Ethiopian Journal of Translational Sciences

Immunohistochemical Expression of MLH1 and MSH2 in Prostate Cancer and Its Implications

2025-02-14T07:50:17+00:00

Background: Prostate cancer is a complex disease characterized by the uncontrolled growth of cells in the prostate. DNA mismatch repair (MMR) proteins, such as MutS homolog 2 (MSH2) and MutL protein homolog 1 (MLH1), play a crucial role in correcting errors in DNA replication that can lead to cancer. Loss of these proteins can result in genetic changes that contribute to the development of cancer. This study aimed to assess the expression of MLH1 and MSH2 in prostate cancer.

Methods: The study was retrospective and involved the analysis of 40 formalin-fixed paraffin-embedded tissue blocks, including 20 blocks from malignant invasive prostate cancer and 20 from benign prostatic hyperplasia (BPH) tissues. Immunohistochemical analysis was conducted using the Avidin-biotin immuno-peroxidase method to detect MLH1 and MSH2 expression. The expression levels were evaluated using a semi-quantitative method, which involved grading the intensity of staining and the percentage of stained cells per field. The stained sections were examined under a LEICA research microscope (LEICA DM750, Switzerland) equipped with a digital camera (LEICA ICC50).

Results: Nuclear staining of MLH1 was observed, with a mean positivity rate (MPR) of 6.4% in BPH cases and 29.7% in prostate cancer cases, where only 50% of cancer cells showed moderate significant expression. Nuclear staining of MSH2 was also detected, with a MPR of 7.6% in BPH cases and 77.4% in prostate cancer cases, where 60% of cancer cells showed significant marked expression. Statistically, MLH1 and MSH2 expression were significantly higher in PC compared to BPH (P<0.05), and MSH2 loss was higher compared to MLH1.

Conclusion: In conclusion, this study revealed low frequency of MLH1 immunohistochemical expression in BPH and prostate cancer. The loss of mismatch repair proteins in prostate cancer suggests a role in DNA repair processes and potential resistance to chemotherapeutic medications. As a result, defect in mismatch repair may accelerate prostate cancer development. Determining the immunohistochemical expression of the DNA mismatch repair (MMR) proteinscan predict tumor behavior, serve as diagnostic markers and guide treatment decisions.

Scabies outbreak investigation in Shashego woreda Southern, Ethiopia

2025-03-11T08:58:11+00:00

Background: Scabies is a contagious ectoparasite of the skin caused by the microscopic mite Sarcoptic scabies var. hominis. It is usually spread by direct and prolonged skin-to-skin contact with someone with scabies. Schools, refugee camps, and prisons are often sources of scabies outbreaks in developing countries, with the major aggravating factors being environmental (warm weather and climate change)

Objectives: To investigate and manage the outbreak, and ultimately offer recommendations for preventive measures in the Shashego district of the Hadiya zone, Southern Ethiopia, in 2018. Methods: An unmatched community-based case-control (1:2 or 47 cases and 94 controls) nonprobability purposive sampling investigation was conducted, using predesigned questionnaires.

Results: One thousand forty-one scabies cases were reported from August to November 2018; there were no death reports. A case-control study was conducted, there were 47 scabies cases (21 males and 19 females) with a mean and median age of cases were 16 and 12 years, respectively, ranging (from 1 to 50 years) and 94 community controls (37 males and 43 females) with a mean and median age were 20.6 and 17.5 years (ranging 2-50 years). Male accounts 623(56.33%). A high attack rate of 1.69% was observed among children aged 0- 7 years. Multivariate analysis shows that infrequent use of soaps [(AOR) =15.246, 95%CI (1.901-122.268)], changing clothes once a month [(AOR)=20.668,95%CI (2.406-177.548)], washing clothes once a month [(AOR) = 66.876,95%CI (6.107-732.314)], sharing cloths with scabies case of last two month [(AOR) = 11.864,95% CI (1.664-84.562)], and prolonged direct skin to skin contact [(AOR)=54.193, CI (1.082-2714.433) were independent risk factors for scabies outbreaks.

Conclusion: The scabies outbreak occurred in the Shashego district, mainly in children 0-7 years old. Infrequent use of soaps, washing clothes once a month, changing clothes once a month, sharing clothes in families, and prolonged direct skin-to-skin contact were significant risk factors for scabies outbreaks. We recommended increasing strong active case detection and providing mass treatments. We also recommended using mass media worldwide at schools, markets, and religious places to raise awareness.

Prevalence and factors associated with acute diarrheal disease among under- five children in Halaba Special District, Southern Ethiopia

2025-06-26T14:02:22+00:00

Background: Diarrheal disease remains the leading cause of morbidity and mortality among under-five children worldwide. It is one of the top leading causes of under-five morbidity & mortality in Ethiopia. Identifying the determinants of a disease enables to design an effective intervention. The main objective of this study was to assess the prevalence and associated factors of acute diarrheal disease among under-five years of age in Halaba Special District Southern Ethiopia.

Methods: Community-based cross-sectional study was carried out in 2021. Five hundred thirty mothers/care givers with under-five children were selected by using systematic random sampling from selected kebeles in the district. Data were collected using structured and pre-tested questionnaires. Data were cleaned and analyzed using SPSS version 20. Bivariate and multivariate analysis were done to assess factors affecting diarrhea.

Results: The mean ages of the respondents and the index children were 33.30(+6.26SD) years and 22.75 (+12.79SD) months, respectively. Prevalence of acute diarrheal disease over a period of two weeks preceding the study was 21.3%. Water source [AOR: 4.476, 95% CI (1.962, 10.210)], distance to water source [AOR: 2.252, 95% (1.139, 4.451)], feces seen outside the pit hole of latrines [AOR: 2.943, 95% (1.347, 6.429)], mothers/care givers who feed adult food to the children [AOR: 6.985,95 % (1.074, 45,433)] and bottle feeding [AOR: 8.269 ,95% (1.086, 62.975)] were significantly associated with acute diarrheal disease.

Conclusions and recommendations: Acute diarrhea is prevalent in children under five, linked to improper latrine use, unsafe drinking water sources, distance to water sources, and inadequate food and feeding practices. Recommendations to mitigate this include improving water sources, promoting proper latrine use, educating on appropriate food and feeding, and implementing health education programs on household hygiene, sanitation, and behavior.

Impacts of the Northern Ethiopian Conflict on Malaria Elimination Programs in the Amhara region, Northwest Ethiopia: A Time-Series Analysis

2024-10-09T08:12:33+00:00

Background: Malaria remains a significant public health challenge in the Amhara Region of Ethiopia. The armed Northern conflict from 2020 to 2022 significantly impacted the Amhara region, including driving internal displacement and disrupting healthcare services. This report aimed to assess the pattern of malaria epidemiology and the impact of war on elimination programs in conflict-affected zones of the Amhara Region.

Methods: Retrospective data, cross-sectional interrupted time-series analysis, and a project model were used to estimate the impact and calculate the relative level changes from 2020 to 2022. The model was validated by comparing the results with observed malaria incidence data.

Results: Although most health institutions have restored malaria services, they are still 24% below the pre-war levels, with up to 35 weeks of treatment interruptions occurring in conflict-affected areas and significant decreases in other zones. Malaria cases reported in 2021 surpassed those from 2018–2020, reaching 2020 levels, which is concerning because of continuous service interruptions. The number of confirmed cases increased across all district categories, with non-affected districts experiencing a proportionally larger increase than conflict-affected districts. Significant damage to malaria elimination supplies occurred in conflict-affected areas, especially North Shewa and South Wollo, leading to increases in cases. Ordinary least squares regression analysis further indicates a general decline in relative incidence ratios across conflict-affected districts, underscoring the impact of conflict on malaria control efforts.

Conclusions: A significant decline from pre-war levels and ongoing service disruptions in conflict-affected areas fuel malaria transmission, reactivation, and failed elimination. These calls for malaria elimination programs and vigilance surveillance systems for community screening, active case detection and effective management, and epidemiological studies to monitor the transmission dynamics.

Dog-Mediated Rabies Exposure to Humans in Ethiopia: A Systematic Review and Meta-analysis

2024-11-11T05:48:11+00:00

Background: Dog-mediated rabies is a global public health agenda, especially in developing countries like in Asia and Africa. More than 95% of rabies incidence can be reduced by dog vaccination coverage of 70 %. In Ethiopia, a review of facility-based studies indicated around 32 % of dog-mediated human rabies exposure cases, which seems low compared to the global estimate. Given this finding, assessing comprehensive level of human exposure to dog-mediated rabies in Ethiopia becomes a crucial first step toward addressing the issue. Therefore, this review aimed to pool the prevalence of dog-mediated rabies exposure to humans using both community and facility-level studies.

Methods: We prepared a review protocol per Joanna Briggs Institute (JBI) manual for evidence synthesis and conducted a comprehensive search of PubMed, Cochrane, Google Scholar, and African Index Medicus databases and grey literature from 17 December 2023 to 06 April 2024. The pooled prevalence of dog-mediated rabies exposure to humans was computed using R v 4.3.1 software. Subgroup analysis was done on sample size, geographical location, and year of publication. Publication bias was assessed using a funnel plot.

Results: Based on 21 studies and 9,261 participants, the pooled prevalence of dog-mediated rabies exposure to humans was 90% (95% CI: 83-94) for the random effects model with I2 = 97% and p < 0.01. Sub-group analysis was done to investigate the source of heterogeneity, including sample size, study area, and year of publication. All the above-listed variables were not significant sources of statistical heterogeneity.

Conclusion and recommendations: This finding showed that the prevalence of dog mediated rabies exposure to humans is high. Therefore, the Ethiopian ministry of health, in collaboration with animal health, through a one-health approach, should target dog management including vaccination to preventive coverage (70%) to prevent the risk of rabies by dogs.

Health Challenges in Resource-Limited Settings: The Burden of Cancer, Infectious Diseases, and the Impact of Conflict on Disease Control

2025-08-18T12:53:52+00:00