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Abdu Y, Ahmed K, Ibrahim MIM, Abdou M, Ali A, Alsiddig H, Selim NA, Yassin MA. Perception of consanguineous marriage among the qatari population. Front Public Health 2023; 11:1228010. [PMID: 37601216 PMCID: PMC10436573 DOI: 10.3389/fpubh.2023.1228010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/10/2023] [Indexed: 08/22/2023] Open
Abstract
Background Hereditary blood diseases are widespread among the Arab population due to the high rates of consanguineous marriages; research regarding the perception of consanguineous marriage in some countries, such as Qatar, is extremely scarce. Therefore, this study aimed to investigate the prevalence of consanguineous marriage and assess the perception of consanguineous marriage among the Qatari population. Methods A cross-sectional study used a self-administered questionnaire among 395 Qatari adults aged 18-35 who attended primary healthcare institutions in Qatar. A convenience sampling technique was used to select the study participants. An independent t-test was used to compare the significance of the mean between the two groups with positive and negative perceptions of consanguineous marriage. Categorical data were analyzed for association using the chi-square or Fisher's exact test. Finally, a multiple logistic regression analysis was conducted to determine the significant predictors of the positive perception of consanguineous marriage. A significant level was set at p < 0.05. Results Approximately 45% of the participants had a positive perception toward consanguineous marriage, and the most common reason stated by those participants was "habit and traditions." The prevalence of consanguineous marriage among married couples was 62.6%, and among those with consanguineous marriage, most were married to first cousins (81.7%). Moreover, compared to the participants with negative perceptions of consanguineous marriage, those with positive ones were significantly older, married, with lower educational levels and higher monthly income levels, did not hear about glucose-6-phosphate dehydrogenase (G6PD) deficiency, did not know what kinds of diseases are being screened in the premarital test, and were married to a relative. Conclusion The prevalence of consanguineous marriage is high among the Qatari population, and this requires an immediate need for community-based campaigns to raise public awareness about the problem and its potential impact.
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Affiliation(s)
- Yasamin Abdu
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Khalid Ahmed
- Department of Hematology, NCCCR, Hamad Medical Corporation, Doha, Qatar
| | | | - Mariam Abdou
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Arwa Ali
- College of Medicine and Surgery, University of Bahri, Khartoum, Sudan
| | | | - Nagah A. Selim
- Community Medicine Department, Primary Health Care Corporation, Doha, Qatar
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2
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Yamada S, Yassin MA, Torelli F, Hansmann J, Green JBA, Schwarz T, Mustafa K. Unique osteogenic profile of bone marrow stem cells stimulated in perfusion bioreactor is Rho-ROCK-mediated contractility dependent. Bioeng Transl Med 2023; 8:e10509. [PMID: 37206242 PMCID: PMC10189446 DOI: 10.1002/btm2.10509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 03/19/2023] Open
Abstract
The fate determination of bone marrow mesenchymal stem/stromal cells (BMSC) is tightly regulated by mechanical cues, including fluid shear stress. Knowledge of mechanobiology in 2D culture has allowed researchers in bone tissue engineering to develop 3D dynamic culture systems with the potential for clinical translation in which the fate and growth of BMSC are mechanically controlled. However, due to the complexity of 3D dynamic cell culture compared to the 2D counterpart, the mechanisms of cell regulation in the dynamic environment remain relatively undescribed. In the present study, we analyzed the cytoskeletal modulation and osteogenic profiles of BMSC under fluid stimuli in a 3D culture condition using a perfusion bioreactor. BMSC subjected to fluid shear stress (mean 1.56 mPa) showed increased actomyosin contractility, accompanied by the upregulation of mechanoreceptors, focal adhesions, and Rho GTPase-mediated signaling molecules. Osteogenic gene expression profiling revealed that fluid shear stress promoted the expression of osteogenic markers differently from chemically induced osteogenesis. Osteogenic marker mRNA expression, type 1 collagen formation, ALP activity, and mineralization were promoted in the dynamic condition, even in the absence of chemical supplementation. The inhibition of cell contractility under flow by Rhosin chloride, Y27632, MLCK inhibitor peptide-18, or Blebbistatin revealed that actomyosin contractility was required for maintaining the proliferative status and mechanically induced osteogenic differentiation in the dynamic culture. The study highlights the cytoskeletal response and unique osteogenic profile of BMSC in this type of dynamic cell culture, stepping toward the clinical translation of mechanically stimulated BMCS for bone regeneration.
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Affiliation(s)
- Shuntaro Yamada
- Center of Translational Oral Research (TOR)‐Tissue Engineering Group, Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenNorway
| | - Mohammed A. Yassin
- Center of Translational Oral Research (TOR)‐Tissue Engineering Group, Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenNorway
| | - Francesco Torelli
- Center of Translational Oral Research (TOR)‐Tissue Engineering Group, Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenNorway
| | - Jan Hansmann
- Translational Center Regenerative TherapiesFraunhofer Institute for Silicate Research ISCWürzburgGermany
- Chair of Tissue Engineering and Regenerative MedicineUniversity Hospital WürzburgWürzburgGermany
- Department of Electrical EngineeringUniversity of Applied Sciences Würzburg‐SchweinfurtSchweinfurtGermany
| | - Jeremy B. A. Green
- Centre for Craniofacial & Regenerative Biology, Faculty of Dentistry, Oral & Craniofacial SciencesKing's College LondonUK
| | - Thomas Schwarz
- Translational Center Regenerative TherapiesFraunhofer Institute for Silicate Research ISCWürzburgGermany
| | - Kamal Mustafa
- Center of Translational Oral Research (TOR)‐Tissue Engineering Group, Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenNorway
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Kivijärvi T, Øyvind Goksøyr, Yassin MA, Jain S, Yamada S, Morales-López A, Mustafa K, Finne-Wistrand A. Hybrid material based on hyaluronan hydrogels and poly(l-lactide-co-1,3-trimethylene carbonate) scaffolds toward a cell-instructive microenvironment with long-term in vivo degradability. Mater Today Bio 2022; 17:100483. [DOI: 10.1016/j.mtbio.2022.100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/14/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022] Open
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Yamada S, Yassin MA, Schwarz T, Mustafa K, Hansmann J. Optimization and Validation of a Custom-Designed Perfusion Bioreactor for Bone Tissue Engineering: Flow Assessment and Optimal Culture Environmental Conditions. Front Bioeng Biotechnol 2022; 10:811942. [PMID: 35402393 PMCID: PMC8990132 DOI: 10.3389/fbioe.2022.811942] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/07/2022] [Indexed: 11/29/2022] Open
Abstract
Various perfusion bioreactor systems have been designed to improve cell culture with three-dimensional porous scaffolds, and there is some evidence that fluid force improves the osteogenic commitment of the progenitors. However, because of the unique design concept and operational configuration of each study, the experimental setups of perfusion bioreactor systems are not always compatible with other systems. To reconcile results from different systems, the thorough optimization and validation of experimental configuration are required in each system. In this study, optimal experimental conditions for a perfusion bioreactor were explored in three steps. First, an in silico modeling was performed using a scaffold geometry obtained by microCT and an expedient geometry parameterized with porosity and permeability to assess the accuracy of calculated fluid shear stress and computational time. Then, environmental factors for cell culture were optimized, including the volume of the medium, bubble suppression, and medium evaporation. Further, by combining the findings, it was possible to determine the optimal flow rate at which cell growth was supported while osteogenic differentiation was triggered. Here, we demonstrated that fluid shear stress up to 15 mPa was sufficient to induce osteogenesis, but cell growth was severely impacted by the volume of perfused medium, the presence of air bubbles, and medium evaporation, all of which are common concerns in perfusion bioreactor systems. This study emphasizes the necessity of optimization of experimental variables, which may often be underreported or overlooked, and indicates steps which can be taken to address issues common to perfusion bioreactors for bone tissue engineering.
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Affiliation(s)
- Shuntaro Yamada
- Centre of Translational Oral Research, Tissue Engineering Group, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- *Correspondence: Shuntaro Yamada, ; Jan Hansmann,
| | - Mohammed A. Yassin
- Centre of Translational Oral Research, Tissue Engineering Group, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Thomas Schwarz
- Translational Centre Regenerative Therapies, Fraunhofer Institute for Silicate Research ISC, Würzburg, Germany
| | - Kamal Mustafa
- Centre of Translational Oral Research, Tissue Engineering Group, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Jan Hansmann
- Translational Centre Regenerative Therapies, Fraunhofer Institute for Silicate Research ISC, Würzburg, Germany
- Chair of Tissue Engineering and Regenerative Medicine, University Hospital Würzburg, Würzburg, Germany
- Department Electrical Engineering, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
- *Correspondence: Shuntaro Yamada, ; Jan Hansmann,
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Hara K, Hellem E, Yamada S, Sariibrahimoglu K, Mølster A, Gjerdet NR, Hellem S, Mustafa K, Yassin MA. Efficacy of treating segmental bone defects through endochondral ossification: 3D printed designs and bone metabolic activities. Mater Today Bio 2022; 14:100237. [PMID: 35280332 PMCID: PMC8914554 DOI: 10.1016/j.mtbio.2022.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/15/2022] [Accepted: 03/05/2022] [Indexed: 10/25/2022]
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Yamada S, Yassin MA, Weigel T, Schmitz T, Hansmann J, Mustafa K. Surface activation with oxygen plasma promotes osteogenesis with enhanced extracellular matrix formation in three-dimensional microporous scaffolds. J Biomed Mater Res A 2021; 109:1560-1574. [PMID: 33675166 DOI: 10.1002/jbm.a.37151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/03/2021] [Accepted: 02/10/2021] [Indexed: 12/13/2022]
Abstract
Various types of synthetic polyesters have been developed as biomaterials for tissue engineering. These materials commonly possess biodegradability, biocompatibility, and formability, which are preferable properties for bone regeneration. The major challenge of using synthetic polyesters is the result of low cell affinity due to their hydrophobic nature, which hinders efficient cell seeding and active cell dynamics. To improve wettability, plasma treatment is widely used in industry. Here, we performed surface activation with oxygen plasma to hydrophobic copolymers, poly(l-lactide-co-trimethylene carbonate), which were shaped in 2D films and 3D microporous scaffolds, and then we evaluated the resulting surface properties and the cellular responses of rat bone marrow stem cells (rBMSC) to the material. Using scanning electron microscopy and Fourier-transform infrared spectroscopy, we demonstrated that short-term plasma treatment increased nanotopographical surface roughness and wettability with minimal change in surface chemistry. On treated surfaces, initial cell adhesion and elongation were significantly promoted, and seeding efficiency was improved. In an osteoinductive environment, rBMSC on plasma-treated scaffolds exhibited accelerated osteogenic differentiation with osteogenic markers including RUNX2, osterix, bone sialoprotein, and osteocalcin upregulated, and a greater amount of collagen matrix and mineral deposition were found. This study shows the utility of plasma surface activation for polymeric scaffolds in bone tissue engineering.
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Affiliation(s)
- Shuntaro Yamada
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mohammed A Yassin
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Tobias Weigel
- Chair of Tissue Engineering and Regenerative Medicine (TERM), University Hospital Würzburg, Würzburg, Germany
- Translational Center Regenerative Therapies, Fraunhofer Institute for Silicate Research (ISC), Würzburg, Germany
| | - Tobias Schmitz
- Chair of Tissue Engineering and Regenerative Medicine (TERM), University Hospital Würzburg, Würzburg, Germany
| | - Jan Hansmann
- Chair of Tissue Engineering and Regenerative Medicine (TERM), University Hospital Würzburg, Würzburg, Germany
- Translational Center Regenerative Therapies, Fraunhofer Institute for Silicate Research (ISC), Würzburg, Germany
- Department Electrical Engineering, University for Applied Sciences Würzburg/Schweinfurt, Schweinfurt, Germany
| | - Kamal Mustafa
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
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7
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Yassin MA, Samson K, Wandwalo E, Grzemska M, Gegia M, Nwaneri N, Hansen P, Kunii O. Performance-based technical support for drug-resistant TB responses: lessons from the Green Light Committee. Int J Tuberc Lung Dis 2021; 24:22-27. [PMID: 32005303 DOI: 10.5588/ijtld.19.0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Drug-resistant tuberculosis (DR-TB) constitutes a global threat and a major contributor to deaths related to antimicrobial resistance. Despite progress in DR-TB detection and treatment over the last decade, huge gaps remain in treatment coverage, access to quality care and treatment outcome. Global Fund investments have been critical to scaling up the existing and new diagnostic tools, treatment coverage and people-centred service delivery. The United Nations General Assembly (UNGA) high-level meeting represents unprecedented opportunities to accelerate towards addressing DR-TB. Established in 2000 and funded by the Global Fund since 2009, the Green Light Committee (GLC) mechanism has evolved from project approval to providing demand-based technical assistance to countries to scale up response to DR-TB based on their need and priorities. Lessons learnt from the GLC mechanism over 10 years demonstrate that a result-based, systematic and accountable technical assistance model to support scale-up of DR-TB response is critically important. Meeting the UNGA declaration targets requires major scale-up of current efforts and new tools, and hence the need for predictable, consistent and sustained technical support to countries, including through the regional GLC mechanism. The application of the principles and processes of this model could be adapted and replicated to design a similar performance-based and quality-assured technical support mechanism.
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Affiliation(s)
- M A Yassin
- Global Fund to Fight AIDS, Tuberculosis and Malaria. Geneva
| | - K Samson
- World Health Organization. Geneva, Switzerland
| | - E Wandwalo
- Global Fund to Fight AIDS, Tuberculosis and Malaria. Geneva
| | - M Grzemska
- World Health Organization. Geneva, Switzerland
| | - M Gegia
- World Health Organization. Geneva, Switzerland
| | - N Nwaneri
- Global Fund to Fight AIDS, Tuberculosis and Malaria. Geneva
| | - P Hansen
- Global Fund to Fight AIDS, Tuberculosis and Malaria. Geneva
| | - O Kunii
- Global Fund to Fight AIDS, Tuberculosis and Malaria. Geneva
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8
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Mohamed-Ahmed S, Yassin MA, Rashad A, Espedal H, Idris SB, Finne-Wistrand A, Mustafa K, Vindenes H, Fristad I. Comparison of bone regenerative capacity of donor-matched human adipose-derived and bone marrow mesenchymal stem cells. Cell Tissue Res 2020; 383:1061-1075. [PMID: 33242173 PMCID: PMC7960590 DOI: 10.1007/s00441-020-03315-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
Adipose-derived stem cells (ASC) have been used as an alternative to bone marrow mesenchymal stem cells (BMSC) for bone tissue engineering. However, the efficacy of ASC in bone regeneration in comparison with BMSC remains debatable, since inconsistent results have been reported. Comparing ASC with BMSC obtained from different individuals might contribute to this inconsistency in results. Therefore, this study aimed to compare the bone regenerative capacity of donor-matched human ASC and BMSC seeded onto poly(l-lactide-co-ε-caprolactone) scaffolds using calvarial bone defects in nude rats. First, donor-matched ASC and BMSC were seeded onto the co-polymer scaffolds to evaluate their in vitro osteogenic differentiation. Seeded scaffolds and scaffolds without cells (control) were then implanted in calvarial defects in nude rats. The expression of osteogenesis-related genes was examined after 4 weeks. Cellular activity was investigated after 4 and 12 weeks. Bone formation was evaluated radiographically and histologically after 4, 12, and 24 weeks. In vitro, ASC and BMSC demonstrated mineralization. However, BMSC showed higher alkaline phosphatase activity than ASC. In vivo, human osteogenesis–related genes Runx2 and collagen type I were expressed in defects with scaffold/cells. Defects with scaffold/BMSC had higher cellular activity than defects with scaffold/ASC. Moreover, bone formation in defects with scaffold/BMSC was greater than in defects with scaffold/ASC, especially at the early time-point. These results suggest that although ASC have the potential to regenerate bone, the rate of bone regeneration with ASC may be slower than with BMSC. Accordingly, BMSC are more suitable for bone regenerative applications.
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Affiliation(s)
- Samih Mohamed-Ahmed
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Mohammed A Yassin
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ahmad Rashad
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Heidi Espedal
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Shaza B Idris
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Kamal Mustafa
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Hallvard Vindenes
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department for Plastic, Hand and Reconstructive Surgery, National Fire Damage Center, Bergen, Norway
| | - Inge Fristad
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
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9
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Gegia M, Yassin MA. The Green Light Committee could contribute to ending TB: reply to Correspondence. Int J Tuberc Lung Dis 2020; 24:1223-1228. [PMID: 33172535 DOI: 10.5588/ijtld.20.0402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- M Gegia
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - M A Yassin
- Global Fund to Fight AIDS Tuberculosis and Malaria, Geneva, Switzerland, ,
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10
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Wandwalo E, Kamara V, Yassin MA, Morrison L, Nwaneri NB, Asiimwe S, Matiku S, Mutayoba B. Enhancing tuberculosis case finding in Tanzania: implementation of a quality improvement initiative. Public Health Action 2020; 10:57-59. [PMID: 32640006 DOI: 10.5588/pha.19.0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/07/2020] [Indexed: 11/10/2022] Open
Abstract
Tuberculosis (TB) is one of the major causes of morbidity and mortality in Tanzania. A quality improvement (QI) initiative was implemented by the National Tuberculosis Programme with support from The Global Fund to enhance TB case finding. The initiative involved identifying gaps in the quality of services, introducing tools, building capacity of health workers, and strengthening laboratory and referral services. The initiative was piloted at sub-national level and subsequently scaled-up nationally. Overall, 1280 health workers were trained, leading to an 81% cumulative increase in notified TB cases in the pilot region and 4000 additional TB cases notified nationally. The QI initiative could serve as a model for the improvement of TB case notification in other settings.
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Affiliation(s)
- E Wandwalo
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - V Kamara
- National TB and Leprosy Programme, Dodoma, United Republic of Tanzania
| | - M A Yassin
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - L Morrison
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - N B Nwaneri
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - S Asiimwe
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - S Matiku
- New Dimension Consulting, Dar es Salaam, United Republic of Tanzania
| | - B Mutayoba
- National TB and Leprosy Programme, Dodoma, United Republic of Tanzania
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Yassin MA, Yirdaw KD, Datiko DG, Cuevas LE, Yassin MA. Yield of household contact investigation of patients with pulmonary tuberculosis in southern Ethiopia. BMC Public Health 2020; 20:737. [PMID: 32434507 PMCID: PMC7238661 DOI: 10.1186/s12889-020-08879-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 05/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Household Contacts (HHCs) of patients with pulmonary tuberculosis (PTB) have a higher risk of developing TB. Contact investigation is recommended to reach this group and identify undiagnosed cases. In this study, we have determined the yield of contact investigation among HHCs of patients with smear-positive PTB, and estimated TB burden. METHODS We conducted retrospective record review for the occurrence of TB among HHCs of Index PTB+ cases treated between November 2010 and April 2013 in 12 public health facilities in Boricha district. HHCs were followed up monthly and revisited between March and June 2015. Information on additional TB cases diagnosed and treated among HHCs were documented. HHCs who were diagnosed as having TB after the index cases were diagnosed and treated were considered as 'incident cases'. Presumptive TB case was defined as those having cough for ≥2 weeks or enlarged lymph node. Diagnosis of TB among HHCs were made using smear-microscopy and/or X-rays, and clinically for Extra-pulmonary TB (EPTB). RESULTS One thousand five hundred and seventeenth HHCs of 344 index cases were visited and screened for TB and followed up for a median of 37 months. 77 (5.1% - 72 with PTB and 5 with EPTB) HHCs developed TB during 4713 person-years of follow-up with an estimated incidence of 1634 (95% CI: 1370-2043) per 100,000 person-years follow-up which is much higher than the estimated TB incidence for the general population in Ethiopia of 210/100,000. Half (41/77) of incident TB cases were diagnosed within the first year of diagnosis of the index cases and 88% (68/77) were adults (Hazard Ratio: 4.03; 95% CI: 2.00-8.12). CONCLUSION HHCs of index PTB+ cases have high risk of developing active TB. Long term follow-up of HHCs could help improve TB case finding depending on country contexts. Further studies on effectiveness and feasibility of the approach and integration in routine settings are needed.
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Affiliation(s)
| | | | | | - Luis E Cuevas
- Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
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12
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Al-Dubai HN, Yassin MA, Abdulla MA, Aldapt MS, Ghassoub RS. Ramadan Fasting in a Patient with Chronic Myeloid Leukemia Receiving Nilotinib as Upfront. Case Rep Oncol 2020; 13:664-667. [PMID: 32774253 PMCID: PMC7383202 DOI: 10.1159/000507508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 11/19/2022] Open
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm classically described as triphasic disease: chronic, accelerated, and blast crisis. There are many unmet needs and unanswered questions about CML. Intermittent fasting in patients with CML on tyrosine kinase inhibitors is among these unmet needs. Here we report the effect of intermittent fasting on response to nilotinib as upfront in a 49-year-old female Muslim who fasted during Ramadan and took her medication once instead of twice daily and remained in major molecular response.
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Affiliation(s)
- Husam N. Al-Dubai
- Internal Medicine Department, Hamad General Hospital, HMC, Doha, Qatar
| | - Mohammed A. Yassin
- Department of Medical Oncology/National Centre for Cancer Care and Research, HMC, Doha, Qatar
| | - Mohammed A. Abdulla
- Department of Medical Oncology/National Centre for Cancer Care and Research, HMC, Doha, Qatar
| | - Mahmood S. Aldapt
- Department of Medical Oncology/National Centre for Cancer Care and Research, HMC, Doha, Qatar
| | - Rola S. Ghassoub
- Department of Pharmacy, National Centre for Cancer Care and Research, HMC, Doha, Qatar
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Auer C, Mazitov R, Makhmudov A, Pirmahmadzoda B, Skrahina A, Dobre A, Sécula F, Bosch-Capblanch X, Van den Boom M, Migliori GB, Mdivani N, Yassin MA. Factors contributing to drug-resistant tuberculosis treatment outcome in five countries in the Eastern Europe and Central Asia region. Monaldi Arch Chest Dis 2020; 90. [PMID: 32231347 DOI: 10.4081/monaldi.2020.1235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/11/2020] [Indexed: 11/22/2022] Open
Abstract
Drug-resistant tuberculosis (DR-TB) is a global challenge and a major contributor of death from anti-microbial resistance. With the main aim to determine factors contributing to treatment outcomes observed among DR-TB patients in the countries in Eastern Europe and Central Asia (EECA), a multi-method study was conducted in: Azerbaijan, Belarus, Romania, Tajikistan and Ukraine. Both quantitative and qualitative methodologies were used for data collection and analysis. The quantitative approaches included a desk review of documents related to the DR-TB responses and an analysis of clinical records of DR-TB patients in selected health facilities of the five countries. Qualitative methods included in-depth interviews with national TB programme (NTP) managers, other healthcare providers and non-governmental organizations (NGOs) workers, as well as interviews and Focus Group Discussions (FGDs) with DR-TB patients. The desk review of 38 reports identified as the main challenges to address DR-TB financial and/or management issues and adverse events of the medicines. The most common recommendations related to treatment outcome focussed on general programme management, treatment regimen composition, clinical management and social support for the patients. In all the five countries the NTPs still have a vertical structure. Some integration into the primary health care system (PHC) already exists but further involvement of PHC facilities is feasible and recommended. Interviews with stakeholders indicated that alcoholism and homelessness and a lack of appropriate response to these issues remain as major challenges for a sub-set of patients. Civil society groups, NGOs and communities are substantially engaged in providing different services to DR-TB patients, especially in Ukraine, Romania and Tajikistan. Data from clinical records of 212 patients revealed that independent risk factors for unfavourable treatment outcome (death, loss to follow-up, failure) were culture-positivity at two months of treatment, history of treatment with second-line drugs and homelessness. More powerful, less toxic and shorter oral treatment regimens as well as comprehensive patient support are needed to improve treatment outcome of patients with DR-TB.
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Affiliation(s)
- Christian Auer
- Swiss Tropical and Public Health Institute, Basel; University of Basel.
| | | | | | | | - Alena Skrahina
- Republican Scientific and Practical Centre for Pulmonology and TB, Minsk.
| | | | - Florence Sécula
- Swiss Tropical and Public Health Institute, Basel; University of Basel.
| | | | | | - Giovanni Battista Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute IRCCS, Tradate.
| | - Nino Mdivani
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva.
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14
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Shaltout AA, Boman J, Hassan SK, Abozied AM, Al-Ashkar EA, Abd-Elkader OH, Yassin MA, Al-Tamimi JH. Elemental Composition of PM 2.5 Aerosol in a Residential-Industrial Area of a Mediterranean Megacity. Arch Environ Contam Toxicol 2020; 78:68-78. [PMID: 31760439 DOI: 10.1007/s00244-019-00688-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
Very little is known about the elemental composition and possible sources of fine aerosol particles from Mediterranean megacities. Fine aerosol particles were collected at a residential-industrial area in Greater Cairo, Egypt, during the period from October 2010 to May 2011. The elemental compositions of the collected samples were quantified by using a homemade energy dispersive x-ray fluorescence spectrometer, whereas black carbon was quantified by a black smoke detector. Fifteen elements have been quantified. Of these constituents, Ca, C, Cl, S, and Fe had the highest concentrations: greater than 1 µg m-3. The overall mean mass concentration of the collected samples equals 70 µg m-3; this value exceeds the European Union annual Air Quality Standard levels. The individual elemental concentrations of the fine particles were found to be dominated by elements linked to mineral dust. Most of the monthly variations of elemental concentrations can be attributed to seasonal meteorological conditions. Other possible sources were vehicle-exhaust and industrial activities. The results pinpoint the problem of identifying different sources when one source, in this case, the nearby deserts, is dominant. The results from this study contribute to the growing knowledge of concentrations, composition, and possible sources of ambient fine particulate matter.
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Affiliation(s)
- Abdallah A Shaltout
- Spectroscopy Department, Physics Division, National Research Centre, El-Behooth St., Dokki, Cairo, 12622, Egypt.
- Physics Department, Faculty of Science, Taif University, P.O. Box 888, Taif, 21974, Kingdom of Saudi Arabia.
| | - Johan Boman
- Department of Chemistry and Molecular Biology, Atmospheric Science, University of Gothenburg, 412 96, Gothenburg, Sweden
| | - Salwa K Hassan
- Air Pollution Research Department, National Research Centre, El-Behooth St., Dokki, Cairo, 12622, Egypt
| | - Asmaa M Abozied
- Spectroscopy Department, Physics Division, National Research Centre, El-Behooth St., Dokki, Cairo, 12622, Egypt
| | - Emad A Al-Ashkar
- Spectroscopy Department, Physics Division, National Research Centre, El-Behooth St., Dokki, Cairo, 12622, Egypt
| | - Omar H Abd-Elkader
- Physics & Astronomy Department, Science College, King Saud University, P.O. Box 2455, Riyadh, 11451, Kingdom of Saudi Arabia
- Physics Division, Electron Microscope & Thin Films Department, National Research Centre, El Behooth St., Giza, 12622, Egypt
| | - M A Yassin
- Botany & Microbiology Department, Science College, King Saud University, P.O. Box 2455, Riyadh, 11451, Kingdom of Saudi Arabia
| | - J H Al-Tamimi
- Zoology Department, Science College, King Saud University, P.O. Box 2455, Riyadh, 11451, Kingdom of Saudi Arabia
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15
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Ahlinder A, Fuoco T, Morales‐López Á, Yassin MA, Mustafa K, Finne‐Wistrand A. Nondegradative additive manufacturing of medical grade copolyesters of high molecular weight and with varied elastic response. J Appl Polym Sci 2019. [DOI: 10.1002/app.48550] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Astrid Ahlinder
- Department of Fibre and Polymer TechnologyKTH Royal Institute of Technology 100 44 Stockholm Sweden
| | - Tiziana Fuoco
- Department of Fibre and Polymer TechnologyKTH Royal Institute of Technology 100 44 Stockholm Sweden
| | - Álvaro Morales‐López
- Department of Fibre and Polymer TechnologyKTH Royal Institute of Technology 100 44 Stockholm Sweden
| | - Mohammed A. Yassin
- Department of Clinical Dentistry, Faculty of MedicineUniversity of Bergen Bergen Norway
| | - Kamal Mustafa
- Department of Clinical Dentistry, Faculty of MedicineUniversity of Bergen Bergen Norway
| | - Anna Finne‐Wistrand
- Department of Fibre and Polymer TechnologyKTH Royal Institute of Technology 100 44 Stockholm Sweden
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16
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Jain S, Fuoco T, Yassin MA, Mustafa K, Finne-Wistrand A. Printability and Critical Insight into Polymer Properties during Direct-Extrusion Based 3D Printing of Medical Grade Polylactide and Copolyesters. Biomacromolecules 2019; 21:388-396. [DOI: 10.1021/acs.biomac.9b01112] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Shubham Jain
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Teknikringen, 56-58, SE 10044 Stockholm, Sweden
| | - Tiziana Fuoco
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Teknikringen, 56-58, SE 10044 Stockholm, Sweden
| | - Mohammed A. Yassin
- Tissue Engineering Group, Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, 5009 Bergen, Norway
| | - Kamal Mustafa
- Tissue Engineering Group, Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, 5009 Bergen, Norway
| | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Teknikringen, 56-58, SE 10044 Stockholm, Sweden
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17
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Worku M, Agonafir M, Yassin MA, Yassin MA, Datiko DG, Theobald S, Cuevas LE. Use of Xpert MTB/RIF for the Identification of TB and Drug Resistance Among Smear-Negative and Re-Treatment Cases in Rural Areas of Ethiopia. Open Microbiol J 2019. [DOI: 10.2174/1874285801913010188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality worldwide. A key contributor to this burden is poor diagnosis as only 60% of new pulmonary tuberculosis (TB) cases in Africa are ever detected. Therefore, this study aimed to assess the feasibility of Xpert MTB/RIF test implementation in the region, and the performance of the assay to increase case detection on the selected rural health care setting.
Objective:
To assess the feasibility of Xpert MTB/RIF test implementation in the rural health care setting in Southern Ethiopia.
Methods:
Two Xpert MTB/RIF machines were brought in 2012 through TB REACH project. It was placed at Yirgalem hospital and at Aletawondo health centre. The instruments were installed after formal training was provided to laboratory technologists for three days. We collected sputum sample from participants who repeatedly had negative smear microscopy and those who had not responded to first-line anti-TB drugs.
Result:
Of the total participants tested, 1828 have valid result (MTB-, MTB+/RIF-, MTB+/RIF+, MTB+/RIF Indeterminate). From the participants with valid results, 217 (11.9%) were Xpert-positive of which were 165 (9.0%) RIF-negative, 6 (0.3%) RIF-indeterminate and 46 (2.5%) RIF-positive. Among TB suspects with previous treatment history and positive by Xpert, RIF resistance was detected in 10 (2.2%). From the new TB suspects with positive Xpert, RIF resistance was detected in 29 (2.7%). All cases identified were linked with TB/MDR-TB treatment centers.
Conclusion:
Xpert provides an additional tool for the diagnosis of TB and drug resistance, with almost 12% of new and retreatment cases obtaining information that is useful for clinical management. To enhance its efficient utilisation, operational challenges should be minimized particularly in relation to availing robust alternative power source.
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18
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Yassin MA, Fuoco T, Mohamed-Ahmed S, Mustafa K, Finne-Wistrand A. 3D and Porous RGDC-Functionalized Polyester-Based Scaffolds as a Niche to Induce Osteogenic Differentiation of Human Bone Marrow Stem Cells. Macromol Biosci 2019; 19:e1900049. [PMID: 31050389 DOI: 10.1002/mabi.201900049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/18/2019] [Indexed: 01/05/2023]
Abstract
Polyester-based scaffolds covalently functionalized with arginine-glycine-aspartic acid-cysteine (RGDC) peptide sequences support the proliferation and osteogenic differentiation of stem cells. The aim is to create an optimized 3D niche to sustain human bone marrow stem cell (hBMSC) viability and osteogenic commitment, without reliance on differentiation media. Scaffolds consisting of poly(lactide-co-trimethylene carbonate), poly(LA-co-TMC), and functionalized poly(lactide) copolymers with pendant thiol groups are prepared by salt-leaching technique. The availability of functional groups on scaffold surfaces allows for an easy and straightforward method to covalently attach RGDC peptide motifs without affecting the polymerization degree. The strategy enables the chemical binding of bioactive motifs on the surfaces of 3D scaffolds and avoids conventional methods that require harsh conditions. Gene and protein levels and mineral deposition indicate the osteogenic commitment of hBMSC cultured on the RGDC functionalized surfaces. The osteogenic commitment of hBMSC is enhanced on functionalized surfaces compared with nonfunctionalized surfaces and without supplementing media with osteogenic factors. Poly(LA-co-TMC) scaffolds have potential as scaffolds for osteoblast culture and bone grafts. Furthermore, these results contribute to the development of biomimetic materials and allow a deeper comprehension of the importance of RGD peptides on stem cell transition toward osteoblastic lineage.
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Affiliation(s)
- Mohammed A Yassin
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Teknikringen, 56-58, SE, 100-44, Stockholm, Sweden.,Department of Clinical Dentistry, Årstadveien 19, 5009 Bergen, Bergen, Norway
| | - Tiziana Fuoco
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Teknikringen, 56-58, SE, 100-44, Stockholm, Sweden
| | - Samih Mohamed-Ahmed
- Department of Clinical Dentistry, Årstadveien 19, 5009 Bergen, Bergen, Norway
| | - Kamal Mustafa
- Department of Clinical Dentistry, Årstadveien 19, 5009 Bergen, Bergen, Norway
| | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Teknikringen, 56-58, SE, 100-44, Stockholm, Sweden
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19
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Sharma S, Xue Y, Xing Z, Yassin MA, Sun Y, Lorens JB, Finne-Wistrand A, Sapkota D, Mustafa K. Adenoviral mediated mono delivery of BMP2 is superior to the combined delivery of BMP2 and VEGFA in bone regeneration in a critical-sized rat calvarial bone defect. Bone Rep 2019; 10:100205. [PMID: 31193299 PMCID: PMC6525280 DOI: 10.1016/j.bonr.2019.100205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 03/11/2019] [Accepted: 04/10/2019] [Indexed: 01/30/2023] Open
Abstract
Apart from osteogenesis, neovascularization of the defect area is an important determinant for successful bone healing. Accordingly, several studies have employed the combined delivery of VEGFA and BMP2 for bone regeneration. Nevertheless, the outcomes of these studies are highly variable. The aim of our study was to compare the effectiveness of adenoviral mediated delivery of BMP2 alone and in combination with VEGFA in rat bone marrow stromal cells (rBMSC) seeded on a poly(LLA-co-CL) scaffold in angiogenesis and osteogenesis using a critical-sized rat calvarial defect model. Both mono delivery of BMP2 and the combined delivery of a lower ratio of VEGFA and BMP2 (1:4) led to up-regulation of osteogenic genes (Alpl and Runx2) and increased calcium deposition in vitro, compared with the GFP control. Micro computed tomography (microCT) analysis of the rat calvarial defect at 8 weeks showed that the mono delivery of BMP2 (43.37 ± 3.55% defect closure) was the most effective in healing the bone defect, followed by the combined delivery of BMP2 and VEGFA (27.86 ± 2.89%) and other controls. Histological and molecular analyses supported the microCT findings. Analysis of the angiogenesis, however, showed that both mono delivery of BMP2 and combined delivery of BMP2 and VEGFA had similar angiogenic effect in the calvarial defects. Examination of the key genes related to host response against the adenoviral vectors showed that the current model system was not associated with adverse immune response. Overall, the results show that the mono delivery of BMP2 was superior to the combined delivery of BMP2 and VEGFA in healing the critical-sized rat calvarial bone defect. These findings underscore the importance of appropriate growth factor combination for the successful outcome in bone regeneration.
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Affiliation(s)
- Sunita Sharma
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ying Xue
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Zhe Xing
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mohammed A Yassin
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Yang Sun
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, Sweden
| | - James B Lorens
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Dipak Sapkota
- Department of Oral Biology, Faculty of Dentistry, 0316 Oslo, Norway
| | - Kamal Mustafa
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
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20
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Datiko DG, Guracha EA, Michael E, Asnake G, Demisse M, Theobald S, Tulloch O, Yassin MA, Cuevas LE. Sub-national prevalence survey of tuberculosis in rural communities of Ethiopia. BMC Public Health 2019; 19:295. [PMID: 30866870 PMCID: PMC6417109 DOI: 10.1186/s12889-019-6620-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 03/03/2019] [Indexed: 12/04/2022] Open
Abstract
Background Tuberculosis is a major public health problem with varying prevalence in different settings. National prevalence surveys provide evidence for planning and decision making. However, they lack the capacity to estimate subnational magnitude that affected the capacity to make selected intervention based on the prevalence. Ethiopia is among high TB burden countries with estimated prevalence of 108 per 100,000 population varying by regions. We aimed to study sub national prevalence of smear-positive TB in rural communities of southern Ethiopia. Methods This cross-sectional study, enrolled community members aged over 14 years who had cough of at least two weeks duration. Two sputum samples were collected and examined by using smear microscopy. Results 38,304 eligible people were enumerated (10,779 from Hadiya, 10,059 from Gurage and 17,466 from Sidama) and indentified 960 presumptive cases. 16, 14 and 14 smear-positive pulmonary TB cases were identified respectively. The point prevalence of smear-positive TB were 148 per 100,000 population (95% CI: 91–241) in Hadiya, 139 per 100,000 population (95% CI: 83–234) in Gurage and 80/100,000 population (95%CI: 48–135) in Sidama zone. Gurage zone had the highest prevalent to notified cases of seven to one. Conclusions The prevalence of smear positive TB varies by districts and is high in rural southern Ethiopia compared to the estimated national prevalence. More TB patients remain missed and unreached, impacting negatively on health outcomes. TB case finding approaches should be revisited and innovative approaches and tools to identify missing people with TB should be scaled up.
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Affiliation(s)
- Daniel G Datiko
- REACH ETHIOPIA, Box 303, Hawassa, Ethiopia. .,Liverpool School of Tropical Medicine, Pembroke Place L5 3QA, Liverpool, UK.
| | | | | | | | - Meaza Demisse
- Addis Continental School of Public Health, Addis Ababa, Ethiopia
| | - Sally Theobald
- Liverpool School of Tropical Medicine, Pembroke Place L5 3QA, Liverpool, UK
| | | | | | - L E Cuevas
- Liverpool School of Tropical Medicine, Pembroke Place L5 3QA, Liverpool, UK
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21
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Tabbara A, Grigorescu D, Yassin MA, Fristad I. Evaluation of Apical Dimension, Canal Taper and Maintenance of Root Canal Morphology Using XP-endo Shaper. J Contemp Dent Pract 2019; 20:136-144. [PMID: 31058626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM To evaluate the shaping ability of the XP-endo shaper file system in maxillary molars, representing root canals with variation in morphology. MATERIALS AND METHODS Twenty maxillary molars were instrumented according to recommended protocols. Pre- and postoperative microcomputed tomography (CT) scans were performed and the root canals classified according to canal type and curvature. The volume change, number of strokes needed to prepare the canals and the size of the 0.04-tapered gutta-percha cone that was adapted in the canal were recorded. RESULTS XP-endo shaper created a significant change in volume after instrumentation in all the canals, with the biggest change found in the DB canals, followed by the MB1 and the P canals, both at full length and in the apical 4 mm. The number of strokes needed to achieve working length and final shape did not differ between the various root canals. Although not significant, the number of strokes needed to prepare the root canal increased with severity of the curvature, but the severity of the curvature did not result in increased removal of dentin in the apical 4 mm. It was possible to achieve a final root canal size where a 0.04-tapered gutta-percha cone could be adapted. CONCLUSION The XP-endo shaper was a safe and effective instrument to achieve a root canal preparation of at least size 30 and a 0.04 taper. CLINICAL SIGNIFICANCE The clinical performance of XP-endo shaper was to some extent dependent on preoperative volume and curvature of the root canal.
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Affiliation(s)
- Afif Tabbara
- Department of Clinical Dentistry, University of Bergen, Bergen, Kingdom of Norway
| | - Dan Grigorescu
- Department of Clinical Dentistry, University of Bergen, Bergen, Kingdom of Norway
| | - Mohammed A Yassin
- Department of Clinical Dentistry, University of Bergen, Bergen, Kingdom of Norway Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, Kingdom of Sweden
| | - Inge Fristad
- Department of Clinical Dentistry, University of Bergen, Bergen, Kingdom of Norway, e-mail:
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22
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Rashad A, Mohamed-Ahmed S, Ojansivu M, Berstad K, Yassin MA, Kivijärvi T, Heggset EB, Syverud K, Mustafa K. Coating 3D Printed Polycaprolactone Scaffolds with Nanocellulose Promotes Growth and Differentiation of Mesenchymal Stem Cells. Biomacromolecules 2018; 19:4307-4319. [DOI: 10.1021/acs.biomac.8b01194] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Ahmad Rashad
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | | | - Miina Ojansivu
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Adult Stem Cell Research Group, Faculty of Medicine and Life Sciences and BioMediTech Institute, University of Tampere, Tampere, Finland
| | - Kaia Berstad
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Mohammed A. Yassin
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Department of Fiber and Polymer Technology, Royal Institute of Technology (KTH), Stockholm, Sweden
| | - Tove Kivijärvi
- Department of Fiber and Polymer Technology, Royal Institute of Technology (KTH), Stockholm, Sweden
| | | | - Kristin Syverud
- RISE PFI, Trondheim, Norway
- Department of Chemical Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kamal Mustafa
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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23
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Datiko DG, Yassin MA, Theobald SJ, Cuevas LE. A community-based isoniazid preventive therapy for the prevention of childhood tuberculosis in Ethiopia. Int J Tuberc Lung Dis 2018; 21:1002-1007. [PMID: 28826449 PMCID: PMC5566998 DOI: 10.5588/ijtld.16.0471] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND: Although children in contact with adults with tuberculosis (TB) should receive isoniazid (INH) preventive therapy (IPT), this is rarely implemented. OBJECTIVE: To assess whether a community-based approach to provide IPT at the household level improves uptake and adherence in Ethiopia. METHODS: Contacts of adults with smear-positive pulmonary TB (PTB+) were visited at home and examined by health extension workers (HEWs). Asymptomatic children aged <5 years were offered IPT and followed monthly. RESULTS: Of 6161 PTB+ cases identified by HEWs in the community, 5345 (87%) were visited, identifying 24 267 contacts, 7226 (29.8%) of whom were children aged <15 years and 3102 (12.7%) were aged <5 years; 2949 contacts had symptoms of TB and 1336 submitted sputum for examination. Ninety-two (6.9%) were PTB+ and 169 had TB all forms. Of 3027 asymptomatic children, only 1761 were offered (and accepted) IPT due to INH shortage. Of these, 1615 (91.7%) completed the 6-month course. The most frequent reason for discontinuing IPT was INH shortage. CONCLUSION: Contact tracing contributed to the detection of additional TB cases and provision of IPT in young children. IPT delivery in the community alongside community-based TB interventions resulted in better acceptance and improved treatment outcome.
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Affiliation(s)
- D G Datiko
- REACH Ethiopia, Hawassa, Southern Region, Ethiopia, Liverpool School of Tropical Medicine, Liverpool, UK
| | - M A Yassin
- Liverpool School of Tropical Medicine, Liverpool, UK, The Global Fund to fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - S J Theobald
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - L E Cuevas
- Liverpool School of Tropical Medicine, Liverpool, UK
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24
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Sharma S, Sapkota D, Xue Y, Rajthala S, Yassin MA, Finne-Wistrand A, Mustafa K. Delivery of VEGFA in bone marrow stromal cells seeded in copolymer scaffold enhances angiogenesis, but is inadequate for osteogenesis as compared with the dual delivery of VEGFA and BMP2 in a subcutaneous mouse model. Stem Cell Res Ther 2018; 9:23. [PMID: 29386057 PMCID: PMC5793460 DOI: 10.1186/s13287-018-0778-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 01/12/2018] [Accepted: 01/16/2018] [Indexed: 12/19/2022] Open
Abstract
Background In bone tissue engineering (BTE), extensive research into vascular endothelial growth factor A (VEGFA)-mediated angiogenesis has yielded inconsistent results. The aim of this study was to investigate the influence on angio- and osteogenesis of adenoviral-mediated delivery of VEGFA alone or in combination with bone morphogenetic protein 2 (BMP2) in bone marrow stromal cells (BMSC) seeded onto a recently developed poly(LLA-co-CL) scaffold. Methods Human BMSC were engineered to express VEGFA alone or in combination with BMP2 and seeded onto poly(LLA-co-CL) scaffolds. Changes in angiogenic and osteogenic gene and protein levels were examined by quantitative reverse-transcription polymerase chain reaction (RT-PCR), PCR array, and alkaline phosphatase assay. An in vivo subcutaneous mouse model was used to investigate the effect on angio- and osteogenesis of VEGFA alone or in combination with BMP2, using microcomputed tomography (μCT), histology, immunohistochemistry, and immunofluorescence. Results Combined delivery of a lower ratio (1:3) of VEGFA and BMP2 (ad-BMP2 + VEGFA) led to upregulation of osteogenic and angiogenic genes in vitro at 3 and 14 days, compared with mono-delivery of VEGFA (ad-VEGFA) and other controls. In vivo, in a subcutaneous mouse model, both ad-VEGFA and ad-BMP2 + VEGFA scaffold explants exhibited increased angiogenesis at 2 weeks. Enhanced angiogenesis was largely related to the recruitment and differentiation of mouse progenitor cells to the endothelial lineage and, to a lesser extent, to endothelial differentiation of the implanted BMSC. μCT and histological analyses revealed enhanced de novo bone formation only in the ad-BMP2 + VEGFA group, corresponding at the molecular level to the upregulation of genes related to osteogenesis, such as ALPL, RUNX2, and SPP1. Conclusions Although BMSC expressing VEGFA alone or in combination with BMP2 significantly induced angiogenesis, VEGFA alone failed to demonstrate osteogenic activity both in vitro and in vivo. These results not only call into question the use of VEGFA alone in bone regeneration, but also highlight the importance in BTE of appropriately formulated combined delivery of VEGFA and BMP2. Electronic supplementary material The online version of this article (10.1186/s13287-018-0778-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sunita Sharma
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, 5020, Bergen, Norway.
| | - Dipak Sapkota
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, 0316, Oslo, Norway
| | - Ying Xue
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, 5020, Bergen, Norway
| | - Saroj Rajthala
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Mohammed A Yassin
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, 10044, Stockholm, Sweden
| | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, 10044, Stockholm, Sweden
| | - Kamal Mustafa
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, 5020, Bergen, Norway.
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25
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Datiko DG, Yassin MA, Theobald SJ, Blok L, Suvanand S, Creswell J, Cuevas LE. Health extension workers improve tuberculosis case finding and treatment outcome in Ethiopia: a large-scale implementation study. BMJ Glob Health 2017; 2:e000390. [PMID: 29209537 PMCID: PMC5704104 DOI: 10.1136/bmjgh-2017-000390] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/14/2017] [Accepted: 10/06/2017] [Indexed: 11/26/2022] Open
Abstract
Background Tuberculosis (TB) is a major cause of death in Ethiopia. One of the main barriers for TB control is the lack of access to health services. Methods We evaluated a diagnostic and treatment service for TB based on the health extension workers (HEW) of the Ethiopian Health Extension Programme in Sidama Zone, with 3.5 million population. We added the services to the HEW routines and evaluated their effect over 4.5 years. 1024 HEWs were trained to identify individuals with symptoms of TB, request sputum samples and prepare smears. Smears were transported to designated laboratories. Individuals with TB were offered treatment at home or the local health post. A second zone (Hadiya) with 1.2 million population was selected as control. We compared TB case notification rates (CNR) and treatment outcomes in the zones 3 years before and 4.5 years after intervention. Results HEWs identified 216 165 individuals with symptoms and 27 918 (12%) were diagnosed with TB. Smear-positive TB CNR increased from 64 (95% CI 62.5 to 65.8) to 127 (95% CI 123.8 to 131.2) and all forms of TB increased from 102 (95% CI 99.1 to 105.8) to 177 (95% CI 172.6 to 181.0) per 100 000 population in the first year of intervention. In subsequent years, the smear-positive CNR declined by 9% per year. There was no change in CNR in the control area. Treatment success increased from 76% before the intervention to 95% during the intervention. Patients lost to follow-up decreased from 21% to 3% (p<0.001). Conclusion A community-based package significantly increased case finding and improved treatment outcome. Implementing this strategy could help meet the Ethiopian Sustainable Development Goal targets.
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Affiliation(s)
| | - Mohammed A Yassin
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - Sally J Theobald
- Faculty of Clinical Sciences and International Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Lucie Blok
- Royal Tropical Institute (KIT), Amsterdam, The Netherlands
| | | | | | - Luis E Cuevas
- Faculty of Clinical Sciences and International Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Yassin MA, Jaramillo E, Wandwalo E, Falzon D, Scardigli A, Kunii O, Weyer K. Investing in a novel shorter treatment regimen for multidrug-resistant tuberculosis: to be repeated. Eur Respir J 2017; 49:49/3/1700081. [DOI: 10.1183/13993003.00081-2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 01/18/2017] [Indexed: 11/05/2022]
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27
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Yassin MA, Mustafa K, Xing Z, Sun Y, Fasmer KE, Waag T, Krueger A, Steinmüller-Nethl D, Finne-Wistrand A, Leknes KN. A Copolymer Scaffold Functionalized with Nanodiamond Particles Enhances Osteogenic Metabolic Activity and Bone Regeneration. Macromol Biosci 2017; 17. [DOI: 10.1002/mabi.201600427] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/13/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Mohammed A. Yassin
- Department of Clinical Dentistry; Center for Clinical Dental Research Faculty of Medicine and Dentistry; University of Bergen; N-5020 Bergen Norway
| | - Kamal Mustafa
- Department of Clinical Dentistry; Center for Clinical Dental Research Faculty of Medicine and Dentistry; University of Bergen; N-5020 Bergen Norway
| | - Zhe Xing
- Department of Clinical Dentistry; Center for Clinical Dental Research Faculty of Medicine and Dentistry; University of Bergen; N-5020 Bergen Norway
- Department of Clinical Science; Faculty of Medicine and Dentistry; University of Bergen; N-5020 Bergen Norway
| | - Yang Sun
- Department of Clinical Dentistry; Center for Clinical Dental Research Faculty of Medicine and Dentistry; University of Bergen; N-5020 Bergen Norway
- Department of Fibre and Polymer Technology, KTH; Royal Institute of Technology; SE-100 44 Stockholm Sweden
| | - Kristine Eldevik Fasmer
- Center for Nuclear Medicine/PET; Department of Radiology; Haukeland University Hospital; N-5021 Bergen Norway
| | - Thilo Waag
- Institute of Organic Chemistry; University of Würzburg; 97070 Würzburg Germany
| | - Anke Krueger
- Institute of Organic Chemistry; University of Würzburg; 97070 Würzburg Germany
| | | | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology, KTH; Royal Institute of Technology; SE-100 44 Stockholm Sweden
| | - Knut N. Leknes
- Department of Clinical Dentistry; Center for Clinical Dental Research Faculty of Medicine and Dentistry; University of Bergen; N-5020 Bergen Norway
- Department of Clinical Dentistry-Periodontics; Faculty of Medicine and Dentistry; University of Bergen; N-5020 Bergen Norway
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Abstract
Lymphatic vessels are important for maintenance of tissue fluid homeostasis and afferent antigen transport. In chronic inflammation, lymphangiogenesis takes place and is characterized by lymphatic endothelial cell proliferation and lymphatic hyperplasia. Vascular endothelial growth factor C (VEGFC) is the main known lymphangiogenic growth factor, and its expression is increased in periodontitis, a common chronic infectious disease that results in tissue destruction and alveolar bone loss. The role of lymphangiogenesis during development of periodontitis is unknown. Here, we test if transgenic overexpression of epithelial VEGFC in a murine model is followed by hyperplasia of lymphatic vessels in oral mucosa and if the lymphatic drainage capacity is altered. We also test if lymphatic hyperplasia protects against periodontal disease development. Transgenic keratin 14 (K14)-VEGFC mice had significant hyperplasia of lymphatics in oral mucosa, including gingiva, without changes in blood vessel vasculature. The basal lymph flow was normal but slightly lower than in wild-type mice when oral mucosa was challenged with lipopolysaccharide from Porphyromonas gingivalis. Under normal conditions, K14-VEGFC mice exhibited an increased number of neutrophils in gingiva, demonstrated enhanced phagocyte recruitment in the cervical lymph nodes, and had more alveolar bone when compared with their wild-type littermates. After induction of periodontitis, no strain differences were observed in the periodontal tissues with respect to granulocyte recruitment, bone resorption, angiogenesis, cytokines, and bone-related protein expressions or in draining lymph node immune cell proportions and vascularization. We conclude that overexpression of VEGFC results in hyperplastic lymphatics, which do not enhance lymphatic drainage capacity but facilitate phagocyte transport to draining lymph nodes. Hyperplasia of lymphatics does not protect against development of ligature-induced periodontitis.
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Affiliation(s)
- P Papadakou
- 1 Department of Biomedicine, University of Bergen, Bergen, Norway
| | - A Bletsa
- 2 Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - M A Yassin
- 2 Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - T V Karlsen
- 1 Department of Biomedicine, University of Bergen, Bergen, Norway
| | - H Wiig
- 1 Department of Biomedicine, University of Bergen, Bergen, Norway
| | - E Berggreen
- 1 Department of Biomedicine, University of Bergen, Bergen, Norway
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Abstract
The Global Fund to fight AIDS, Tuberculosis and Malaria provides over three-quarters of all international financing towards TB programs with US$4.7 billion disbursed, supporting provision of treatment for 13.2 million patients with smear-positive TB and 210 000 patients with multidrug-resistant TB in over 100 countries since 2002. In 2013, the Global Fund launched a new funding model that, among others, is advancing strategic investments to maximize impact, addressing 'missing' TB cases, enhancing a synergistic response to TB/HIV dual epidemics, and building resilient and sustainable systems for health. A new Global Fund Strategy is under development through consultation with various stakeholders, with which the Global Fund will work to play a more catalytic role and foster innovations to end the TB epidemic.
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Affiliation(s)
- Osamu Kunii
- Strategy, Investment and Impact Division, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8, Vernier - Geneva 1214, Switzerland
| | - Mohammed A Yassin
- Strategy, Investment and Impact Division, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8, Vernier - Geneva 1214, Switzerland
| | - Eliud Wandwalo
- Strategy, Investment and Impact Division, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8, Vernier - Geneva 1214, Switzerland
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Abdurrahman ST, Lawson L, Blakiston M, Obasanya J, Yassin MA, Anderson RM, Oladimeji O, Ramsay A, Cuevas LE. Are patients with pulmonary tuberculosis who are identified through active case finding in the community different than those identified in healthcare facilities? New Microbes New Infect 2016; 15:35-39. [PMID: 27942386 PMCID: PMC5137337 DOI: 10.1016/j.nmni.2016.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 10/07/2016] [Accepted: 10/14/2016] [Indexed: 11/30/2022] Open
Abstract
The lack of healthcare access contributes to large numbers of tuberculosis (TB) cases being missed and has led to renewed interest in outreach approaches to increase detection. It is however unclear whether outreach activities increase case detection or merely identify patients before they attend health facilities. We compared adults with cough of >2 weeks' duration recruited in health facilities (1202 participants) or in urban slums (2828 participants) in Nigeria. Participants provided demographic and clinical information and were screened using smear microscopy. The characteristics of smear-positive and smear-negative individuals were compared stratified by place of enrolment. Two hundred nine health facility participants (17.4%) and 485 community-based participants (16.9%) were smear positive for pulmonary TB. Community-based smear-positive cases were older (mean age, 36.3 vs. 31.8 years), had longer cough duration (10.3 vs. 6.8 weeks) and longer duration of weight loss (4.6 vs. 3.6 weeks) than facility-based cases; and they complained more of fever (87.4% vs. 74.6%), chest pain (89.0% vs. 67.0%) and anorexia (79.5% vs. 55.5%). Community smear-negative participants were older (mean, 39.4 vs. 34.0 years), were more likely to have symptoms and were more likely to have symptoms of longer duration than smear-negative facility-based participants. Patients with pulmonary TB identified in the community had more symptoms and longer duration of illness than facility-based patients, which appeared to be due to factors differentially affecting access to healthcare. Community-based activities targeted at urban slum populations may identify a different TB case population than that accessing stationary services.
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Affiliation(s)
- S T Abdurrahman
- Federal Capital Territory Tuberculosis and Leprosy Control Programme, Nigeria
| | - L Lawson
- Zankli Medical Centre, Nigeria; Bingham University, Karu, Nassarawa State, Nigeria
| | | | - J Obasanya
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - M A Yassin
- Liverpool School of Tropical Medicine, UK; Global Fund to Fight Aids, Tuberculosis and Malaria, Switzerland
| | - R M Anderson
- Bingham University, Karu, Nassarawa State, Nigeria; University of Liverpool, Liverpool, UK
| | - O Oladimeji
- Zankli Medical Centre, Nigeria; Liverpool School of Tropical Medicine, UK
| | - A Ramsay
- Special Program for Research in Tropical Diseases, WHO/TDR, Geneva, Switzerland
| | - L E Cuevas
- Liverpool School of Tropical Medicine, UK
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Falzon D, Timimi H, Kurosinski P, Migliori GB, Van Gemert W, Denkinger C, Isaacs C, Story A, Garfein RS, do Valle Bastos LG, Yassin MA, Rusovich V, Skrahina A, Van Hoi L, Broger T, Abubakar I, Hayward A, Thomas BV, Temesgen Z, Quraishi S, von Delft D, Jaramillo E, Weyer K, Raviglione MC. Digital health for the End TB Strategy: developing priority products and making them work. Eur Respir J 2016; 48:29-45. [PMID: 27230443 PMCID: PMC4929075 DOI: 10.1183/13993003.00424-2016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/10/2016] [Indexed: 12/23/2022]
Abstract
In 2014, the World Health Organization (WHO) developed the End TB Strategy in response to a World Health Assembly Resolution requesting Member States to end the worldwide epidemic of tuberculosis (TB) by 2035. For the strategy's objectives to be realised, the next 20 years will need novel solutions to address the challenges posed by TB to health professionals, and to affected people and communities. Information and communication technology presents opportunities for innovative approaches to support TB efforts in patient care, surveillance, programme management and electronic learning. The effective application of digital health products at a large scale and their continued development need the engagement of TB patients and their caregivers, innovators, funders, policy-makers, advocacy groups, and affected communities. In April 2015, WHO established its Global Task Force on Digital Health for TB to advocate and support the development of digital health innovations in global efforts to improve TB care and prevention. We outline the group's approach to stewarding this process in alignment with the three pillars of the End TB Strategy. The supplementary material of this article includes target product profiles, as developed by early 2016, defining nine priority digital health concepts and products that are strategically positioned to enhance TB action at the country level. Priority digital health products will be profiled and developed to support the scale-up of WHO's End TB Strategyhttp://ow.ly/4mRRjR
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Affiliation(s)
- Dennis Falzon
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Hazim Timimi
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | - Giovanni Battista Migliori
- European Respiratory Society, Lausanne, Switzerland WHO Collaborating Centre, Fondazione S. Maugeri, Tradate, Italy
| | - Wayne Van Gemert
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Alistair Story
- Find & Treat, University College London Hospitals, London, UK
| | - Richard S Garfein
- University of California San Diego School of Medicine, La Jolla, CA, USA
| | | | - Mohammed A Yassin
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | | | - Alena Skrahina
- Republican Scientific and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | | | | | | | - Andrew Hayward
- Farr Institute of Health Informatics, University College London, London, UK
| | | | | | | | | | | | - Karin Weyer
- Global TB Programme, World Health Organization, Geneva, Switzerland
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Mahmoud1 MA, El-Samawaty AMA, Yassin MA, Abd El-Aziz ARM. Genetic diversity analysis of Aspergillus flavus isolates from plants and air by ISSR markers. Genet Mol Res 2016; 15:gmr8081. [PMID: 27173296 DOI: 10.4238/gmr.15028081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Aspergillus flavus is one of the most abundant and widely distributed fungi on earth. A. flavus produces aflatoxins (AFs), which are toxic secondary metabolites. AFs have harmful effects on public health (humans and animals) and agricultural crops. Inter-simple sequence repeat (ISSR) markers were used to analyze the genetic diversity of 30 A. flavus isolates from five agricultural crops and air. Genetic similarity coefficients (GSC) ranged from 0.51 to 0.10 based on three ISSR markers for the isolates tested. A. flavus isolates grouped into 6, 5, and 3 clusters using the unweighted pair-group method with arithmetic average of three ISSR markers. This study suggests that ISSR biotechnology is a highly useful tool for characterizing genetic diversity of A. flavus isolated from different sources.
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Affiliation(s)
- M A Mahmoud1
- Plant Pathology Research Institute, Agricultural Research Center, Giza, Egypt
| | - A M A El-Samawaty
- Plant Pathology Research Institute, Agricultural Research Center, Giza, Egypt.,Botany and Microbiology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - M A Yassin
- Plant Pathology Research Institute, Agricultural Research Center, Giza, Egypt.,Botany and Microbiology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - A R M Abd El-Aziz
- Botany and Microbiology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
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Yassin MA, Leknes KN, Sun Y, Lie SA, Finne-Wistrand A, Mustafa K. Surfactant tuning of hydrophilicity of porous degradable copolymer scaffolds promotes cellular proliferation and enhances bone formation. J Biomed Mater Res A 2016; 104:2049-59. [DOI: 10.1002/jbm.a.35741] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/09/2016] [Accepted: 04/06/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Mohammed A. Yassin
- Department of Clinical Dentistry; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
| | - Knut N. Leknes
- Department of Clinical Dentistry; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
| | - Yang Sun
- Department of Clinical Dentistry; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
- Department of Fibre and Polymer Technology; Royal Institute of Technology (KTH); Stockholm Sweden
| | - Stein A. Lie
- Department of Clinical Dentistry; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
| | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology; Royal Institute of Technology (KTH); Stockholm Sweden
| | - Kamal Mustafa
- Department of Clinical Dentistry; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
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34
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de Cuevas RMA, Lawson L, Al-Sonboli N, Al-Aghbari N, Arbide I, Sherchand JB, Nnamdi EE, Aseffa A, Yassin MA, Abdurrahman ST, Obasanya J, Olanrewaju O, Datiko D, Theobald SJ, Ramsay A, Squire SB, Cuevas LE. Patients direct costs to undergo TB diagnosis. Infect Dis Poverty 2016; 5:24. [PMID: 27009093 PMCID: PMC4806474 DOI: 10.1186/s40249-016-0117-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/14/2016] [Indexed: 12/28/2022] Open
Abstract
Background A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable. Methods We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis. Surveys of 2225 adults attending smear-microscopy centres in Nigeria, Nepal, Ethiopia and Yemen. Adults >18 years with cough >2 weeks were enrolled prospectively. Direct costs were quantified using structured questionnaires. Patients with costs >75th quartile were considered to have high expenditure (cases) and compared with patients with costs <75th quartile to identify factors associated with high expenditure. Results The most significant expenses were due to clinic fees and transport. Most participants attended the centres with companions. High expenditure was associated with attending with company, residing in rural areas/other towns and illiteracy. Conclusions The costs incurred by patients are substantial and share common patterns across countries. Removing user fees, transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs. In locations with limited resources, support could be prioritised for those most at risk of high expenditure; those who are illiterate, attend the service with company and rural residents. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0117-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Lovett Lawson
- Zankli Medical Center, Abuja, Nigeria.,Bingham University, Nassarawa State, Abuja, Nigeria
| | | | | | | | | | | | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mohammed A Yassin
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.,The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - Saddiq T Abdurrahman
- Federal Capital Territory Tuberculosis and Leprosy Control Programme, Abuja, Nigeria
| | - Joshua Obasanya
- Nigeria Tuberculosis and Leprosy Control Programme, Abuja, Nigeria
| | | | | | - Sally J Theobald
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Ramsay
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - S Bertel Squire
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Luis E Cuevas
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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35
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Al-Dewik NI, Jewell AP, Yassin MA, Morsi HM. Studying the Impact of Presence of Alpha Acid Glycoprotein and Protein Glycoprotein in Chronic Myeloid Leukemia Patients Treated with Imatinib Mesylate in the State of Qatar. Biomark Cancer 2015; 7:63-7. [PMID: 26640393 PMCID: PMC4664201 DOI: 10.4137/bic.s31427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 10/14/2015] [Accepted: 10/17/2015] [Indexed: 01/26/2023]
Abstract
Despite the efficacy of imatinib mesylate (IM) in treating chronic myeloid leukemia (CML), there is a high degree of resistance. Alpha- 1-acid glycoprotein may reduce drug efficacy through its ability to interact with IM and blocks it from reaching its target, while protein glycoprotein (PGP) may reduce the intracellular concentration of the drug via an active pump mechanism. We thus investigated the correlation between AGP and PGP levels and the resistance/response to treatment. A total of 26 CML patients were investigated for AGP and PGP levels at diagnosis and during treatment. There was no significant difference or correlation between AGP levels and the different groups of patients. There was also no significant difference in the fluorescence intensities of PGP levels among the different patient groups. The resistance observed in our CML patient population could not be correlated with AGP and PGP levels. There was no significant pattern of AGP and PGP expression, irrespective of the response or resistance to treatment.
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Affiliation(s)
- Nader I Al-Dewik
- National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar. ; Qatar Medical Genetics Center, Hamad Medical Corporation (HMC), Doha, Qatar. ; Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, UK
| | - Andrew P Jewell
- Medical Research Centre, HMC, Doha, Qatar. ; Department of Hematology, University College of London (UCL), UK
| | - Mohammed A Yassin
- National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Hisham M Morsi
- Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, UK. ; Academic Health System (AHS), Hamad Medical Corporation (HMC), Doha, Qatar
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Datiko DG, Yassin MA, Tulloch O, Asnake G, Tesema T, Jamal H, Markos P, Cuevas LE, Theobald S. Exploring providers' perspectives of a community based TB approach in Southern Ethiopia: implication for community based approaches. BMC Health Serv Res 2015; 15:501. [PMID: 26553340 PMCID: PMC4638085 DOI: 10.1186/s12913-015-1149-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 10/16/2015] [Indexed: 11/30/2022] Open
Abstract
Background There is increasing interest in the role of close-to-community providers in supporting universal health coverage, but questions remain about the best approaches to supporting and motivating these providers, and the optimal package they can deliver indifferent contexts and support required. We report on the experiences of different health providers involved in a community based intervention to support access to tuberculosis diagnosis and treatment in Southern Ethiopia. Methods The aim of the study is to explore the experiences of health providers in delivering a community-based tuberculosis package in southern Ethiopia and to draw lessons for community-based programmes. A qualitative methodology was used. Methods included in-depth interviews (IDIs, n= 37) with all health provider groups: Community health promoters (CHPs), health extension workers (HEWs), district supervisors and laboratory technicians were undertaken to obtain a detailed understanding of the experiences of providers in the community based tuberculosis package. These were complemented with cadre specific focus group discussions (n= 3). We used the framework approach for qualitative analysis. Results The key theme that emerged was the positive impact the community-based intervention had on vulnerable groups’ access to diagnosis, care and treatment for tuberculosis. Providers found the positive feedback from, and visible impact on, communities very motivating. Other themes related to motivation and performance included supervision and support; learning new skills; team problem solving/ addressing challenges and incentives. Against the backdrop of the Ethiopian Health Extension Programme (HEP), HEWs were successfully able to take on new tasks (collecting sputum and preparing smears) with additional training and appropriate support from supervisors, laboratory technicians and CHPs. Conclusion All categories of providers were motivated by the high visible impact of the community-based intervention on poor and vulnerable communities and households. HEWs role in the community-based intervention was supported and facilitated through the structures and processes established within the community-based intervention and the broader nation-wide Health Extension Programme. Within community based approaches there is need to develop context embedded strategies to support, sustain and motivate this critical cadre who play a pivotal role in linking health systems and rural communities.
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Affiliation(s)
- Daniel G Datiko
- TB REACH Project, Sidama Zone, Hawassa, Ethiopia. .,Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
| | - Mohammed A Yassin
- Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
| | - Olivia Tulloch
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK. .,Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Girum Asnake
- TB REACH Project, Sidama Zone, Hawassa, Ethiopia.
| | | | - Habiba Jamal
- TB REACH Project, Sidama Zone, Hawassa, Ethiopia.
| | | | - Luis E Cuevas
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
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Yassin MA, Leknes KN, Pedersen TO, Xing Z, Sun Y, Lie SA, Finne-Wistrand A, Mustafa K. Cell seeding density is a critical determinant for copolymer scaffolds-induced bone regeneration. J Biomed Mater Res A 2015; 103:3649-58. [PMID: 26013960 PMCID: PMC4744655 DOI: 10.1002/jbm.a.35505] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 05/06/2015] [Accepted: 05/11/2015] [Indexed: 12/15/2022]
Abstract
Constructs intended for bone tissue engineering (TE) are influenced by the initial cell seeding density. Therefore, the objective of this study was to determine the effect of bone marrow stromal stem cells (BMSCs) density loaded onto copolymer scaffolds on bone regeneration. BMSCs were harvested from rat's bone marrow and cultured in media with or without osteogenic supplements. Cells were seeded onto poly(l‐lactide‐co‐ε‐caprolactone) [poly(LLA‐co‐CL)] scaffolds at two different densities: low density (1 × 106 cells/scaffold) or high density (2 × 106 cells/scaffold) using spinner modified flasks and examined after 1 and 3 weeks. Initial attachment and spread of BMSC onto the scaffolds was recorded by scanning electron microscopy. Cell proliferation was assessed by DNA quantification and cell differentiation by quantitative real‐time reverse transcriptase‐polymerized chain reaction analysis (qRT‐PCR). Five‐millimeter rat calvarial defects (24 defects in 12 rats) were implanted with scaffolds seeded with either low or high density expanded with or without osteogenic supplements. Osteogenic supplements significantly increased cell proliferation (p < 0.001). Scaffolds seeded at high cell density exhibited higher mRNA expressions of Runx2 p = 0.001, Col1 p = 0.001, BMP2 p < 0.001, BSP p < 0.001, and OC p = 0.013. More bone was formed in response to high cell seeding density (p = 0.023) and high seeding density with osteogenic medium (p = 0.038). Poly (LLA‐co‐CL) scaffolds could be appropriate candidates for bone TE. The optimal number of cells to be loaded onto scaffolds is critical for promoting Extracellular matrix synthesis and bone formation. Cell seeding density and osteogenic supplements may have a synergistic effect on the induction of new bone. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 103A: 3649–3658, 2015.
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Affiliation(s)
- Mohammed A Yassin
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
| | - Knut N Leknes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
| | - Torbjorn O Pedersen
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
| | - Zhe Xing
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
| | - Yang Sun
- Department of Fibre and Polymer Technology, School of Chemical Science and Engineering, KTH Royal Institute of Technology, Teknikringen 42, SE-100 44, Stockholm, Sweden
| | - Stein A Lie
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
| | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology, School of Chemical Science and Engineering, KTH Royal Institute of Technology, Teknikringen 42, SE-100 44, Stockholm, Sweden
| | - Kamal Mustafa
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
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Tulloch O, Theobald S, Morishita F, Datiko DG, Asnake G, Tesema T, Jamal H, Markos P, Cuevas LE, Yassin MA. Patient and community experiences of tuberculosis diagnosis and care within a community-based intervention in Ethiopia: a qualitative study. BMC Public Health 2015; 15:187. [PMID: 25885789 PMCID: PMC4349713 DOI: 10.1186/s12889-015-1523-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 02/11/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The Ethiopian TB control programme relies on passive case finding of TB cases. The predominantly rural-based population in Ethiopia has limited access to health facilities creating barriers to TB services. An intervention package aimed to bring TB diagnosis and treatment services closer to communities has been implemented through partnership with health extension workers (HEWs). They undertook advocacy, communication and social mobilization (ACSM) activities, identified symptomatic individuals, collected sputum, prepared smears and fixed slides at community level. Field supervisors supported HEWs by delivering smeared slides to the laboratory, feeding back results to the HEWs and following up smear-negative cases. Patients diagnosed with TB initiated treatment in the community, they were supported by supervisors and HEWs through the local health post. Case notification increased from 64 to 127/100,000 population/year. METHODS This qualitative study assessed community members' treatment seeking behaviour and their perceptions of the intervention. In-depth interviews (n=36) were undertaken with participants in six districts. Participants were clients of the community-based intervention, currently on TB treatment or those screened negative for TB. Transcripts were translated to English and a thematic analytical framework was developed guided by the different steps symptomatic individuals take within the intervention package. Coding was done and queries run using NVivo software. RESULTS Prior to the intervention many patients with chronic cough did not access TB services. Participants described difficulties they faced in accessing district level health facilities that required travel outside their communities. Giving sputum samples and receiving results from within their home communities was appreciated by all participants. The intervention had a high level of acceptability; particularly clear benefits emerged for poor women and men and those too weak to travel. Some participants appeared to prefer a diagnosis of TB, this is likely because receiving a negative smear microscopy result brought further uncertainty and necessitated seeking further investigation. CONCLUSIONS There is evidence rural populations with high levels of poverty, and in particular women, are at high risk of unmet health needs and undiagnosed TB. Embedding TB services within communities was an acceptable approach for vulnerable groups experiencing poor access to health facilities. In the Ethiopian context this approach can facilitate early diagnosis and improve treatment outcomes.
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Affiliation(s)
- Olivia Tulloch
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Fukushi Morishita
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Daniel G Datiko
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
- HHA/REACH ETHIOPIA, Hawassa, SNPPR, Ethiopia.
| | | | | | | | | | - Luis E Cuevas
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Mohammed A Yassin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
- Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin des Blandonnet 8, 1214, Vernier, Geneva, Switzerland.
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Al-Dewik NI, Jewell AP, Yassin MA, El-Ayoubi HR, Morsi HM. Molecular Monitoring of patients with Chronic Myeloid Leukemia (CML) in the state of Qatar: Optimization of Techniques and Response to Imatinib. QScience Connect 2014. [DOI: 10.5339/connect.2014.24] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Nader I. Al-Dewik
- 1National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
- 2Qatar Medical Genetics Center, Hamad General Hospital (HGH), HMC, Doha, Qatar
- 4Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, London, United Kingdom
| | - Andrew P. Jewell
- 3Medical Research Centre, HMC, Doha, Qatar
- 4Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, London, United Kingdom
| | - Mohammed A. Yassin
- 1National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Hanadi R. El-Ayoubi
- 1National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Hisham M. Morsi
- 3Medical Research Centre, HMC, Doha, Qatar
- 4Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, London, United Kingdom
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Al-Dewik NI, Jewell AP, Yassin MA, El-Ayoubi HR, Morsi HM. Studying the impact of presence of point mutation, insertion mutation and additional chromosomal abnormalities in chronic myeloid leukemia patients treated with imatinib mesylate in the State of Qatar. QScience Connect 2014. [DOI: 10.5339/connect.2014.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Nader I Al-Dewik
- 1National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
- 2Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, United Kingdom
| | - Andrew P Jewell
- 2Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, United Kingdom
- 3Medical Research Centre, HMC, Doha, Qatar
| | - Mohammed A Yassin
- 1National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Hanadi R El-Ayoubi
- 1National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Hisham M Morsi
- 2Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, United Kingdom
- 3Medical Research Centre, HMC, Doha, Qatar
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Yassin MA, Datiko DG, Tulloch O, Markos P, Aschalew M, Shargie EB, Dangisso MH, Komatsu R, Sahu S, Blok L, Cuevas LE, Theobald S. Innovative community-based approaches doubled tuberculosis case notification and improve treatment outcome in Southern Ethiopia. PLoS One 2013; 8:e63174. [PMID: 23723975 PMCID: PMC3664633 DOI: 10.1371/journal.pone.0063174] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/28/2013] [Indexed: 11/18/2022] Open
Abstract
Background TB Control Programmes rely on passive case-finding to detect cases. TB notification remains low in Ethiopia despite major expansion of health services. Poor rural communities face many barriers to service access. Methods and Findings A community-based intervention package was implemented in Sidama zone, Ethiopia. The package included advocacy, training, engaging stakeholders and communities and active case-finding by female Health Extension Workers (HEWs) at village level. HEWs conducted house-to-house visits, identified individuals with a cough for two or more weeks, with or without other symptoms, collected sputum, prepared smears and supervised treatment. Supervisors transported smears for microscopy, started treatment, screened contacts and initiated Isoniazid preventive therapy (IPT) for children. Outcomes were compared with the pre-implementation period and a control zone. Qualitative research was conducted to understand community and provider perceptions and experiences. HEWs screened 49,857 symptomatic individuals (60% women) from October 2010 to December 2011. 2,262 (4·5%) had smear-positive TB (53% women). Case notification increased from 64 to 127/100,000 population/year resulting in 5,090 PTB+ and 7,071 cases of all forms of TB. Of 8,005 contacts visited, 1,949 were symptomatic, 1,290 symptomatic were tested and 69 diagnosed with TB. 1,080 children received IPT. Treatment success for smear-positive TB increased from 77% to 93% and treatment default decreased from 11% to 3%. Service users and providers found the intervention package highly acceptable. Conclusions Community-based interventions made TB diagnostic and treatment services more accessible to the poor, women, elderly and children, doubling the notification rate and improving treatment outcome. This approach could improve TB diagnosis and treatment in other high burden settings.
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Affiliation(s)
- Mohammed A Yassin
- Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
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Gammo M, Lamaric W, Hadida M, Abuazza A, Askar NA, Yassin MA, Cuevas LE. Front-loaded smear microscopy for the diagnosis of pulmonary TB in Tripoli, Libya. Trans R Soc Trop Med Hyg 2013; 107:137-9. [PMID: 23358991 DOI: 10.1093/trstmh/trs023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Diagnosis of pulmonary TB by conventional smear microscopy requires patient attendance on 2 consecutive days. We investigated whether collecting sputum on-the-spot for smear microscopy on the day the patient presented was as sensitive and specific for diagnosis as the conventional spot-morning-spot scheme. METHOD We enrolled 412 adults who presented between January 2009 and October 2010 at the National Centre for TB Control in Tripoli, Libya, with cough of >2 weeks' duration, into a cross-sectional survey collecting four sputum specimens: on-the-spot and Xspot on Day 1; morning and on-the-spot on Day 2. RESULTS 97 (24%) of 401 culture results were culture positive. Spot-Xspot and spot-morning smear microscopy had, respectively, 65% and 66% sensitivity and 97% and 96% specificity (p > 0.5). Spot-Xspot-morning and Spot-morning-spot smear-microscopy had, respectively, 67% and 66% sensitivity and 96% and 96% specificity (p > 0.5). CONCLUSION For the diagnosis of pulmonary TB, the sensitivity and specificity of front-loaded (same-day) smear microscopy is similar to that of the standard smear microscopy scheme.
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Affiliation(s)
- Mohamed Gammo
- Parasitology Department, Al Zawiya University, Zawiya, Libya
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Yassin MA, Petrucci R, Garie KT, Harper G, Teshome A, Arbide I, Asnake G, Ahmed HJ, Mammo T, Yesuf K, Cuevas LE. Use of tuberculin skin test, IFN-γ release assays and IFN-γ-induced protein-10 to identify children with TB infection. Eur Respir J 2012; 41:644-8. [PMID: 22997219 DOI: 10.1183/09031936.00012212] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Current tests of tuberculosis (TB) infection (tuberculin skin test (TST), interferon (IFN)-γ-release assays (IGRAs) and IFN-γ-induced protein (IP)-10) have limitations and their value when used consecutively to identify infected children has not been explored. This study describes TST, IGRA and IP-10 responses in children in contact with adults with TB, the agreement of the tests and whether using multiple tests indentifies more infected children. 330 children (aged 1-15 yrs) in contact with adults with pulmonary TB and 156 controls were studied in Ethiopia. Children exposed to adults with high bacilli grades in sputum were more likely to have positive TST, IFN-γ and IP-10 than controls. The agreement of positive tests was directly associated with the sputum bacilli grades (p<0.001 for all). The agreement of negative tests was higher in control children. The consecutive use of the tests increased the number of children classified as having at least one positive test. Using three tests increases the number of children classified as infected. This increase is associated with the bacilli load of the adults. Using only one test may underestimate the proportion of infected children, but the interpretation of the data is difficult due to the lack of reference standards.
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Abstract
BACKGROUND Gastro-enteritis is associated with significant mortality in low- and middle-income countries, and rotavirus and norovirus are the principal viral agents implicated. AIMS To investigate the molecular epidemiology and burden of disease associated with rotavirus and norovirus in children attending a health centre in Ethiopia. METHODS A cross-sectional study was conducted in children attending a health centre in Awassa, southern Ethiopia. Children with diarrhoea (cases) and without diarrhoea (controls) were recruited over a 6-month period from December 2008 to May 2009. Rotavirus was detected by ELISA and genotyped by RT-PCR, and norovirus was amplified by RT-PCR with genotyping by sequence analysis of RT-PCR products. RESULTS Rotavirus was detected in 44/200 (22%) cases and in none of the controls, with genotypes G3P[6] (48%), G1P[8] (27%) and G2P[4] (7%) being the strains most commonly identified. Norovirus was detected in 16 (8%) of 200 cases and in 4 (7%) of 57 controls. Norovirus GII.3 was the strain most commonly detected (40%: 8/20) and ten other genotypes were also detected. CONCLUSION Rotavirus is a common cause of severe gastro-enteritis in children in Ethiopia; however, norovirus occurred with a similar frequency in cases and controls. A globally uncommon strain type, G3P[6], predominated within the rotavirus strains detected.
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Garie KT, Yassin MA, Cuevas LE. Lack of adherence to isoniazid chemoprophylaxis in children in contact with adults with tuberculosis in Southern Ethiopia. PLoS One 2011; 6:e26452. [PMID: 22069451 PMCID: PMC3206033 DOI: 10.1371/journal.pone.0026452] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/27/2011] [Indexed: 01/09/2023] Open
Abstract
SETTING Hawassa, Southern Region of Ethiopia. OBJECTIVES To determine compliance to isoniazid (INH) preventive therapy (IPT) and its effectiveness in preventing (TB) disease in children in contact with adults with pulmonary TB (PTB). DESIGN This was a prospective cohort study of children <15 years old in contact with adults with smear-positive PTB. Asymptomatic children ≤5 years were provided IPT independently of their Tuberculin Skin Test (TST) status and children >5 years old were given advice but did not receive IPT, as recommended by the National TB control programme. Compliance to IPT and incidence of clinical TB were determined monthly for six months and then quarterly for up to 30 months. RESULTS One hundred and eighty four children in contact with 83 smear-positive PTB cases were identified. Eighty two were ≤5 and 102>5 years old. Only 27 (33%) of 82 children given IPT took it for >4 months and 10 (12%) completed the 6-month course. The main reason for non-compliance was the perception that drugs were not necessary when the child was healthy. Eleven children (all except one >5 years old) developed symptoms of TB disease and initiated treatment, resulting in an incidence of 28.6 cases for all and 53.5 for children >5 years old per 1000 children-year. CONCLUSION Compliance to IPT in children is poor in Southern Region of Ethiopia and this was associated with the parents' perception of the low importance of chemoprophylaxis in asymptomatic children. Poor compliance might be an important barrier for the wider implementation of IPT. TRIAL REGISTRATION Clinicaltrials.gov NCT00456469.
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Affiliation(s)
- Kefyalew T. Garie
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Mohammed A. Yassin
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - Luis E. Cuevas
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Teferi E, Lera M, Sita S, Bogale Z, Datiko DG, Yassin MA. Treatment outcome of children with severe acute malnutrition admitted to therapeutic feeding centers in Southern Region of Ethiopia. ETHIOP J HEALTH DEV 2011. [DOI: 10.4314/ejhd.v24i3.68392] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lawson L, Yassin MA, Abdurrahman ST, Parry CM, Dacombe R, Sogaolu OM, Ebisike JN, Uzoewulu GN, Lawson LO, Emenyonu N, Ouoha JO, David JS, Davies PDO, Cuevas LE. Resistance to first-line tuberculosis drugs in three cities of Nigeria. Trop Med Int Health 2011; 16:974-80. [PMID: 21564425 DOI: 10.1111/j.1365-3156.2011.02792.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the levels of resistance to first-line tuberculosis drugs in three cities in three geopolitical zones in Nigeria. METHODS A total of 527 smear-positive sputum samples from Abuja, Ibadan and Nnewi were cultured on BACTEC- MGIT 960. Drug susceptibility tests (DST) for streptomycin, isoniazid, rifampicin and ethambutol were performed on 428 culture-positive samples on BACTEC-MGIT960. RESULTS Eight per cent of the specimens cultured were multi-drug-resistant Mycobacterium tuberculosis (MDR-TB) with varying levels of resistance to individual and multiple first-line drugs. MDR was strongly associated with previous treatment: 5% of new and 19% of previously treated patients had MDR-TB (OR 4.1 (95% CI 1.9-8.8), P = 0.001) and with young adult age: 63% of patients with and 38% without MDR-TB were 25-34 years old (P = 0.01). HIV status was documented in 71%. There was no association between MDR-TB and HIV coinfection (P = 0.9) and gender (P > 0.2 for both). CONCLUSIONS MDR-TB is an emerging problem in Nigeria. Developing good quality drug susceptibility test facilities, routine monitoring of drug susceptibility and improved health systems for the delivery of and adherence to first- and second-line treatment are imperative to solve this problem.
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Affiliation(s)
- L Lawson
- Zankli Medical Centre, Abuja, Nigeria.
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Lawson L, Thacher TD, Yassin MA, Onuoha NA, Usman A, Emenyonu NE, Shenkin A, Davies PDO, Cuevas LE. Randomized controlled trial of zinc and vitamin A as co-adjuvants for the treatment of pulmonary tuberculosis. Trop Med Int Health 2010; 15:1481-90. [PMID: 20958890 DOI: 10.1111/j.1365-3156.2010.02638.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the efficacy of weekly zinc or zinc plus retinol as adjuncts for the treatment of pulmonary tuberculosis. METHODS Double-blind, randomized, placebo-controlled trial in 350 patients >15 years old with smear-positive tuberculosis in Nigeria (ISRCTN36636609). In addition to antituberculous treatment, patients were randomly allocated to weekly supplements of zinc (90 mg), zinc plus retinol (5000 IU) or placebos for 6 months. Primary outcomes were time to sputum smear conversion and resolution of radiographic abnormalities. RESULTS After 8 weeks of treatment, 68% had achieved sputum smear conversion, and the median conversion time was 6.5 weeks. Hazard ratios (HR, 95%CI) for sputum conversion relative to the placebo group were not significant for zinc (1.07, 0.92-1.29) or zinc plus retinol (0.89, 0.76-1.07). Significant predictors of time to sputum conversion were lung abnormality score, sputum smear grade, age and serum C-reactive protein. HIV co-infection and gender were not independent predictors of time to sputum conversion. There were no significant differences between supplement groups in clinical, radiological or laboratory outcomes at 2 months or 6 months. There were 9, 9 and 2 deaths in patients receiving zinc, zinc plus retinol or placebos, respectively. Mortality in those who received zinc (HR 1.71, 0.88-3.58) or zinc plus retinol (HR 1.54, 0.78-3.26) did not differ significantly from those who received placebos. Most deaths occurred in patients co-infected with HIV. CONCLUSIONS Supplementation with zinc or zinc plus retinol did not lead to better outcomes than placebos, and caution is warranted regarding routine micronutrient supplementation, particularly in patients co-infected with HIV.
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Ibrahim FA, Yassin MA, El-Ayoubi HR, Alhiji IA, Albinali AS, Almansour SM, Qafoud FM. Clinico-pathological profile of acute promyelocytic leukaemia at Al-Amal Oncology-Haematology Centre, Qatar. East Mediterr Health J 2010; 16:958-965. [PMID: 21218723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This cases series describes the profile of adult patients with acute promyelocytic leukaemia (APt) at a referral hospital in Qatar. Of 34 acute myeloid leukaemia (AML) cases diagnosed, 11(32%) were classified as APt. Disseminated intravascular coagulation was common at presentation (91%). Severe thrombocytopenia was seen in 73%, leukocytosis in 55% and severe anaemia in 45%. Only 2 patients were of the classic hypergranular type. In the remaining 9 patients, 3 morphological subtypes were recognized: microgranular variant (6 patients), hyperbasophilic (2 patients) and regular nuclear outline M3r (1 patient). Translocation t(15;17) was detected in 63% of cases. APL constitutes a high proportion of AML cases in Qatar, with considerable morphological heterogeneity and a oredominance of APL variants with unfavourable oresenting features.
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Affiliation(s)
- F A Ibrahim
- Department of Laboratory Medicine and Pathology, A-Ameal Hospital, Qatar
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Muñoz-Sellart M, Cuevas LE, Tumato M, Merid Y, Yassin MA. Factors associated with poor tuberculosis treatment outcome in the Southern Region of Ethiopia. Int J Tuberc Lung Dis 2010; 14:973-979. [PMID: 20626941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
SETTING Tuberculosis (TB) treatment centres in southern Ethiopia. OBJECTIVES To describe the outcomes of patients registered for anti-tuberculosis treatment and to identify factors associated with poor treatment outcome. DESIGN Retrospective audit of patients registered from 2002 to 2007. Patients were categorised as having successful (cured or completed treatment) or poor treatment outcome (failed treatment, defaulted or died). Logistic regressions were used to identify risk factors for poor outcome. RESULTS A total of 6547 patients (55.6% male, 44.4% female) with a mean age of 27.5 years were registered for treatment; 2873 (43.9%) were smear-positive, 2493 (30.1%) smear-negative and 1157 (17.7%) had extra-pulmonary TB. Most (n = 6033, 92%) were new cases; 4900 (74.8%) had a successful and 1095 (16.7%) a poor treatment outcome. Of those with a poor outcome, 667 (60.9%) patients defaulted, 404 (36.9%) died and 24 (2.2%) failed treatment. Attending the regional capital health centre (aOR 2.09, 95%CI 1.85-2.69), being on retreatment (aOR 2.07, 95%CI 1.47-2.92), having a positive smear at the second month follow-up (aOR 1.68, 95%CI 1.07-2.63), having smear-negative pulmonary TB (aOR 1.62, 95%CI 1.4-1.86), age >55 years (aOR 1.44, 95%CI 1.12-1.86) and being male (aOR 1.24, 95%CI 1.09-1.42) were independent risk factors for poor outcome. CONCLUSION Treatment outcome was suboptimal and targeted measures should be considered to reduce the rate of poor treatment outcome among high-risk groups.
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