The diagnostic accuracy of mean platelet volume in differentiating immune thrombocytopenic purpura from hypo-productive thrombocytopenia: A systematic review and meta-analysis.

BACKGROUND: Thrombocytopenia is defined as a decreased number of platelets in the circulating blood as a result of hypo-proliferation in marrow or peripheral destruction of platelets. Several diagnostic methods have been proposed to discriminate the underline cause of thrombocytopenia. Recent studies showed that mean platelet volume (MPV) could be used for differential diagnosis of immune thrombocytopenic purpura (ITP). Thus, we aimed to investigate the diagnostic accuracy of MPV for differential diagnosis of ITP from hypo-productive thrombocytopenia. METHODS: This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (PRISMA). The study protocol was registered on PROSPERO with the reference number CRD42023447789. Relevant published studies that were published up to April 10, 2023, in peer-reviewed journals were searched on electronic different databases. The methodological quality of the included studies was appraised using the quality assessment of diagnostic accuracy studies 2 (QADAS-2) tool. The pooled weight mean difference (WMD) of MPV between the ITP group and hypo-productive group was analyzed using a random-effects model meta-analysis. Relevant data were extracted using a Microsoft Excel spreadsheet and analyzed using STATA 11.0 and Meta-disc 1.4 software. Publication bias was evaluated using Deek's funnel plot asymmetry test. RESULTS: A total of 14 articles were included in this systematic review and meta-analysis. The comparison of MPV between groups revealed that the pooled mean value of MPV increased significantly in ITP patients compared to patients with hypo-productive thrombocytopenia (WMD = 2.03; 95% CI, 1.38-2.69). The pooled sensitivity and specificity of MPV in differentiating ITP from hypo-productive thrombocytopenia were 76.0% (95% CI: 71.0%, 80.0%) and 79.0% (95% CI: 75.0%, 83.0%), respectively. The summary positive likelihood ratio (PLR) and negative likelihood ratio (NLR)using the random effects model were 3.89 (95% CI: 2.49, 6.10) and 0.29 (95% CI: 0.18, 0.46), respectively. CONCLUSION: MPV can be used to discriminate ITP from hypo-productive thrombocytopenia. It can possess large advantages as it is noninvasive, simple, quick, inexpensive, easy to perform, reliable, and routinely generated by automated cell counters.

The association of ABO and Rhesus blood groups with the occurrence of type 2 diabetes mellitus: A comparative cross-sectional study.

Type 2 diabetes mellitus (DM) is a chronic metabolic disorder characterized by elevated levels of glucose in circulation which result from insufficient insulin or insulin resistance. The blood group of an individual is thought to be genetically predetermined and plays a vital role in increasing susceptibility to DM for particular blood groups. Therefore, this study aimed to determine the association between ABO and Rhesus blood groups with type 2 DM. A comparative cross-sectional study was conducted on 326 participants (163 type 2 DM patients and 163 age and sex-matched healthy individuals). Socio-demographic data were collected using a semi-structured questionnaire while Clinical data were extracted from the patient chart. A blood sample was collected from each study participant for ABO and Rhesus blood grouping. Chi-square test, bivariable, and multivariable logistic regression analysis were employed to indicate the association between different blood group types and type 2 DM. The current result showed that blood group O had the highest frequency among all study participants followed by blood groups B, A, and AB. Blood groups B and A were more common in the type 2 DM group compared with the control group while blood groups O and AB were more frequent in the control group. A chi-square test indicated that the ABO blood group had a significant association with type 2 DM while the Rhesus blood group was not associated with type 2 DM. Moreover, logistic regression analysis showed that B and O blood groups had a significant association with type 2 DM while A and AB blood groups had no association. The findings of this study indicated that type 2 DM has an association with the ABO blood group and has no association with the Rhesus blood group. Individuals with blood group B have a higher risk of developing T2DM (type II DM) as compared to other ABO blood groups.

Prevalence, Antimicrobial Drug Resistance and Associated Risk Factors of Streptococcus Pneumoniae Bacteria Infection Among Under-Five Children With Acute Lower Respiratory Tract Infection Attending Sheik Hassan Yebere Referral Hospital, Jig-Jiga, Ethiopia.

Background: Pneumonia is inflammation of the lung. The Streptococcus pneumoniae (S. pneumoniae) is commensal in the upper airway and can cause infection to under-five children. The bacteria is gram-positive diplococci, catalase negative, and optochin sensitive. The bacteria is the leading cause of bacterial pneumonia among under-five children. No similar data is reported from the current study area. Objective: To determine prevalence, antimicrobial drug resistance and associated factors of S. pneumoniae infection among under-five children with acute lower respiratory tract infection attending Sheck Hassan Yebere Referral Hospital from March 1 to April 30, 2021 Jig-Jiga, Ethiopia. Methods: A cross-sectional study was conducted among 374 study participants selected by convenience sampling method. A structured questionnaire was used to collect child data. Nasopharyngeal/oropharyngeal swabs were collected and diagnosed to isolate S. pneumoniae by using culture then identified by biochemical examination. Later antimicrobial drug resistance testing was performed by Kirby-Bauer disk diffusion method. All data were entered on epi-data 3.1 then exported to SPSS version 22 to calculate analysis. Statistically significant value was found by calculating an adjusted odds ratio with p-value ≤ 0.05 in a multivariate logistic regression model. Results: Among 374 under-five children, 180 (48.1%) were males and 109 (29.2%) were from low income families. The overall prevalence of S. pneumoniae infection in the study was 18% (95% CI 14.4-22.2). No window (AOR=2.8 CI 1.1-7.6), no/non-exclusive breast-feeding (AOR= 2.1 CI 1.1-4.1), and previous URTI (AOR= 3.2 CI 1.7-6.1) were significantly associated with S. pneumoniae infection. The isolated organism showed drug resistance for Cotrimoxazole (35%), and Tetracycline (34%). Conclusion: The prevalence and antimicrobial resistance in this study were comparatively high. No window, non-exclusive breast-feeding and previous URTI were associated with S. pneumoniae infection. The isolated S. pneumoniae showed high drug resistance to cotrimoxazole and tetracycline.

Antimicrobial Resistance Profile and Associated Factors of Group B Streptococci Colonization among Pregnant Women Attending Antenatal Clinics in Jigjiga, Southeast Ethiopia.

Background: Streptococcus agalactiae (group B Streptococcus, GBS) is one of the causes of maternal and neonatal morbidity and mortality in many parts of the world. It is associated with severe maternal and neonatal outcomes. The colonization rate, associated factors, and antimicrobial sensitivity (AST) profile of GBS among pregnant women in Eastern Ethiopia is less studied. Methods: A cross-sectional study was conducted from 1st March to 30th May, 2021 in Jigjiga. A total of 182 pregnant women with a gestational period of ≥36 weeks were included. A structured questionnaire was used to collect data on the participants' demographic and clinical history. Vaginal-rectal samples were collected by brushing the lower vagina and rectum with a sterile cotton swab for bacteriological culture. An antimicrobial sensitivity test (AST) was performed using the Kary-Bauer disk diffusion method. Data were entered and analyzed using SPSS version 25. The logistic regression model was used to find out factors associated with GBS colonization. Results: GBS colonization among pregnant women attending antenatal care was at 15.9% (29/182). The AST result showed that the majority of the isolates were sensitive to vancomycin (96.6%), chloramphenicol (96.6%), ampicillin (93.1%) azithromycin (89.7%), and penicillin (86.2%). In contrast, the isolates were found to be resistant to ceftriaxone, erythromycin, ciprofloxacin, clindamycin, and tetracycline at 17.2%, 20.7%, 27.6%, 27.6%, and 34.5%, respectively. Multidrug resistance (MDR) was noted in 4 isolates (13.79%). GBS colonization was significantly associated a with history of preterm labor (<37 weeks of gestation) (AOR = 3.87, 95% CI = 1.36-10.9) and a history of prolonged ruptured membrane (>18 hr.) (AOR = 3.44, 95% CI = 1.34-8.83). Conclusions: The colonization rate of GBS was considerably high among pregnant women attending antenatal care in the present study area. The observed antimicrobial resistance for the common drugs and the reported MDR level calls for routine screening of pregnant women for GBS and actions to minimize antimicrobial resistance (AMR) should be strengthened.

Risk factors of induced abortion among preparatory school student in Guraghe zone, Southern region, Ethiopia: a cross-sectional study.

BACKGROUND: Induced abortion is a common undergo in many societies of the world. Every year, around 20 million unsafe abortions are done worldwide. From fragmented studies conducted in Ethiopia, the prevalence of induced abortion and its adverse effects are increasing over time. The aim of this study was to assess factors associated with induced abortion among female preparatory school students in Guraghe zone. METHODS: A cross-sectional study was conducted among female students of preparatory schools in April 2017. Systematic random sampling technique was employed to select 404 students from the total of 3960 female preparatory school students in the study area. Data was collected through self-administered questionnaires. Descriptive summary, binary and multivariate analyses were underwent to identify factors associated with induced abortion. The study was ethically approved by institutional review board of Wolkite University. RESULTS: The response rate of this study was 98.3%. The lifetime prevalence of induced abortion among young preparatory schools students whose age range from 15 to 22 years was 13.6% [95% CI (10.4, 17.1)]. The odds of induced abortion undergo was 2.3 times more likely in rural family residents [AOR = 2.3, 95% CI (1.1, 4.8)] as compared to that of urban family residents. Students without sexual health education were 6.4 times more likely to undergo induced abortion as compared to those who got sexual health education at sc0000hool [AOR = 6.4, 95% CI (3.1, 13.1)]. Furthermore, students who drank alcohol often were 4 times [AOR = 4.0, 95% CI (1.1, 14.2)] more likely to undergo induced abortion and students who consumed alcohol sometimes had 3.3 times [AOR: 3.3, 95%CI (1.4, 8.1)] the risk of induced abortion compared with girls with no history of alcohol consumption. CONCLUSION: A high lifetime prevalence of induced abortion among young adolescent was observed. Being rural residence, not having reproductive health education, and alcohol consumption were found to be independent predictors of induced abortion undergo. Therefore, IEC/BCC programs with special emphasis on youth friendly sexual and reproductive health services should be strengthened to reduce induced abortion.

The Relative Contribution of Symptomatic and Asymptomatic Plasmodium vivax and Plasmodium falciparum Infections to the Infectious Reservoir in a Low-Endemic Setting in Ethiopia.

Background: The majority of Plasmodium vivax and Plasmodium falciparum infections in low-endemic settings are asymptomatic. The relative contribution to the infectious reservoir of these infections compared to clinical malaria cases is currently unknown. Methods: We assessed infectivity of passively recruited symptomatic malaria patients (n = 41) and community-recruited asymptomatic individuals with microscopy-detected (n = 41) and polymerase chain reaction (PCR)-detected infections (n = 82) using membrane feeding assays with Anopheles arabiensis mosquitoes in Adama, Ethiopia. Malaria incidence and prevalence data were used to estimate the contributions of these populations to the infectious reservoir. Results: Overall, 34.9% (29/83) of P. vivax- and 15.1% (8/53) P. falciparum-infected individuals infected ≥1 mosquitoes. Mosquito infection rates were strongly correlated with asexual parasite density for P. vivax (ρ = 0.63; P < .001) but not for P. falciparum (ρ = 0.06; P = .770). Plasmodium vivax symptomatic infections were more infectious to mosquitoes (infecting 46.5% of mosquitoes, 307/660) compared to asymptomatic microscopy-detected (infecting 12.0% of mosquitoes, 80/667; P = .005) and PCR-detected infections (infecting 0.8% of mosquitoes, 6/744; P < .001). Adjusting for population prevalence, symptomatic, asymptomatic microscopy-detected, and PCR-detected infections were responsible for 8.0%, 76.2%, and 15.8% of the infectious reservoir for P. vivax, respectively. For P. falciparum, mosquito infections were sparser and also predominantly from asymptomatic infections. Conclusions: In this low-endemic setting aiming for malaria elimination, asymptomatic infections were highly prevalent and responsible for the majority of onward mosquito infections. The early identification and treatment of asymptomatic infections might accelerate elimination efforts.