Strongyloides stercoralis infection in Ethiopia: systematic review and meta-analysis on prevalence and diagnostic methods

Summary Strongyloides stercoralis is a helminthic intestinal parasite that causes the disease strongyloidiasis. Its prevalence is high in tropics and sub-tropics due to poor sanitation and hygiene. However, its true prevalence is not well known in Ethiopia as most health institutions use low sensitive diagnostic methods. This review aimed to determine the pooled prevalence of S. stercoralis at country, and regional state levels. Papers published on S. stercoralis in Ethiopia from 2010 to 2020 were collected from PubMed, Google Scholar and Science direct databases and Addis Ababa repository. Identification, screening, checking the eligibility, and inclusion of the relevant literatures were done. Articles with S. stercoralis positive results from Ethiopian populations were included. Articles which focused on Strongyloides infection in foreigners, and other than stool samples were excluded. The pooled prevalence of S. stercoralis and heterogeneity between studies and across regions were computed. From the 43 articles, the overall prevalence of S. stercoralis in Ethiopia was 1.82 %. Across regions, relatively high prevalence of S. stercoralis (8.78 %) was recorded in Addis Ababa city. High prevalence of S. stercoralis was found to be 44.02 % with a combination of formol ether concentration, Baermann concentration, and molecular methods. Low prevalence of 0.26 %, 0.31 %, and 1.20 % was evidenced respectively with Kato-Katz, direct saline microscopy, and formol ether concentration methods. Using random effect analysis, the pooled prevalence of S. stercoralis in Ethiopia, across regions and across diagnostic methods was 2.1 % (95 %CI: 1.20 – 3.60), 2.6 % (95 %CI: 0.80 – 8.20) and 3.7 % (95 %CI: 1.10 – 11.70), respectively. The heterogeneity was high (P<0.001). This review revealed that Strongyloides infection is probably underreported and its prevalence could be higher than the reported in Ethiopia. Therefore, a revision of the best combination of diagnostic methods could be advisable as it gives better diagnostic results in routine diagnosis of Strongyloides infection in Ethiopia.

DETERMINANTS OF PROFITABILITY OF GENERAL INSURANCE COMPANIES IN INDONESIA

This paper investigates the determinants of profitability of General Insurance in Indonesia, focusing on firm-specific factors and macroeconomics factors. General Insurance in Indonesia play important role in the economy by providing protection of risk of loss either to organizations and individuals. Based on this background, the aim of this paper is to study and improve the profitability of general insurance through a random effect analysis of 40 general insurance companies since 2013 until 2017. The data obtained is time series data and cross section data so that the data analysis in this study uses Panel Data Regression Analysis. The empirical study shows that firm size, liquidity ratio, equity growth, underwriting result, return on investment, input cost, claim ratio, technical ratio, economic growth rates and Bank Indonesia interest rate are significant factors that affect profitability of general insurance companies. Companies can improve their profitability by planning, monitoring and defining financial strategy based on the relation whether – positive or negative, between significant factors and profitability.

465. Comparative Efficacy of Double vs. Single Antibiotic Regimens for the Empiric Treatment of MRSA-Induced Acute Bacterial Skin and Skin Structure Infection

Background The initial management of Acute bacterial skin and skin structure infection (ABSSSI) is burdensome. It requires empirical antibiotic therapy that covers both gram-positive and gram-negative bacteria. Vancomycin plus aztreonam are the most commonly used antibiotic combination, nonetheless, they have many limitations which limits their use. Hence, many new single agents with MRSA and gram-negative coverage, oral options, and/or good safety profile have been developed to be a potential alternative such as: ceftaroline, ceftobiprole, tigecycline and the recent FDA approved antibiotic (delafloxacin). In the absence of head-to-head trials comparing these agents, we decided to conduct a network meta-analysis for these therapeutic regimens. Methods A Bayesian network meta-analysis of randomized clinical trials identified in PubMed/Medline and Embase databases was conducted. We performed both fixed and random effect models for clinical cure as the primary outcome of interest. Additionally, rankograms were generated using the surface under the cumulative ranking curve (SUCRA) to obtain the treatment ranking probabilities in relation to their relative effect. Results We identified 10 eligible studies involving 4,914 patients. The indirect comparison demonstrated that delafloxacin showed no difference in terms of clinical cure compared with ceftaroline (OR, 0.82, 95% Cr.I 0.39–1.8), ceftobiprole (OR, 0.79, 95% Cr.I 0.32–1.9), SOC (OR, 1.2, 95% Cr.I 0.62–2.4) and tigecycline (OR, 1.0, 95% Cr.I 0.45–2.2) in the fixed effect analysis, nor in the random-effect analysis (OR, 0.8, 95% Cr.I 0.26–2.2; OR, 0.78, 95% Cr.I 0.2–3.0; OR, 1.2, 95% Cr.I 0.51–3.1; and OR, 0.96, 95% Cr.I 0.30–3.0), respectively. Furthermore, the ranking probabilities in the fixed-effect and random-effect analysis showed that ceftaroline was ranked the first in terms of clinical cure (SUCRA, 40.02%) followed by ceftobiprole (SUCRA, 22.80%), delafloxacin (SUCRA, 16.60%), SOC (SUCRA, 13.80%), and then tigecycline (SUCRA, 6.70%). Conclusion Ceftaroline, ceftbiprole, delafoxacin, SOC and tigecycline are similarly effective. However, delafloxacin provides better convenience. Further comparative studies regarding their safety are needed. Disclosures All authors: No reported disclosures.

Labor Productivity and Foreign Direct Investment in the Indonesian Manufacturing Sector

This paper investigates the determinants of foreign direct investment (FDI) inflow, focusing on the effect of labor productivity in the Indonesian manufacturing sector. Indonesia has the advantage of abundant labor supply in attracting FDI to bring positive externalities to its economy. Based on this background, this paper is aimed to study and to improve FDI inflow through a random effect analysis of 19 manufacturing industries from 2001 to 2014. The empirical result shows that labor productivity, wages, and export have become significant factors that attract FDI. FDI inflow in this sector tends to target non-labor industries. For the labor-intensive industries, the primary strategy is to increase labor quality through improvement in education, training, internship program, and worker certification. Improving research and development climate, and maintaining the quality of labor through health and social protection regulation can attain improvement in non-labor intensive industries.

The Determinants of Profitability of the Pharmaceutical Industry of Bangladesh: A Random Effect Analysis

The present study investigates the factors affecting the profitability of the pharmaceutical industry of Bangladesh. Using the data of 20 listed pharmaceutical companies fully functional in Bangladesh, we found both the firm specific and the macroeconomic specific variables affect the profitability of the companies. A panel dataset of 10 years starting from 2007 to 2016, we ran the random effect regression. The regression output depicts that among the firm specific variables, sales, operating income, operating cost, return on equity and total liabilities have significant effect on the profitability of the companies. We also found that the GDP growth rate and the rate of inflation among the macroeconomic variables have significant deterministic role on the profitability. The regression results followed by recommendations will be a great help to the policy makers both from inside and outside of the corporations.

Efficacy of olanzapine for prevention of chemotherapy-induced nausea and vomiting: A systematic review and meta-analysis.

e21692 Background: Olanzapine is an atypical antipsychotic medication which has shown efficacy in prevention of chemotherapy-induced nausea and vomiting (CINV) in multiple trials. This study aims to investigate the efficacy of Olanzapine to prevent CINV with an up-to-date systematic review and meta-analysis. Methods: A literature search of Ovid MEDLINE, Embase and Cochrane library was performed to identify randomized controlled trials of olanzapine compared to other antiemetic therapy (5HT3 and/or NK1 antagonist with or without steroids) for prevention of CINV in patients age >=18 years up until December 2016. The primary endpoint was no emesis or nausea episodes in acute (0-24hrs), delayed (24-120hrs) and overall (0-120hrs) period in patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC). Statistical analysis was performed using Review Manager (RevMan 5.3). The Mantel–Haenszel method was applied and random effect analysis model was used to calculate risk ratios. Results: From the literature, 12 RCTs met the inclusion criteria. The age range of patients was 18-89 years. Seven trials included only patients who received HEC while 5 trials included patients receiving either HEC or MEC in various proportions. Olanzapine was statistically superior for 5 primary endpoints except for no nausea in acute period (Table 1). In the non-steroids cohort, olanzapine was superior for no emesis in all 3 periods but statistically significant only for delayed period. Conclusions: Olanzapine is superior to other antiemetic therapy for prevention of CINV. It is less expensive and can improve patient’s quality of life and chemotherapy adherence. [Table: see text]