Diagnostic utility of haematological parameters in predicting the severity of HIV infection in southwestern Ethiopia: a comparative cross-sectional study.

OBJECTIVES: This study aimed to evaluate the diagnostic utility of haematological parameters as a predictive marker of the severity of HIV infection in southwestern Ethiopia. DESIGN: Comparative cross-sectional study. SETTING: This study was conducted in southwestern Ethiopia. PARTICIPANTS: Venous blood samples were collected from 344 participants (172 HIV, 172 healthy controls (HC)) and haematological parameters were determined using the automated haematology analyser. The diagnostic utility of haematological parameters was determined by a receiver operating curve analysis. Data were analysed using SPSS V.21 and the p value was set at less than 0.05 for the statistical significance. RESULTS: In this study, red cell count (RCC) distinguishes HIV-infected patients from HC at a threshold value of 4.05×109/L with sensitivity, specificity and an area under the curves (AUC) of 73.8%, 78.5% and 0.87, respectively. At a cut-off value of 4.25×109/L, RCC significantly distinguishes non-severe HIV-infected patients from HC with a sensitivity of 72.7%, specificity of 81.7% and an AUC of 0.86. Haemoglobin (Hgb) significantly differentiates severe HIV-infected patients from HC with sensitivity, specificity and an AUC of 95.9%, 86.7% and 0.96, respectively. Platelet count (PLT) significantly discriminates HC from non-severe and severe HIV-infected patients with an AUC of 0.74 and 0.963, respectively. CONCLUSION: RCC, PLT and Hgb demonstrated better diagnostic performance in predicting the severity of HIV infection and have been identified as the best haematological markers in predicting the presence and severity of HIV infection. Thus, the haematological profiles (RCC, PLT and Hgb) should be used as an alternative marker to predict the severity of HIV infection and may provide supportive information for evidence-based interventions and early diagnosis of infections.

Evaluation of Peripheral Blood Parameters of Pulmonary Tuberculosis Patients at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: Comparative Study.

BACKGROUND AND AIM: Pulmonary tuberculosis is still among the leading cause of morbidity and mortality in Ethiopia. Different hematological abnormalities are commonly associated with pulmonary tuberculosis even though inconsistent results have been described. Hence, this study aimed to evaluate the hematological parameters of pulmonary tuberculosis patients visited St. Paul's hospital millennium medical college, Addis Ababa, Ethiopia. METHODS: From April to September 2018, a comparative cross-sectional study was conducted among pulmonary tuberculosis patients (n=40) and control patients (n=40). About 5 mL venous blood and 2-5 mL sputum samples were collected and examined by Cell Dyn 1800 hematology analyzer and cultured using Mycobacteria Growth Indicator Tube (BACTEC MGIT 960), respectively. Independent t-test was performed with the help of SPSS version 20 software, and p-value < 0.05 was considered as statistically significant difference. RESULTS: The proportion of male to female in the pulmonary tuberculosis patients (PTB) and the control patients was 1.7 (25/15). Two-sample independent t-test revealed that the mean values of hemoglobin level (P=0.002), hematocrit (P=0.018), mean cell hemoglobin concentration (P=0.001) and relative lymphocyte percentage (P=0.036) of PTB were significantly lower than the control group. Moreover, significantly higher mean values were also observed in total white blood cell count (P=0.004), platelet count (P<0.001) and erythrocyte sedimentation rate (P<0.001). Among the hematologic abnormalities detected, thrombocytosis and anemia presented in 65% and 25% of PTB patients, respectively. CONCLUSION: Statistically significant mean differences were observed in hemoglobin, hematocrit (HCT), MCHC, relative lymphocyte percentage, WBC, platelet count, relative neutrophil percentage and ESR values. So, the utilization of such data is important in providing preliminary information for diagnosis and management of pulmonary tuberculosis. In fact, a further large scale study is needed to substantiate this finding.

Trend of malaria prevalence in Wolkite health center: an implication towards the elimination of malaria in Ethiopia by 2030.

BACKGROUND: Malaria is one of the main public health challenges in Ethiopia that hinder the productivity and development of the country. In 2018, Ethiopia is on track to minimize the incidence of malaria by 40% as per its 2020 malaria reduction strategy. Currently, Ethiopia is working to eliminate malaria in 2030 by extending the 2020 strategy. Hence, this study aimed to analyze the trend of malaria prevalence in Wolkite health center, Gurage zone, Southern Central Ethiopia from 2015 to 2018. METHODS: A retrospective study was conducted to determine the prevalence of malaria by reviewing the malaria registration laboratory logbook at Wolkite health center from 2015 to 2018. For all patients, blood films were done for the detection of malaria cases. All the socio-demographic data, year, month and malaria data were collected using a predesigned data collection sheet from January to March, 2019. RESULTS: From a 121,230 clinically malaria suspected patients, the overall prevalence of microscopically confirmed cases were 8.56% (n = 10,379/121,230). Plasmodium vivax was the most predominant species accounted for 69.7% (n = 7237/10,379) followed by Plasmodium falciparum 29.3% (n = 3044/10,379). Age group > 15 years old were more affected by malaria accounting 54% (n = 5609/10,379) and malaria cases regarding sex were proportional (51.1% of males and 48.3% of female). Among the catchment areas, a higher number of malaria prevalence was recorded in the Wolkite town 66.2% (n = 0.6538/10,379). Higher malaria cases were shown in the season of Spring 29.8% (n = 3096/10,379) while lower cases 20.4% (n = 2123/10,379) were seen in the Winter season. CONCLUSION: The prevalence of malaria in Wolkite health center showed a consistent downward trend from the year of 2015-2018. Importantly, the higher prevalence of P. vivax seems overlooked in the study area. Therefore, malaria prevention and control strategy should be reinforced to reduce the prevalence of malaria in the study area.

The serum concentration of vitamin B12 as a biomarker of therapeutic response in tuberculosis patients with and without human immunodeficiency virus (HIV) infection.

BACKGROUND: Prior to clinical trials of new tuberculosis (TB) drugs or therapeutic vaccines, it is necessary to develop monitoring tools to predict treatment outcomes in TB patients. METHODS: Micronutrients concentration level was determined from a total of 262 study participants with five clinical groups: 57 TB patients coinfected with HIV (HIV+TB+), 87 active TB Patients (TB cases), 71 HIV infected without active and latent TB infection (HIV+TST-), 22 latent TB infection (TST+) and 25 healthy controls (TST-). Vitamin A concentration was measured using high-performance liquid chromatography (HPLC), whereas iron and vitamin B12 concentrations were measured using Cobas® 6000 analyzer. RESULT: The serum concentration levels of iron, vitamin A and vitamin B12 had a significant difference between active TB and latent (LTBI) or healthy controls. Six months after treatment, the serum concentration levels of vitamin A, vitamin B12 and iron in tuberculosis became indistinguishable from the levels of LTBIs and healthy control individuals. The concentration levels of iron and vitamin B12 in HIV+TB+patients at the end of TB treatment were normalized to the levels observed in healthy controls (TST-) regardless of HAART treatment. However, the concentration level of vitamin A in HIV+TB+patients HAART untreated at the end of TB treatment was not normalized to the levels observed in healthy controls (TST-) or HAART untreated HIV+TST-. CONCLUSION: Detecting serum concentration levels of vitamin B12 and vitamin A might be used as a biomarker of the diagnostic method of active TB regardless of HIV-infected individuals. Moreover, detecting serum concentration of vitamin B12 might also be used for TB treatment responses monitoring biomarker in TB-HIV-co-infected individuals regardless of HAART (in)eligibility and therapy.

Impact of annual preventive mass chemotherapy for soil-transmitted helminths among primary school children in an endemic area of Gurage zone: a prospective cross-sectional study.

BACKGROUND AND AIM: School-based preventive mass chemotherapy has been a key component of Ethiopia's national plan for the control of soil-transmitted helminths. Without an impact evaluation on the impact of a deworming program on infection levels, it is unclear whether the deworming program warrants levels of environmental transmission of infection. This study aimed to determine the impact of annual preventive mass chemotherapy for soil-transmitted helminths among schoolchildren in an endemic area of Gurage zone, south-central Ethiopia. METHODS: A repeated school-based quantitative prospective cross-sectional method was employed. Data were collected from study participants selected using systematic sampling with probability proportional to size at baseline and after annual treatment. Fresh stool samples were collected and processed using the Kato─Katz technique at the Wolkite University parasitology laboratory. SPSS-21 was used for data management and analysis. Changes in parasitological variables after treatment were estimated. RESULTS: Overall, 41.1% prevalence and 22.3% mean geometric infection-intensity reduction were found. Reductions in prevalence of Schistosoma mansoni and hookworms were 13.2% and 15.3%, respectively. Similarly, decreases in prevalence were seen in Ascaris lumbricoides and Trichuris trichiura, representing 94.4% and 80.0% reduction rates, respectively, while 25.9% of the children had heavy S. mansoni (≥400 eggs per gram) infections at baseline, which were reduced to 4.5% after annual treatment. Geometric mean infection intensity-reduction rates for hookworms, A. lumbricoides, and T. trichiura were 80.8%, 20.2%, and 96.7%, respectively. CONCLUSION: Annual mass chemotherapy failed to clear soil-transmitted helminths completely in the present study. However, it resulted in a substantial reduction in overall prevalence and infection intensity. Therefore, other than deworming for school children, interventions such as access to improved personal hygiene and environmental hygiene in school should be emphasized to interrupt transmission.