A qualitative study on cultural bloodletting among Ethiopian immigrants.
(49/1130)
BACKGROUND: Bloodletting is practiced in Ethiopia. Physicians in Israel engaging in transcultural encounters with Ethiopian immigrants are generally unaware of these ethno-medical beliefs and practices. OBJECTIVE: To assess the past and present use of bloodletting among Ethiopian immigrants in Israel. METHODS: We interviewed a sample of 50 adult patients of Ethiopian origin about present and past use of bloodletting. A second consecutive sample of 10 adult patients of Ethiopian origin who often asked their doctors to perform blood tests were identified and interviewed. Data analysis was performed by "immersion-crystallization" analysis. RESULTS: More than half of the interviewed patients reported the use of bloodletting. Scars were commonly present on their upper extremities. A qualitative analysis identified the different reasons for the use of bloodletting, the technique used and its appreciated efficacy. We also found an unexpected cultural synergy between traditional bloodletting and western medical blood sampling. CONCLUSIONS: Some Ethiopian immigrants continue to perform traditional bloodletting in their new country of residency, a practice that local physicians may not be aware of. Bloodletting-type scars on the upper extremities may be common in these patients. Patients may ask for blood sampling as a culturally accepted way to perform bloodletting (synergy). (+info)
Compliance to treatment of latent tuberculosis infection in a region of Israel.
(50/1130)
BACKGROUND: One of the measures adopted in Israel since 1959 as part of the tuberculosis control program was screening children aged 12-13 years old. The screening comprised single-step tuberculin skin testing using the Mantoux method. OBJECTIVES: To assess the efficacy of tuberculin skin screening for TB in schoolchildren in southwestern Israel as well as the compliance to treatment for latent tuberculosis infection. METHODS: We retrospectively reviewed the records of children in the Ashkelon region who underwent a tuberculin skin test during the period 1995-99. RESULTS: Of the 28,016 eligible children, 27,232 were tested. In 923 children, mostly from the former USSR and Ethiopia, an induration of 10 mm or more was found. Only 52 Israeli-born children tested positive. Tuberculosis was found in seven children with a positive test, five of whom were from Ethiopia. All children who tested positive were referred to the local TB clinic; only 266 children (28.8%) presented. Only 151 completed the recommended treatment of isoniazid for 6 months. Thus, although screening included most of the targeted children aged 13, only a third of them presented to a TB clinic, and of these only about half completed treatment for latent infection. CONCLUSIONS: Our results indicate that the current policy of screening for latent TB in our region is ineffective in terms of implementation of the recommended treatment. We suggest that only high risk groups be screened, and that a concerted effort be made to implement treatment. (+info)
A controlled estimate of the risk of HIV infection in Ethiopian children with tuberculosis.
(51/1130)
To quantify the risk of human immunodeficiency virus (HIV) infection in children with tuberculosis (TB) a hospital-based, 1-year prospective, case-control study was performed in Addis Ababa, Ethiopia. Children with TB were compared to a control group of children admitted for elective surgery. The control group was also compared to a recent census of the background population. The crude odds ratio for HIV infection was 8.6 (95 % CI 2.2-73). After adjustment for possible confounders in a multivariate regression model, the odds ratio for HIV infection in children with TB was found to be 12.7 (95% CI 2.9-55). Of several independent determinants of TB assessed in the study, this association was the strongest. Until HIV transmission has reached its peak, an increasing burden of dual infection among Ethiopian children is to be expected. (+info)
Pattern and associated factors of the neurolathyrism epidemic in Ethiopia.
(52/1130)
OBJECTIVES: To describe the neurolathyrism epidemic in Ethiopia and to identify associated household factors. METHODS: We interviewed 589 randomly selected heads of household in Debre Sina district of Ethiopia, the area afflicted by the recent neurolathyrism epidemic. Disease information was obtained for 2987 family members. RESULTS: Neurolathyrism patients were detected in 56 (9.5%) households (prevalence rate 2.38%). The mean number of affected family members per household was 1.27 (SD 0.65, range 1-3). Most (77.5%) patients developed the disability during the epidemic (1995-1999). The median age at onset of paralysis was 11 years with a range of 41 (range 3-44). Younger people were more affected during the epidemic than during the non-epidemic period (P=0.01). The presence of a neurolathyrism patient in the family was associated with illiteracy [adjusted OR (95% CI)=2.23 (1.07-5.10)] of the head of household, with owning a grass pea farm [adjusted OR (95% CI)=2.01 (1.04-3.88)] and with the exclusive cooking of grass pea foods using handmade traditional clay pots [adjusted OR (95% CI=2.06 (1.08-3.90)]. CONCLUSION: Males aged 10-14 years were most affected by neurolathyrism. Increased household risk was associated with illiteracy of the head of the household and exclusive cooking of grass pea foods with handmade traditional clay pots. (+info)
Functional analysis of six different polymorphic CYP1B1 enzyme variants found in an Ethiopian population.
(53/1130)
Cytochrome P450 1B1 (CYP1B1) is an extrahepatic enzyme of potential importance for the metabolism of estrogen and for metabolic activation of environmental carcinogens. We investigated an Ethiopian population for functional polymorphisms in the CYP1B1 gene using genomic DNA sequencing and detected three novel single nucleotide polymorphisms (SNPs). One of these (4360C-->G in exon 3) is present at a frequency of 7% and causes an Ala443Gly amino acid substitution. In addition, the four described previously missense mutations Arg48Gly, Ala119Ser, Leu432Val, and Asn453Ser were found with frequencies of 51, 50, 53, and 2%, respectively, yielding a total of 32 possible CYP1B1 haplotypes. Allele-specific PCR methods for haplotype analysis were developed and seven different CYP1B1 alleles were found: CYP1B1*1, *2, *3, *4, *5, *6, and *7 with frequencies of 8, 37, 39, 2, 0.7, 6, and 7%, respectively. The functional properties of different forms of CYP1B1, as well as of the Leu432Val + Asn453Ser and Leu432Val + Ala443Gly variants, were evaluated after heterologous expression of the corresponding cDNAs in Saccaromyces cerevisiae. The results revealed that CYP1B1.6 and CYP1B1.7, having the amino acid substitutions Arg48Gly, Ala119Ser, and Leu432Val in common, exhibited altered kinetics with significantly increased apparent K(m) and lowered V(max) values for both the 2- and 4-hydroxylation of 17 beta-estradiol, whereas the other constructs were indistinguishable from the CYP1B1.1 enzyme. The results emphasize the necessity of a complete haplotype analysis of enzyme variants for evaluation of functional consequences in vivo and for analyses of genetic polymorphisms in relation to, for example, cancer incidence. (+info)
The use of armspan measurement to assess the nutritional status of adults in four Ethiopian ethnic groups.
(54/1130)
OBJECTIVES: To investigate the use of armspan as a proxy for height in the assessment of nutritional status using body mass index (BMI) for four ethnic groups in Ethiopia. DESIGN: Cross-sectional study. SETTING: Four regions in Ethiopia, namely Oromia, Amhara, Tigre and Somali Region. SUBJECTS: A total of 1706 (884 males and 822 females) Ethiopians aged 18-50 y from four different ethnic groups. METHODS: Anthropometric measurements (weight, height and armspan) were obtained using standard techniques. BMI using height (BMI-ht) and using armspan (BMI-as) were calculated, t-tests were used to compare means, and linear regression to investigate the relationship between BMI-ht and BMI-as. RESULTS: Ethnic and sex differences in the relationship between height and armspan, and their derived variables (BMI-ht and BMI-as), were found. Armspan and height (r=0.83-0.9), and BMI-ht and BMI-as (r=0.89-0.97), were highly correlated in all ethnic groups. BMI-as cut-offs equivalent to the conventional BMI-ht classification of chronic energy deficiency were similar in the Oromo, Amhara and Tigre, but substantially higher in the Somalis. CONCLUSION: Armspan can be used as a proxy for height to estimate BMI, but the relationship between the two measures varies considerably with ethnicity and sex. Unless sex- and ethnicity-specific cut-offs are applied, the use of BMI-as using conventional cut-offs will overestimate the prevalence of underweight in these populations. SPONSORSHIP: HelpAge International. (+info)
Dietary intake in the third trimester of pregnancy and birth weight of offspring among nonprivileged and priviledged women.
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The dietary intake during the third trimester of pregnancy among 20 nonprivileged and 10 privileged primigravidae in Addis Ababa was studied in a 2 day weighting inventory survey. With the exception of iron and thiamin, the nonprivileged group consumed a diet that was deficient in all nutrients, with an average daily protein and energy intake below 60% of the FAO/WHO Recommendations. The privileged group was found to meet the recommendations for all nutrients except for calcium and riboflavin. Infants born to the nonprivileged women had significantly lower mean birth weight when compared with the infants born to the privileged women. (+info)
Molecular epidemiology and drug resistance of Mycobacterium tuberculosis isolates from Ethiopian pulmonary tuberculosis patients with and without human immunodeficiency virus infection.
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We have analyzed the molecular epidemiology and drug resistance of 121 Mycobacterium tuberculosis isolates from consecutive patients with culture-positive pulmonary tuberculosis attending a university hospital outpatient department in Addis Ababa, Ethiopia. Restriction fragment length polymorphism analysis and spoligotyping were used to analyze the DNA fingerprinting patterns. Fifty-one (41.2%) of the isolates were found in 13 clusters with two or more identical DNA patterns. Two such clusters contained 49.0% of all clustered isolates. In a multivariate logistic regression model, human immunodeficiency virus (HIV)-positive serostatus was significantly associated with clustering of isolates for patients of both sexes (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.17 to 5.80). There was a trend toward increased clustering of isolates from tuberculous women residing in Addis Ababa (OR, 2.10; 95% CI, 0.85 to 5.25). In total, 17 of 121 isolates (14.0%) were resistant to one or more of the antituberculosis drugs isoniazid (8.3%), streptomycin (7.4%), rifampin (2.5%), and ethambutol (1.7%). The high rate of drug-resistant isolates (29.6%) coincided with the peak prevalence of HIV infection (77.8%) in patients 35 to 44 years old. The majority (62.5%) of resistant isolates in this group were found within clusters. The simultaneous accumulation of certain bacterial clones in a patient population likely reflects recent transmission. Hence, we conclude that tuberculosis is commonly caused by recent infection with M. tuberculosis in HIV-positive Ethiopian patients. Furthermore, with the rapidly increasing prevalence of HIV infection in Ethiopia, the burden of tuberculosis, including drug-resistant tuberculosis, is likely to increase. Strengthening of classical tuberculosis control measures by promoting active case finding among HIV-positive adults with tuberculosis is warranted to reduce rates of transmission. (+info)