Browsing by Author "Ayele, Birhanu T."
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- ItemBaseline audiological profiling of South African females with cervical cancer : an important attribute for assessing cisplatin-associated ototoxicity(BMC (part of Springer Nature), 2021-04-20) Paken, Jessica; Govender, Cyril D.; Pillay, Mershen; Ayele, Birhanu T.; Sewram, VikashBackground: Cisplatin is a popular antineoplastic agent used to treat cervical cancer in women from low and middle-income countries. Cisplatin treatment is associated with ototoxicity, often resulting in hearing loss. In light of this, it is crucial to conduct baseline audiological assessments prior to treatment initiation in order to evaluate the extent of cisplatin-associated-ototoxicity. Additionally, the identification of inherent risk factors and hearing patterns in specific patient cohorts is needed, especially in South Africa, a middle-income country characterized by the quadruple burden of disease (Human Immunodeficiency Virus (HIV), Tuberculosis (TB), Diabetes and Hypertension). Methods: This study aimed to describe a profile of risk factors and hearing in a cohort of females with cervical cancer before cisplatin treatment commenced. A descriptive study design that included 82 cervical cancer patients, who underwent audiological evaluation prescribed for ototoxicity monitoring was conducted. Results: All participants (n = 82) presented with risk factors (diabetes, hypertension, HIV, and antiretroviral therapy) for cisplatin ototoxicity and/or pre-existing sensorineural hearing loss. High-frequency tinnitus was the most common otological symptom experienced by 25 (31%) participants. Fifty-nine (72%) participants presented with normal hearing, twenty-two (27%) with a sensorineural hearing loss, and 36% were diagnosed with mild hearing loss. Abnormal Distortion Product Otoacoustic Emissions (DPOAE) findings were obtained bilaterally in two participants (2.4%), in the right ear only of another two (2.4%) participants and the left ear of three participants (3.7%). Most participants (94%) had excellent word recognition scores, demonstrating an excellent ability to recognize words within normal conversational levels under optimal listening conditions. Age was significantly associated with hearing loss at all thresholds. Among the co-morbidities, an HIV positive status significantly triggered hearing loss, especially at higher frequencies. Conclusion: This study demonstrated that South African females with cervical cancer present with various co-morbidities, which may predispose them to develop cisplatin-associated -ototoxic hearing loss. Identification of these comorbidities and hearing loss is essential for the accurate monitoring of cisplatin toxicities. Appropriate management of these patients is pivotal to reduce the adverse effects that hearing impairment can have on an individual’s quality of life and to facilitate informed decision-making regarding the commencement of cisplatin chemotherapy.
- ItemImmune biomarkers as an adjunct diagnostic modality of infection in cases of sudden and unexpected death in infancy (SUDI) at Tygerberg Medico-legal Mortuary, Cape Town, South Africa(Elsevier, 2021) De Beer, Corena; Ayele, Birhanu T.; Dempers, JohanENGLISH ABSTRACT: Child mortality is a major health concern worldwide with over 4.2 million infants dying before reaching the age of one year in 2016 alone. Several international intervention initiatives have resulted in a decrease in the number of infant deaths; however, the incidence of sudden unexpected death in infancy (SUDI) and sudden infant death syndrome (SIDS) remain unacceptably high. SIDS still accounts for approximately 50–80% of SUDI cases, followed by infection. The aim of this study was to investigate a selection of immune biomarkers that are associated with an immune response in an effort to support the diagnosis of an infectious cause (“Infection”) e.g. bronchopneumonia, interstitial pneumonitis, etc., instead of SIDS in SUDI cases. C-reactive protein and 18 different cytokines were retrospectively quantified in serum collected during post-mortem investigations of SUDI cases admitted to the Tygerberg Medico-legal Mortuary in the Western Cape Province of South Africa between 2015 and 2017. Statistical comparison was done between infants with a final cause of death (COD) of Infection and SIDS to investigate any correlations between the immune markers and sociodemographic information of the groups. A p-value of < 0.0026, after Bonferroni correction for multiple comparisons, was considered as statistically significant. A total of 169 cases were included, of which 65 (38.5%) were assigned a cause of death of Infection and 104 (61.5%) SIDS by forensic pathologists. The male to female ratio of the entire group was 1:0.97 and the median age at the time of death was 9 (interquartile range [IQR] 10.9) weeks. The majority (56.8%) of deaths occurred during the colder seasons (autumn and winter) and the median post-mortem interval was 4 (IQR 3) days. No statistically significant differences were demonstrated for gender, season, sleeping position or bed-sharing between the Infection and SIDS groups. Age and interleukin-1α were identified as predictors of a COD of Infection before adjusting for the multiple comparisons problem. C-reactive protein was a statistically significant predictor of a COD of Infection even after adjusting for the effect of multiple comparisons. The COD is primarily based on histopathology of the lungs, where other causes of interstitial inflammation have been ruled out, and where there are morphological changes present suggestive of infection, but not enough evidence to assign a final COD of Infection, the cases are concluded as SIDS. These biomarkers can therefore be valuable in the investigation protocol of SUDI cases to increase the number Infection cases where the histopathology of the lungs is suggestive of, but does not support conclusive evidence of infection.
- ItemImplications of COVID-19 in high burden countries for HIV/TB : a systematic review of evidence(BMC (part of Springer Nature), 2020-10-09) Tamuzi, Jacques L.; Ayele, Birhanu T.; Shumba, Constance S.; Adetokunboh, Olatunji O.; Uwimana-Nicol, Jeannine; Haile, Zelalem T.; Inugu, Joseph; Nyasulu, Peter S.Background: The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the twenty-first century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field. However, several gaps remain in the knowledge of the burden of COVID-19 on patients with TB and HIV. This study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB, to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management. Methods: We conducted an electronic search of potentially eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and July, 2020 in which SARSCoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB in adults. We screened titles, abstracts and full articles for eligibility. Descriptive and meta-analysis were done and results have been presented in graphs and tables. Results: After removing 95 duplicates, 58 out of 437 articles were assessed for eligibility, of which 14 studies were included for descriptive analysis and seven studies were included in the meta-analysis. Compared to the descriptive analysis, the meta-analysis showed strong evidence that current TB exposure was high-risk COVID-19 group (OR 1.67, 95% CI 1.06–2.65, P = 0.03). The pooled of COVID-19/TB severity rate increased from OR 4.50 (95% CI 1.12– 18.10, P = 0.03), the recovery rate was high among COVID-19 compared to COVID-19/TB irrespective of HIV status (OR 2.23, 95% CI 1.83–2.74, P < 0.001) and the mortality was reduced among non-TB group (P < 0.001). Conclusion: In summary, TB was a risk factor for COVID-19 both in terms of severity and mortality irrespective of HIV status. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB or COVID-19/TB co-infections outcomes.
- ItemLaboratory biomarkers of COVID-19 disease severity and outcome : findings from a developing country(Public Library of Science, 2021-03) Leulseged, Tigist W.; Hassen, Ishmael S.; Ayele, Birhanu T.; Tsegay, Yakob G.; Abebe, Daniel S.; Edo, Mesay G.; Maru, Endalkachew H.; Zewde, Wuletaw C.; Naylor, Lydia K.; Semane, Dejene F.; Dresse, Menayit T.; Tezera, Bereket B.Aim: To identify laboratory biomarkers that predict disease severity and outcome among COVID-19 patients admitted to the Millennium COVID-19 Care Center in Ethiopia. Methods: A retrospective cohort study was conducted among 429 COVID-19 patients who were on follow up from July to October 2020. Data was described using frequency tables. Robust Poisson regression model was used to identify predictors of COVID-19 severity where adjusted relative risk (ARR), P-value and 95 CI for ARR were used to test significance. Binary Logistic regression model was used to assess the presence of statistically significant association between the explanatory variables and COVID-19 outcome where adjusted odds ratio (AOR), P-value and 95%CI for AOR were used for testing significance. Results: Among the 429 patients studied, 182 (42.4%) had Severe disease at admission and the rest 247 (57.6%) had Non-severe disease. Regarding disease outcome, 45 (10.5%) died and 384 (89.5%) were discharged alive. Age group (ARR = 1.779, 95%CI = 1.405–2.252, p-value <0.0001), Neutrophil to Lymphocyte ratio (NLR) (ARR = 4.769, 95%CI = 2.419–9.402 p-value <0.0001), Serum glutamic oxaloacetic transaminase (SGOT) (ARR = 1.358, 95%CI = 1.109–1.662 p-value = 0.003), Sodium (ARR = 1.321, 95%CI = 1.091–1.600 p-value = 0.004) and Potassium (ARR = 1.269, 95%CI = 1.059–1.521 p-value = 0.010) were found to be significant predictors of COVID-19 severity. The following factors were significantly associated with COVID-19 outcome; age group (AOR = 2.767, 95%CI = 1.099–6.067, p-value = 0.031), white blood cell count (WBC) (AOR = 4.253, 95%CI = 1.918–9.429, p-value = 0.0001) and sodium level (AOR = 3.435, 95%CI = 1.439–8.198, p-value = 0.005). Conclusions: Assessing and monitoring the laboratory markers of WBC, NLR, SGOT, sodium and potassium levels at the earliest stage of the disease could have a considerable role in halting disease progression and death.
- ItemTime to optimal glycaemic control and prognostic factors among type 2 diabetes mellitus patients in public teaching hospitals in Addis Ababa, Ethiopia(PLoS, 2019-07-31) Leulseged, Tigist W.; Ayele, Birhanu T.Aim: To estimate time to first optimal glycaemic control and identify prognostic factors among type 2 diabetes mellitus (T2DM) patients attending diabetes clinic of public teaching hospitals in Addis Ababa, Ethiopia. Methods: A retrospective chart review study was conducted at diabetes clinic of Addis Ababa’s public teaching hospitals among a randomly selected sample of 685 charts of patients with T2DMwho were on follow up from January 1, 2013 to June 30, 2017. Data was collected using data abstraction tool. Descriptive statistics, Kaplan Meier plots, median survival time, Log-rank test and Cox proportional hazard survival models were used for analysis. Results: Median time to first optimal glycaemic control among the study population was 9.5 months. Factors that affect time to first optimal glycaemic control were age group (HR = 0.635, 95% CI: 0.486–0.831 for 50–59 years, HR = 0.558, 95% CI: 0.403–0.771for 60–69 years and HR = 0.495, 95% CI: 0.310–0.790 for > = 70 years), diabetes neuropathy (HR = 0.502, 95% CI: 0.375–0.672), more than one complication (HR = 0.381, 95% CI: 0.177–0.816), hypertension (HR = 0.611, 95% CI: 0.486–0.769), dyslipidemia (HR = 0.609, 95% CI: 0.450–0.824), cardiovascular disease (HR = 0.670, 95% CI: 0.458–0.979) and hospital patient being treated (HR = 1.273, 95% CI: 1.052–1.541). Conclusions: Median time to first optimal glycaemic control among T2DM patients is longer than expected which might imply that patients are being exposed to more risk of complication and death.