Behailu Merdekios

Expanded program of immunization coverage and associated factors among children age 12 – 23 months in Arba Minch town and Zuria District, Southern Ethiopia, 2013

BackgroundImmunization averts an estimated 2 to 3 million deaths every year globally. In Ethiopia only quarter of children are fully immunized; the rest are remained at risk for vaccine-preventable mortality. To increase the immunization, its coverage and predictors has to be identified. This study has measured immunization coverage and identified the predictors.MethodsCross-sectional community based study has been conducted within 630 age 12–23 months children in 15 districts of Arba Minch town and Arba Minch Zuria district, Southern Ethiopia in March 2013. Census was done to identify eligible children. The 2005 world health organization expanded program of immunization cluster sampling method has been used. Data were collected using semi-structured pretested Amharic version questionnaire by interviewing index children’s mothers/caretakers, copying from vaccine card and observing BCG vaccine scar. Data were processed using SPSS version 16. Associations between dependent and independent variables has been assessed and presented using three consecutive logistic regression models.ResultNearly three fourth (73.2%) of children in Arba Minch Town and Arba Minch Zuria district were fully immunized. The rest 20.3% were partially immunized and 6.5% received no vaccine. Mother education, mothers’ perception to accessibility of vaccines, mothers’ knowledge to vaccine schedule of their site, place of delivery and living altitude were independent predictors of children immunization status.ConclusionExpanded program of immunization (EPI) coverage at Arba Minch town and Arba Minch Zuria district is better than the national immunization coverage but still below the goal. Educating mother, promoting institution delivery could help to maintain and enhance current immunization coverage. More emphasis should be given to the highland areas of the area.

A Qualitative Study of Barriers to Effectiveness of Interventions to Prevent Mother-to-Child Transmission of HIV in Arba Minch, Ethiopia

Objectives. Despite the availability of services to prevent mother-to-child transmission (PMTCT) of HIV, socio-cultural, health system and operational factors constrain many pregnant women from accessing services or returning for followup thereby increasing the risk of vertical transmission of HIV to newborns. We highlight and describe unique contextual factors contributing to low utilization of PMTCT services in Arba-Minch, Ethiopia. Methods. Qualitative research design was utilized to obtain data through focus group discussions and in-depth interviews with antenatal clinic attendees, health workers health facilities in the study area. Results. Awareness of PMTCT services and knowledge of its benefits was nearly universal, although socioeconomic, cultural and health system factors, including stigma and desire to prevent knowledge of serostatus, impede access to and utilization of services. Health system factors—lack of appropriate followup mechanisms, inadequate access to ARV drugs and poorly equipped manpower also contribute to low utilization of services. Conclusion. Reducing mother-to-child transmission of HIV in sub-Saharan Africa will be more effective when unique contextual factors are identified and addressed. Effectiveness of PMTCT interventions rests on a well functioning health system that recognize the importance of social, economic, cultural contexts that HIV positive pregnant women live in.

Effectiveness of interventions to prevent mother-to-child transmission of HIV in Southern Ethiopia.

Background In Ethiopia, Progress in Reducing Mother-to-Child-Transmission (PMTCT) of human immunodeficiency virus (HIV) is being curtailed by behavioral and cultural factors that continue to put unborn children at risk, and mother-to-child transmission is responsible for more than 90% of HIV infection in children. The objective of this study was to assess PMTCT services by examining knowledge about reducing vertical transmission among pregnant women. Methods A multistaged sampling institution-based survey was conducted in 113 pregnant women in Arba Minch. Qualitative and quantitative data were obtained. Results Of the 113 respondents, 89.4% were from Arba Minch, 43.4% were at least 25 years of age, 73.4% had formal education at primary level or above, 100% reported acceptance of voluntary counseling and testing, 92.0% were knowledgeable about mother-to-child transmission, and 90.3% were aware of the availability of the PMTCT service in the health facility. Of 74 HIV-positive women in PMTCT, only three (4.1%) had had skilled birth attendants at delivery. There was an unacceptable degree of loss of women from PMTCT. Maternal educational level had a statistical association with income (P < 0.001) and voluntary counseling and testing for pregnant women (P < 0.05). Factors that determined use of PMTCT included culture, socioeconomic status, and fear of stigma and discrimination. Conclusion In the area studied, intervention to reduce mother-to-child transmission of HIV is failing to reach its goal. This is an alarming discovery requiring quick reconsideration and strengthening of preventive strategies at all levels.

Children Who Received PCV-10 Vaccine from a Two-Dose Vial without Preservative Are Not More Likely to Develop Injection Site Abscess Compared with Those Who Received Pentavalent (DPT-HepB-Hib) Vaccine: A Longitudinal Multi-Site Study

Background The single dose pneumonia ten-valent vaccine has been widely used and is highly efficacious against selected strains Streptococcus pneumonia. A two-dose vial without preservative is being introduced in developing countries to reduce the cost of the vaccine. In routine settings improper immunization practice could result in microbial contamination leading to adverse events following immunization. Objective To monitor adverse events following immunization recommended for routine administration during infancy by comparing the rate of injection-site abscess between children who received PCV-10 vaccine and children who received the Pentavalent (DPT-HepB-Hib) vaccine. Methods A longitudinal population-based multi-site observational study was conducted between September 2011 and October 2012. The study was conducted in four existing Health and Demographic Surveillance sites run by public universities of Abraminch, Haramaya, Gondar and Mekelle. Adverse events following Immunization were monitored by trained data collectors. Children were identified at the time of vaccination and followed at home at 48 hour and 7 day following immunization. Incidence of abscess and relative risk with the corresponding 95% Confidence Intervals were calculated to examine the risk difference in the comparison groups. Results A total of 55, 268 PCV and 37, 480 Pentavalent (DPT-HepB-Hib) vaccinations were observed. A total of 19 adverse events following immunization, 10 abscesses and 9 deaths, were observed during the one year study period. The risk of developing abscess was not statistically different between children who received PCV-10 vaccine and those received Pentavalent (RR = 2.7, 95% CI 0.576–12.770), and between children who received the first aliquot of PCV and those received the second aliquot of PCV (RR = 1.72, 95% CI 0.485–6.091). Conclusion No significant increase in the risk of injection site abscess was observed between the injection sites of PCV-10 vaccine from a two-dose vial without preservative and pentavalent (DPT-HepB-Hib) vaccine in the first 7 days following vaccination.

Salivary and serum antibody response against Neisseria meningitidis after vaccination with conjugate polysaccharide vaccines in Ethiopian volunteers

Meningococcal conjugate vaccines induce serum antibodies crucial for protection against invasive disease. Salivary antibodies are believed to be important for hindering meningococcal acquisition and/or clearance of established carriage. In this study, we measured salivary IgA and IgG antibodies induced by vaccination with a monovalent serogroup A conjugate vaccine or a tetravalent A, C, W and Y conjugate vaccine, in comparison with antibody levels in serum. Saliva and serum samples from Ethiopian volunteers (1–29 years) collected before and eight times on a weekly basis after receiving the serogroup A conjugate vaccine, the tetravalent serogroup A, C, W and Y conjugate vaccine, or no vaccine (control group), were analysed using a multiplex microsphere immunoassay for antibody detection. Serogroup‐specific IgG antibody levels in saliva increased significantly after vaccination with both vaccines. The monovalent serogroup A vaccine also induced an increase in salivary IgA antibodies. A strong correlation between serogroup‐specific IgG antibodies in saliva and serum, and a somewhat lower correlation for IgA, was observed for all serogroups. There was also a strong correlation between specific secretory IgA and IgA antibodies in saliva for all serogroups. Meningococcal conjugate vaccines are able to elicit salivary antibodies against serogroup A, C, W and Y correlating with antibody levels in serum. The strong correlation between saliva and serum antibody levels indicates that saliva may be used as a surrogate of systemic antibody responses.

Evaluating the antibacterial and anticandidal potency of mangrove, Avicennia marina

Abstract Objective To evaluate the antibiotic activity of mangrove plant, Avicennia marina (A. marina) against human and shrimp pathogens and to delineate bioactive constituents by gas chromatography-mass spectrometer (GC-MS) profiling. Methods The antimicrobial activity of the different polar and non-polar extracts of A. marina was inspected by well diffusion technique against 16 bacterial pathogens and two fungal pathogens. Results Of the six organic extracts examined, methanolic extract of A. marina fairly repressed the growth of all bacterial and fungal pathogenic strains tested. In general, mangrove extract was more active against the bacterial pathogens while against yeasts, the activity was lesser. The antibiotic activity was attributed to the presence of diverse bioactive secondary metabolites. The chemical profiling of the methanolic extract was performed by GC combined with mass spectrometry. The results of GC-MS showed that the main phytoconstituents were benzeneethanol,4-hydroxy- (RT = 12.173), followed by benzaldehyde,3-methyl- (RT = 6.811). Finally, the GC-MS data evinced that the antimicrobial activity of A. marina was due to the synergistic effect of all constituents or the activity of major constituents. Conclusions Considering the urgent need of novel antibiotics, the present study brings out a new insight on the exploration of mangroves for antibiotic production in future.

An in vitro antagonistic efficacy validation of Rhizophora mucronata

Objective To assess the in vitro antimicrobial efficacy of Rhizophora mucronata (R. mucronata) collected from the mangrove wetland of Ayiramthengu (southwest coast of India) against potential human and shrimp pathogens and to analyse the allelochemical constituents by gas chromatography-mass spectrometer (GC-MS) profiling.

Antibacterial Activity and Phytochemical Analysis of L. Extracted in Different Organic Solvents

Background: Controlling infectious disease using medicinal plants is the oldest healthcare known to mankind. Regardless of the enormous advances observed in modern medicine, medicinal plants are still playing vital roles. However, only a small proportion of medicinal plants are examined for bioactive compounds which may vary in different factors. This study aimed to evaluate phytochemical constituent and antimicrobial activities of Nicotiana tabacum L. extracted by different solvents against three set of bacteria. Methods: Nicotiana tabacum L. was collected from the Western Ethiopia and extracted in seven organic solvents. An in-vitro anti-bacterial activity of plant extracts was carried out by agar well diffusion assay against microbial type culture collection of human pathogens, clinical bacterial isolates, and biofilm forming bacteria. Gas Chromatographic and Mass Spectroscopic (GC-MS) analysis was used to determine the phytochemical constituents. Results: Antimicrobial activities of plant extract vary by extraction solvents; and ethyl acetate based extracts showed better antimicrobial activities. Of the experimental organisms, biofilm forming uropathogens were the most sensitive while clinical isolates were quite resistant. Analysis of the active ethyl acetate extract by GC-MS evinced a mixture of five volatile compounds; and Pyridine, 3-(1-methyl-2-pyrrolidinyl)-, (S) was the major compound detected. The overall results of the present study revealed that N. tabacum L extract has high antimicrobial activities against biofilm forming uropathogens. Conclusion: High antimicrobial activity was observed in ethyl acetate extract of N. tabacum against the biofilm forming bacteria whereas the clinically isolated bacteria were the most resistant group. The antibacterial property demonstrated could be due to Pyridine, 3-(1-methyl-2-pyrrolidinyl)-(S) with a broad spectrum of activity.

An In Vitro Antibacterial and Cytotoxic Potentials of Bioactive Metabolites Extracted from Padina tetrastromatica

Marine brown algae, Padina tetrastromatica was extracted using diverse organic solvents of increasing polarity such as diethyl ether, chloroform, acetone, dichloromethane: methanol and methanol. The obtained extracts were evaluated for antibacterial and brine shrimp cytotoxicity assays. It was found that methanolic extract of P. tetrastromatica exhibited the broadest and highest range of antibacterial activity. In cytotoxic activity, the methanolic extract of P. tetrastromatica showed significant activity (LD50=354.4 μg/mL). Based on the present findings, it could be inferred that the bioassay guided purification and fractionation of crude methanolic extract of P. tetrastromatica may bring forth potent novel antibiotic and anticancer leads.

Prevalence, Diversity and Antimicrobial Resistance of Bacteria Isolated from the UTI Patients of Arba Minch Province, Southern Ethiopia

UTIs have been implicated as the most common bacterial infections in clinical practices and accounts one-third of all nosocomial infections. The development of resistances among uropathogens is a major crisis which restricts drug of choice for the treatment. Hitherto, the prevalence, etiological profile and antibiotic susceptibility pattern of bacterial uropathogens from the study area is not investigated. In this regard, a prospective study was conducted in adult patients clinically suspected to have urinary tract infection who consulted at the Internal Medicine Unit of Arba Minch Hospital from January- September 2015. In this study, prevalence of uropathogenic bacteria was reported among 37.2% of the study participants. The uropathogenic isolates were identified and grouped into seven species including Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Coagulase negative Staphylococcus (CNS), Citrobacter sp., Enterococcus faecalis and Proteus mirabilis. To demonstrate the antimicrobial susceptibility profile, all uropathogenic isolates were subjected to antibiotic sensitivity test against nine antibiotics. The results evinced that majority of the uropathogens were resistant to ampicillin, penicillin, amoxicillin, tetracycline and erythromycin, annulling its empirical usage. Ciprofloxacin is found to be effective against both groups of uropathogens. For the vigilant selection of antibiotics, further judicial study emphasizing the mechanism of antibiosis is warranted.