Daniel Mekonnen

TB/HIV co-infections and associated factors among patients on directly observed treatment short course in Northeastern Ethiopia: a 4 years retrospective study.

AbstractBackgroundnHuman immunodeficiency virus (HIV) and tuberculosis (TB) are the leading independent global causes of death among patients with infectious diseases. Additionally, due to the shared immune defense mechanisms, they are the leading cause of co-morbidities globally. However, little information was found regarding the proportion of TB/HIV co-infection in the study area. Thus, this study determined the proportion and associated factors of TB/HIV co-infection.MethodsAll TB patients treated from January/2011 to December/2014 were included in this study. Data were collected from three health centers namely; Kobo, Robit and Gobiye. Data were entered, cleared, and analyzed using SPSS version 20. Frequency, percentage, median and range were used to present the data. To assess the associated factors, logistic regression was employed.ResultsOf the total 990xa0TB patients enrolled in the study,xa098.2xa0% were screened for HIV; of these, 24.3xa0% were co-infected with TB and HIV. The odds of having TB/HIV co-infection were 3.4 times higher among in the age group of 25–45xa0years compared to older (≥45xa0years) age TB patients (ORxa0=xa03.4; 95xa0% CI 2–5). Moreover,xa0the odds of having TB/HIV co-infection were 2.8 and 1.7 times higher among smear positive and smear negative patients with pulmonary TB respectively than patients with extra pulmonary TB. Of 236 co-infected patients, 71.2xa0% took co-trimoxazole preventive therapy and 76.3xa0% took antiretroviral treatment.ConclusionTB/HIV co-infection is one of the serious public health problems in the study area. Thus, Collaborative TB/HIV activities that reduce the co-morbidities and mortalities should be addressed.

Methicillin Resistant Staphylococcus aureus among HIV Infected Pediatric Patients in Northwest Ethiopia: Carriage Rates and Antibiotic Co-Resistance Profiles.

Background MRSA infections are becoming more prevalent throughout the HIV community. MRSA infections are a challenge to both physicians and patients due to limited choice of therapeutic options and increased cost of care. Objectives This study was aimed to determine the prevalence of colonization and co-resistance patterns of MRSA species among HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia. Methods Culture swabs were collected from the anterior nares, the skin and the perineum of 400 participants. In vitro antimicrobial susceptibility testing was done on Muller Hinton Agar by the Kirby-Bauer disk diffusion method, using 30 μg cefoxitin (OXOID, ENGLAND) according to the recommendations of the Clinical and Laboratory Standards Institute. Methicillin sensitivity/resistance was tested using cefoxitin. Data was analyzed by descriptive statistics and logistic regression model using Epi Info 7. Results S. aureus was detected in 206 participants (51.5%). The prevalence of MRSA colonization in this study was 16.8%. Colonization by S. aureus was associated with male gender (OR = 0.5869; 95% CI: 0.3812–0.9036; p-value = 0.0155), history of antibiotic use over the previous 3 months (OR = 2.3126; 95% CI: 1.0707–4.9948; p-value = 0.0329) and having CD4 T-cell counts of more than 350 x 106 cells / L (OR = 0.5739; 95% CI = 0.3343–0.9851; p-value = 0.0440). Colonization by MRSA was not associated with any one of the variables. Concomitant resistance of the MRSA to clindamycin, chloramphenicol, co-trimoxazole, ceftriaxone, erythromycin and tetracycline was 7.6%, 6%, 5.25%, 20.9%, 23.9% and 72.1%, respectively. Conclusion High rates of colonization by pathogenic MRSA strains is observed among HIV positive pediatric patients in the Amhara National Regional state.

Multidrug-resistant and heteroresistant Mycobacterium tuberculosis and associated gene mutations in Ethiopia

BACKGROUNDnThe prevalence of multidrug-resistant tuberculosis (TB) among new and retreatment cases in 2011 in Ethiopia was 2.7% and 17.9%, respectively. However, data on heteroresistance and gene mutation profiles of Mycobacterium tuberculosis were not documented.nnnMETHODSnA cross-sectional study was conducted on 413 TB-positive clinical specimens submitted between 2012 and 2014 to Bahir Dar Regional Laboratory Center for confirmation of multidrug resistance. Resistance determining genes were analyzed using a line probe assay.nnnRESULTSnOf 413M. tuberculosis isolates, 150 (36.3%) were multidrug-resistant, 19 (4.6%) were resistant only to rifampicin, and 26 (6.3%) were resistant to isoniazid. Of 169 rifampicin-resistant and 176 isoniazid-resistant isolates, only eight (4.7%) showed rifampicin heteroresistance and only two (1.13%) showed isoniazid heteroresistance. Failing of the rpoB WT8 gene with corresponding hybridization of rpoB MUT3 (S531L substitution) accounted for 85 (50.3%) rifampicin-resistant mutations. Among 176 isoniazid-resistant isolates, 155 (88.1%) strains had the Ser315Thr1 substitution.nnnCONCLUSIONSnThe prevalence of multidrug-resistant M. tuberculosis was high in the study area. Ser531Leu and Ser315Thr1 substitutions were the highest gene mutations for rifampicin and isoniazid, respectively.

Erratum to: Clinical profile of tetanus patients attended at Felege Hiwot Referral Hospital, Northwest Ethiopia: a retrospective cross sectional study

[This corrects the article DOI: 10.1186/s40064-016-2592-8.].

Pathogenic bacteria profile and antimicrobial susceptibility patterns of ear infection at Bahir Dar Regional Health Research Laboratory Center, Ethiopia

Ear infection linked with frequent antibiotic prescription, hearing impairment, severe disability and death is a public health threat in developing countries. However, there is scarcity of documented data in the study area. Therefore, this study aimed at determining bacterial etiologic agents and their antimicrobial susceptibility patterns among patients of all age groups referred to Bahir Dar Regional Health Research Laboratory Center. Retrospective data recorded on culture and antimicrobial susceptibility profile were retrieved for analysis. Pus swabs from discharging ears collected and processed for aerobic bacteria culture and susceptibility testing. Of the total 368 pus swab samples processed, 296 (80.4xa0%) were culture positive. Of which, 289 (97.6xa0%) were bacteria and 7 (2.4xa0%) were yeast cells. The proportion of ear infection was higher in males (92.7xa0%) than females (65xa0%) (Pxa0=xa00.014). The frequency of ear infection below 21xa0years of age was 65.2xa0%. The predominant isolate was Pseudomonas aeruginosa (29.7xa0%) followed by Staphylococcus aureus (26.3xa0%) and Proteus spp. (21.9xa0%). High level of antimicrobial resistance rates were observed for amoxicillin/clavulanic acid, ampicillin and penicillin whereas ciprofloxacin, ceftriaxone, chloramphenicol, cotrimoxazole, gentamicin and amikacin were found effective against the isolated bacteria. Aerobic bacterial otitis media linked with high levels of resistance against amoxicillin/clavulanic acid and ampicillin is major health problem in the study area. Moreover, considerable level of oxacillin resistant S. aureus suggests the diffusion of methicillin resistant S. aureus in the community. Therefore, treatment of otitis media in the study area needs to be guided by antibiotic susceptibility testing of isolates.

Profile of tuberculosis and its response to anti-TB drugs among tuberculosis patients treated under the TB control programme at Felege-Hiwot Referral Hospital, Ethiopia

BackgroundTuberculosis (TB) is a global concern for both developing and developed countries. Currently it becomes more complex due to increasing levels of drug resistance and HIV co-infection. Delayed diagnosis and high case load are major factors contributing to continued transmission and failure to the treatment outcome. The study was conducted to determine the profile and treatment outcomes of TB patients at Felege-Hiwot Referral Hospital.MethodsWe analyzed the records of 1761 TB patients registered for treatment in Felege Hiwot Referral Hospital from July 2010 to June 2015. Data on patients’ socio-demographic characteristics, type of TB, HIV status and treatment outcome were analysed. Descriptive statistics and binary logistic regression models were used to present data. The odds ratio and the 95xa0% confidence intervals were calculated. A p-value ofu2009<u20090.05 was considered statistical significant.ResultsThe proportion of smear positive, smear-negative and extra-pulmonary TB were 205 (11.6xa0%), 548 (31.1xa0%) and 1008 (57.2xa0%), respectively. The overall treatment success rate accounts 542(80.8xa0%) with unsuccessful treatment of 129(19.2xa0%). The treatment outcome varied by the years from 68.9 to 97.4xa0%. Among tuberculosis patients, 459(26.1xa0%) of them were HIV positive. Being HIV positive (AORu2009=u20094.29, 95xa0% CI, 2.20–8.37 Pu2009=u20090.001), retreatment (AORu2009=u20095.32, 95xa0% CI, 1.92–14.3, Pu2009=u20090.001), rural residency (AORu2009=u200918.0, 95xa0% CI, 9.06–37.82, Pu2009=u20090.001) and the age group of 15–24 years (AORu2009=u20092.91, 95%CI, 1.00–8.45, Pu2009=u20090.04) showed statistical significant association for poor treatment outcome.ConclusionsIn the studied region, the overall treatment success rate was still below the WHO target of success rate, 85xa0%. However, the trend of treatment success rate showed a promising increment. Patients at high risk of unsuccessful treatment outcome should be identified early and given additional follow-up, medical intervention and social support.

Burden and determinant factors of anemia among elementary school children in northwest Ethiopia: a comparative cross sectional study

Background: Anemia is an indicator of both poor nutrition and health. In low-income countries like Ethiopia, the prevalence of anemia remains high due to several determinant factors. There is a lack of regular surveillance system to determine the magnitude of anemia among school age children. The aim of this study was to determine the burden and determinant factors of anemia among school children. Materials and Methods: A comparative cross-sectional study was conducted from March 2014 to May 2014 among elementary school children in Northwest Ethiopia. Multi stage and simple random sampling techniques were used to select the schools and the study subjects. Standard questionnaire was employed to assess the socioeconomic status of study participants. Intestinal parasitosis infections and hemoglobin level were determined by formula ether concentration technique and automated hematology analyzer, respectively. Descriptive statistics were used to determine the burden of anemia. Stepwise logistic regression was used to identify the determinants of anemia. Results: Among 2,372 elementary school children, the prevalence of anemia was 7.6% (95 % CI: 7% - 9%). The mean hemoglobin level was 11.6 g/dl ranging from 10 g/dl to 13g/dl. The magnitude of hookworm infection was 530 (22.3%). In multivariate analysis anemia was found associated with residence, source of water, availability of latrine, maternal education, family size and hookworm infection. Conclusion: Anemia still remains as a major public health problem among the school children in the study area. Residence, source of water, availability of latrine, maternal education, family size and hookworm infection are also the major determinant factors for the high prevalence of anemia. Therefore, health education, iron supplement and deworming should be given to school age children.

Surfaces and Air Bacteriology of Selected Wards at a Referral Hospital, Northwest Ethiopia: A Cross-Sectional Study

Background The hospital environment is a source of medically important pathogens that are mostly multidrug resistant (MDR) and posing a major therapeutic challenge. The aim of this study was to assess the surface and air bacteriology of selected wards at Felege Hiwot Referral Hospital (FHRH), Northwest Ethiopia. Methods A cross-sectional study was carried out from 15th February to 30th April 2017. A total of 356 surface and air samples were collected from selected wards using 5% sheep blood agar (Oxoid, UK) and processed at FHRH microbiology laboratory following the standard bacteriological procedures. Pure isolates were tested against the recommended antibiotics using Kirby–Bauer disc diffusion methods, and the susceptibility profile was determined based on Clinical Laboratory Standards Institute (CLSI). Data were entered and analyzed using SPSS version 23 for Windows. Results Of the total 356 samples processed, 274 were from surfaces and 82 were from air. Among these, 141 (39.6%) showed bacterial growth, yielding a total of 190 isolates. Gram-positive isolates were predominant at 81.6% (n=155), while the gram negatives were at 18.4% (n=35). The main isolates were coagulase negative staphylococci (CoNs), 44%, followed by S. aureus, 37.4%, and Klebsiella species at 11.6%. The bacterial load on surfaces and air was found beyond the standard limits. Besides, the antimicrobial susceptibility profile of the isolates showed that about 75% of the identified isolates were found resistant for two and more antimicrobial agents tested. Conclusions This study showed high degree of bacterial load that is beyond the standard limits on both surfaces and air samples of the hospital. Furthermore, some 75% of the isolates were found multidrug resistant. Therefore, it is important to evaluate and strengthen the infection prevention practice of the hospital. Moreover, stakeholders should also reinforce actions to decrease the pressure of antimicrobial resistance in the studied area.

Evaluation of the efficacy of bleach routinely used in health facilities against Mycobacterium tuberculosis isolates in Ethiopia.

Introduction In Ethiopia, the most widely used disinfectant is 5% Hypochlorites. However, Ethiopian national health safety and infection prevention guideline recommendation on the use of bleach is not consistent and varying from 0.1%-4%. The purpose of this study was therefore to assess the effective time-concentration relationship of sodium hypochlorite against Mycobacterium tuberculosis complex isolates in the absence of any organic load. Methods This experimental study was conducted in Bahir Dar Regional laboratory from February-June 2013. Test suspensions of 1.5 X 108 CFU/ml prepared using normal saline containing 0.5% tween 80. From 5% stock, 0.1%, 0.5%, 1% and 2% bleach was prepared. A 1ml of test strain suspension and 1ml of bleach mixed and allowed to stand until the specified time achieved, neutralized by 48 ml phosphate buffer. 100µl from the diluted sediment were spread on two L-J mediums and incubated at 37°C for 8 weeks. Results When 0. 1% bleach was used for 10 min, majority 11/20 of isolates showed 3 x 103 CFU/ml growth (ME = 4.4) which was inefficient. However, when the time increased, the log10 reduction was acceptable, ME >5 and it was effective. The bleach solution containing 0.5% and above was effective in all respective times. In this study, there is no difference observed in the tuberculocidal activity of bleach against resistant and sensitive strains. Conclusion Our study showed that in the absence of any organic load, 0.1% bleaches over 15 min and 0.5% bleaches over 10 min was found to be tuberculocidal.

Corrigendum to “Surfaces and Air Bacteriology of Selected Wards at a Referral Hospital, Northwest Ethiopia: A Cross-Sectional Study”

[This corrects the article DOI: 10.1155/2018/6413179.].