Getachew Tadesse

Prevalence of human Salmonellosis in Ethiopia: a systematic review and meta-analysis

BackgroundHuman Salmonellosis is one of the major diseases in Ethiopia and several factors including under and mal-nutrition and HIV-AIDS may substantially contribute to its occurrence. Despite its importance, surveillance and monitoring systems are not in place and a comprehensive picture of its epidemiology is not available. The objectives of this study were to systematically review and estimate the prevalence of the disease and identify the dominant serogroups and serotypes in Ethiopia.MethodsPublished studies on Salmonellosis in Ethiopia were electronically and manually searched. Eligible studies were selected by using inclusion and exclusion criteria. Generic, methodological and statistical information were extracted from the eligible studies. The extracted data included sample sizes, the numbers of Salmonella positive samples, serogroups and serotypes. The variations in prevalence estimates attributable to heterogeneities were assessed and pooled prevalence was estimated by the random effects model.ResultsTwenty studies carried out between 1974 and 2012 were eligible. The pooled prevalence estimates of Salmonella in stool samples of diarrheic children, diarrheic adults and carriers were 8.72%, 5.68%, and 1.08% respectively. Invasive infections in children (5.71%) and adults (0.76%) were significantly different (p < 0.001). Non-typhi isolates accounted for 57.9% of the isolates from patients. Serogroup D occurred more frequently than serogroups C and B. S. Concord, S. Typhi, S. Typhimurium and S. Paratyphi were dominant and accounted for 82.1% of the serotypes isolated from patients.ConclusionThe prevalence of Salmonellosis is considerable and most infections are due to four serotypes. The results imply the need for a policy to promote public hygiene and regularly screen individuals in contact with food items for public consumption.

A meta-analysis of the proportion of antimicrobial resistant human Salmonella isolates in Ethiopia.

BackgroundAntimicrobial resistant Salmonella is a global problem and recently, a strain on the verge of pan-resistance was reported. In Ethiopia, the therapeutic management of Salmonellosis is difficult because drug sensitivity tests are not routinely carried out and treatment alternatives are not available in most health care facilities. The objectives of this study were to estimate the temporal changes and proportions of drug resistant isolates in Ethiopia.MethodsPublished studies on drug resistant Salmonella isolates were searched in Medline, Google Scholar and the lists of references of articles. Eligible studies were selected by using inclusion and exclusion criteria. Generic, methodological and statistical information were extracted from the eligible studies. The extracted data included the proportions of ampicillin, co-trimoxazole, chloramphenicol, ceftriaxone, ciprofloxacin and multi-drug resistant isolates. Pooled proportions were estimated by a random effects model.ResultsThe odds of multi-drug resistant isolates in the 2000s was higher than before the 1990s (OR =18.86, 95% CI = 13.08, 27.19). The pooled proportions of ampicillin, co-trimoxazole, chloramphenicol, ciprofloxacin and multi-drug resistant isolates in the 2000s were 86.01%, 68.01%, 62.08%, 3.61% and 79.56% respectively. S. Concord (>97%) was resistant to ampicillin, co-trimoxazole, chloramphenicol and ceftriaxone.ConclusionThe proportion of drug resistant isolates has increased since the 1970s. All drugs currently used for the treatment of Salmonellosis but ciprofloxacin are not reliable for an empirical therapy. Alternative drugs should be included in the essential drug list and measures should be taken to re-enforce the drug use policy.

Prevalence and species composition of ixodid ticks infesting horses in three agroecologies in central Oromia, Ethiopia.

A cross-sectional study was conducted to determine the species composition and prevalence of ixodid ticks infesting horses in three agroecological zones in central Ethiopia. For this purpose, a total of 1,168 horses were examined for tick infestation. An overall prevalence of 39.04% of tick infestation on horses was recorded. A total of 917 adult ticks were collected from infested horses. Amblyomma, Boophilus, Rhipicephalus, and Hyalomma genera with the respective prevalence of 3.2%, 1.8%, 29.2%, and 4.7% were identified. In the study, Rhipicephalus evertsi evertsi was encountered with the highest prevalence (15.8%) whereas Amblyomma gemma was with lowest prevalence (1.5%). From the highland, Hyalomma marginatum rufipes (3.1%), Hyalomma truncatum (1.0%), and Boophilus decoloratus (0.3%) were identified. From the midland, R. evertsi evertsi (27.5%), Rhipicephalus pulchellus (18%), Amblyomma variegatum (3.6%), B. decoloratus (2.8%), H. marginatum rufipes (2.6%), H. truncatum (1.8%), and A. gemma (1.5%) were identified. R. evertsi evertsi, 107 (27.5%), was with the highest prevalence in the midland. From the lowland, R. pulchellus (22.3%), R. evertsi evertsi (20%), H. truncatum (3.6%), A. gemma (3.1%), B. decoloratus (2.3%), H. marginatum rufipes (2.1%), and A. variegatum (1.5%) were identified. In the lowland, R. pulchellus, 87 (22.3%), was the most abundant tick species. The overall prevalence of tick infestation on horses was significantly (P < 0.05) higher both in the midland, 225 (57.8%), and the lowland, 214 (54.87%), than the highland, 17 (4.4%). This suggests that horses in midland and lowland are at higher risk of tick infestation than those horses in the highland. Further studies on the role of ticks in transmission of diseases to equines and the importance of horses as alternative hosts in different parts of Ethiopia are needed.

A meta-analysis of the prevalence of Salmonella in food animals in Ethiopia.

BackgroundThe globalization of the food supply and the increased movements of people, animals and goods have increased the threat of Salmonella infections in several countries. The objective of this study was to estimate the prevalence of Salmonella in food animals in Ethiopia by using meta-analytical methods.ResultsThe prevalence of Salmonella in slaughtered cattle, sheep, goats and pigs were 7.07%, 8.41%, 9.01% and 43.81% respectively. The occurrence of Salmonella was significantly higher in pigs than in slaughtered true ruminants (p <0.001) but not significantly different between cattle, sheep and goats (p >0. 05). S. Mishmarhaemek, S. Infantis and S. Hadar were the predominant isolates in cattle, small ruminants and pigs respectively. S. Typhimurium was isolated from all host species.ConclusionsAll food animals are considerable reservoirs of Salmonella and pose a significant risk to public health. Safety measures in slaughter houses and butcheries and education of the public could reduce the risk of transmission of Salmonella from animals to humans.

Prevalence of Salmonella in raw animal products in Ethiopia: a meta-analysis.

BackgroundThe contributions of animal products to human salmonellosis differ across countries, and source attribution is a major step in prioritizing control measures. The objectives of this study were to estimate the prevalence of Salmonella in raw animal products in Ethiopia by using meta-analytical methods.ResultsThe odds of Salmonella contaminated meat was more than twice higher in markets than in slaughter houses [Odds ratio (OR) = 2.25 (95% Confidence Interval [CI] = 1.75, 2.89)]. The source species significantly affected meat contamination in slaughter houses (P < 0.05) but not in the markets (P > 0.05). The pooled estimates of Salmonella contaminated goat carcasses, beef carcasses, minced beef and milk were 3.86%, 4.53%, 8.34% and 10.76% respectively.ConclusionsThe estimates demonstrate the extent of contamination, and imply the need for safety intervention measures to reduce the risks of contamination of animal products and human illnesses.

A meta-analysis of the proportion of animal Salmonella isolates resistant to drugs used against human salmonellosis in Ethiopia

BackgroundThe emergence and spread of drug resistant Salmonellae of both human and animal origins are global concerns and worrisome in countries where the risk of infection is high and treatment options are limited. The objective of this study was to estimate the proportions of animal isolates resistant to antimicrobials used against human salmonellosis in Ethiopia.MethodsPublished studies on the antimicrobial resistance features of Salmonellae isolated from food animals of Ethiopia were searched in Medline, Google Scholar and the lists of references of articles. Eligible studies were selected by using inclusion and exclusion criteria and data were extracted. The extracted data included the host species, the numbers of isolates and the numbers of ampicillin, co-trimoxazole, chloramphenicol, ceftriaxone and ciprofloxacin resistant isolates. The risks of bias were assessed and the percentages of the variations of the estimates attributable to heterogeneities were quantified. Pooled proportions were estimated by the DerSimonian and Laird random effects model.ResultsFive hundred and fifty four Salmonellae isolated from cattle, camels, sheep, goats and pigs were tested with a variety of antimicrobials. The percentages of the variations attributable to heterogeneities were low for chloramphenicol and ceftriaxone (I2 = 0) and high for ampicillin, co-trimoxazole and ciprofloxacin resistance estimates (I2 > 75%). The pooled estimate of ampicillin resistant isolates was higher in slaughtered ruminants (17.28%) than in pigs (3.95%), (p < 0.001). The pooled estimates of co-trimoxazole resistant isolates in true ruminants (4.35%) and pigs (1.12%) were not significantly different (p > 0.05). The overall pooled estimates of chloramphenicol and ceftriaxone resistant isolates were 2.24% and 1.25%, respectively. Seven serotypes have been reported to be resistant to antimicrobials uncommonly used in veterinary clinical practice in Ethiopia.ConclusionsAmong Salmonellae of farm animals, there exist strains that are resistant to drugs used in the therapeutic management of human salmonellosis in Ethiopia. Intervention measures should be taken to ensure the prudent use of antimicrobials and curb the spread of high risk strains across the country.

Molecular epidemiology of fluoroquinolone resistant Salmonella in Africa: A systematic review and meta-analysis

Background Wide-ranging evidence on the occurrence of fluoroquinolone (FQ) resistance genetic determinants in African Salmonella strains is not available. The main objectives of this study were to assess the heterogeneity, estimate pooled proportions and describe the preponderance of FQ-resistance determinants in typhoidal and non-typhoidal Salmonella (NTS) isolates of Africa. Methods Genetic and phenotypic data on 6103 Salmonella isolates were considered. Meta- and frequency analyses were performed depending on the number of studies by category, number of isolates and risks of bias. A random effects model was used to assess heterogeneity and estimate pooled proportions. Relative and cumulative frequencies were calculated to describe the overall preponderance of FQ-resistance determinants in quinolone resistant isolates. Results The pooled proportion of gyrA mutants (Salmonella enterica serovar Typhi, Salmonella enterica serovar Typhimurium, and Salmonella enterica serovar Enteritidis) was estimated at 5.7% (95% Confidence interval (CI) = 2.6, 9.8; Tau squared (T2) = 0.1105), and was higher in S. Typhi than in S. Typhimurium (odds ratio (OR) = 3.3, 95%CI = 2, 5.7). The proportions of each of gyrB and parC mutants, and strains with Plasmid Mediated Quinolone Resistance genes (qnrA, qnrB and qnrS) were low (≤ 0.3%). Overall, 23 mutant serotypes were identified, and most strains had mutations at codons encoding Ser83 and Asp87 of gyrA (82%, 95%CI = 78, 86). Conclusions Mutations at gyrA appear to account for ciprofloxacin non-susceptibility in most clinical Salmonella strains in Africa. The estimates could be harnessed to develop a mismatch-amplification mutation-assay for the detection of FQ-resistant strains in Africa.

Brucellosis Seropositivity in Animals and Humans in Ethiopia: A Meta-analysis

Background The objectives of this study were to assess the heterogeneities of estimates and to estimate the seroprevalence of brucellosis in animals and humans in Ethiopia. Methods/Principal findings Data from 70 studies covering 75879 animals and 2223 humans were extracted. Rose Bengal Plate Test (RBPT) and Complement Fixation Test (CFT) in series were the most frequently used serological tests. A random effects model was used to calculate pooled prevalence estimates. The overall True Prevalence of brucellosis seropositivity in goats and sheep were estimated at 5.3% (95%CI = 3.5, 7.5) and 2.7% (95%CI = 1.8, 3.4), respectively, and 2.9% for each of camels and cattle. The prevalence was higher in post-pubertal than in pre-pubertal animals (OR = 3.1, 95% CI = 2.6, 3.7) and in the pastoral than in the mixed crop-livestock production system (OR = 2.8, 95%CI = 2.5, 3.2). The incidence rates of brucellosis in humans of pastoral and sedentary system origins were estimated at 160 and 28 per 100 000 person years, respectively. Conclusions The seroprevalence of brucellosis is higher in goats than in other species. Its occurrence is evocative of its importance in the country in general and in the pastoral system in particular. Public awareness creation could reduce the transmission of Brucella spp. from animals to humans and the potential of livestock vaccination as a means of control of brucellosis needs to be assessed.

Correction: Brucellosis Seropositivity in Animals and Humans in Ethiopia: A Meta-analysis

[This corrects the article DOI: 10.1371/journal.pntd.0005006.].