Seroprevalence of rubella antibodies among adult Egyptian females aged 20-30 years. Is there a need for rubella vaccination?

INTRODUCTION: Egypt adopted a comprehensive strategy to eliminate measles and rubella by conducting a catch up campaign (in 2008) targeting children and young adults in the age group 10-19 years. This study aimed to explore the seroprevalence of rubella among females aged 20 to 30 years in order to provide the Ministry of Health with information to develop future strategies for rubella supplemental immunization activities among women of childbearing age before marriage and conception. METHODS: A total of 339 females in the age group 20 to 30 were selected. The study group comprised women who attended the central laboratory of the Ministry of Health for checking up before travelling abroad as pre-travel requirements for visa application. The collected serum samples were tested for rubella-specific IgG antibodies. RESULTS: The overall prevalence of rubella antibodies in the study group was 88.2%. Around 5.0% of females, who reported that they had been vaccinated, were susceptible to rubella. Age, history of measles, mumps and rubella (MMR) vaccination and past history of rubella infection were considered factors associated with seropositivity for rubella. CONCLUSION: The seroprevalence rate of rubella antibodies among our female study group was considered low.

Climate variability and environmental stress in the Sudan-Sahel zone of West Africa.

Environmental change in the Sudan-Sahel region of West Africa (SSWA) has been much debated since the droughts of the 1970s. In this article we assess climate variability and environmental stress in the region. Households in Senegal, Mali, Burkina Faso, Niger, and Nigeria were asked about climatic changes and their perceptions were compared across north-south and west-east rainfall gradients. More than 80% of all households found that rainfall had decreased, especially in the wettest areas. Increases in wind speeds and temperature were perceived by an overall 60-80% of households. Contrary to household perceptions, observed rainfall patterns showed an increasing trend over the past 20 years. However, August rainfall declined, and could therefore potentially explain the contrasting negative household perceptions of rainfall trends. Most households reported degradation of soils, water resources, vegetation, and fauna, but more so in the 500-900 mm zones. Adaptation measures to counter environmental degradation included use of manure, reforestation, soil and water conservation, and protection of fauna and vegetation. The results raise concerns for future environmental management in the region, especially in the 500-900 mm zones and the western part of SSWA.

Structure, light absorption properties and photocatalytic activity of carbon-containing titania nanocomposites synthesized via a facile sol-gel method.

Facile and green sol-gel method was used to synthesize carbon-containing titania nanopowder, and diethanolamine (DEA) was used as the in situ carbon source. The titania gel was heat treated at temperatures ranging from 300 to 700 °C. X-ray diffraction (XRD), thermal analysis, and Raman spectroscopy reported no crystalline phase at <325 °C. Crystallization of the anatase phase with traces of brookite phases was observed at T > 325 °C, followed by a transformation to anatase/rutile in the range of 400 °C < T ≤ 650 °C. Finally, the complete phase transformation to the rutile phase occurs at temperatures of T > 650 °C. High-resolution electron microscopy (HREM) micrographs confirm the coexistence of anatase and rutile nanocrystals and amorphous carbon clusters in the composite samples. Chemical element analysis via X-ray photoelectron spectroscopy (XPS) indicated nonstoichiometry in the O/Ti ratio, the presence of (Ti3+) oxidation state, and elemental carbon. Thermogravimetric (TG) measurements are the most accurate method to measure the carbon content in samples. UV-vis spectroscopy demonstrated considerable enhancement in the optical absorption properties and electronic structure of prepared samples compared to the pure anatase and rutile. This enhancement is strongly correlated with the structure and composition of prepared samples and consequently depends on the preparation method as well as conditions. Innovative features such as self-cleaning action was demonstrated in carbon containing titanate nanocomposite.

Normal intraocular pressure in Egyptian children and meta-analysis.

OBJECTIVE: To determine the normal intraocular pressure in a sample of Egyptian children 0-12 years of age, and compare it to that recorded in previous studies. METHODS: This is a prospective cross-sectional study, including 345 eyes. All children underwent complete history taking and ophthalmic examination. Any glaucomatous patients or glaucoma suspects were excluded. Intraocular pressure was measured using Haag Streit Perkins M2 handheld applanation tonometer under topical or general anaesthesia. Three readings were recorded for each eye and the average was calculated. Central corneal thickness was measured, using handheld pachymeter (Pachmate 2), whenever possible. RESULTS: The study included 345 eyes of 187 children (101 males and 86 females), aged 2 months to 12 years (mean: 5.69 ± 3.42 years). The recorded IOP was 5-20 mm Hg (mean: 11.5 ± 2.34 mm Hg). Central corneal thickness was 469-742 µm (mean: 564.8 ± 42.72 µm). The mean recorded intraocular pressure showed positive correlation with increased age (p = 0.026) and increased central corneal thickness (p = 0.037), with a difference of 1 mm Hg for every 100-µm change in central corneal thickness. The mean IOP was significantly lower than that recorded by most previous studies. A detailed comparative analysis is presented comparing our findings with other studies including grouped analysis, by country, ethnicity and tonometers used. CONCLUSIONS: The mean IOP in a group of normal Egyptian children was 11.5 ± 2.34 mm Hg, with positive correlation to age and central corneal thickness. This mean intraocular pressure was lower than that previously reported in any other population.

Diversity of tsetse flies and trypanosome species circulating in the area of Lake Iro in southeastern Chad.

BACKGROUND: African trypanosomiases are vector-borne diseases that affect humans and livestock in sub-Saharan Africa. Although data have been collected on tsetse fauna as well as trypanosome infections in tsetse flies and mammals in foci of sleeping sickness in Chad, the situation of tsetse fly-transmitted trypanosomes remains unknown in several tsetse-infested areas of Chad. This study was designed to fill this epidemiological knowledge gap by determining the tsetse fauna as well as the trypanosomes infecting tsetse flies in the area of Lake Iro in southeastern Chad. METHODS: Tsetse flies were trapped along the Salamat River using biconical traps. The proboscis and tsetse body were removed from each fly. DNA was extracted from the proboscis using proteinase K and phosphate buffer and from the tsetse body using Chelex 5%. Tsetse flies were identified by amplifying and sequencing the cytochrome c oxydase I gene of each tsetse fly. Trypanosome species were detected by amplifying and sequencing the internal transcribed spacer 1 of infecting trypanosomes. RESULTS: A total of 617 tsetse flies were trapped; the apparent density of flies per trap per day was 2. 6. Of the trapped flies, 359 were randomly selected for the molecular identification and for the detection of infecting trypanosomes. Glossina morsitans submorsitans (96.1%) was the dominant tsetse fly species followed by G. fuscipes fuscipes (3.1%) and G. tachinoides (0.8%). Four trypanosome species, including Trypanosoma vivax, T. simiae, T. godfreyi and T. congolense savannah, were detected. Both single infection (56.7%) and mixed infections of trypanosomes (4.6%) were detected in G. m. submorsitans. The single infection included T. simiae (20.5%), T. congolense savannah (16.43%), T. vivax (11.7%) and T. godfreyi (9.8%). The trypanosome infection rate was 61.4% in G. m. submorsitans, 72.7% in G. f. fuscipes and 66.6% in G. tachinoides. Trypanosome infections were more prevalent in tsetse bodies (40.6%) than in the proboscis (16.3%). CONCLUSION: This study revealed the presence of different tsetse species and a diversity of trypanosomes pathogenic to livestock in the area of Lake Iro. The results highlight the risks and constraints that animal African trypanosomiasis pose to livestock breeding and the importance of assessing trypanosome infections in livestock in this area.

The First Case of Impella RP Use in Acute Right Ventricular Failure From Air Embolism.

BACKGROUND: Air embolism can cause the following catastrophic complications that must be avoided: cardiogenic shock (from right heart failure), obstructive shock, myocardial infarction, stroke, RVOT obstructions, and pulmonary embolism. Currently there is a paucity of data on Impella RP use in rare causes of acute right ventricle (RV) failure, especially if caused by air embolism. CASE REPORT: We report a case of a patient with acute RV failure due to air embolism who recovered from temporary use of Impella RP. DISCUSSION: This case highlights the utility of right-sided mechanical support (MCS) devices for acute RV failure.

Helminth infracommunities of the maculated toad Amietophrynus regularis (Anura: Bufonidae) from Ismailia, Egypt.

The objective of the present work was to study the helminth infracommunities of Amietophrynus (Bufo) regularis and the possible effects of intrinsic and extrinsic factors on infracommunity structure and on the infection parameters of each parasite species involved. A total of 129 A. regularis were collected from Ismailia, Egypt, over 3 seasons. Helminth infracommunities consisted of 8 helminth taxa (1 monogenean, 1 digenean, 1 cestode, 3 nematodes, and 2 acanthocephalans [1 adult and 1 cystacanth]). Aplectana macintoshii had the highest prevalence (82.94%), mean abundance (73.74), and mean intensity (88.91) and can be considered a core species. A. macintoshii dominated in 68.99% of the infracommunities, with a high Berger-Parker index value (0.9). Only 9 toads were uninfected; the remainder harbored between 1 and 7 helminth species and 1 to 632 ind. Mean species richness and abundance were 2.13 +/- 0.13 and 81.34 +/- 13.60, respectively, while evenness and diversity were 0.3 and 0.44, respectively. The results revealed that season, host sex, and age played significant roles in determining infracommunity species richness. The patterns of helminth infracommunity richness and diversity were similar to those previously observed in other amphibian hosts. This study indicated that the helminth community of A. regularis was depauperate.

Cost-effectiveness analysis of the introduction of the pneumococcal conjugate vaccine (PCV-13) in the Egyptian national immunization program, 2013.

INTRODUCTION: Pneumonia is one of the most important causes of morbidity and mortality in children under 5 in Egypt, and the Ministry of Health of Egypt is considering introducing pneumococcal conjugate vaccine (PCV) in its national immunization program. We performed an economic analysis to evaluate the cost-effectiveness of this vaccine in Egypt and to provide the decision-makers with needed evidence. METHODS: The analysis was done using the TRIVAC model. Data included demographic characteristics, burden of disease, coverage and efficacy of the vaccine, health resource utilization, and costs of pneumococcal disease vaccination and treatment. Whenever possible, we used national or regional data. Two alternatives were compared: (1) general vaccination of children younger than 5 years with the 13-valent pneumococcal conjugate vaccine (PCV13), using a three-dose schedule without booster, and (2) no vaccination. Outcomes of 10 cohorts from birth to 5 years were analyzed. The study was performed from the governmental perspective and selected public health providers. RESULTS: In comparison to no vaccine, the introduction of PCV13 would be cost-effective, with an incremental cost-effectiveness ratio of US$ 3916 per disability-adjusted life-year (DALY) averted (government perspective). The total incremental cost of the PCV vaccination program (10 cohorts) would be approximately US$ 1.09 billion. Over the 10 cohorts, the program would avert 8583 pneumococcal deaths - 42% of all pneumococcal-related deaths. CONCLUSION: The introduction of PCV13 would be a good value for money from the government perspective. It would represent a high-impact public health intervention for Egypt and respond to the National Immunization Technical Advisory Group (NITAG) resolution on reducing pneumonia burden and overall child mortality. Strengthening surveillance will be critical to generating high-quality national data, improving future economic analyses that support evidence-based decisions for introducing vaccines and public health interventions, and to monitoring their impact.