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Purpose: This research, conducted in Ethiopia, involved select stakeholders in the variety evaluation process early: to identify a greater number of acceptable varieties and to shorten a lengthy research and release process. Design/methodology/approach: A Participatory Plant Breeding (PPB) approach was used in both on-station and community-based trial evaluations. Farmers, traders and processors evaluated bean varieties for promotion, considering field performance, culinary characteristics, market value, and canning acceptability. Findings: Within four years, two varieties were identified and recommended for release which were high performing, had excellent consumption and cooking characteristics for local foods, fetched high local market prices and met international canning quality standards. Practical implications: (1) Ethiopian men and women have distinct criteria for evaluating white pea beans, the former putting emphasis on marketability, with women focusing on food security issues. Both groups might be involved in the selection process. (2) Key characteristics cited by farmers, for instance, use for forage, may not be taken into account in the formal breeding process. Expanding the criteria used to determine which varieties should be released would make economic sense. (3) Farmers screened for local product acceptability before researchers put forward lines for testing by the export and canning industry. Local acceptability need not necessarily conflict with market chain acceptability--if the right processes are followed. Originality/value: The context was unusual: a) the region was drought-prone; and b) the crop had to meet rigorous canning requirements, plus local preferences. The involvement of traders and processors was novel, as was the use of a "participatory framework" even when the product had to meet stringent market requirements.

Background: Knowing and seeking medical attention for neonatal danger signs has many benefits for reducing neonatal morbidity and death. Despite numerous interventions that have been made to raise mothers’ awareness about neonatal danger signs, the desired level of knowledge has not yet been reached in Ethiopia. Objective: To assess the level of knowledge of neonatal danger signs and associated factors among postpartum mothers in public hospitals in the Eastern Amhara region, northeastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted in four government hospitals between January 10, 2023, and February 10, 2023.421 participants in the study were selected using a systematic random sampling technique. Face-to-face interviews, observation, and chart reviews were used to collect the data. The association was discovered through multivariate logistic regression analysis. Result: Only 36.6% (154) of mothers were knowledgeable about newborn danger signs in this study. Mothers who had higher institution status [(adjusted odds ratio) AOR = 3.355, 95% CI (1.751, 6.428)]; who were civil servants or a private employer [AOR = 2.986, 95% CI (1.822, 4.892)] and [AOR = 2.544, 95% CI (1.269, 5.138)]; and who had counseling about breastfeeding [AOR = 2.614, 95% CI (1.695, 4.029)] were positive predictors of awareness of neonatal danger signs. Conclusion: In this study, the level of mothers' awareness of newborn danger signs was low and required more effort. Moreover, mothers who were educated, worked as civil servants or private employers, had a family size of 4–6, and received breastfeeding counseling were linked to mothers’ good awareness of newborn danger signs. As a result, intensive community and facility-based health promotion activities on newborn danger signs should be strengthened, with special emphasis on uneducated and housewife mothers and breastfeeding counseling sessions.

Abstract Background Anemia is a significant global public health issue among children aged 6 to 59 months, particularly in low-income countries like Ethiopia. Studies focusing on pastoral communities, especially in the Afar Region, often underestimate the prevalence of anemia in these children. To address this information gap, this study aimed to determine the prevalence of anemia and its associated factors among children aged 6 to 59 months in public hospitals in the Afar Region of northeastern Ethiopia. Method A hospital-based cross-sectional study was conducted among children aged 6 to 59 months, using systematic random sampling, at public hospitals in the Afar Region from February 28 to April 30, 2023.The data collection tool was adapted from the Ethiopian National Food Consumption Survey and the World Health Organization Infant and Young Child Feeding guidelines. Data entry was performed using EpiData version 4.2 and Anthroplus software for anthropometric measurements. Data analysis was conducted using SPSS version 26. Binary logistic regression models were applied to identify predictors of anemia, with a p-value of ≤ 0.05 considered statistically significant. Result Among the 306 children aged 6 to 59 months, the overall prevalence of anemia was 46.41 (95 CI: 43.8–48.9 ). Of the 142 anemic children aged 6 to 59 months, 62 (43.66 ) had mild anemia, 60 (42.25 ) had moderate anemia, and 20 (14.08 ) had severe anemia. Key factors associated with anemia included mothers with no formal education, the lowest family monthly income, a family size greater than five, and rural residence. Additionally, a previous diagnosis of parasitic infection, children aged 24–35 months, early weaning, a malaria diagnosis within the past three months, and diarrhea in the last two weeks were significant predictors of anemia in children aged 6 to 59 months. Conclusion In the current study, anemia in children aged 6 to 59 months was classified as severe and is regarded as a critical public health issue. This suggests that more efforts should be made to significantly decrease anemia by actively involving rural mothers with no formal education and low income who have children aged 6–59 months, focusing on the prevention and management of malaria, diarrhea, and parasitic infections.

The author of the article examines Fyodor Dostoevsky’s first multi-plot novel Netochka Nezvanova while also exploring the versions and reasons for the novel’s incompletion. The article suggests reading it in the context of the autobiographical works of Anna Grigorievna Dostoevskaya. The article draws a parallel between the first part of the novel about the musician Efimov and fragments from the Diaries and Memoirs of the writer’s wife. For the contemporary reader, accustomed to reading differently constructed texts, these fragments might be perceived as a kind of sequel to the early unfinished work (for example, the names of the novel’s heroine and the writer’s second wife, certain dates, behavioral models, and similar situations). The article suggests the idea that incorporating a literary text into the context of a writer’s biography is one way of ‘completing the incomplete’, while at the same time expanding the possibilities of interpreting classic works.

Physical inactivity is linked to pregnancy-related complications. Exercise participation during pregnancy is restricted in low-middle income nations, including Ethiopia. Therefore, this study aimed to assess factors associated with physical activity practice among pregnant women attending antenatal care at public health institutions in Debre Berhan Town Northeastern Ethiopia. Institutional based cross-sectional study was conducted from March 22, 2021 to May 22, 2021 in Debre Berhan Town. The systematic random sampling technique was used to obtain the 418 participants. Data were collected by using standardized questionnaires. Data were entered, cleaned by Epi data version 3.1 and analyzed by SPSS version 25. The variables which had p -value 24 weeks (AOR: 2.538, 95% CI [1.02, 6.29]) were factors associated with practice of physical exercise during pregnancy. Physical activity during pregnancy was more common in the current study than in the national average. During an ANC visit, health care providers should improve and strengthen physical activity counseling sessions.

Abstract Breastfeeding is the cornerstone of child and maternal health. However, maternal breast problems during breastfeeding have been frequently reported as one of the reasons for early discontinuation of breastfeeding. Despite the importance of having knowledge on breast problems magnitude and its associated factors in the clinical practices and designing effective interventions, there is limited data on this topic. Therefore, this study aimed to assess the prevalence and associated factors of breast problem among postnatal lactating women in Legambo district, south wollo zone, North East Ethiopia, in 2022. A community-based cross sectional study was conducted among 610 lactating mothers in Legambo district. Multi-stage sampling was employed to select study participants. Interviewer administered, WHO B-R-E-A-S-T-Feeding, observational checklist and maternal self-reported breast problem questionnaires were used to collect the data. Epi-Data version 3.1 was used for data entry and export to SPSS version 25.0 for analysis. Descriptive statistics and bi-variable and multivariable analysis was carried out. On the multivariable logistic regression, variables with p-value

[Introducción]: La variabilidad del espacio geográfico, en términos de la estructura horizontal de los paisajes, influye en la ecología y sugiere una asociación entre los índices de heterogeneidad paisajística (IHP) y los servicios ecosistémicos (SE). Esta relación es crucial para la conservación y el desarrollo sostenible en América Latina, dada la diversidad de paisajes, desde selvas tropicales hasta montañas nevadas y desiertos, que albergan una riqueza única de biodiversidad y funciones ecológicas. [Objetivo]: Se buscó determinar la relación entre los IHP y los SE. [Metodología]: Se calcularon catorce índices de heterogeneidad paisajística y siete servicios ecosistémicos en el municipio de Santa María Huatulco, Oaxaca, y se relacionaron con los servicios ecosistémicos estimados para la misma área de estudio. [Resultados]: Los modelos demostraron una relación estadísticamente significativa entre los IHP y los SE. [Conclusiones]: Investigar y comprender como los IHP afectan la oferta y distribución de los SE es esencial para promover un desarrollo sostenible en América Latina.

Abstract Background Hydrocephalus constitutes a complex neurological condition of heterogeneous origin characterized by excessive cerebrospinal fluid (CSF) accumulation within the brain ventricles. The condition may dangerously elevate the intracranial pressure (ICP) and cause severe neurological impairments. Pharmacotherapies are currently unavailable and treatment options remain limited to surgical CSF diversion, which follows from our incomplete understanding of the hydrocephalus pathogenesis. Here, we aimed to elucidate the molecular mechanisms underlying development of hydrocephalus in spontaneously hypertensive rats (SHRs), which develop non-obstructive hydrocephalus without the need for surgical induction. Methods Magnetic resonance imaging was employed to delineate brain and CSF volumes in SHRs and control Wistar-Kyoto (WKY) rats. Brain water content was determined from wet and dry brain weights. CSF dynamics related to hydrocephalus formation in SHRs were explored in vivo by quantifying CSF production rates, ICP, and CSF outflow resistance. Associated choroid plexus alterations were elucidated with immunofluorescence, western blotting, and through use of an ex vivo radio-isotope flux assay. Results SHRs displayed brain water accumulation and enlarged lateral ventricles, in part compensated for by a smaller brain volume. The SHR choroid plexus demonstrated increased phosphorylation of the Na+/K+/2Cl− cotransporter NKCC1, a key contributor to choroid plexus CSF secretion. However, neither CSF production rate, ICP, nor CSF outflow resistance appeared elevated in SHRs when compared to WKY rats. Conclusion Hydrocephalus development in SHRs does not associate with elevated ICP and does not require increased CSF secretion or inefficient CSF drainage. SHR hydrocephalus thus represents a type of hydrocephalus that is not life threatening and that occurs by unknown disturbances to the CSF dynamics.

Abstract Background It is crucial to maintain the intracranial pressure (ICP) within the physiological range to ensure proper brain function. The ICP may fluctuate during the light-dark phase cycle, complicating diagnosis and treatment choice in patients with pressure-related disorders. Such ICP fluctuations may originate in circadian or sleep-wake cycle-mediated modulation of cerebrospinal fluid (CSF) flow dynamics, which in addition could support diurnal regulation of brain waste clearance. Methods ICP was monitored continuously in patients who underwent placement of an external ventricular drain (EVD) and by telemetric monitoring in experimental rats. CSF was collected via the EVD in patients and the rodent CSF secretion rate determined by in vivo experimentation. Rodent choroid plexus transporter transcripts were quantified with RNAseq and transport activity with ex vivo isotope transport assays. Results We demonstrated that ICP increases by 30% in the dark phase in both species, independently of vascular parameters. This increase aligns with elevated CSF collection in patients (12%) and CSF production rate in rats (20%), the latter obtained with the ventriculo-cisternal perfusion assay. The dark-phase increase in CSF secretion in rats was, in part, assigned to increased transport activity of the choroid plexus Na+,K+,2Cl- cotransporter (NKCC1), which is implicated in CSF secretion by this tissue. Conclusion CSF secretion, and thus ICP, increases in the dark phase in humans and rats, irrespective of their diurnal/nocturnal activity preference, in part due to altered choroid plexus transport activity in the rat. Our findings suggest that CSF dynamics are modulated by the circadian rhythm, rather than merely sleep itself.

Introduction Currently, patient safety and quality of care have become a public health concern. However, medication administration errors are common in global medical settings and may cause problems ranging from the subtle to the fatal. Objective To assess the Magnitude and determinant factors of Medication Administration Errors among nurses working in the public hospitals in the Eastern Amhara region, Northeastern Ethiopia, 2022. Methods A multicenter hospital-based cross-sectional study design was used in South Wollo Zone public hospitals from February–March 2022, with 423 nurses selected using a simple random method. Data were collected using a pretested questionnaire, entered, and analyzed using EpiData 4.6.0 and SPSS 26. Predictors of medication administration errors were identified by multivariate logistic regression. Result Magnitude of Medication Administration Errors in the study areas was 229 (55%), 95% CI [0.501, 0.599]. Service provision to ≥ 11 patients per day (AOR: 2.52, 95% CI [1.187, 6.78]), interruption (AOR: 4.943, 95% CI [2.088, 11.712]), lack of training (AOR: 6.35, 95% CI [3.340, 7.053]), ≥ 4 years and 5–9 years of experience respectively (AOR: 3.802, 95% CI [1.343, 10.763]), (AOR: 2.804, 95% CI [1.062, 7.424]) were factors associated with Medication Error. likewise, shortage of time (AOR: 5.637, 95% CI [2.575, 12.337]), lack of guidelines (AOR: 2.418, 95% CI [1.556, 5.086]), workload (AOR: 7.32, 95% CI [3.146, 17.032]) and stress (AOR: 12.061, 95% CI [33.624, 53.737]) were determinant factors for Medication Administration Errors. Conclusion and recommendation In the current study, medication administration errors were common. Patient load, interruption, nurse's service experience, time deficit, stress, a lack of training, and the absence of guidelines were associated with medication administration errors. Therefore, ongoing training, the availability of guidelines, the presence of a good working environment, and the retention of experienced nurses can all be critical steps in improving patient safety.

Abstract Background A range of neurological pathologies may lead to secondary hydrocephalus. Treatment has largely been limited to surgical cerebrospinal fluid (CSF) diversion, as specific and efficient pharmacological options are lacking, partly due to the elusive molecular nature of the CSF secretion apparatus and its regulatory properties in physiology and pathophysiology. Methods CSF obtained from patients with subarachnoid hemorrhage (SAH) and rats with experimentally inflicted intraventricular hemorrhage (IVH) was analyzed for lysophosphatidic acid (LPA) by alpha-LISA. We employed the in vivo rat model to determine the effect of LPA on ventricular size and brain water content, and to reveal the effect of activation and inhibition of the transient receptor potential vanilloid 4 (TRPV4) ion channel on intracranial pressure and CSF secretion rate. LPA-mediated modulation of TRPV4 was determined with electrophysiology and an ex vivo radio-isotope assay was employed to determine the effect of these modulators on choroid plexus transport. Results Elevated levels of LPA were observed in CSF obtained from patients with subarachnoid hemorrhage (SAH) and from rats with experimentally-inflicted intraventricular hemorrhage (IVH). Intraventricular administration of LPA caused elevated brain water content and ventriculomegaly in experimental rats, via its action as an agonist of the choroidal transient receptor potential vanilloid 4 (TRPV4) channel. TRPV4 was revealed as a novel regulator of ICP in experimental rats via its ability to modulate the CSF secretion rate through its direct activation of the Na+/K+/2Cl− cotransporter (NKCC1) implicated in CSF secretion. Conclusions Together, our data reveal that a serum lipid present in brain pathologies with hemorrhagic events promotes CSF hypersecretion and ensuing brain water accumulation via its direct action on TRPV4 and its downstream regulation of NKCC1. TRPV4 may therefore be a promising future pharmacological target for pathologies involving brain water accumulation.

Even if limited amount of fluoride is vital, excessive accumulation of it has a serious health effect to human. Thus fluoride ions need to be removed using an environmentally friendly method and cost-effective material. Bismuth-doped hydroxyapatite nanorod was synthesized using co-precipitation technique and characterized by XRD, FT-IR, FE-SEM and EDS. XRD data revealed that the synthesized materials are hydroxyapatite having hexagonal structure with a space group of P63/m. Crystallite size and degree of crystallinity were increased as the amount of bismuth doped increased. Characteristics peaks of hydroxyapatite were observed in the FT-IR analysis. Energy dispersive spectroscopic analysis indicates that calcium, phosphorous, oxygen and bismuth are available in the synthesized product. In addition, the result indicates that the molar ratio of calcium to phosphorous reduced due to substitution of calcium by bismuth. Morphology analysis shows the presences of an aggregates of rod-like structure having diameters in the range of 10.06 – 31.93 nm. Batch adsorption experimental data were well fitted to pseudo-second order and Langmuir models, which implies that the sorption process is chemisorption through a monolayer on homogenous surface. The maximum adsorption capacity of bismuth doped hydroxyapatite nanorod was 60.67 mg/g using Langmuir model at room temperature. Thermodynamic data revealed that the adsorption process is endothermic and spontaneous. Regeneration and reuse analysis insured that the materials have good potential for reuse. The adsorption mechanism was inferred as chemisorption through electrostatic interaction and ion exchange. The modification of hydroxyapatite with bismuth can be considered a competent sorbent for removing fluoride ions.

Abstract Introduction Posthemorrhagic hydrocephalus (PHH) often develops following hemorrhagic events such as intraventricular hemorrhage (IVH) and subarachnoid hemorrhage (SAH). Treatment is limited to surgical diversion of the cerebrospinal fluid (CSF) since no efficient pharmacological therapies are available. This limitation follows from our incomplete knowledge of the molecular mechanisms underlying the ventriculomegaly characteristic of PHH. Here, we aimed to elucidate the molecular coupling between a hemorrhagic event and the subsequent PHH development, and reveal the inflammatory profile of the PHH pathogenesis. Methods CSF obtained from patients with SAH was analyzed for inflammatory markers using the proximity extension assay (PEA) technique. We employed an in vivo rat model of IVH to determine ventricular size, brain water content, intracranial pressure, and CSF secretion rate, as well as for transcriptomic analysis. Ex vivo radio-isotope assays of choroid plexus transport were employed to determine the direct effect of choroidal exposure to blood and inflammatory markers, both with acutely isolated choroid plexus and after prolonged exposure obtained with viable choroid plexus kept in tissue culture conditions. Results The rat model of IVH demonstrated PHH and associated CSF hypersecretion. The Na+/K+-ATPase activity was enhanced in choroid plexus isolated from IVH rats, but not directly stimulated by blood components. Inflammatory markers that were elevated in SAH patient CSF acted on immune receptors upregulated in IVH rat choroid plexus and caused Na+/K+/2Cl- cotransporter 1 (NKCC1) hyperactivity in ex vivo experimental conditions. Conclusions CSF hypersecretion may contribute to PHH development, likely due to hyperactivity of choroid plexus transporters. The hemorrhage-induced inflammation detected in CSF and in the choroid plexus tissue may represent the underlying pathology. Therapeutic targeting of such pathways may be employed in future treatment strategies towards PHH patients.

Abstract Background Disturbances in the brain fluid balance can lead to life-threatening elevation in the intracranial pressure (ICP), which represents a vast clinical challenge. Nevertheless, the details underlying the molecular mechanisms governing cerebrospinal fluid (CSF) secretion are largely unresolved, thus preventing targeted and efficient pharmaceutical therapy of cerebral pathologies involving elevated ICP. Methods Experimental rats were employed for in vivo determinations of CSF secretion rates, ICP, blood pressure and ex vivo excised choroid plexus for morphological analysis and quantification of expression and activity of various transport proteins. CSF and blood extractions from rats, pigs, and humans were employed for osmolality determinations and a mathematical model employed to determine a contribution from potential local gradients at the surface of choroid plexus. Results We demonstrate that CSF secretion can occur independently of conventional osmosis and that local osmotic gradients do not suffice to support CSF secretion. Instead, the CSF secretion across the luminal membrane of choroid plexus relies approximately equally on the Na+/K+/2Cl− cotransporter NKCC1, the Na+/HCO3 − cotransporter NBCe2, and the Na+/K+-ATPase, but not on the Na+/H+ exchanger NHE1. We demonstrate that pharmacological modulation of CSF secretion directly affects the ICP. Conclusions CSF secretion appears to not rely on conventional osmosis, but rather occur by a concerted effort of different choroidal transporters, possibly via a molecular mode of water transport inherent in the proteins themselves. Therapeutic modulation of the rate of CSF secretion may be employed as a strategy to modulate ICP. These insights identify new promising therapeutic targets against brain pathologies associated with elevated ICP.

Abstract Background Elevated intracranial pressure (ICP) is observed in many neurological pathologies, e.g. hydrocephalus and stroke. This condition is routinely relieved with neurosurgical approaches, since effective and targeted pharmacological tools are still lacking. The carbonic anhydrase inhibitor, acetazolamide (AZE), may be employed to treat elevated ICP. However, its effectiveness is questioned, its location of action unresolved, and its tolerability low. Here, we determined the efficacy and mode of action of AZE in the rat . Methods We employed in vivo approaches including ICP and cerebrospinal fluid secretion measurements in anaesthetized rats and telemetric monitoring of ICP and blood pressure in awake rats in combination with ex vivo choroidal radioisotope flux assays and transcriptomic analysis. Results AZE effectively reduced the ICP, irrespective of the mode of drug administration and level of anaesthesia. The effect appeared to occur via a direct action on the choroid plexus and an associated decrease in cerebrospinal fluid secretion, and not indirectly via the systemic action of AZE on renal and vascular processes. Upon a single administration, the reduced ICP endured for approximately 10 h post-AZE delivery with no long-term changes of brain water content or choroidal transporter expression. However, a persistent reduction of ICP was secured with repeated AZE administrations throughout the day. Conclusions AZE lowers ICP directly via its ability to reduce the choroid plexus CSF secretion, irrespective of mode of drug administration.

The consumption of too much fluoride ions through drinking water can seriously harm human health. Thus fluoride ions need to be removed by the novel and efficient nanomaterials materials synthesized via eco-friendly method. The pure and iron-doped hydroxyapatites were synthesized using a simple co-precipitation technique for the removal of fluoride from water. The synthesized materials were characterized by advanced technical tools. The point of zero charge of the materials was determined by the salt addition method. Crystallite size and degree of crystallinity were observed to decrease with the substitution of calcium. However, the surface area and pore volume were found to have enhanced with modification of iron in the apatite. Batch adsorption experimental data were well fitted to pseudo-second order and Langmuir models, which implied that the sorption process is chemisorption through a monolayer on a homogenous surface. The maximum sorption capacities of HA and Fe-HA were found to be 40.46 and 83.86 mg g ^−1 , respectively. The thermodynamic data revealed that the adsorption process is endothermic and spontaneous. The regeneration and reuse analysis insured that the materials have good potential for reuse. The adsorption mechanism was inferred as chemisorption through electrostatic interaction and ion exchange. The modification of hydroxyapatite using iron considered as a competent sorbent for the removal of fluoride ions.

This paper analyzes the book of memoirs The Power of Weak written by Elena Chervinskiene, Professor of the Department of Russian Literature at Vilnius University. Chervinskiene’s book discusses her experiences being deported to the Altai region and Yakutia, part of the wave of deportations from Lithuania that began in the fateful year of 1941. The early traumatic experience determined not only the author’s further personal life but also her professional choice. It is stated that the chosen field of scientific and creative interests of the expert on classical Russian literature, author of books and articles about L. Tolstoy, F. Dostoevsky and A. Chekhov, was also shaped by the all of the human experience gained during this tragic stage of her life.

Abstract Background Mobile phones of health care professionals could harbor microbes which cause nosocomial infections to the patient, family members, and the community at large. Thus, the aim of this study was to determine the prevalence of bacterial contamination of the mobile phones of health professionals, identify bacterial isolates, assess their antimicrobial susceptibility patterns, and define the associated factors. Method A cross-sectional study was conducted from February to March 2018 on 226 health professionals’ mobile phones which were selected by a simple random sampling technique. Data were collected using a self-administered questionnaire. A swab sample from each of health professional’s mobile phone device was collected and transported to the microbiology laboratory for bacterial culture and antimicrobial susceptibility tests. Data were entered into EpiData version 3.1 and analyzed by using the Statistical Package for Social Sciences (SPSS) program version 20. Result The overall prevalence of mobile phone contamination with one or more bacteria was 94.2%. Coagulase-negative staphylococci (CoNS; 58.8%), Staphylococcus aureus (14.4%), and Klebsiella species (6.9%) were the most predominant bacterial isolates. The overall prevalence of multidrug-resistant bacteria was 69.9%. About half of Gram-positive and Gram-negative bacteria were resistant to ampicillin and trimethoprim-sulfamethoxazole. Male sex (adjusted odds ratio (AOR) 4.1, 95% confidence interval (CI) 1.1, 15.8) and the absence of regular phone cleaning/disinfecting were found to be the most significant factors (AOR 4.1, 95% CI 1.2, 13.5) associated with health care professionals’ mobile phone bacterial contamination. Conclusion There is a high contamination rate of mobile phones with nosocomial pathogens. Most of the isolates were resistant to ampicillin and trimethoprim-sulfamethoxazole and also multidrug-resistant. A mobile phone belonging to male health professionals and to those not disinfecting mobile phones was significantly contaminated with bacteria. Therefore, strategies for preventing nosocomial transmission of drug-resistant pathogens through mobile phones, like hand washing and cleaning mobile phones, are recommended.

Arterial hypertension, is a common disorder with multiple and variable etiologies. Single nucleotide polymorphism analyses have detected an association between variants in the gene encoding the electrogenic Na+:HCO3– cotransporter NBCe2 (Slc4a5), and salt-sensitive hypertension. Mice with genetic deletion of NBCe2 are hypertensive, and the cause of the blood pressure (BP) increase is believed to arise from a lack of renal NBCe2 function. The exact cellular expression of NBCe2 in the kidney tubular system is, however, not determined. Here, we find NBCe2 to be expressed predominantly in isolated connecting tubules (CNT) and cortical collecting ducts (CD) by RT-PCR. In isolated renal CNT and CCD, genetic deletion of NBCe2 leads to decreased net base extrusion. To determine the role of renal NBCe2 in the development of hypertension, we generated CNT and intercalated cell NBCe2 knockout mice by crossing an Slc4a5 lox mouse with mice expressing cre recombinase under the V-ATPase B1 subunit promotor. Although the mice displayed changes in the expression of renal membrane transporters, we did not detect hypertension in these mice by tail cuff recordings. In conclusion, while global NBCe2 deletion certainly causes hypertension this study cannot confirm the role of renal NBCe2 expression in blood pressure regulation.

Osmotic forces do not suffice to explain the rate of cerebrospinal fluid (CSF) production. Here, the authors show that the Na+/K+/2Cl− cotransporter in the choroid plexus contributes substantially to CSF production via its inherent ability to cotransport water.

The article discusses the issue of theatricality arising from the reception of Dostoevsky’s novel Uncle’s Dream. Until now, researchers have dwelled on the external scenic elements of the story and have not paid much attention to the nature of the monologues of the main heroine of the story, where the orientation to directing and acting is obvious. Moskaleva’s monologues are not only built “in a theatrical manner” and foreshow the emergence of a complex dialogical structure characteristic of Dostoevsky’s main novels, but at the same time they reveal features characteristic of the future hero – the ideologist of Dostoevsky. And the identification of the Shakespearean leitmotif of the story supports the idea of it as a work in which theatrical elements are intertwined with the prosaic, and at the same time, it reveals the most important topics that are typical in the writer’s further work.

Entre los días 25 y 29 de mayo de 2018, afectó a Cuba la tormenta subtropical Alberto, la cual produjo intensas lluvias y algunos valores de viento peligrosos para las operaciones aéreas. Con el objetivo de analizar el impacto de las variables meteorológicas en la FIR1 Habana con el paso de la misma, se examinaron los datos de dirección y velocidad del viento, visibilidad, tiempo presente, presión y acumulado de precipitación de 11 aeropuertos cubanos, además de las estadísticas de operaciones y sobrevuelos. La tormenta subtropical Alberto afectó fundamentalmente a la región central del país donde se encuentran los aeropuertos internacionales de Abel Santamaría (Villa Clara), Vilo Acuña (Cayo Largo) y Jaime González (Cienfuegos). Aunque no existieron grandes afectaciones en las operaciones sobre el espacio aéreo cubano, ocurrieron tormentas intensas acompañadas de fuertes lluvias, fenómenos que reducen la visibilidad y contaminan las pistas en los aeródromos.

Straipsnyje aptariami bendri klasikinės rusų literatūros vertimų į lietuvių kalbą bruožai, tarp kurių išsiskiria akivaizdus vertėjų dėmesys poezijai, kai prozoje geriausiu atveju tenkinamasi vos po vieną kokio nors stambesnio epinio kūrinio vertimą, ir tai atliktą dažniausiai daugiau nei prieš pusę amžiaus. Apžvelgdama F. Dostojevskio vertimų istoriją straipsnio autorė teigia, kad lietuviškų rašytojo tekstų leidimų seka galėjo sąlygoti bendrą šio rusų rašytojo kūrybos recepciją Lietuvoje. Lygia greta straipsnyje pateikiama trumpa konkrečių, anksčiau nenagrinėtų lietuviškų Dostojevskio vertimų analizė, leidžianti daryti išvadas, kad seniai išversti svarbiausi rusų literatūros kūriniai šiandien jau nebeatitinka nei reikalavimų, kuriuos kelia literatūrinio vertimo specialistai, nei, svarbiausia, netenkina šiuolaikinio skaitytojo, kuriam rūpi ne tik knygoje papasakota istorija, bet ir savitas autoriaus stilius, ko dažniausiai ir pasigendama rusų klasikos vertimuose.

A pesar de las medidas de reducción de emisiones y el fortalecimiento de la voluntad política a nivel internacional, las concentraciones globales de CO2 rompen record cada año, llegando a alcanzar en el año 2014 los 400 ppm. Aunque las emisiones nacionales a nivel mundial no son representativas (apenas alcanzan el 0.1% de todas las emisiones de GEI a nivel mundial), habrá que adoptar compromisos de mitigación con el fin de honrar el nuevo “Acuerdo de París”, que entra en vigor a partir de 2020. El objetivo de esta investigación es determinar los valores de eficiencia en el uso de la electricidad por provincia, y los potenciales de ahorro de energía y mitigación de emisiones de dióxido de carbono resultantes del mejoramiento de la eficiencia eléctrica para el sector residencial cubano. Este estudio presenta como valor científico la estimación de la eficiencia por provincias para determinar el potencial de mitigación de emisiones de GEI, que resultan una información muy conveniente y oportuna para determinar la participación del sector en los esfuerzos encaminados a la reducción de emisiones resultante de futuros compromisos a las que las autoridades políticas del país se verán obligadas a honrar; además de determinar los impactos de la variación climática sobre la demanda de electricidad en el sector residencial. Los resultados obtenidos permiten aceptar la hipótesis que el uso de los modelos de frontera estocástica para la estimación de la eficiencia en el uso de la electricidad del sector residencial cubano resulta un procedimiento más robusto para la obtención de los potenciales de ahorro de electricidad y de mitigación de emisiones de dióxido de carbono asociados.

Las evidencias observadas demuestran que desde mediados de los años 60 del siglo XX, la temperatura superficial del aire al sur de las provincias de Artemisa y Mayabeque se ha incrementado notablemente. Tal incremento está condicionado por el ascenso de la temperatura mínima, lo que repercute en una importante disminución de la oscilación diaria de la temperatura. En cuanto a las lluvias, existe una muy ligera tendencia al aumento de los valores en los últimos años, no estadísticamente significativa, condicionada por igual comportamiento en el período lluvioso (mayo-octubre donde se concentra el 79.1% del acumulado anual) y una ligera disminución en los valores del período poco lluvioso (noviembre-abril). La evapotranspiración real por su parte, tiene una tendencia global al incremento, fundamentalmente en el período lluvioso, mientras que en el período poco lluvioso esta indica una reducción. Todo esto se traduce en una tendencia (no estadísticamente significativa) a un mayor volumen potencial anual de los recursos hídricos en los últimos años. Palabras claves: balance hídrico, tendencia climática, variabilidad climática

The mechanism by which pancreas secretes high HCO3- has not been fully resolved. This alkaline secretion, formed in pancreatic ducts, can be achieved by transporting HCO3- from serosa to mucosa or by moving H+ in the opposite direction. The aim of the present study was to determine whether H+/K+-ATPases are expressed and functional in human pancreatic ducts and whether proton pump inhibitors (PPIs) have effect on those. Here we show that the gastric HKα1 and HKβ subunits (ATP4A; ATP4B) and non-gastric HKα2 subunits (ATP12A) of H+/K+-ATPases are expressed in human pancreatic cells. Pumps have similar localizations in duct cell monolayers (Capan-1) and human pancreas, and notably the gastric pumps are localized on the luminal membranes. In Capan-1 cells, PPIs inhibited recovery of intracellular pH from acidosis. Furthermore, in rats treated with PPIs, pancreatic secretion was inhibited but concentrations of major ions in secretion follow similar excretory curves in control and PPI treated animals. In addition to HCO3-, pancreas also secretes K+. In conclusion, this study calls for a revision of the basic model for HCO3- secretion. We propose that proton transport is driving secretion, and that in addition it may provide a protective pH buffer zone and K+ recirculation. Furthermore, it seems relevant to re-evaluate whether PPIs should be used in treatment therapies where pancreatic functions are already compromised.

XIX a. rusų poeto F. Tiutčevo meilės lyrika jau ne kartą susilaukė literatūros tyrėjų dėmesio. Šio straipsnio tikslas – pabandyti dar sykį perskaityti Tiutčevo meilės temomis parašytus eilėrasčius kaip atspindinčius bendrus poeto filosofinės minties ieškojimus ir atradimus. Tradiciškai literatūroje apie Tiutčevo kūrybą meilės tema išskiriamas „Denisjevos ciklas“, tačiau nepatikslinamas jam priklausančių poetinių tekstų sąrašas, ką, remiantis ciklo sąvokos aiškinimu, bando padaryti straipsnio autorė. Tuo pačiu pabrėžiama, kad visi (net ir nepatekę į „realų“ ciklą) su „Denisjevos istorija“ susiję eilėraščiai – tik dalis Tiutčevo meilės lyrikos. Tikras jos subjekto savitumas, poeto „aš“ pozicijos prieštaringumas ir dramatizmas atsiskleidžia tik įvertinus visus Tiutčevo meilės lyrikos pavyzdžius, adresuotus skirtingoms moterims. Straipsnyje nagrinėjami eilėraščiai, įrodantys, kad kiekvieną sykį naujai mylimajai dedikuotas „išgrynintas“ meilės išgyvenimas tik dar kartą atkartoja jau patirtą jausmą, pakylėdamas jį vis į naujas poetines aukštumas. Visi Tiutčevo intymiosios lyrikos pavyzdžiai byloja apie neišvengiamą žmogaus gyvenimo judėjimą užburtu ratu – iš Nebūties į Būtį ir atgal, ir nuo paties žmogaus valios niekas čia nepriklauso.

Introduction: Access to antenatal ultrasound is limited in low-income countries such as Ethiopia. Virtual care platforms that facilitate supervision and mentoring for ultrasound scanning may improve patient access by facilitating task-sharing of antenatal ultrasound with midlevel providers. The purpose of this study was to assess the feasibility of a large volume tele-ultrasound program in Ethiopia, its impact on antenatal care (ANC) and patient access, and its sustainability as it transitioned from a pilot project to a continuing clinical program. Methods: Health care providers at two health centers in the North Shoa Zone, Ethiopia, performed antenatal tele-ultrasound exams with remote guidance from obstetricians located in urban areas. Data regarding ANC and ultrasound utilization, participant travel, ultrasound findings, specialist referrals, and participant experience were collected through a mobile app. Results: Between November 2020 and December 2023, 7,297 tele-ultrasound exams were performed. Of these, 489 tele-ultrasound exams were performed during the period of data collection from October to December 2022. The availability of tele-ultrasound at the two health centers significantly reduced participant travel distance (4.2 km vs. 10.2 km; p < 0.01; one-way distance). Most participants (99.2%) indicated the tele-ultrasound service was very important or important, with high levels of satisfaction. Clinically significant findings were identified in 26 cases (5.3%), leading to necessary referrals. Conclusion: This study demonstrated the feasibility of a large volume tele-ultrasound program in Ethiopia, its impact on improving the quality of ANC, and its sustainability. These findings lay a foundation upon which low-income countries can develop tele-ultrasound programs to improve antenatal ultrasound access.

Introduction: Ultrasound imaging is an important aspect of antenatal care, though access to antenatal ultrasound imaging is limited in many developing countries. The objective of this study was to evaluate a pilot programme which aimed to improve access to antenatal ultrasound for rural Ethiopians through enhanced training of healthcare providers (including midwives, nurses and clinical officers) with support remotely provided by obstetricians using a tele-ultrasound platform., Methods: Thirteen healthcare providers in the North Shoa Zone in Ethiopia completed training to enable them to perform antenatal ultrasound with the remote supervision of an obstetrician via a tele-ultrasound platform. Pregnant women attending an antenatal appointment at two facilities were offered an antenatal ultrasound exam performed by one of the healthcare providers. Image interpretations between obstetricians and healthcare providers were compared. Participants and healthcare providers were invited to complete a questionnaire regarding their experience with tele-ultrasound, and participants, healthcare providers and obstetricians were interviewed regarding their experience with the tele-ultrasound pilot programme., Results: 2795 pregnant women had an antenatal ultrasound exam. Of 100 exams randomly selected to assess concordance between healthcare providers' and obstetricians' image interpretations, concordance ranged from 79% to 100% for each parameter assessed. 99.4% of participants surveyed indicated that they would recommend antenatal ultrasound using tele-ultrasound to friends and family. Themes relating to participants' experiences of having a tele-ultrasound exam were reduced travel and cost, equivalence in quality of virtual care to in-person care and empowerment through diagnostic information., Conclusion: Healthcare provider-performed antenatal ultrasound - supported by obstetricians via tele-ultrasound - showed high levels of concordance, was well-received by participants and provided rural Ethiopian women with enhanced access to antenatal imaging., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Background: The emergence of drug-resistant tuberculosis (DR-TB) has been a major obstacle to global tuberculosis control programs, especially in developing countries, including Ethiopia. This study investigated drug resistance patterns and associated mutations of Mycobacterium tuberculosis Complex (MTBC) isolates from the Amhara, Gambella, and Benishangul-Gumuz regions of Ethiopia., Methods: A cross-sectional study was conducted using 128 MTBC isolates obtained from patients with presumptive tuberculosis (TB). Phenotypic (BACTEC MGIT 960) and genotypic (MTBDRplus and MTBDRsl assays) methods were used for drug susceptibility testing. Data were entered into Epi-info and analyzed using SPSS version 25. Frequencies and proportions were determined to describe drug resistance levels and associated mutations., Results: Of the 127 isolates recovered, 100 (78.7%) were susceptible to four first-line anti-TB drugs. Any drug resistance, polydrug resistance, and multi-drug resistance (MDR) were detected in 21.3% (27), 15.7% (20), and 15% (19) of the isolates, respectively, by phenotypic and/or genotypic methods. Mono-resistance was observed for Isoniazid (INH) (2, 1.6%) and Streptomycin (STR) (2, 1.6%). There were two genotypically discordant RIF-resistant cases and one INH-resistant case. One case of pre-extensively drug-resistant TB (pre-XDR-TB) and one case of extensively drug-resistant TB (XDR-TB) were identified. The most frequent gene mutations associated with INH and rifampicin (RIF) resistance were observed in the katG MUT1 (S315T1) (20, 76.9%) and rpoB (S531L) (10, 52.6%) genes, respectively. Two MDR-TB isolates were resistant to second-line drugs; one had a mutation in the gyrA MUT1 gene, and the other had missing gyrA WT1, gyrA WT3, and rrs WT1 genes without any mutation., Conclusions: The detection of a significant proportion of DR-TB cases in this study suggests that DR-TB is a major public health problem in Ethiopia. Thus, we recommend the early detection and treatment of DR-TB and universal full first-line drug-susceptibility testing in routine system., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Yenew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The Mycobacterium tuberculosis complex (MTBC) includes several human- and animal-adapted pathogens. It is thought to have originated in East Africa from a recombinogenic Mycobacterium canettii-like ancestral pool. Here, we describe the discovery of a clinical tuberculosis strain isolated in Ethiopia that shares archetypal phenotypic and genomic features of M. canettii strains, but represents a phylogenetic branch much closer to the MTBC clade than to the M. canettii strains. Analysis of genomic traces of horizontal gene transfer in this isolate and previously identified M. canettii strains indicates a persistent albeit decreased recombinogenic lifestyle near the emergence of the MTBC. Our findings support that the MTBC emergence from its putative free-living M. canettii-like progenitor is evolutionarily very recent, and suggest the existence of a continuum of further extant derivatives from ancestral stages, close to the root of the MTBC, along the Great Rift Valley., (© 2023. The Author(s).)

Background: Drug-resistant tuberculosis (TB) epidemic in high-TB-incidence countries, particularly Ethiopia, remains a significant challenge. As a result, we investigated the drug resistance, common gene mutation, and molecular characterization of mycobacterial isolates from patients with suspected tuberculous lymphadenitis (TBLN). Methodology . A cross-sectional study of 218 FNA samples from TBLN patients inoculated on Lowenstein-Jensen media was carried out. The culture isolates were identified as MTB by polymerase chain reaction (PCR) and the difference-9 (RD9) test region. In addition, the GenoType MTBDR plus assay tested the first and second-line MTB drugs, and the spoligotyping strain-dependent polymorphism test was determined., Results: Among the 50 culture-positive isolates, 14% (7/50) had drug resistance caused by a gene mutation. Out of these, 4 (8%) isolates were mono-resistant to isoniazid drug, which is caused by a gene mutation in katG in the region of interrogated at codon 315 in the amino acid sequence of S315T1, and 3 (6%) isolates were resistant to both rifampicin and isoniazid drugs. The mutation was observed for katG (at codon 315 with a change in the sequence of amino acid S315T) and rpoB (at codon 530-533 with a change in the sequence of amino acid S531L (S450L)) genes. The most prevalent spoligotypes were orphan and SIT53 strains., Conclusion: The predominance of INH mono-resistance poses a critical risk for the potential development of MDR-TB, as INH mono-resistance is a typical pathway to the occurrence of MDR-TB. The orphan and SIT53 (T) strains were the most common in the study area, and a drug-resistant strain caused by a common gene mutation could indicate the transmission of clonal-resistant strains in the community., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2023 Gebeyehu Assefa et al.)

Background: Tuberculosis (TB) which is caused by Mycobacterium tuberculosis poses a significant public health global treat. Tuberculosis meningitis (TBM) accounts for approximately 1% of all active TB cases. The diagnosis of Tuberculosis meningitis is notably difficult due to its rapid onset, nonspecific symptoms, and the difficulty of detecting Mycobacterium tuberculosis in cerebrospinal fluid (CSF). In 2019, 78,200 adults died of TB meningitis. This study aimed to assess the microbiological diagnosis TB meningitis using CSF and estimated the risk of death from TBM., Methods: Relevant electronic databases and gray literature sources were searched for studies that reported presumed TBM patients. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal tools designed for prevalence studies. Data were summarized using Microsoft excel ver 16. The proportion of culture confirmed TBM, prevalence of drug resistance and risk of death were calculated using the random-effect model. Stata version 16.0 was used perform the statistical analysis. Moreover, subgroup analysis was conducted., Results: After systematic searching and quality assessment, 31 studies were included in the final analysis. Ninety percent of the included studies were retrospective studies in design. The overall pooled estimates of CSF culture positive TBM was 29.72% (95% CI; 21.42-38.02). The pooled prevalence of MDR-TB among culture positive TBM cases was 5.19% (95% CI; 3.12-7.25). While, the proportion of INH mono-resistance was 9.37% (95% CI; 7.03-11.71). The pooled estimate of case fatality rate among confirmed TBM cases was 20.42% (95%CI; 14.81-26.03). Based on sub group analysis, the pooled case fatality rate among HIV positive and HIV negative TBM individuals was 53.39% (95%CI; 40.55-66.24) and 21.65% (95%CI;4.27-39.03) respectively., Conclusion: Definite diagnosis of TBM still remains global treat. Microbiological confirmation of TBM is not always achievable. Early microbiological confirmation of TBM has great importance to reduce mortality. There was high rate of MDR-TB among confirmed TBM patients. All TB meningitis isolates should be cultured and drug susceptibility tested using standard techniques., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Seid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The Mycobacterium tuberculosis complex causes tuberculosis, a severe public health problem. Close contacts of someone who has active pulmonary tuberculosis were at a greater risk of contracting the disease. Despite the large number of primary research available in Sub-Saharan African nations, there are no systematic reviews or meta -analyses that estimate the pooled prevalence of tuberculosis among tuberculosis patients' household contacts (HHC). Thus, this study aimed to estimate the pooled prevalence of tuberculosis in a household contact of tuberculosis patients in the sub-Saharan African region., Methods: Potential papers were systematically searched from electronic databases (PubMed, Google scholar and web of science). To analyze the quality of the papers featured, we used the Joanna Briggs Institute Critical Appraisal methods. Data were analyzed using STATA Version 16., Result: After screening 373 studies, the final analysis includes 20 articles from twelve countries. The overall prevalence of tuberculosis among household contacts was 3.29 % (95 % CI; 2.35 %-4.23 %). The overall prevalence rate of active tuberculosis in children aged less than five years was 2.60 % (95 % CI; 1.81 %-3.39 %). When the index patient age was less than 18 years old, the pooled prevalence of active TB in HHC was 2.64 % (95 % CI; 1.46 %-3.81 %). The pooled proportion of HIV in index TB patients was 53.12 % (95 % CI, 39.73 %-66.51 %). The overall pooled prevalence of HIV in household contacts was 7.75 % (95 % CI, 4.21 %-11.29 %)., Conclusion: Our systematic review showed that, in Sub-Saharan African nations, household contacts are at a high risk of contracting tuberculosis from their index patient. According to this study, one out of every thirty household contacts will develop active tuberculosis. This demonstrated the significance of doing thorough active tuberculosis case tracing in household contacts to locate missing tuberculosis patients., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s).)

Competing Interests: None declared.

Objective: This study aimed to determine the frequencies and trends of Mycobacterium tuberculosis and rifampicin resistance among presumptive tuberculosis patients in Ethiopia, who were tested using the Xpert MTB/RIF assay between 2014 and 2021., Methods: Data were collected retrospectively from patient registries. Laboratory-based data were extracted from the national tuberculosis (TB) referral laboratory database. All patients referred to the National Tuberculosis Reference Laboratory (NTRL) for TB diagnosis from all over the country between March 1, 2014 and September 30, 2021, and tested using the Xpert MTB/RIF assay, were included. The extracted data were entered into a Microsoft Excel sheet and analyzed by Statistical Package for Social Sciences (SPSS) version 23., Results: Among a total of 13 772 individuals tested using the Xpert MTB/RIF assay, the majority (8223; 59.7%) were males, and 48.5% (6678) of the individuals were aged between 15 and 39 years. Mycobacterium tuberculosis (MTB) was detected in 17.0% (2347) of the examined individuals. Of the detected MTB cases, nearly 9.9% (233) were rifampicin resistant (RR-TB), while 24 (1.0%) were RR-intermediate. Among all RR-TB cases, more than half (125; 53.6%) were detected in males, and 105 were new TB cases. Extrapulmonary (EPTB) patients had a greater rate of rifampicin resistance (11.0%) than pulmonary (PTB) patients (9.6%)., Conclusion: The frequency of TB and RR-TB remains high in the study setting. RR-TB was found to have a statistically significant association with previous anti-TB medication treatment. As a result, improving treatment adherence in recognized instances could assist in preventing MTB and RR-TB cases., (© 2022 The Author(s).)

Background: There is limited information on the performance of the Xpert ® MTB/RIF test for diagnosis of smear-negative pulmonary tuberculosis (SNPT) and rifampicin resistance (RR) in the same-day diagnosis approach. The effects of sputum quality and other factors affecting the Xpert performance are also under-investigated., Objective: This study aimed to determine the performance of the Xpert ® MTB/RIF test for detection of SNPT and RR in the same-day diagnosis strategy and the effect of sputum quality and other factors on its performance., Methods: A cross-sectional study was conducted from August 2017 to January 2018 across 16 health facilities in Addis Ababa, Ethiopia. Two spot sputum samples were collected from 418 presumptive SNPT patients, tested with Xpert® MTB/RIF, then compared to tuberculosis culture. Additionally, culture isolates were tested for RR by BACTEC MGIT™ 960 drug susceptibility testing (DST) and MTBDRplus version 2., Results: The Xpert ® MTB/RIF test detected 24 (5.7%) SNPT cases, with a sensitivity of 92.3% (75.9% - 97.9%) and specificity of 99.2% (97.8% - 99.7%) compared with tuberculosis culture. Xpert ® MTB/RIF also detected three (11.58%) RR strains with 100.0% concordance with BACTEC MGIT™ 960 DST and MTBDRplus results. Three blood-stained SNPT samples were positive by Xpert (30.0%), which was 6.9 times higher compared to salivary sputum (odds ratio: 6.9, 95% confidence interval: 1.36-34.96, p = 0.020)., Conclusion: The performance of the Xpert ® MTB/RIF to detect SNPT and RR in same-day diagnosis is high. However, SNPT positivity varies among sputum qualities, and good sample collection is necessary for better test performance., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2022. The Authors.)

Background: The rise of drug-resistant tuberculosis (DR-TB) has presented a substantial challenge to the national tuberculosis (TB) control program. Understanding the epidemiology of pre-extensively drug-resistant tuberculosis (pre-XDR-TB) could help clinicians to adapt MDR-TB treatment regimens at an earlier stage. This study aimed to assess second-line anti-TB drug resistance among MDR-TB patients in Ethiopia using routine laboratory-based data., Methods: Laboratory-based cross-sectional data were collected from the national TB reference laboratory and seven regional tuberculosis culture laboratories in Ethiopia from July 2019 to March 2022. The required data, such as drug-susceptibility testing (DST) results and sociodemographics, were collected on a structured checklist from laboratory registration books and electronic databases. Data were entered into a Microsoft Excel spreadsheet and analyzed using SPSS version 23. Descriptive statistics were performed to show the distribution and magnitude of drug resistance., Results: Second-line drugs (SLDs) susceptibility testing was performed for 644 MDR isolates, of which 19 (3%) were found to be pre-XDR-TB cases. Of the total MDR-TB isolates, 19 (3%) were resistant to at least one fluoroquinolone drug, while 11 (1.7%) were resistant to at least one injectable second-line drug. Of the 644 MDR-TB isolates, 1.9% (5/261) pre-XDR were from new MDR-TB cases, while 3.7% (14/383) were from previously treated MDR-TB patients. The most frequently identified mutations, based on MTBDR sl results, were in codon A90V of the gyrA gene (77.3%) and A1401G of the rrs gene (45.5%)., Conclusion: The overall prevalence of pre-XDR-TB in Ethiopia is considerable. The majority of SLD resistance mutations were in the gyrA gene at position A90V . Modern, rapid DST is necessary to enable identification of pre-XDR-TB and XDR-TB in supporting proper regimen administration for patients., (© 2022 The Author(s).)

Background: Tuberculosis (TB) is a global burden, and this is likely to remain the case due to a lack of adequate and accurate point-of-care diagnostic tests. Obtaining good-quality sputum from the bottom of the respiratory tract of children is challenging. Lipoarabinomannan (LAM) is a specific component of the mycobacterial cell envelope that is excreted in the urine of people with active TB. This study aimed to assess the performance of different types of urine-based LAM antigen tests for the diagnosis of TB in children., Methods: Relevant databases were searched for studies that used urine-based LAM tests to diagnose TB in children. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Pooled sensitivity and specificity were calculated using the random-effect model in STATA Version 16.0. Moreover, subgroup analysis was undertaken to hinder the heterogeneity of the studies., Results: Eleven articles were included in the final systematic review and meta-analysis. The pooled sensitivity and specificity of the Mycobacterium tuberculosis enzyme-linked immunosorbent assay (MTB-LAM-ELISA), Alere Determine TB LAM Ag (Alere LAM) test and the Fujifilm SILVAMP TB LAM (Fuji LAM) test in children aged <15 years with TB were 16.0% [95% confidence interval (CI) 10.25-42.25] and 95.61% (95% CI 93.74-97.74); 45.90% (95% CI 40.40-51.40) and 80.42% (95% CI 69.39-91.46); and 52.32% (95% CI 35.03-69.62) and 89.37% (95% CI 82.88-95.86), respectively. Subgroup analysis revealed that the pooled sensitivity and specificity of MTB-LAM-ELISA, Alere LAM test and Fuji LAM test were 33.5% (95% CI 34.86-100) and 95.83% (95% CI 91.50-100); 46.59% (95% CI 32.98-60.19) and 76.45% (95% CI 57.07-95.82); and 57.89% (95% CI 48.44-67.35%) and 87.66% (95% CI 75.29-100), respectively, in human immunodeficiency virus (HIV)-positive children; and 3.35% (95% CI 1.61-8.31) and 96.0% (95% CI 93.88-98.11); 32.33% (95% CI 7.63-57.03) and 79.07% (95% CI 62.62-95.51); and 50.95% (95% CI 27.45-74.45) and 89.47% (95% CI 84.72-94.22), respectively, in HIV-negative children., Conclusion: The Fuji LAM and Alere LAM tests may be useful for the diagnosis of TB in children in conjunction with other more sensitive and specific tests, although a prospective study in relevant clinical settings is needed to evaluate this. There is a need for more evidence-based data on the use of these rapid diagnostic tools to diagnose TB in children independent of HIV status., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2022 The Author(s).)

Introduction: Molecular tests allow rapid detection of Mycobacterium tuberculosis and drug resistance in a few days. Identifying the mutations in genes associated with drug resistance may contribute to the development of appropriate interventions to improve tuberculosis control. So far, there is little information in Ethiopia about the diagnostic performance of line probe assay (LPA) and the M. tuberculosis common gene mutations associated with drug resistance in extrapulmonary tuberculosis. Thus, this study aimed to assess the frequency of drug resistance-associated mutations in patients with extrapulmonary tuberculosis (EPTB) and to compare the agreement and determine the utility of the genotypic in the detection of drug resistance in Addis Ababa, Ethiopia., Methods: A cross-sectional study was conducted on stored M. tuberculosis isolates. The genotypic and phenotypic drug susceptibility tests were performed using LPA and BACTEC-MGIT-960, respectively. The common mutations were noted, and the agreement and the utility of the LPA were determined using the BACTEC-MGIT-960 as a gold standard., Results: Of the 151 isolates, the sensitivity and specificity of MTBDR plus in detecting isoniazid resistance were 90.9% and 100%, respectively. While for rifampicin, it was 100% and 99.3% for sensitivity and specificity, respectively. The katG S315Tl was the most common mutation observed in 85.7% of the isoniazid-resistant isolates. In the case of rifampicin, the most common mutation (61.9%) was observed at position rpoB S531L . Mutations in the gyrA promoter region were strongly associated with Levofloxacin and Moxifloxacin resistance., Conclusion: Line probe assay has high test performance in detecting resistance to anti-TB drugs in EPTB isolates. The MTBDR plus test was slightly less sensitive for the detection of isoniazid resistance as compared to the detection of rifampicin. The most prevalent mutations associated with isoniazid and rifampicin resistance were observed at katG S315Tl and rpoB S531L respectively. Besides, all the fluoroquinolone-resistant cases were associated with gyrA gene. Finally, a validation study with DNA sequencing is recommended., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Rapid and sensitive Tuberculosis (TB) diagnosis closer to patients is a key global TB control priority. Truenat assays (MTB, MTB Plus, and MTB-RIF Dx) are new TB molecular diagnostic tools for the detection of TB and Rifampicin (RIF)-resistance from sputum samples. The diagnostic accuracy of the assays is needed prior to implementation in clinical use in Ethiopia. This study aimed to determine the sensitivity and specificity of Truenat assays; and aimed to compare the assays to the Xpert MTB/RIF assay., Methods: A prospective evaluation study was conducted among 200 presumptive TB patients in microscopy centers in Addis Ababa, Ethiopia from May 2019 to December 2020. Culture (Solid and Liquid methods) and phenotypic (liquid method) drug susceptibility testing (DST) were used as a reference standard., Results: Of 200 adult participants, culture confirmed TB cases were 25 (12.5%), and only one isolate was resistant to RIF by phenotypic DST. The sensitivity of Truenat MTB was 88.0% [95% CI 70.1, 95.8], while 91.7 [95% CI 74.2, 97.7] for Truenat MTB Plus at the microscopy centers. The specificity of Truenat MTB was 97.2% [95% CI 93.1, 98.9], while for Truenat MTB Plus was 97.2% [95% CI 93.0, 99.0]. The sensitivity of Truenat MTB was 90.5% while for MTB Plus, 100% compared to the Xpert MTB/RIF assay., Conclusion: Truenat assays were found to have high diagnostic accuracy. The assays have the potential to be used as a point of care (POC) TB diagnostic tests., Competing Interests: The authors have declared that no competing interests exist.

Background: In Ethiopia, tuberculosis (TB) is one of the most common causes of illness and death. However, there is limited information available on lineages associated with drug resistance among extrapulmonary tuberculosis patients in Ethiopia. In this study, researchers looked into Mycobacterium tuberculosis lineages linked to drug resistance in patients with extrapulmonary tuberculosis in Addis Ababa, Ethiopia., Methods: On 151 Mycobacterium tuberculosis isolates, a cross-sectional analysis was performed. Spoligotyping was used to characterize mycobacterial lineages, while a phenotypic drug susceptibility test was performed to determine the drug resistance pattern. Data were analyzed using SPSS version 23., Results: Among 151 Mycobacterium tuberculosis complex (MTBC) genotyped isolates, four lineages (L1-L4), and Mycobacterium bovis were identified. The predominantly identified lineage was Euro-American (73.5%) followed by East-African-Indian (19.2%). Any drug resistance (RR) and multidrug-resistant (MDR) tuberculosis was identified among 16.2% and 7.2% of the Euro-American lineage, respectively, while it was 30.8% and 15.4% among the East-African-Indian lineages. Among all three preextensively drug-resistance (pre-XDR) cases identified, two isolates belong to T3-ETH, and the other one strain was not defined by the database. There was no statistically significant association between any type of drug resistance and either lineage or sublineages of Mycobacterium tuberculosis ., Conclusion: A higher proportion of any type of drug resistance and MDR was detected among the East-African-Indian lineage compared to others. However, there was no statistically significant association between any type of drug resistance and either lineages or sublineages. Thus, the authors recommend a large-scale study., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Getu Diriba et al.)

Background: The comparatively straightforward and cheaper light-emitting diode fluorescent microscope (LEDFM) was suggested by WHO to replace conventional microscope in tuberculosis (TB) laboratories. However, the comparable efficacy of each of those techniques differs from laboratory to laboratory. We investigated the efficacy of LEDFM for the diagnosis of tuberculous lymphadenitis (TBLN) patients., Methods: A cross-sectional study was conducted on 211 samples from clinically suspected tuberculous lymphadenitis patients. Three smears were prepared from FNA on microscope slides for cytomorphology study, Auramine O (AO), and for Ziehl-Neelsen (ZN) staining. The left-over samples were inoculated onto Lowenstein-Jensen (LJ) media. Statistical analysis was done using STATA version 11. The sensitivity, specificity, positive and negative predictive values were calculated by considering the culture results as the gold standard using a 95% confidence interval., Results: Among 211 samples 49.7% (105) were positive by cytomorphology, 32.7% (69) by LEDFM, 23.69% (50) by LJ culture, and 13.7% (29) by ZN. Compared to the gold standard sensitivity of ZN, LEDFM, and cytomorphology were 30% [95% CI: 17.9-44.6], 66% [95% CI: 51.2-78.8] 78% [95% CI: 64-88.5], respectively. The specificity of ZN, LEDFM, and cytomorphology was 91.3% [95% CI: 85.8-95.2], 77.6% [95% CI: 70.4-83.8], 58.8% [95% CI: 50.7-66.5], respectively., Conclusion: LED fluorescence microscopy gives a legitimate option in contrast to conventional ZN techniques in terms of its higher sensitivity, a bit lower specificity, time-saving, and minimal effort., Competing Interests: The authors have declared that no competing interests exist.

Background: Drug-resistance in Mycobacterium tuberculosis complex remains a major health burden in human history and still is a major leading cause of death in developing countries including Ethiopia. Early detection of all forms of drug-resistant Tuberculosis(TB) is a key factor to reduce and contain the spread of these resistant strains., Methods: A health facility-based cross-sectional study was employed, based on demographic, clinical, and laboratory data collected from 204 patients with bacteriological confirmed TB. Sputum samples were analyzed using conventional TB culture and identification test followed by molecular species identification, and then phenotypic drug susceptibility tests. Data were entered using an excel spreadsheet and exported to SPSS version 20 for analysis. Descriptive analysis; frequencies, and proportions were computed., Results: Among the 204 sputum samples inoculated in culture media, Mycobacterium species were recovered from 165 specimens, with 160 Mycobacterium tuberculosis complex and five Non- Tuberculosis Mycobacterium(NTM) species. All Mycobacterium tuberculosis complex was found to be M. tuberculosis. Of the five NTM species, 2 M.fortuitum, 2 M.intracellulare, and 1 M.gordonae were identified. Among 160 species of M. tuberculosis isolates, 110(68.8%) were resistant to any of the anti-TB drugs. The resistance pattern was; INH (109, 68.1%), RIF (99, 61.9%), STM (73,45.6%), and EMB (32,20.0%). Mono-resistance was found for INH (7,4.3%) and STM (1,0.6%). Ninety-nine (61.9%) isolates become MDR, while resistance to any of the second-line anti-TB drugs was detected in 9 (5.6%) strains, with 8(5%) Pre-XDR and one (0.6%) XDR cases., Conclusion: Our findings highlight high frequencies of drug resistance to first and second-line anti-TB drugs.Determining the drug-resistance pattern of MTB is important for programmatic management of drug-resistant TB in Ethiopia. The circulating Pre-XDR and XDR case identified in the current study is alarming to the tuberculosis control program in the country., Competing Interests: The authors have declared that no competing interests exist.

Background: Molecular characterization of Mycobacterium tuberculosis (MTB) is important to understand the pathogenesis, diagnosis, treatment, and prevention of tuberculosis (TB). However, there is limited information on molecular characteristics and drug-resistant patterns of MTB in patients with extra-pulmonary tuberculosis (EPTB) in Ethiopia. Thus, this study aimed to determine the molecular characteristics and drug resistance patterns of MTB in patients with EPTB in Addis Ababa, Ethiopia., Methods: This study was conducted on frozen stored isolates of EPTB survey conducted in Addis Ababa, Ethiopia. A drug susceptibility test was performed using BACTEC-MGIT 960. Species and strain identification were performed using the Geno-Type MTBC and spoligotyping technique, respectively. Data were entered into the MIRU-VNTRplus database to assess the spoligotype patterns of MTB. Analysis was performed using SPSS version 23, and participants' characteristics were presented by numbers and proportions., Results: Of 151 MTB isolates, 29 (19.2%) were resistant to at least one drug. The highest proportion of isolates was resistant to Isoniazid (14.6%) and Pyrazinamide (14.6%). Nine percent of isolates had multidrug-resistant TB (MDR-TB), and 21.4% of them had pre-extensively drug-resistant TB (pre-XDR-TB). Among the 151 MTB isolates characterized by spoligotyping, 142 (94.6%) had known patterns, while 9 (6.0%) isolates were not matched with the MIRU-VNTRplus spoligotype database. Of the isolates which had known patterns, 2% was M.bovis while 98% M. tuberculosis. Forty-one different spoligotype patterns were identified. The most frequently identified SpolDB4 (SIT) wereSIT149 (21.2%), SIT53 (14.6%) and SIT26 (9.6%). The predominant genotypes identified were T (53.6%), Central Asia Strain (19.2%) and Haarlem (9.9%)., Conclusion: The present study showed a high proportion of MDR-TB and pre-XDR-TB among EPTB patients. The strains were mostly grouped into SIT149, SIT53, and SIT26. The T family lineage was the most prevalent genotype. MDR-TB and pre-XDR-TB prevention is required to combat these strains in EPTB. A large scale study is required to describe the molecular characteristics and drug resistance patterns of MTB isolates in EPTB patients., Competing Interests: The authors have declared that no competing interests exist.

Background: Xpert® MTB/RIF assay is currently used in Ethiopia for the rapid diagnosis of Mycobacterium tuberculosis (MTB) and mutations that confer Rifampicin resistance. Rifampicin resistance is determined based on any mutation in the 81 bp of rpoB gene using five overlapping probes represented as Probe A (codons 507-511), Probe B (codons 512-518), Probe C (codons 518-523), Probe D (codons 523-529) and Probe E (codons 529-533). In this review, we assessed the frequency of missed probe types for Rifampicin Resistance results., Methods: Data were reviewed from specimens received and tested using Xpert® MTB/RIF assay at Ethiopian National Tuberculosis Reference Laboratory, in Addis Ababa from 15 July 2016 to 31 December 2018 retrospectively. All archived data were reviewed carefully to describe missed probe types and the quantity of DNA in the sample., Results: A total of 100 specimens were reported as MTB Detected Rifampicin Resistance Detected by Xpert® MTB/RIF assay. More than half (55%) of these results were reported from male patients. The median age was 28.0 years (5 months to 88 years). Majorities (62%) of the cases were detected from sputum. Among the total of 38 extrapulmonary samples, lymph node aspirates were accounted for 50% (19/38). The most common mutations (81.0%) were found in the Probe E region followed by Probe D (10.0%), and Probe B (3.0%). Mutations in Probe A and Probe C regions were not observed. However, six (6.0%) Rifampicin resistance cases were found without any missed probe type. The delta Ct max is ≥4.3. No specimen yielded Rifampicin resistance associated with more than one probe failure or mutation combinations., Conclusion: Mutations associated with Probe E (codons 529-533) region were identified as the commonest rpoB gene mutations. The Rifampicin resistance results found without any identified missing probe needs further study. The lower DNA amount was observed in extrapulmonary specimens compared with sputum.