Prevalence of tuberculosis treatment non-adherence in Ethiopia: a systematic review and meta-analysis.

Non-adherence to treatment is one of the challenges facing global tuberculosis (TB) control. In Ethiopia, an extremely variable and high magnitude of TB treatment non-adherence have been reported from different parts of the country. However, there has been no attempt to estimate the pooled prevalence of non-adherence from this heterogeneous data. To review the available literature and estimate the overall prevalence of treatment non-adherence among patients with TB on first-line treatment in Ethiopia. A systematic review and meta-analysis of published articles on TB treatment non-adherence. We included 26 studies, which contained data on 37 381 patients with TB. The crude prevalence of non-adherence reported by the studies included was extremely variable (range 0.2-35%). The overall pooled estimate of non-adherence prevalence was 10.0% (95%CI 8.0-11.0). The pooled prevalence of patients lost to follow-up alone was 5.0% (95%CI 4.0-6.0), while the pooled prevalence of intermittent non-adherence was 20.0% (95%CI 15.0-25.0). The rate of TB treatment non-adherence in Ethiopia remains too high to achieve target treatment success rates and prevent drug resistance. Implementing an effective patient retention scheme, along with the DOTS strategy, is critical to improving treatment adherence and preventing drug resistance. .

Effects of post-mortem delay on subunits of ionotropic glutamate receptors in human brain.

The effect of post-mortem delay on the stability of the protein subunits that combine to form NMDA and AMPA type glutamate receptors has been assessed in samples of human brain tissue. While most of the subunits (i.e. GluR1, GluR2/3, GluR4, NR1) appear to be stable for up to 18 h post-mortem, the NR2A and NR2B subunits appear to be proteolyzed rapidly following death. These results are consistent with the concept that the proteolytic products of NR2A and NR2B, although at smaller molecular sizes than the full-length protein, are all identifiable on Western blots. Thus, a method is proposed that allows for the estimation of the levels of these labile proteins even in samples obtained up to 18 h post-mortem. Using this method we have estimated the levels of all AMPA and NMDA receptor subunits in selected (i.e. hippocampus, frontal and entorhinal cortex) brain tissue samples obtained from control patients and patients who have died with Alzheimer's disease. Modest decreases in NMDA receptor subunits NR1, NR2A, and NR2B were found in the hippocampus and in frontal cortex while little or no change in any of these subunits were documented in entorhinal cortex. Subunits for AMPA receptors (GluR1, GluR2/3, and GluR4) appeared to show a generalized decrease in all these tissues. As a surrogate marker for overall decreases due to generalized neuronal cell death, levels of neuron-specific enolase were measured in all tissues and were found to be nearly identical in control and Alzheimer's brains.