BackgroundBoth podoconiosis and soil-transmitted helminth (STH) infections occur among barefoot people in areas of extreme poverty; however, their co-morbidity has not previously been investigated. We explored the overlap of STH infection and podoconiosis in Southern Ethiopia and quantified their separate and combined effects on prevalent anemia and hemoglobin levels in podoconiosis patients and health controls from the same area.Methods and Principal FindingsA two-part comparative cross-sectional study was conducted in Wolaita zone, southern Ethiopia. Data were collected from adult patients presenting with clinically confirmed podoconiosis, and unmatched adult neighborhood controls living in the same administrative area. Information on demographic and selected lifestyle factors was collected using interviewer-administered questionnaires. Stool samples were collected and examined qualitatively using the modified formalin-ether sedimentation method. Hemoglobin level was determined using two different methods: hemoglobinometer and automated hematology analyzer. A total of 913 study subjects (677 podoconiosis patients and 236 controls) participated. The prevalence of any STH infection was 47.6% among patients and 33.1% among controls (p<0.001). The prevalence of both hookworm and Trichuris trichiura infections was significantly higher in podoconiosis patients than in controls (AOR 1.74, 95% CI 1.25 to2.42, AOR 6.53, 95% CI 2.34 to 18.22, respectively). Not wearing shoes and being a farmer remained significant independent predictors of infection with any STH. There was a significant interaction between STH infection and podoconiosis on reduction of hemoglobin level (interaction p value = 0.002).ConclusionsPrevalence of any STH and hookworm infection was higher among podoconiosis patients than among controls. A significant reduction in hemoglobin level was observed among podoconiosis patients co-infected with hookworm and ‘non-hookworm STH’. Promotion of consistent shoe-wearing practices may have double advantages in controlling both podoconiosis and hookworm infection in the study area.
This is the first study, to our knowledge, to attempt to elucidate the molecular pathogenetic events in podoconiosis. We conclude that TGF-beta1 may have a pathogenetic role, with oxidative stress playing a minor role in the early stages of disease.
Conflicts between the Qimant communityan intrastate minority ethnic group endogenous to Amhara state in the Ethiopian federationand the state's special police forces have caused hundreds of deaths and the internal displacement of close to 50,000 people. Linked to these conflicts are the Qimants' demands for recognition as a distinct ethnic community and the establishment of local government in the territories they inhabit; demands which have not received a satisfactory response from the federal or Amhara state government and which officials view with disdain. The situation raises several questions. Do the federal and regionalstate constitutions provide the necessary framework for accommodating intra-state ethnic minorities such as the Qimant? If they do, why have the two levels of government failed to resolve the Qimant issue peacefully? What institutional mechanisms could they have used to satisfy the demands of the Qimant community? This article seeks to answer these and related questions.
Background: Diabetic kidney disease (DKD) is one of the major complications of Type 2 diabetes, clinically characterized by a progressive increase in albuminuria and/or a subsequent decline in glomerular filtration rate. Identification of novel risk factors contributes to reduction in the risk of diabetic kidney disease. Bilirubin, as an antioxidant and anti-inflammatory molecule, is believed to have a protective role in kidney disease. On the other hand, uric acid is implicated in the pathogenesis of DKD due to its pro-oxidant and pro-inflammatory property in vascular tissues. Methods: A hospital based comparative cross-sectional study was conducted from October 2020 to March 2021 on 200 eligible Type 2 diabetic patients (58 with DKD and 142 without DKD) to assess the association of serum total bilirubin and serum uric acid levels with low GFR diabetic kidney disease using consecutive sampling technique. Results:The serum total bilirubin level was significantly decreased (0.15±2.29, mean±SD) in the DKD group compared to the non-DKD group (0.19±2.26), whereas the mean±SD serum uric acid was significantly increased in the DKD group (7.13±2.21) compared to the non-DKD group (5.24±1.92). A low serum total bilirubin level was significantly associated with increased risk of DKD in multivariate analysis (AOR=2.23, 95% CI=1.55-4.13) also to high serum uric acid levels (AOR=2.09, 95% CI=1.06-4.12). Moreover, a low serum total bilirubin level was significantly associated with increased risk of DKD among patients with high serum uric acid (AOR=2.55, 95% CI=1. 05-6.19). Similarly, high serum uric acid was significantly associated with increased risk of DKD among patients with low serum total bilirubin (AOR=3.49, 95% CI=1.29-9.42). Conclusion: Co-presence of low serum total bilirubin and high serum uric acid may be useful for stratification of DKD risk among patients with Type 2 diabetes mellitus.
Background: Aflatoxin is a toxic cancerous fungal secondary metabolite produced by Aspergillus species. Consumption of aflatoxin-contaminated cereals and their products can cause several health-related effects including acute and chronic aflatoxicosis. This study is aimed to evaluate the total aflatoxin content in Cheka and its major ingredients using the Immuno-Affinity Column Clean-up technique by sensitive HPLC with fluorescence detection. Methods:This study followed a completely randomized experimental design to evaluate the level of aflatoxin in traditionally brewed Cheka and its major ingredients (maize) by HPLC from November 2019 to June 2020. Traditionally brewed 6 Cheka beverage and 6 maize seed samples were collected randomly from Konso and transported to Bless Agri Food Laboratory in Addis Ababa for laboratory evaluation of aflatoxin in samples. The data were analyzed by SPSS version 25. Results: In the present study aflatoxin contamination was detected in all maize and Cheka samples. A mean total aflatoxin level of 6.78 ± 8.28 μg/kg and 10.76 ± 4.50 μg/kg were observed in maize and Cheka samples respectively. AFB1 predominantly contributed to the contamination of all samples. Although there was no significant difference while comparing between mean total aflatoxin of any other sample types, a significant difference was observed for the AFB1 mean of pitfall maize and their respective Cheka samples (P= 0.033). Conclusion: The mean level of AFB1 in pitfall maize differs from a respective Cheka sample. As most of the samples evaluated for aflatoxin contamination showed levels above healthy cut-off points of aflatoxin set by different authorities like the European Union, CODEX, and Ethiopian standards agency, there must be a protracted interventional approach to reduce aflatoxin contamination in maize and its products in the region.
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