African health sciences最新文献

Background: Increase in antimicrobial resistance poses a global threat for treatment of Salmonellosis.

Objectives: In this study, serovar distribution, antimicrobial susceptibility, resistance genes, and clonal diversity were characterized in clinical Salmonella isolates.

Methods: In this study, serovar distribution of clinical Salmonella isolates was characterized by the Kauffman-White scheme. The antimicrobial susceptibility was determined by the broth microdilution method. Resistance genes and clonal diversity were investigated by PCR and PFGE.

Results: The serovars were Salmonella enterica serovar Enteritidis (n=92), Salmonella enterica serovar Typhimurium (n=14), and others (n=25). Resistance to ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole, azithromycin, meropenem, and colistin were 13.3%, 2.2%, 5.2%, 3.0%, 0%, 29.6%, respectively. Two ESBL-positive isolates carried TEM-type β-lactamases. Carbapenemases, mcr-1 and mcr-2 could not be detected. Colistin-resistant S. Enteritidis isolates were grouped in 4 pulsotypes [A1 (n=12), A2 (n=2), A3 (n=13) and B (n=1)]. All except one (B) were found closely related.

Conclusions: A relative decrease in resistance to trimethoprim-sulfamethoxazole was detected with time. Trimethoprim-sulfamethoxazole and azithromycin can be good alternatives to the widely-used ciprofloxacin and third-generation cephalosporins. High resistance of colistin and ciprofloxacin may be due to the extensive use of antibiotics in poultry, which highlights the significance of one health concept.

Background: To evaluate the efficacy and safety of apatinib plus tenozolomide in the treatment of recurrent malignant brain glioma.

Methods: A retrospective analysis of 108 patients with recurrent malignant brain glioma was conducted at our hospital. Out of these, 54 patients received apatinib plus tenozolomide as combination therapy (Combination group) while the remaining 54 were treated with temozolomide alone (Control group). Clinical data was collected and analyzed to compare the treatment efficacy and incidence of adverse reactions between the two groups. Additionally, patient survival and progression-free survival (PFS) were monitored and recorded.

Results: The study evaluated the efficacy of a treatment among patients who completed it. The Combination group had a higher objective response rate (ORR) and disease control rate (DCR) compared to the Control group. Treatment-related adverse reactions were mostly grade I-II and improved with symptomatic treatment. The Combination group had higher incidence rates of hypertension, proteinuria, and hand-foot syndrome. Follow-up results showed that the Combination group had a significantly better overall survival (OS) and progression-free survival (PFS) than the Control group.

Conclusion: Compared with temozolomide alone, apatinib plus tenozolomide can significantly improve the clinical efficacy in treating recurrent malignant brain glioma, prolong the survival of patients and produce tolerable adverse reactions.

Background and objective: Even though the pathogenesis of vitiligo is still unclear, recent studies have suggested that miRNAs can contribute to the occurrence and progression of the disease. The aim of the present study was to investigate the associations between SNPs of miRNA processing genes and their expression levels with vitiligo susceptibility.

Methods: 55 patients and 56 controls were investigated for Dicer, Drosha, and DGCR8 gene expressions and genotyped for Drosha rs493760, DGCR8 rs1640299, and Dicer rs1057035 by real-time PCR. The correlation of the expression levels of these three genes was analyzed. The ROC curve was used to analyze their diagnostic efficacy for vitiligo.

Results: The current findings showed that the Dicer CT genotype was more frequent in vitiligo (p=0.046) compared to controls, while Drosha and DGCR8 polymorphisms did not show significant associations. The relative expression levels of the three genes in vitiligo patients were significantly lower than those in the control group (p<0.05). The areas under the curves for Drosha, DGCR8, and Dicer were 0.969, 0.66, 0.67.

Conclusions: For the first time, we demonstrate that the Dicer rs1057035 polymorphism is associated with vitiligo susceptibility, and the downregulation of Drosha, DGCR8, and Dicer suggests their potential roles as biomarkers in the pathogenesis of vitiligo.

Background: To compare and analyze the clinical efficacy and safety of Three-dimensional (3D) laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in the treatment of obesity complicated with type 2 diabetes mellitus (T2DM).

Methodology: A total of 132 T2DM patients were divided into LSG group (n=66) and LRYGB group (n=66). The operation time, time of postoperative gastrointestinal function recovery, postoperative hospital stay, and incidence rate of complications were compared. The glucolipid metabolism indexes [fasting plasma glucose (FPG), fasting insulin (FINS), fasting C-peptide (FCP), glycated hemoglobin A1c (HbA1c)], body weight and nutritional status [body mass index (BMI), hemoglobin (Hb)], insulin function and insulin resistance were recorded. Short-from 36 (SF-36) questionnaire was also conducted.

Results: LSG group had shorter operation time, less blood loss, and quicker postoperative recovery than LRYGB group. Both groups showed significant improvements in BMI, FBG, FINS, FCP, HbA1c, and HOMA-IR. After 12 months, LRYGB group had significantly higher scores in physical function, general health, vitality, role emotional, and mental health in SF-36 questionnaire compared to LSG group. Compared with LRYGB group, LSG group had significantly decreased operation time, reduced intraoperative blood loss, and shortened postoperative off-bed time. BMI, FBG, FINS, FCP, HbA1c and HOMA-IR all markedly declined in the two groups after operation. At 12 months after operation, the scores of physical function, general health, vitality, role emotional and mental health in the SF-36 questionnaire were all remarkably higher in LRYGB group than those in LSG group.

Conclusion: LSG can be used to treat obesity complicated with T2DM, which is characterized by simple operation, small trauma and quick postoperative recovery.

Background: Addressing nursing resource challenges in obstetrics and gynecology, this study employs decision tree analysis within nursing vertical management to enhance allocation efficiency and patient care. This study aimed to assess the efficacy of employing decision tree analysis within nursing vertical management for allocating obstetrics and gynecology nurses.

Methodology: Sixty-one obstetrics and gynecology nurses were included in the study from January to December 2022 at our hospital. The control group, from January to June 2022, underwent routine nurse allocation management, while the observation group, from July to December 2022, experienced nurse allocation based on nursing vertical management using decision tree analysis. Nursing quality scores and satisfaction with allocation were statistically compared between the groups. Additionally, obstetrics and gynecology nursing level, illness matching rate, nursing quality scores, and patient satisfaction were evaluated.

Results: The observation group showed significantly higher nursing quality scores and greater satisfaction with allocation compared to the control group. Moreover, the observation group exhibited higher obstetrics and gynecology nursing levels, illness matching rates, nursing quality scores, and patient satisfaction compared to the control group, all with statistical significance (P<0.05).

Conclusions: Implementing the decision tree analysis method within nursing vertical management notably enhanced both satisfaction levels and the quality of care among obstetrics and gynecology nurses. It outperformed traditional deployment management, ensuring improved nursing work quality and heightened patient satisfaction. This approach is pivotal for fostering harmonious nurse-patient relationships and deserves widespread adoption.

Background: NCDs risk behaviours are modifiable and particularly patterned during adolescence. This study assessed the prevalence and sociodemographic predictors of multiple NCDs risk behaviours among in-school adolescents.

Methods: A cross-sectional study design was employed to assess the simultaneous occurrence of NCD risk behaviours among a random multistage sample of 607 participants. Data was collected using an interviewer-administered semi-structured questionnaire. Bivariate and multivariate analysis was carried using the IBM SPSS version 22 software.

Results: The mean age of the study participants was 14.7 (SD = 1.52) years. The prevalence of two and at least three co-occurring NCDs risk behaviours among the study participants 46.1 % (n=280) and 16.6 % (n = 101). Increasing age (AOR=1.84; 95% CI: 1.11 - 3.05), male sex (AOR=1.75; 95% CI: 1.28 - 2.82) and being an urban resident (AOR=1.41; 95% CI: 1.06 - 2.86) were predictors of at least three co-occurring NCDs risk behaviours.

Conclusion: The prevalence of multiple NCDs risk behaviours was relatively high among the study participants. This calls for urgent implementation of interventions at all ecological levels that will equip in-school adolescents with the skills to adopt healthy lifestyles and choices.

Background: Vitamin D plays a role in numerous metabolic functions. In this study we aimed to assess vitamin D levels in Hashimoto's Thyroditis (HT) patients, and demonstrate the relationship between these levels and thyroid function tests or thyroid autoantibodies.

Methods: A retrospective analysis of 112 newly diagnosed euthyroid HT (EHT) patients and 178 healthy controls was carried out. 25-OH D level was classified as vitamin D deficiency, vitamin D insufficiency, and vitamin D sufficient.

Results: Mean age was 35.33±11.54 years in the patient group, and 35.84±10.9 in the control group (p=0.777). Compared with the healthy controls, patients in the EHT group had significantly lower vitamin D levels (p=0.007), and a significantly higher prevalence of vitamin D deficiency (p=0.001). While there was a negative correlation between vitamin D levels and anti-TPO values (r=-0.133, p=0.023), there was no significant relationship between vitamin D and TSH, fT4, fT3, and anti-TG values (p>0.05).

Conclusıons: This study showed that EHT patients had lower vitamin D levels compared to healthy controls, and there was a significant negative correlation between vitamin D levels and anti-TPO levels. Based on our study, patients diagnosed with HT should undergo vitamin D screening, and replacement if necessary.

Background: Hypertension self-management practices have proven beneficial in controlling blood pressure and preventing complications as part of the chronic care model. However, these practices among older persons 50 years and above have not been well evaluated in sub Saharan Africa despite the emerging hypertension burden in the region.

Objective: The study determined adherence to hypertension self-management practices and factors associated with good adherence among older persons attending the Non-Communicable Diseases clinic in rural Eastern Uganda.

Methods: In a facility-based cross-sectional study, individuals 50 years and above were selected consecutively from the bi-weekly hypertension out-patient clinic from January-February 2023. The adopted Hypertension Self-Care Activity Level Effects (H-SCALE) questionnaire was used to assess adherence to the self-management practices. The generalised linear model was used to determine predictors of adherence to the self-management practices.

Results: Of the 74 hypertensive patients, level of adherence to the hypertension self-management practices of atleast 4 out of the 6 practices was 27 (36.5%). Adherence to diet, weight management, medication adherence, aerobic physical activity, non-smoking and recommended alcohol intake was 0(0%), 23(31.1%), 33(44.6%), 37(50.0%), 67 (90.5%) and 74(100%) respectively. Being married and having hypertension for less than 4 years were associated with good adherence p-value 0.01 and 0.03 respectively.

Conclusions: Social factors like marriage and duration with hypertension were associated with better adherence to hypertension self-management practices. We recommend better implementation of the chronic care model to improve hypertension control in the community.

Background: Antibiotic resistance continues to be a threat to public health worldwide, with its associated increased healthcare costs and loss of human lives. Despite the increasing reports of multi-drug resistant (MDR) Klebsiella pneumoniae (K. pneumoniae), its prevalence and resistance patterns remain under-reported in several developing countries, including Ghana.

Objectives: This study hence sought to investigate the prevalence and resistance patterns of K. pneumoniae isolates from five selected hospitals in the Ashanti region of Ghana.

Methods: K. pneumoniae isolates were identified using biochemical tests, API 20 E and Matrix Assisted Laser Desorption Ionisation-Time of Flight Mass Spectrometry (MALDI-TOF MS). AST and ESBL production were determined phenotypically and via PCR.

Results: Twenty (20) K. pneumoniae isolates were confirmed from the samples. The isolates were resistant to ampicillin (100%), ciprofloxacin (76.67%), co-trimoxazole (75%), chloramphenicol (63.33%) and cephalosporins (76.67 to 55%). Eighteen of the K. pneumoniae isolates (90%) were multi-drug resistant (MDR) while 60% of the isolates (n=12) produced Extended Spectrum Beta-Lactamases (ESBL) with blaCTX-M, blaSHV and blaTEM β-lactamase resistant encoding genes confirmed in 83, 75 and 33% of the isolates respectively.

Conclusion: There is low prevalence but high multidrug resistance and high production of ESBL among K. pneumoniae isolates from the selected hospitals.