.0.

Symptoms of depression among outpatients with suspected COVID-19 in metropolitan Local Government Areas of Kaduna State, Nigeria.

BACKGROUND: The novel SARS-CoV-2 virus that causes Coronavirus disease (COVID-19) has redefined global health and response to Acute Respiratory Infection (ARI). The outbreak of a cluster of influenza-like illnesses in Wuhan, China, has morphed into a pandemic in the last quarter of 2019, stretching from South East Asia to Europe, The Americas, Africa, and the Australian subcontinent. We evaluated the prevalence of depression among outpatients diagnosed with ARI. MATERIALS AND METHODS: We utilized a cross-sectional, observational design and investigated the prevalence of symptoms of depression among outpatients with ARI and described the characteristics of outpatients with ARI in Kaduna State. RESULTS: The prevalence of symptoms of depression was 19.6% for respondents with symptoms of ARI and 14.4% for those without symptoms of ARI. On no risk of depression, we had a higher proportion of the respondents without symptoms of ARI (86%) than those with symptoms of depression (80%) (M = 318.4, SD = 29.62 case, and M = 344.0, SD = 14.2 control, r = 0.88, CI = 13.5 to 6.5, P = 0.000952). Likewise, in the category with mild risk of depression, respondents without symptoms of ARI were fewer (10%) than those with symptoms of depression (15%) (M = 58.4, SD = 26.0 case, and M = 42.1, SD = 12.7 control, r = 0.86, CI = 11.8 to 5.8, P = 0.0136. There was no significant difference between respondents with symptoms of ARI and without symptoms of ARI in the categories of moderate (M = 13.6, SD = 5.1 case, and M = 11.6, SD = 4.6 control, r = 0.87, CI = 2.3 to 2.1, P = 0.178) and high (M = 5.6, SD = 2.5 case, and M = 4.4, SD = 3.2 control, r = 0.61, CI = 1.2 to 1.5, P = 0.174) risk of depression. CONCLUSION: Symptoms of depression were commoner among respondents who presented with symptoms of Acute Respiratory Infection (ARI) at the Outpatient Department (OPD). However, further explanatory research is needed to establish causality.

Neonatal birth trauma and associated factors in low and middle-income countries: A systematic review and meta-analysis.

Neonatal birth trauma, although it has steadily decreased in industrialized nations, constitutes a significant health burden in low-resource settings. Keeping with this, we sought to determine the pooled cumulative incidence (incidence proportion) of birth trauma and identify potential contributing factors in low and middle-income countries. Besides, we aimed to describe the temporal trend, clinical pattern, and immediate adverse neonatal outcomes of birth trauma. We searched articles published in the English language in the Excerpta Medica database, PubMed, Web of Science, Google, African Journals Online, Google Scholar, Scopus, and in the reference list of retrieved articles. Literature search strategies were developed using medical subject headings and text words related to the outcomes of the study. The Joana Briggs Institute quality assessment tool was employed and articles with appraisal scores of seven or more were deemed suitable to be included in the meta-analysis. Data were analyzed using the random-effect Dersimonian-Laird model. The full search identified a total of 827 articles about neonatal birth trauma. Of these, 37 articles involving 365,547 participants met the inclusion criteria. The weighted pooled cumulative incidence of birth trauma was estimated at 34 per 1,000 live births (95% confidence interval (CI) 30.5 to 38.5) with the highest incidence observed in Africa at 52.9 per 1,000 live births (95% CI 46.5 to 59.4). Being born to a mother from rural areas (odds ratio (OR), 1.61; 95% CI1.18 to 2.21); prolonged labor (OR, 5.45; 95% CI 2.30, 9.91); fetal malpresentation at delivery (OR, 4.70; 95% CI1.75 to 12.26); shoulder dystocia (OR, 6.11; 95% CI3.84 to 9.74); operative vaginal delivery (assisted vacuum or forceps extraction) (OR, 3.19; 95% CI 1.92 to 5.31); and macrosomia (OR, 5.06; 95% CI 2.76 to 9.29) were factors associated with neonatal birth trauma. In conclusion, we found a considerably high incidence proportion of neonatal birth trauma in low and middle-income countries. Therefore, early identification of risk factors and prompt decisions on the mode of delivery can potentially contribute to the decreased magnitude and impacts of neonatal birth trauma and promote the newborn's health.

Stabilizing effect of various polyols on the native and the denatured states of glucoamylase.

Different spectral probes were employed to study the stabilizing effect of various polyols, such as, ethylene glycol (EG), glycerol (GLY), glucose (GLC) and trehalose (TRE) on the native (N), the acid-denatured (AD) and the thermal-denatured (TD) states of Aspergillus niger glucoamylase (GA). Polyols induced both secondary and tertiary structural changes in the AD state of enzyme as reflected from altered circular dichroism (CD), tryptophan (Trp), and 1-anilinonaphthalene-8-sulfonic acid (ANS) fluorescence characteristics. Thermodynamic analysis of the thermal denaturation curve of native GA suggested significant increase in enzyme stability in the presence of GLC, TRE, and GLY (in decreasing order) while EG destabilized it. Furthermore, CD and fluorescence characteristics of the TD state at 71°C in the presence of polyols showed greater effectiveness of both GLC and TRE in inducing native-like secondary and tertiary structures compared to GLY and EG.

A systematic review and meta-analysis of antimicrobial resistance knowledge, attitudes, and practices: Current evidence to build a strong national antimicrobial drug resistance narrative in Ethiopia.

Antimicrobial resistance (AMR) is a silent pandemic that has claimed millions of lives, and resulted in long-term disabilities, limited treatment options, and high economic costs associated with the healthcare burden. Given the rising prevalence of AMR, which is expected to pose a challenge to current empirical antibiotic treatment strategies, we sought to summarize the available data on knowledge, attitudes, and practices regarding AMR in Ethiopia. Articles were searched in international electronic databases. Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 checklist was followed. The methodological quality of the studies included was assessed by the Joana Briggs Institute critical appraisal checklists. The random-effect meta-analysis model was used to estimate Der Simonian-Laird's pooled effect. Statistical heterogeneity of the meta-analysis was checked through Higgins and Thompson's I2 statistics and Cochran's Q test. Publication bias was investigated by funnel plots, and the regression-based test of Egger for small study effects with a P value < 0.05 was considered to indicate potential reporting bias. In addition, sensitivity and subgroup meta-analyses were performed. Fourteen studies with a total of 4476 participants met the inclusion criteria. Overall, the pooled prevalence of good AMR knowledge was 51.53% [(95% confidence interval (CI): 37.85, 65.21), I2 = 99.0%, P <0.001]. The pooled prevalence of favorable attitudes and good practices were 63.43% [(95% CI: 42.66, 84.20), I2 = 99.6, P <0.001], and 48.85% [(95% CI: 38.68, 59.01), I2 = 93.1, P <0.001] respectively. In conclusion, there is a significant knowledge and practice gap on AMR among the general public, patients, and livestock producers. As a result, we call for greater educational interventions to raise awareness and build a strong national AMR narrative.

Prevalence and determinants of opportunistic infections among HIV-infected adults receiving antiretroviral therapy in Ethiopia: A systematic review and meta-analysis.

Background: Reliable data on the burden of opportunistic infections (OIs) after the initiation of antiretroviral therapy (ART) is critical for planning health services and reducing OI-related morbidity and mortality. Nevertheless, there has been no nationally representative information on the prevalence of OIs in our country. Therefore, we have undertaken this comprehensive systematic review and meta-analysis to estimate the pooled prevalence, and identify factors associated with the development of OIs in Human Immunodeficiency Virus (HIV)-infected adults receiving ART in Ethiopia. Methods: Articles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. The random-effect meta-analysis model was used to estimate the pooled effect. The statistical heterogeneity of the meta-analysis was checked. Subgroup and sensitivity analyses were also performed. Publication bias was examined in funnel plots and the nonparametric rank correlation test of Begg and the regression-based test of Egger. Association was expressed through a pooled odds ratio (OR) with a 95% Confidence Interval (CI). Results: A total of 12 studies with 6,163 study participants were included. The pooled prevalence of OIs was 43.97% [95% CI (38.59, 49.34)]. Poor adherence to ART [OR, 5.90, 95% CI (3.05, 11.40)], under nutrition [OR, 3.70, 95% CI (2.01, 6.80)], CD4 T lymphocyte count <200 cells /µL [OR, 3.23 95% CI (2.06, 5.07)], and advanced World Health Organization (WHO) HIV clinical stages [OR, 4.84 95% CI (1.83, 12.82)] were determinants of OIs. Conclusion: The pooled prevalence of OIs among adults taking ART is high. Poor adherence to ART, under nutrition, a CD4 T lymphocyte count <200 cells /µL, and advanced WHO HIV clinical stages were factors associated with the development of OIs.

Gas chromatography/mass spectrometry analysis and uv absorptivity of bio-oils extracted from some locally grown plant seeds in nothern Nigeria.

Oils play vital roles in various ramifications including health, and food industries. Oils which are components of plant seeds can be extracted using various extraction techniques. This research is an exposition into the chemistry of oils with possible repositioning for purposeful use in the cosmetic, pharmaceutical, and food industries especially as sunscreen. In this work, oils were extracted from nine different seeds and subjected to gas chromatography coupled to mass spectrometry, and Ultraviolet analysis. The extraction method adopted in this work shows that 5 out of the 9 seeds have a relatively high percentage yield ranging from 20.9 to 36.8 % which indicates their potential for use in commercial quantity. The GC- MS analysis shows that (Z, Z)- 9, 12-Octadecadienoic acid is the most abundant components of all the oil samples. n-Hexadecanoic acid and cis-Vaccenic acid are the major constituents of Swietenia macrophylla (mahogany) seed oil. The lead components in the oil samples are usually responsible for their physico-chemical and Ultraviolet interactivities. All the samples were found to have adequate absorbance for Ultraviolet radiation ranging from Ultraviolet C to Ultraviolet A region. Citrullus lanatus, Hyptis spicigera, and Swietenia macrophylla (mahogany) have the highest absorbance ranges of 1.394-1.718, 1.449 to 1.70,2 and 1.402 to 1.711 respectively at Ultraviolet A region. The finding shows that all the samples have the ability to protect the skin from Ultraviolet radiation when expose to the sun, whereas only Citrullus lanatus, Hyptis spicigera and Swietenia macrophylla (mahogany) have the potentials for use as sunscreen with high sun protection factor. Further studies on the antimicrobial activities, cosmeceutical and nutraceutical potentials of the various components of these samples are encouraged.

Ethiopians' knowledge of and attitudes toward epilepsy: A systematic review and meta-analysis.

Background: Epilepsy remains one of the world's most common neurological diseases, but it appears to be widely misunderstood, particularly in under-resourced countries like Ethiopia. Improving individuals' knowledge and attitude toward epilepsy is critical for reducing the multifaceted impacts of epilepsy. Therefore, in this study, we sought to estimate the pooled levels of good knowledge and a favorable attitude toward epilepsy and also identify the associated factors using available data collected from different segments of the population. Methods: Articles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. The random-effect meta-analysis model was used to estimate Der Simonian-Laird's pooled effect. Statistical heterogeneity of the meta-analysis was checked via Higgins and Thompson's I 2 statistics (0-100%), and Cochran's Q test at P < 0.10. Subgroups, based on the study regions, and sensitivity analyses were also performed. Publication bias was examined subjectively using funnel plots and objectively using the nonparametric rank correlation test of Begg and the regression-based test of Egger for small study effects with P < 0.05 considered to indicate potential publication bias. Furthermore, the Trim-and-fill method of Duval and Tweedie was used to explore sources of publication bias for the favorable level of attitudes toward epilepsy. Result: A total of 12 studies with 6,373 study participants and 10 studies with 5,336 study participants were included to estimate the pooled level of good epilepsy knowledge and favorable attitudes respectively. The overall estimated levels of good epilepsy knowledge and favorable attitudes toward epilepsy among Ethiopians were 47.37% [(95% CI: 35.00, 59.74), I 2 = 99.2, P < 0.001] and 46.83%[(95% CI: 32.75, 60.90), I 2 = 99.2, P < 0.001] respectively. Subgroup analysis revealed that the pooled level of good epilepsy knowledge was 48.51% [(95% CI: 38.95, 58.06), I 2 = 95.6%, P < 0.001] in the Amhara region. Conclusion: In the current review, we found out that there is a huge knowledge gap and an unfavorable level of attitudes towardepilepsy, which demand immediate public health action as well as a targeted policy intervention.

COVID-19 Vaccine Acceptance, Attitude, Hesitancy, and Its Associated Factors among Wolaita Sodo University Students: A Mixed-Method Study.

Background: Countries in the world have been experiencing the ongoing impact and spread of the coronavirus disease (COVID-19) virus pandemic. The health and financial burden of the pandemic has prompted the need for timely and effective vaccination to be considered as the best strategy for controlling disease transmission. However, vaccine acceptability remains an area of concern in developing countries like Ethiopia. Objective: To assess attitude, hesitancy in the COVID-19 vaccine acceptance, and associated factors among health science students at Wolaita Sodo University. Methods: A triangulated mixed-method study was conducted. Quantitative data were entered into SPSS Windows version 25 for analysis, and the qualitative data were transcribed using open code version 4.3. A binary logistic regression model was used to establish the association between dependent and independent variables. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the strengths of the association. Thematic approach was used for qualitative data analysis. Results: A total of 352 students participated in this study. Having family members who were infected with COVID-19, information about COVID-19 vaccine, the need for a vaccine with the level of concern, intention to take COVID-19 vaccine, and academic year were strongly associated with vaccine acceptability. Graduating class and other senior students were about 4 and 2 times more likely to accept vaccination as compared to freshman-year students (AOR = 4.128; 95% CI: 1.351-12.610;P = 0.012) and (AOR = 2.195; 95% CI: 1.182-4.077; P value = 0.013), respectively. Even if 67% of students had a good attitude towards the vaccine, 56% of the students hesitated to take the vaccine. Conclusion: The majority of respondents had a constructive attitude towards the COVID-19 vaccine, and only a few of them were vaccinated against the COVID-19 virus. It is of utmost importance to design an evidence-based strategy to increase the uptake of vaccination for healthcare students and other nonhealth science students in universities.

Scabies prevalence and its associated factors among prisoners in southern Ethiopia: An institution-based analytical cross-sectional study.

BACKGROUND: Scabies is an ectoparasitic infestation that can easily spread during close human contact and in overcrowded areas such as prisons and public places where sanitation is a problem. Globally, as many as 300 million people are infested with scabies each year. Within Ethiopia, its burden in institutions like prisons is not well-studied. As a consequence, we sought to estimate the prevalence of scabies and also identify factors associated with it among prison inmates in southern Ethiopia. METHODS: An institution-based analytical cross-sectional study design was employed. We used, a simple random sampling technique to select 422 prisoners. A pretested-structured questionnaire was used to collect the necessary information. EpiData version 4.2.0.0 and Statistical Packages for Social Science version 25 software were used for data entry and analysis respectively. Both descriptive and inferential statistics were computed. The model fitness was checked using the Hosmer-Lemeshow and omnibus tests. The association between the independent and outcome variables was presented in the form of a table showing the crude odds ratio and adjusted odds ratio (AOR) along with their 95% confidence interval (CI). The level of statistical significance was declared at P.value ≤ 0.05. RESULTS: A total of 418 prisoners were interviewed, yielding a 99.1% response rate. The age of the participants ranged from 17 to 60 years. As many as 381 (91.1%) participants were male. The prevalence of scabies was found to be 8.9%. A history of sexual contact in the past two months, before imprisonment (AOR: 9.92 (95% CI 3.07, 32.02), P <0.001), a period of stay less than two months duration in the prison (AOR: 4.54 (95% CI 1.51, 13.54), P = 0.007), poor ventilation (AOR: 3.36 (95% CI 1.07, 10.58), P = 0.038), lack of hygiene soap (AOR: 5.53 (95% CI 1.45, 21.17), P = 0.012), and sharing clothes among each other (AOR: 3.81 (95% CI (1.09, 13.29), P = 0.036) were factors independently associated with a scabies infestation. CONCLUSION: In this study, we found the prevalence of scabies was high among prison inmates in Wolaita Zone prison. Furthermore, scabies infestations were associated with a previous history of sexual contact, poorly ventilated rooms, lack of hygiene soaps for washing, and sharing clothes amongst the inmates. Prison administrations should be encouraged to improve sanitary and screening and isolation of prisoners during imprisonment.

Spatial distribution and ecological niche modeling of geographical spread of Anopheles gambiae complex in Nigeria using real time data.

The need for evidence-based data, to inform policy decisions on malaria vector control interventions in Nigeria, necessitated the establishment of mosquito surveillance sites in a few States in Nigeria. In order to make evidence-based-decisions, predictive studies using available data becomes imperative. We therefore predict the distribution of the major members of the Anopheles gambiae s.l. in Nigeria. Immature stages of Anopheles were collected from 72 study locations which span throughout the year 2020 resulted in the identification of over 60,000 Anopheline mosquitoes. Of these, 716 breeding sites were identified with the presence of one or more vector species from the An. gambiae complex and were subsequently used for modelling the potential geographical distribution of these important malaria vectors. Maximum Entropy (MaxEnt) distribution modeling was used to predict their potentially suitable vector habitats across Nigeria. A total of 23 environmental variables (19 bioclimatic and four topographic) were used in the model resulting in maps of the potential geographical distribution of three dominant vector species under current climatic conditions. Members of the An. gambiae complex dominated the collections (98%) with Anopheles stephensi, Anopheles coustani, Anopheles funestus, Anopheles moucheti, Anopheles nilli also present. An almost equal distribution of the two efficient vectors of malaria, An. gambiae and Anopheles coluzzii, were observed across the 12 states included in the survey. Anopheles gambiae and Anopheles coluzzii had almost equal, well distributed habitat suitability patterns with the latter having a slight range expansion. However, the central part of Nigeria (Abuja) and some highly elevated areas (Jos) in the savannah appear not suitable for the proliferation of these species. The most suitable habitat for Anopheles arabiensis was mainly in the South-west and North-east. The results of this study provide a baseline allowing decision makers to monitor the distribution of these species and establish a management plan for future national mosquito surveillance and control programs in Nigeria.

Amino acid hydrotropes to increase the solubility of indomethacin and carbamazepine in aqueous solution.

A number of amino acids (AA) has been investigated as promising hydrotropes to improve the solubility of biopharmaceutics classification system (BCS) class II drugs carbamazepine (CBZ) and indomethacin (IND) via specific complexations in aqueous solution. The aim of this work is to understand the molecular basis of these hydrotropic interactions by investigating the two model drugs combined with 12 amino acids including phenylalanine, tryptophan, isoleucine, proline, valine, glycine, serine, threonine, arginine, lysine, histidine and aspartic acid in water at 25 °C, 30 °C and 45 °C. The amino acids were chosen based on their different side chains (neutral aromatic, aliphatic, polar charged or uncharged) to investigate their hydrotropic performance. A linear solubility curve was observed between indomethacin and mono-neutral hydrophobic amino acids (phenylalanine, tryptophan, isoleucine, proline and valine) well beyond 1:1 molar ratio indicating the interaction is predominantly non-ionic between the drug and the hydrotropes. Interestingly, the aqueous solubility of carbamazepine (a neutral compound) was enhanced by neutral, charged basic or acidic amino acids, confirming the presence of hydrophobic interactions that involve H-bonds, H/π and π/π stacking and the results were confirmed by UV-Vis spectroscopy. A combination of multiple neutral amino acids showed additive hydrotropic effect in indomethacin solubility with up to 7-folds increases. This study demonstrates for the first time the potential of amino acids as hydrotropes to improve aqueous solubility of poorly water-soluble drugs, which is important for pharmaceutical development.

A Comparative Study of Diospyros malabarica (Gaub) Extracts in Various Polarity-Dependent Solvents for Evaluation of Phytoconstituents and Biological Activities.

Keeping in mind the ascribed repute of Diospyros malabarica (D. malabarica), this investigation was commenced to assess the effect of diverse solvents on extraction yields, phytochemical components and antioxidant capability, and in vitro biological activities of D. malabarica for pharmaceutically active constituents to combat various infections. To screen phytochemicals both qualitatively (flavonoids, terpenoid, saponins, tannins) and quantitatively like total phenolic and flavonoid contents, Diospyros malabarica parts include the following: root, leaves, bark, stem, ripe, and unripe fruit were sequentially extracted with organic solvents such as petroleum ether, dichloromethane, ethyl acetate, ethanol, methanol, and water in increasing order of polarity from less polar to more polar solvents. Furthermore, biological activities such as antibacterial, antifungal, anticancer, antidiabetic, and anti-inflammatory were explored. The results revealed that all the tested solvents displayed a vital role in the extraction yield, the content of phytochemicals, and the studied biological activities. Methanol was found as the best solvent followed by the ethanol for the extraction, representing the highest extraction yield (18.3%), rich diversity of phytochemicals, and the highest total phenolic contents (602 ± 0.001 µg EAG/mg of extract) and total flavonoid contents (455 ± 0.6 µg EQ/mg of extract) in bark extract. Furthermore, methanol bark extract showed high in vitro antibacterial activity (30.25 mm ± 0.9), antifungal activity (18.25 mm ± 0.2), anticancer activity (48%), antidiabetic activity (68%) and anti-inflammatory activity (62%) followed by ethanol amongst other extracts of D. malabarica. Accordingly, methanol might be as an ideal solvent to get maximum content of phytochemicals, promising antioxidants, and in vitro biological activities from bark extract amongst other extracts of D. malabarica compared to pet ether, ethyl acetate, and dichloromethane and may act as free radical rummager because phytochemical constituents exhibit antioxidant capability. Our findings suggest that phytochemical compounds (flavonoids, tannins, phenols, saponins, and terpenoids) found in the bark extract of D. malabarica may be attributed to evaluate potent anti-inflammatory, anticancer, antidiabetic, antibacterial, and antifungal activities.

Mechanistic study of the solubilization effect of basic amino acids on a poorly water-soluble drug.

Amino acids have shown promising abilities to form complexes with poorly water-soluble drugs and improve their physicochemical properties for a better dissolution profile through molecular interactions. Salt formation via ionization between acidic drugs and basic amino acids is known as the major contributor to solubility enhancement. However, the mechanism of solubility enhancement due to non-ionic interactions, which is less pH-dependent, remains unclear. The aim of this study is to evaluate non-ionic interactions between a model acidic drug, indomethacin (IND), and basic amino acids, arginine, lysine and histidine, in water. At low concentrations of amino acids, IND-arginine and IND-lysine complexes have shown a linear relationship (AL-type phase solubility diagram) between IND solubility and amino acid concentration, producing ∼1 : 1 stoichiometry of drug-amino acid complexes as expected due to the strong electrostatic interactions. However, IND-histidine complexes have shown a nonlinear relationship with lower improvement in IND solubility due to the weaker electrostatic interactions when compared to arginine and lysine. Interestingly, the results have also shown that at high arginine concentrations, the linearity was lost between IND solubility and amino acid concentration with a negative diversion from linearity, following the type-AN phase solubility. This is indicative that the electrostatic interaction is being interrupted by non-electrostatic interactions, as seen with histidine. The IND-lysine complex, on the other hand, showed a complex curvature phase solubility diagram (type BS) as lysine self-assembles and polymerizes at higher concentrations. The freeze-dried drug-amino acid solids were further characterized using thermal analysis and infrared spectroscopy, with results showing the involvement of weak non-ionic interactions. This study shows that the solubility improvement of an insoluble drug in the presence of basic amino acids was due to both non-ionic and ionic interactions.

Analgesic Efficacy of Spinal Morphine in Comparison With Transversus Abdominis Plane Block for Postoperative Pain Management in Patients Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial.

BACKGROUND: Cesarean section (CS) has been one of the most frequently performed major surgical interventions and causes severe postoperative pain. Spinal opioid and abdominal field block have been investigated as effective analgesia for postoperative pain and reduce the need for systemic medications and associated side effects. The aim of the current study is to compare spinal morphine (SM) and bilateral landmark oriented transversus abdominis plane (TAP) block for postoperative pain management. METHOD: In this randomized controlled trial, 114 pregnant mothers scheduled for CS under spinal anesthesia were allocated randomly to receive either SM 0.1 mg (group SM; n = 56) or bilateral landmark-oriented TAP block with 20 ml of 0.25% of bupivacaine (group TAP; n = 52). A comparison of numerical variables between study groups was done using unpaired student t-test and Mann-Whitney test for symmetric and asymmetric data, respectively. Time to event variable was analyzed by using Kaplan-Meir's survival function. A p-value of < 0.05 was considered statistically significant. RESULT: A total of 114 patients were recruited and randomly assigned and received interventions. Among them, 108 patients completed this study. Time to first analgesic request was significantly shorter in the TAP block compared to SM. Twenty-four-hour median morphine consumption was reduced in the SM group compared to the TAP block (p < 0.001). Median postoperative pain score during movement and rest shows statistically significant differences between groups (p < 0.001). CONCLUSION: The addition of preservative-free 100 µg SM provides prolonged postoperative analgesia time, superior postoperative analgesia, and less postoperative opioid consumption compared to the TAP block.

Risk factors of pelvic organ prolapse at Asella Teaching and Referral Hospital: Unmatched case control study.

Background: Prolapse is one of the sub-types of pelvic floor dysfunction (PFD) which occurs due to abnormal fall of the pelvic organs from their normal anatomic positions. Although the cause of prolapse is multifactorial, it primarily occurs due to pregnancy and vaginal delivery. Hence, the present study aimed to identify risk factors of prolapse among women who undergo gynecological surgery. Materials and methods: Facility-based-unmatched case-control design was employed. Cases were all gynecological women who were diagnosed with pelvic organ prolapse (POP) at Asella teaching referral hospital (ATRH) while controls were all charts of gynecological women who were diagnosed with other gynecological problems rather than POP at ATRH. For each case, two controls were selected using a simple random sampling technique. The data were entered into Epidata version 4.3.1 and finally exported to SPSS version 25 for further analysis. Then variables that had an association in the bivariate model (p < 0.25) were entered and analyzed by a multivariable conditional logistic regression model to identify the independent effect of different factors. Statistical significance was declared at p < 0.05. Results: A total of 147 cases and 293 controls were included in this study. Women who had a history of chronic cough, previous pelvic floor surgery, constipation, and vaginal tear during delivery, history of pelvic trauma, age of the women, rural resident, and maternal gravidity were strongly associated with prolapse at p-value of < 0.05. Multigravida [adjusted odds ratio (AOR) 2.987 (95% CI 1.237-6.853), p = 0.014], age >50 years [AOR: 2.496 (95% CI 1.372-4.539), p = 0.003], women with a history of pelvic floor surgery [AOR: 0.3.666 (95% CI 1.328-10.124), p = 0.012], women who had diabetes mellitus [AOR: 4.676 (95% CI 0.908-24.075), p = 0.065], and resided in rural areas [AOR = 1.878; (95% CI: 0.984-3.585), I 2 = 47.5%, p = 0.056] were the independent predictors were of prolapse. Conclusions: In this study, women with diabetes mellitus, previous pelvic floor surgery, rural residents, being multigravida, and age >40 were independent predictors of prolapse. Therefore, delivering health education by focusing on the identified risk factors was strongly recommended.

Mothers' Care-Seeking Behavior for Common Childhood Illnesses and Its Predictors in Ethiopia: Meta-Analysis.

Background: Healthcare-seeking interventions can potentially reduce child mortality; however, many children die in developing countries without reaching a health facility. The World Health Organization reported that 70% of child deaths are related to delay care-seeking. So, this review is aimed at identifying mothers' care-seeking behavior for common childhood illnesses and predictors in Ethiopia. Methods: Systematic search of studies was done on PubMed, Scopus, Web of Science, institutional repositories, Academic Search Premier, and manually from reference lists of identified studies in the English language up to August 2021. The quality of the studies was evaluated by the Joanna Briggs Institute (JBI) quality appraisal tool for prevalence study. This meta-analysis used the random-effect method using the STATA™ Version 14 software. Result: Fourteen studies involving 8,031 participants were included in this meta-analysis. After correcting Duval and Tweedie's trim and fill analysis, the overall pooled prevalence of mothers' care-seeking behavior is 60.73% (95% CI: 43.49-77.97), whereas the highest prevalence, 74.80% (95% CI: 62.60, 87.00) and 67.77%(95% CI: 55.66, 79.87), was seen in Amhara region and urban residents, respectively, while the lowest, 36.49% (95% CI: -27.21, 100.18) and 47.80% (95% CI:-15.31, 110.9), was seen in South Nation Nationality Peoples' Regions and among rural residents, respectively. Mothers' educational status (P ≤ 0.001) and mothers' marital status (P ≤ 0.001) were significantly associated with mothers' care-seeking behavior. Conclusion: Even though children are a vulnerable group, mothers' care-seeking behavior for common childhood illnesses is significantly low. Educational status and marital status were determinants of mothers' care-seeking behavior. So, all responsible bodies should work on the improvement of mothers' care-seeking behavior.