Biomedical Center Research Articles

Traditional healers in Senegal: Characteristics and beliefs about treatment of diabetes

Background: It is known that patients with noncommunicable diseases utilize traditional healers (THs) regardless of their ability to access biomedical treatment facilities. However, information regarding the practices of THs and how they treat in Sub-Saharan African (SSA) is limited. This study examines the sociodemographic characteristics of Senegalese THs, how they treat diabetes, and how they interact with both patients and the larger health-care system. Materials and Methods: THs were identified in M'bour, Senegal, who practice alongside a government hospital and several health outposts. Twenty THs agreed to participate in recorded interviews. A standardized questionnaire was used to investigate general practices and management of diabetes. Results: Eighteen of the THs were male, ages 22–70 years. Thirteen were trained through family members, while five never received training, citing that they were born with or received their gift in a dream. All THs treated physical illnesses, including diabetes. Plants were used by all THs and were usually dispensed in the form of powder. Nine THs stated that they could lower blood sugar levels, while five said they were able to cure diabetes completely. Many THs cited referring patients to biomedical treatment centers if unable to manage their conditions either initially or after treatments were unsuccessful. Conclusions: This study provides insight into the practice of THs in rural Senegal. Findings suggest the need for collaboration among THs, health professionals, and patients, given the increasing burden of diabetes in SSA.

A Result Based Experimental Analysis of Rwandan Financial Progress as a Result of OAG Audit with Reference from 2014 to 2018

The study intends to be a result based experimental analysis of Rwandan financial progress as a result of office of auditor general (OAG)’s audit with Reference from 2014 to 2018. The objective of the study was to analyze the financial effectiveness of Rwanda as result of status of OAG audit recommendations. The Research Methodology used was both qualitative and quantitative methods to achieve the research objective, the secondary data were collected and then analyzed through Spreadsheet and SPSS 20 tools. The result of the analysis noted that boards and government business enterprises (GBEs) in general have been predominantly getting adverse opinion in the last 3 years. However, there was a notable improvement for Rwanda development board (RDB), Rwanda biomedical center (RBC) and Rwanda transport development agency (RTDA). Regarding to unnecessary or unlawful expenditures, and whether there was embezzlement or squandering of public funds, there has been 68% decline in the Article 166 type of expenditure from Frw 17.6 billion (2016) to Frw 5.68 billion (2018). The biggest decline has been under “Unsupported expenditure” which has declined by 92% from Frw 6.9bln (2016) to Frw 0.6 billion (2018). Therefore, this is indicative of an improvement in public financial management (PFM) systems and controls when it comes to recording and accounting for expenditure.

Epidemiology, landscape architecture, "one health," and innovation: experience in an amazonian community

This article makes brief reference to the background of the "One Health" concept in the global and Peruvian context, and to the way in which this holistic health perspective served as the foundation for the creation of the Center for Technological, Biomedical, and Environmental Research (CITBM) at Universidad Nacional Mayor de San Marcos. Additionally, it describes the InterACTION Labs project, one of the experiences using the "One Health" approach, led by CITBM, the University of Washington, and Traction, an NGO focused on design and research in health and ecology topics. InterACTION Labs is a design and transdisciplinary action-research (TDAR) program developed in "Claverito," a floating community in the city of Iquitos in the Peruvian Amazon, based on the hypothesis that the built environment is a health determinant for both humans and other species (birds, reptiles, plants, etc.). It also discusses the concept of 'built environment' as related to the theory and practice of public health, landscape architecture, epidemiology, and other health and environmental fields. Finally, it reflects on the achievements and challenges of the project that began in 2015, and describes the work plan for the coming years, with a proposal to extend the program and use the "One Health" approach to promote human, ecological, and environmental health in Peru and other parts of the world.

Integrating Breast Cancer Early Detection Services Into the Rwandan Health Care System

Background and context: Promoting earlier detection of breast cancer is critical in low-income countries like Rwanda where symptomatic women face long diagnostic delays and most patients present with advanced disease. In these settings, promoting earlier clinical diagnosis should be the initial priority before screening of asymptomatic women. However, there are few data to guide such early detection policies. Aim: Develop a pilot breast cancer early detection program in a rural Rwandan district to evaluate its clinical and health system impact, identify the most effective and feasible roles for staff from each health care system level, and inform national policy. Strategy/Tactics: From 2015-2017 we implemented a training program for 12 randomly selected health centers (HCs) in Burera District, where Butaro Cancer Center of Excellence is located. We trained 1076 community health workers in breast awareness and 127 HC nurses in clinical breast exam (CBE) and management of breast concerns. We trained 9 hospital-level nurses and doctors in diagnostic breast ultrasound to facilitate evaluation of palpable masses. We used pre- and posttests, focus groups, patient surveys, HC registries, and hospital medical records to determine the impact of the training on trainees' knowledge and skills, the volume of patients presenting to health facilities and services provided, cancer detection rate, and clinical stage at diagnosis. Program/Policy process: We met regularly with cancer policy leaders in the Ministry of Health (MOH) and Rwanda Biomedical Centre (RBC) to share findings, identify successes and challenges and build support. Clinicians trained through the project have been invited to serve as national trainers in CBE and contribute to national cancer strategy discussions. Outcomes: Trainings significantly improved knowledge and skills among trainees and increased the number of patients with breast concerns at HCs and the hospital. There was an increase in the proportion of patients with benign disease and the number of needed ultrasounds and biopsies. HCs and the hospital were able to accommodate the increased volume without compromising other services. We had limited power to assess the impact on cancer stage, but noted a nonsignificant increase in incidence of early stage disease among patients referred by intervention HCs. We are now working with MOH/RBC in planning scale-up of the program to other districts and identify a strategy of diagnostic breast ultrasound at the DH level to facilitate evaluation of patients referred from HCs. What was learned: A strategy to promote earlier detection of symptomatic breast cancer was feasible in a rural Rwandan district, effectively strengthened health system capacity to care for patients with breast concerns, and suggests promising impact on patient outcomes. Engagement of key stakeholders in implementation science can help foster evidence-based national cancer control policy.

Assessment of Palliative Care Needs in Hospital Settings in Rwanda

Background: Rwanda is among the first African countries with a palliative care (PC) policy and implementation plan. A partnership with the Ministry of Health (MoH) through the Rwanda Biomedical Centre (RBC) and the University of Edinburgh has supported an integrated approach including expanding the evidence base. Aim: To assessing the need for (PC) to inform policy, service delivery and training. Methods: A point prevalence PC needs assessment was conducted in nine public hospitals (referral, provincial and district). A records census identified those with life-limiting illness (LLI) who were then invited to participate by interview. The assessment tool included the APCA African POS, POS S, WHO performance status and demographic information. Results: 608 case notes were reviewed, 152 eligible and 124 completed assessment. 25% of all patients admitted had LLI, of which 99.2% had evidence of unmet need determined by at least one score on the APCA POS ≥ 3. Diagnoses 29% cancer, 29% cardiovascular disease, 16.9% end-stage organ failure and 13.7% HIV. Symptoms with greatest impact; nausea and vomiting (34.7%) and pain (32.3%). 63.7% with WHO performance status 4 or 5. 8.1% seen by existing PC services. Conclusion: Although the MoH and RBC are making bold steps toward developing PC in Rwanda, there remains a significant amount of unmet PC needs. Meeting this need requires recognition of the scope of PC needs beyond cancer, feedback to the hospitals and health care workers, thinking strategically how to further strengthen the health system and further capacity building and training.

Home-Based Care Practitioners: A Strategy for Continuum of Care for Very Ill Patient

Background: Rwanda Ministry of Health in collaboration with partners has initiated an innovative initiative named Home Based Care Practitioners (HBCPs) to respond to the burden of long-term hospitalization for end of life patients. Aim: The program aims at providing home-based care to accompany patients and their families in their home, reduce unnecessary pain and suffering for those with chronic or terminal conditions, provide counseling to the patients and their families, early diagnosis of NCDs and improve awareness on prevention of NCDs risk factors and effectively refer them to either health facilities or community-based resources that can be of further help. Methods: The HBCPs is implemented into phases; phase one has started with a pilot of 200 HBCPs in 100 cells surrounding nine provincial and referral hospitals of Rwanda; 2 practitioners for both gender in each cell, with a criteria of completion at least secondary school. They have undergone a training of 120 credits (900 hours), equivalent of four months for theory and two months of practice. After training they have been deployed into the community with a supervision of health centers in collaboration with hospitals and Rwanda Biomedical Center. Results: During the implementation period of 6 months, 1663 NCDs patients have been transferred from health facility (OPD) to HBCPs for routine follow-up, 482 palliative care patients have been reported on end of life care by HBCPs, there is a remarkable linkage between facilities and community care ensured by supervisory relationship between health services providers and home based care practitioners, long-term admission has reduced the cost for the family and the facility due to the discharge of care from hospital to home. Conclusion: In a limited setting of social and economic cost of providing frivolous care in an expensive hospital for chronic or terminal conditions that would be better managed through treatment or palliative care at home (or less acute setting) home based care effort can better meet the needs of Rwandans at the community level and has started to show the efficiency in providing quality care to people in need of palliative care.

Croton mubango Müll. Arg.: Its Botany, Ethnomedicinal Uses and Pharmacological Properties

Croton mubango is widely used as traditional medicine in tropical Africa. The potential of C. mubango as traditional medicine, its botany, chemical and pharmacological activities are reviewed. The literature relevant to the study was obtained from scientific databases such as BioMed Central (BMC), Web of Science, Google Scholar, Scopus, Science Direct, PubMed, Springerlink and Scielo. Other supplementary literature such as books, book chapters, theses, conference papers and other scientific publications were obtained from the University of Fort Hare Library and dissertation search engines such as EThOS, OATD, ProQuest and Open-thesis. Literature search revealed that the bark, fruits, leaves and roots of C. mubango are commonly used as traditional medicines for abdominal pain, diarrhoea, dysentery, fever, hernia, intestinal worms, malaria, rheumatism, toothache, tuberculosis and as purgative. Phytochemical compounds isolated from C. mubango include alkaloids, flavonoids, reducing sugars, saponins, steroids, tannins, terpenes and triterpenes. Pharmacological studies on C. mubango indicate that the species has in vitro and in vivo antiplasmodial activities. Several medicinal applications and therapeutic potentials of C. mubango have been demonstrated in this study although the majority of them still need pharmacological validation.

A Review of Phytochemistry and Pharmacological Properties of Threatened Croton Species Used as Herbal Medicines in East Africa

Some rare and threatened Croton species have a long history of medicinal usage in East Africa. The objective of this study was to review the phytochemistry and pharmacological properties of five Croton species that are threatened with extinction in East Africa but widely used as herbal medicines in the region. Information on medicinal uses, phytochemistry and pharmacological properties of C. alienus, C. dictyophlebodes, C. jatrophoides, C. megalocarpoides and C. talaeporos was obtained from databases such as Scopus, Web of Science, Science Direct, Google Scholar, PubMed, BioMed Central (BMC), Springerlink and Scielo. Other sources of information included scientific publications, conference proceedings, theses, books and book chapters obtained from libraries. Literature search revealed that the bark, fruits, leaves and roots of these five Croton species are commonly used as traditional medicines for gastro-intestinal disorders, colds and influenza, body pains and weaknesses and intestinal worms. Phytochemical compounds isolated from these species include alkaloids, anthraquinones, diterpenoids, esters, flavonoids, furanoditerpenoids, limonoids, methylcyclohexanes, phenolics, steroids, tannins and triterpenoids. Pharmacological studies indicate that these species have antifungal, anti-leishmanial and insect antifeedant activities. Preliminary phytochemical and pharmacological research done so far on Croton species is promising, but too general to corroborate some of the medicinal uses of the species.

STUDENT-CENTERED LEARNING IN RELATION TO CLASS PERFORMANCES AND SOFT SKILLS: A META-ANALYSIS AND SYSTEMATIC REVIEW

Background: Studies showed that SCL improved quality of medical education through knowledge acquisition, class performance, students’ attitude and soft skills. Although research about SCL and its impact has been widely known, overall correlation of SCL to the class performances has not yet been established. Strong correlation between SCL to class performances would serve the purpose of teaching and learning and more importantly would answer the skepticism of institution or faculty members in implementing SCL. In addition, learning through systematic review of others’ studies, how SCL influenced soft skill aspects would be benefited for medical educators. Soft skills such as learning motivation, communication skills, and teamwork may lead educators to the favor of SCL approaches. This review was to find the correlation of student-centered learning to the students’ performances and soft skill aspects in medical education.Method: To find the correlation of the SCL and class performances, we used meta-analysis. We also performed a systematic review to qualitatively find the relationship between SCL and other aspects, such as teamwork, communication skills, and learning motivation. Literatures were filtered from databases of: Proquest, Springerlink, Biomed Central (BMC) open, BMJ open, and Google Scholar. The inclusion criteria were published empirical articles (2000-2013) reported SCL’s effect on class performances or other aspects (learning motivation, teamwork, communication skills). We utilized PRISMA protocol to filter the inclusion articles. By reading abstracts and further snowballing searching, we found 12 articles for the meta-analysis and 33 articles for the systematic review. Results: Among 12 articles of the meta-analysis, 9 articles showed positive correlation between SCL and class performances. Three studies reported that SCL had no effect on the class performances. None of the articles reported any negative impact. We utilized the Comprehensive Meta-Analysis software to analyze the data and found r = 0.46 and 95% CI: 0.32 - 0.57. It showed a statistically significant correlation between SCL and class performances. On the systematic review, we found that SCL improved communication skills, team work, and learning motivation.Conclusion: From the meta-analysis we found that SCL improved class performances about 46%. It was showed that SCL methods were superior in improving soft skills such as communication skills, teamwork, and learning motivation.

Nursing Provision in Psychological Aspect Management of Natural Disaster

Natural disasters are an event or series of events caused by natural phenomena such as earthquakes, tsunamis, volcanoes, floods, droughts, hurricanes and landslides, resulting in human casualties, environmental damage, property losses objects, and psychological effects. Therefore, the need for nurse preparedness is especially special on the psychological aspect aside from the physical aspect. Nurse personnel is the first milestone that will be sought by the people affected by disaster, because nurses as the front line in a health service has a responsibility and a big role in handling the patient's daily emergency and disaster strikes. To know nurse preparedness in psychological aspect in facing natural disaster. The writing of this journal uses a literature study approach from several sources selected based on the criteria set by the author. The research journal was obtained from several databases, namely PubMed and BioMedCentral (BMC) Psychiatry. In total, the literature review consists of 10 journals, 4 studies report effective outcomes including knowledge, skills, self-awareness, interest, intellectual, cooperation, and motivation need to be prepared to support disaster management, 5 research reports that nurses need to prepare themselves on the psychological aspect in the form of cognitive, intellectual, interest, attitude, clinical skills education and rescue comprehension with basic principles of psychosocial support. Last 1 study reported the result that the need for training for administrators on hospital management in disaster preparedness. The psychological aspect is very important that must be prepared by the nurse in facing natural disaster, thus preventing the occurrence of psychological impact (in the form of psychological disorders such as depression, anxiety and other mental disorders) either self-nurse or victim to be handled by natural disaster happen.

<i>Astraea lobata</i> (L) Klotzsch (Euphorbiaceae): An ethnopharmacological review

This is a review on the medicinal uses, phytochemistry and biological activities of A. lobata with a view to present a better understanding of the medicinal potentials of the species. Published literature on A. lobata were sourced from databases such as Google Scholar, Web of Science, SciFinder, Scopus, Science Direct, PubMed, Scielo, Springerlink, Google Patents, Espacenet, BioMed Central (BMC) and Medline. Astraea lobata is native to north, central and south America, and now naturalized in Benin, Ghana, Ivory Coast, Nigeria, Senegal and Togo where it is used to treat numerous diseases including dysentery, malaria, menstrual problems, scorpion bite, rheumatism pain, skin cancer, sterility in women and as purgative. Multiple classes of phytochemicals such as alkaloids, anthraquinones, esters, diterpene alcohols, flavonoids, hydroxy ketones, peptides, phenolics, saponins, steroids, tannins, triterpenes and triglycerides have been isolated from fruits, leaves, roots and stems of A. lobata. Scientific studies on A. lobata indicate that it has a wide range of pharmacological activities which include antibacterial, antidiabetic, antiplasmodial, antioxidant, antitrypanosomal and leishmanicidal activities. The wide usage of A. lobata as a herbal medicine calls for detailed pharmacological and phytochemical studies aimed at correlating the documented medicinal uses of the species with its biological activities and phytochemistry. Keywords : Astraea lobata , Euphorbiaceae, herbal medicine, pharmacology, phytochemistry

Clinical curative effect research status and analysis of acupuncture treatment for primary insomnia

To grasp the clinical efficacy of acupuncture in the treatment of primary insomnia (PI), and analyze its future research directions. A total of 41 prospective randomized controlled trials (RCTs) were conducted in which the clinical efficacy of acupuncture for treatment of PI was compared with sedative and hypnotic drugs in recent six years by searching databases of CNKI, WANFANG database, PubMed, and BioMed Central (BMC), the aspects of diagnostic criteria, efficacy standards, observation time, control drugs, characteristics of acupoint selection and regularity were used to review and analyse. Acupuncture treatment for PI was mainly based on acupoints in the head, combined with selecting the points according to the different syndrome, showing short-term efficacy and safety advantages, but it was not well-established in many aspects such as diagnostic criteria, efficacy evaluation, observation time, and control drugs. Current evidence shows that acupuncture treatment is effective, but it is necessary to add more stringent RCTs, and introduce objective monitoring indicators to strengthen the evidence and enhance the overall level of research.

PO-520 POLE gene mutation analysis in colorectal cancer patients with MSS – a pilot study

IntroductionTumours characterised by high-mutation rate and neoepitope load, which are hypothesised to be responsible for their high immunogenicity, are known to respond to the immune checkpoint inhibitor therapy. Microsatellite instability (MSI) in patients with colorectal cancer (CRC) is a biomarker for the high mutation rate is these patients. Besides MSI, there exists a subset of CRC patients with stable microsatellites (MSS) and germline or somatic mutations in functional domains of the DNA polymerase ε encoded by POLE gene who can benefit from the immune checkpoint therapy. The aim of this retrospective pilot study was to detect POLE mutations and identify patients with MSS CRC who could benefit from the immune checkpoint inhibitor therapy. Because the detection of POLE mutations requires sensitive methods, we used single tube nested PCR to improve the sensitivity of the method.Material and methodsIn this pilot study, 34 patients with the diagnosis of CRC aged 52 or less out of 270 CRC patient cohort have been enrolled. The lymphocyte infiltration and MSI were determined. PCR primers were designed for exons 9, 11 and 13 of the POLE gene, one pair of external primers as well as one pair of internal primers for each exon. The amplicons were sequenced according to the Sanger method using internal primers. The sequences were aligned with the reference sequence (ENST0000032057.9).Results and discussionsThe average age of our patients was 43.9 years. The nested PCR was optimised by touch down approach with two different annealing temperatures for external and internal primers. In our pilot study, we were not able to find any of the previously described pathogenic mutations. In one case of colorectal adenocarcinoma with mucinous elements (48y), a silent substitution c.893C>T resulting in p.L283L was detected with forward and reverse primers. This substitution is not described in dSNP. Using MutationTaster, we have found a possible effect of this substitution on RNA splicing, which still has to be confirmed on the RNA level.ConclusionMutations in POLE gene in CRC and endometrial cancer are associated with hypermutated tumours and are promising predictive biomarkers in immune checkpoint inhibitor therapy. It is important to develop sensitive methods that enable the detection of somatic mutations in routine clinical setting. Supported by Biomedical Centre Martin (ITMS 26220220187) and APVV-16–0066.

How Metrics-Based Academic Evaluation Could Systematically Induce Academic Misconduct: A Case Study

This article analyzes a case of postproduction misconduct, that is, the BioMed Central (BMC) retraction incident, which is the beginning of a series of massive retraction incidents that China has encountered in recent years. Our analysis echoes the pioneering research of STS scholar Mario Biagioli, who argues that our academic culture is shifting from “publish or perish” to “impact or perish.” Getting a good score on the metrics of academic evaluation becomes the goal of some scholars, leading to the emergency of postproduction misconduct. As revealed in the BMC retraction incident, commercial agencies that claimed to be able to facilitate academic publishing manipulated the peer-review process of academic papers by fabricating their peer reviews to help some clinicians meet the requirements of the title assessment system. This article advances Biagioli’s argument by expounding on the following two characteristics of the BMC retraction incident: first, peer reviews were fabricated by agencies instead of the authors themselves; second, the incident was induced systematically by the title assessment system, instead of particularly by individual factors of the authors. Through analyzing this case, we obtain important insight into postproduction misconduct, which is beneficial to more thoroughly understanding and then mitigating this new type of academic misconduct.

Training programmes to improve evidence uptake and utilisation by physiotherapists: a systematic scoping review

BackgroundResearch training programmes are a knowledge translation (KT) intervention which aim to improve research evidence uptake by clinicians. Whilst KT training programmes have been reported to significantly improve evidence uptake by physiotherapists, it is unclear which aspects of training optimally assist KT into physiotherapy practice. The purpose of the review was to establish the body of evidence regarding KT training programmes to improve physiotherapists’ use of evidence-based practice (EBP) and clinical practice guidelines (CPG).MethodsA systematic scoping review was undertaken in line with the adapted Arksey and O’Malley framework. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PUBMED, OTseeker, Scopus, ERIC) were searched. Targeted keywords identified primary research articles of any hierarchy, that described the nature and impact of KT training programmes for physiotherapists. Where systematic reviews were identified, the component primary studies were considered individually for relevance. Critical appraisal was not undertaken due to the nature of a scoping review, and data was reported descriptively.ResultsTen systematic reviews were identified (yielding four relevant primary studies). Five additional primary studies were identified (two randomised controlled trials, two non-randomised controlled trials and one pre-post study) which were not included in the original systematic reviews. This provided nine eligible primary research studies for review. The KT strategies were all multi-faceted. Interactive sessions, didactic sessions, printed material and discussion and feedback were consistently associated with effective outcomes. When KT strategies addressed local barriers to EBP utilisation, there were better success rates for EBP and CPG uptake, irrespective of the outcome measures used. There were no consistent ways of measuring outcome.ConclusionMulti-faceted KT strategies designed to address local barriers to knowledge translation were most effective in improving EBP/ CPG uptake among physiotherapists.

EFFECT OF RESISTANCE TRAINING ON RESPIRATORY PARAMETERS - A SYSTEMATIC REVIEW

BACKGROUND AND OBJECTIVES Normally, aerobic exercises are considered as the therapeutic medium for improving cardiopulmonary parameters. The objective of this review is to evaluate the impact of aerobic resistance training on pulmonary parameters. DATA SOURCES Pubmed, Google Scholar, Science Direct, Biomed-Central (BMC), Pubmed-Europe, Medline, EMBASE and Pedro ELIGIBILITY CRITERIA Studies investigating role of resistive exercise training on pulmonary parameters including FVC, FEV1, VO2, TLCO etc, either alone or in combination with other exercise regimes, are included. REVIEW METHODS Data was extracted according to a standardized assessment form according to inclusion criteria. Risk of bias was evaluated according to the Cochrane risk of bias guidelines and qualitative analysis was performed.

Chikungunya and West Nile viruses among blood donors in Rwanda: seroprevalence and distribution of mosquito vectors

Introduction : Chikungunya virus (CHIKV) and West Nile viruses (WNV) have natural sylvatic cycles, but may move to cities to infect humans and cause epidemics with serious clinical problems. Nodata exist concerning their seroprevalence in Rwanda, despite their origin from its neighboring countries, Tanzania and Uganda. Here we report a sero-surveillance study of CHIKV and WNV and the regional distribution of their mosquito-vectors in Rwanda. Methods : Rwandan blood donors (n = 874) and Swedish (n = 199) were tested for IgG specific ELISA against CHIKV, using an in-house antigen, the E1 envelope protein, and against WNV using an ELISA commercial kit, FOCUS Diagnostics (Cypress, CA USA). Also data from Rwanda Biomedical Center on assessment of Yellow Fever virus circulation in Rwanda reported in 2014 were collected. Results : seroprevalence of CHIKV IgG was high in Rwanda (47%) compared to Sweden (4.5%), while WNV seroprevalence was 10.4% and 14.1% respectively in Rwanda and Sweden. In the latter group, 78.6% of WNV specific-IgG positive subjects were cross-reactive to Tick Borne Encephalitis virus (TBE), explaining the unexpected seroprevalence of WNV in Sweden. Regarding mosquito-vectors the Culex spp was most prevalent (82.5%) while Aedes spp was found at lower amounts (9.6%) around all Rwanda. Conclusion : in Rwanda, CHIKV is more sero-prevalent as compared to WNV, while the mosquito-vector Culex spp, and is more prevalent followed by Aedes spp. There is a high and bidirectional cross-reactivity between TBE and WNV IgG. The Eastern region of Rwanda reported the highest seroprevalence to CHIKV and WNV, and population of mosquito-vectors.

Ethnopharmacology and Therapeutic Value of Bridelia micrantha (Hochst.) Baill. in Tropical Africa: A Comprehensive Review.

Bridelia micrantha is traditionally used in tropical Africa to treat a wide range of human and animal diseases. The aim of this study was to summarise the research that has been done on the ethnomedicinal uses, phytochemistry and pharmacological properties of B. micrantha so as to understand its importance and potential value in primary healthcare systems. The literature search for information on ethnomedicinal uses and pharmacological activities of B. micrantha was undertaken using databases such as Web of Science, Scopus, Google Scholar, Science Direct, BioMed Central (BMC), PubMed and Springerlink. Other relevant literature sources included books, book chapters, websites, theses, conference papers and other scientific publications. This study showed that B. micrantha is used as herbal medicine in just over half (57.3%) of the countries in tropical Africa where it is indigenous. A total of 54 ethnomedicinal uses of B. micrantha have been recorded with a high degree of consensus on burns, wounds, conjunctivitis, painful eyes, constipation, gastric ulcers, cough, headache, rheumatism, painful joints, dysentery, ethnoveterinary medicine, malaria, sexually transmitted infections, stomach ache, tape worms and diarrhoea. Different plant parts, aqueous and organic extracts exhibited anthelmintic, antimicrobial, anticonvulsant and sedative, antidiabetic, antidiarrhoeal, antinociceptive, antioxidant, antiplasmodial, antischistosomal, hepatoprotective, insecticidal and β-lactamase inhibitory activities.

Help seeking and suicidality among people with epilepsy in a rural low income country setting: cross-sectional survey

BackgroundsEpilepsy is a serious neurological disorder associated with a high level of psychiatric comorbidity. Suicidality is a recognised complication of epilepsy. As part of developing an integrated service for people with epilepsy (PWE) and priority psychiatric disorders within primary care, a cross-sectional study was conducted in a rural district in Ethiopia to investigate patterns of help-seeking, suicidality and the association with duration of untreated epilepsy (DUE) among PWE.MethodsCases were identified through community key informants and diagnosis was confirmed by trained primary care clinicians. Severity of epilepsy, depression and suicidality were assessed using standardised methods. Multivariable regression analysis was used to test the hypothesis that suicidality was associated with DUE.ResultsThe majority of PWE sought help from both religious and biomedical healing centres. The lifetime treatment gap for biomedical care was 26.9%, with a 12 month treatment gap of 56.7%. Close to one-third (29.9%) of participants reported using traditional and cultural healing practices. Nearly one-third (30.2%) of participants reported suicidality (suicidal ideation, plan or attempt) in the previous 1 year. The median (IQR) DUE was 24 months (4–72). There was no association between DUE and suicidality. In the multivariable model, being married [odds ratio (OR) 2.81, 95% CI 1.22, 6.46], increased depressive symptoms (OR 1.17, 95% CI 1.10, 1.26) and perceived poorer wealth relative to others (OR 2.67, 95% CI 1.07, 6.68) were associated independently with suicidality.ConclusionIn this study, PWE sought help from both biomedical and religious healing centres. Suicidality and depression have a high prevalence in PWE in this setting. Integrated mental and neurological health care within primary care is needed for improved holistic management of epilepsy.

Editorial introductions

Current Opinion in Hematology was launched in 1994. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of hematology is divided into nine sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Hal E. BroxmeyerHal E. BroxmeyerDr Hal E. Broxmeyer is a distinguished Professor, Professor of Microbiology and Immunology, Mary Margaret Walther Professor Emeritus, and Co-Leader Program on Hematopoiesis, Malignant Hematology, and Immunology, Indiana University Simon Cancer Center, and former Chairman of Microbiology and Immunology and Scientific Director, Walther Oncology Center, at the Indiana University School of Medicine, Indianapolis, IN, USA. From 1975 to 1983, he worked at the Memorial Sloan Kettering Cancer Center (MSKCC) in New York City rising from the rank of Associate Researcher to that of Associate Member. He was also Assistant Professor of Biology, Sloan Kettering Division of Cornell University Graduate School of Medical Sciences, New York, USA, before being recruited to the Indiana University School of Medicine in 1983 as an Associate Professor of Medicine. To date, he has published 764 scientific papers (527 refereed papers and 237 Reviews/Book Chapters). Dr Broxmeyer's laboratory studies mechanisms regulating hematopoietic stem and progenitor cell, embryonic stem cell and induced pluripotent stem cell: proliferation, self-renewal, survival, differentiation and migration (homing/mobilization) and he was involved in establishing the field of cord blood transplantation. Dr Broxmeyer has been the recipient of numerous awards since the 1970's. The more recently include Indiana University School of Medicine Alumni Association (2008); State of Indiana General Assembly House Resolution No. 46 (2008); Mission Advancement Award, Leukemia Lymphoma Society (2008); Cord Blood Pioneering Award, Int. Cord Blood Symposium (2008); Till and McCullough Award, Canadian Bone Marrow Transplant Group (2010); Donald Metcalf Award, Int. Soc. Expt. Hematol. (2011); Elected Fellow of the American Association for the Advancement of Science (AAAS) (2013); and Honorary Professorship, Peking Union Medical College, Beijing, China (2014). Dr Broxmeyer is a Past President of the American Society of Hematology (ASH; 2010), past President of the International Society for Experimental Hematology (ISEH, 1990, 1991), past Chairman, and member, Board of Scientific Councilors, National Space Biomedical Research Institute (NSBRI/NASA, 1998–2006), and Chairman Emeritus, Board of Directors, National Disease Research Interchange, Philadelphia, PA, USA. Ari MelnickAri MelnickAri Melnick, MD, is the Gebroe Family Professor of Hematology/Oncology and a Professor of Medicine and Pharmacology at Weill Cornell Medical College (WCMC) in New York City, USA. He is Chair of the Hematologic Malignancies Program of the Weill Cornell Cancer Center and is also Director of the Raymond and Beverly Sackler Center for Biomedical and Physical Sciences and Director of the Epigenomics Core Facility, both of which are at WCMC. Dr Melnick was raised in Argentina and received his medical degree from the University of Buenos Aires, Argentina. He completed a residency in internal medicine and a fellowship in hematology/oncology, as well as a postdoctoral fellowship at the Mount Sinai School of Medicine in New York City, USA. Dr Melnick's research interests include the biology and molecular targeting of B-cell lymphomas, targeting transcriptional and epigenetic repressors for cancer therapy, and identifying the epigenetic basis of hematologic malignancies. He and his research associates have also developed novel therapies to correct aberrant transcriptional regulation and signaling in these tumors. Dr Melnick has been Scientific Chair of the American Society of Hematology (ASH) annual meeting and has organized several meetings in the areas of epigenetics and hematologic malignancies. Dr Melnick is a past ASH Faculty Scholar and Kimmel Foundation Scholar, and he has been recognized for this work by the Leukemia & Lymphoma Society. He is also co-leader of the New York Leukemia Working Group. Dr Melnick has authored or coauthored more than 150 published manuscripts in journals such as Nature, Science, Cell, Cancer Cell, Nature Medicine, Nature Immunology, and the New England Journal of Medicine.