Getenet Beyene

Associated risk factors of urinary tract infection among pregnant women at Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia

BackgroundUrinary tract infections (UTIs) are among the most common bacterial infections in humans, both in the community and hospital settings. It is a serious health problem affecting millions of people each year and is the leading cause of Gram-negative bacteremia. We previously conducted a study on “Urinary Bacterial Profile and Antibiotic Susceptibility Pattern of UTI among Pregnant Women in North West Ethiopia” but the study did not address risk factors associated with urinary tract infection so the aim of the study was to assess associated risk factors of UTI among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia.MethodsA total of 367 pregnant women with and without symptoms of urinary tract infection(UTI) were included as a study subject from January 2011 to April 2011. Midstream urine samples were collected and processed following standard bacteriological tests. Data concerning associated risk factors were collected using structured questionnaires and were processed and analyzed using Statistical Package for Social Science (SPSS version 16).ResultBivarait analysis of socio-demographic characteristics and associated risk factors of UTI showed that family income level (family monthly income level ≤ 500 birr(

Prevalence of intestinal parasite, Shigella and Salmonella species among diarrheal children in Jimma health center, Jimma southwest Ethiopia: a cross sectional study

37.85); P = 0.006, OR = 5.581, CI = 1.658, 18.793 and 501–1000 birr (

Nasal Carriage, Risk Factors and Antimicrobial Susceptibility Pattern of Methicillin Resistant Staphylococcus aureus among School Children inEthiopia

37.93-

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

75.70), P = 0.039, OR = 3.429, CI = 1.065, 11.034), anaemia (P = 0.003, OR = 4.388, CI = 1.776, 10.839), sexual activity (P = 0.032, OR = 3.520, CI = 1.197,10.363) and past history of UTI (P = 0.000, OR = 3.397, CI = 1.672, 6.902) were found to be factors significantly associated with increase prevalence of UTI. In contrast multiparity, history of catheterization, genitourinary abnormality, maternal age, gestational age and educational status were not significantly associated with UTI among pregnant women.ConclusionIn this study UTI was high among pregnant women in the presence of associated risk factor such as anaemia, low income level, past history of UTI and sexual activity.

Factors associated with unsuccessful treatment outcome in tuberculosis patients among refugees and their surrounding communities in Gambella Regional State, Ethiopia

BackgroundDiarrheal disease continues to be an important cause of morbidity and mortality among young children in developing countries including Ethiopia. Globally, intestinal parasite, Shigella and Salmonella species remain major contributors to acute enteric infections. The study was aimed at determining the frequency of intestinal parasite, Shigella and Salmonell a species identified from diarrheic children at Jimma Health Centre, Jimma south west Ethiopia.MethodsA health institution based cross sectional study was conducted from March to November 2012. A structured questionnaire was used for collection of data on socio- demographic characteristics. Parasite and bacteria identification as well as susceptibility testing was done using standard parasitological and bacteriological procedures.ResultsA total of 260 diarrheal children were included in the study. A total of 129 (49.6%) samples were positive for intestinal parasite, Shigella and Salmonella species. Of these, 107 (41.1%), 6 (2.3%) and 16 (6.2%) samples were positive for intestinal parasite, Shigella and Salmonella species respectively. The dominant isolated parasite was G. lamblia with prevalence of 13.5% followed by A. lumbricoides (11.5%). The least identified parasites were Schistosoma mansoni and Taenia species accounting 0.4% each. Multiple parasitic infections were observed in 19 (7.3%) patients. Shigella species showed hundred percent resistances to ampicillin, amoxacillin, and cotrimoxazole. All Salmonella isolates were resistant against amoxicillin. All Shigella and Salmonella species were susceptible to ceftriaxone, ciprofloxacin and gentamycin.ConclusionThe presence of reasonably high amount of intestinal parasite and Salmonella and Shigella species that are drug resistance to the commonly prescribed drugs is a treat to the children and community at large. Therefore, measures including health education, improvement of safe water supply, sanitation facilities and continuous monitoring of microbiological and antimicrobial surveillance is crucial.

Xpert MTB/RIF assay for the diagnosis of Mycobacterium tuberculosis and Rifampicin resistance in high Human Immunodeficiency Virus setting in Gambella regional state, southwest Ethiopia

Background: Young children are major reservoir for community acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) and accelerate transmission of CA-MRSA. Objective: The aim of this study was to determine the nasal carriage and antimicrobial resistance patterns of MRSA isolates among school children in Bahir Dar town, Ethiopia. Methods: A community based cross-sectional study was conducted to determine the nasal carriage rate and antimicrobial susceptibility pattern of MRSA isolates among school children. A total of 300 nasal swabs were collected from March 1 to June 30, 2013. MRSA was detected using both Cefoxitin (30 μg) and Oxacillin (1 μg) discs in combination and risk factors were assessed using self-administered structured questionnaires. Statistical analysis was done using SPSS V-20. Result: Of 123 S. aureus isolates 17(13.8%) were MRSA isolates. The main risk factors for nasal carriage of MRSA in the study area were, having recurrent acute otitis media and use of an antibiotic in the previous year. The Susceptibility profiles of MRSA isolates were (94.1%) to Chloramphenicol, Ciprofloxacin and Clindamycin, (88.2%) to Ceftriaxone, Erythromycin and Trimethoprim-sulphamethoxazole and (58.8%) to Doxycycline. All the isolates were resistant to Penicillin G and sensitive to Gentamycin. Conclusion: This study showed a rising rate of nasal carriage of MRSA among school children. Previous use of antibiotics by the children was statistically associated with MRSA carriage. Therefore developing decolonization protocols and proper utilization of drugs are needed in order to reduce the transmission and the burden of MRSA.

BACTERIAL UROPATHOGENS IN URINARY TRACT INFECTION AND ANTIBIOTIC SUSCEPTIBILITY PATTERN IN JIMMA UNIVERSITY SPECIALIZED HOSPITAL, SOUTHWEST ETHIOPIA

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.

Postoperative Nosocomial Infections and Antimicrobial Resistance Pattern of Bacteria Isolates among Patients Admitted at Felege Hiwot Referral Hospital, Bahirdar, Ethiopia

Background Tuberculosis (TB) is a leading cause of public health challenges among immigrant refugees and their surrounding communities in developing countries. Evaluating the treatment outcome of TB patients is one of the key indicators to understand the performance of TB control program. Hence, this study aims to assess profile, treatment outcome and factors associated with unsuccessful outcome of TB patients treated under the TB control program among refugees and their surrounding communities (SCs) in Gambella Regional State, Ethiopia. Methodology Retrospective study was conducted in the health facilities of refugee and their SCs in Gambella Regional State from March 1 to May 30, 2017. Demographic and related data of all TB patients registered in TB Control Program between September, 2008 and October, 2017 in health facilities of refugee and the SCs was extracted using data extraction format. Eight years trend of TB, treatment outcome and factors associated with unsuccessful outcome among refugees and the SCs were computed using SPSS version 20.0 software. Result A total of 886 refugees and 3284 SCs TB patients, registered for anti TB treatment in the last eight years, were evaluated in the study. The trend of all forms of TB is progressively increasing among refugees contrary to the SCs in the course of the study period (X2 trend = 207.7; P<0.0001). Smear positive pulmonary TB (PTB+) was found to be predominant (57.6%) TB form in refugees while smear negative pulmonary TB (PTB-) (44.8%) is in the SCs (X2 = 185.834; P<0.0001). There was also significant difference in the treatment outcome (X2 = 170.915; P<0.0001). Mean treatment success rate was 74.2% and 88.1% for refugees and the SCs, respectively (X2 = 92.887; P<0.0001). The study also revealed that the risk of unsuccessful TB treatment outcome was significantly higher among refugee (AOR = 2.17; 95% CI: 1.69–2.77), retreated cases (AOR = 1.53; 95% CI: 1.07–2.17), patients aged between 35–44 years (AOR = 1.38; 95% CI: 1.0–1.91), and greater than 44 years old (AOR = 1.77; 95% CI: 1.28–2.44), and patients with extra pulmonary TB (EPTB) form (AOR = 1.34; 95% CI: 1.04–1.73) compared to their counterparts. Patient coming from rural area (AOR = 0.77; 95% CI: 0.62–0.97), who are female (AOR = 0.76; 95% CI: 0.63–0.91) and TB/HIV non-infected (AOR = 0.63; 95% CI: 0.51–0.77) were more likely to be successfully treated. Conclusion The study confirmed that there was low treatment success rate among refugees compared to the SCs. Being refugee, retreated case, patient’s age ≥35 years old, EPTB form, gender, rural patient address and HIV status were predictor factors for unsuccessful treatment outcome. Hence, the study urges the need for strengthened TB prevention program among refugees with due consideration of identified predictor factors to prevent the potential effect of hosting refugee to the SCs and the nations at large.

Multidrug resistant Salmonella Concord is a major cause of salmonellosis in children in Ethiopia

Background The introduction of a new and rapid molecular diagnostic for tuberculosis (TB) and rifampicin resistance (RIF) in the national TB program has improved the diagnosis of TB by shortening the turnaround time and detecting the presence of RIF resistance in high TB and human immunodeficiency virus (HIV) settings such as Ethiopia. However, the implementation of this new diagnostic tool for the diagnosis of M. tuberculosis (MTB) and rifampicin (RIF) resistance in clinical setting is limited known in the country. Hence, this study intended to describe the program of GeneXpert MTB/RIF in the diagnosis of TB and RIF in high HIV setting in Gambella Regional State, Southwest Ethiopia. Method Institutional based retrospective study was conducted among presumptive TB patients diagnosed with GeneXpert assay in the last three years (2015–2017) in Gambella Hospital from May 1–30, 2017. The data were collected from GeneXpert registration book using standard data extraction sheet. The data were entered and cleared using EPI data 3.1 and then, exported and analyzed using SPSS version 20.0 statistical software package. Result Of the 995 presumptive TB patients who received the GeneXpert test in the last three years, 20.0% (95% CI: 17.4–22.7) of them had proven MTB detection while 4.9% (95% CI: 2.2–8.1) had RIF resistance. The prevalence of RIF resistance was 2.3% and 14.3% among the new and retreated cases respectively. There was also a 35.5% TB/HIV co-infections. The odd of MTB detection was higher among 15–29 [AOR 2.17 (95% CI: 1.25- 3.76)] and 30–44 [AOR 2.35 (95% CI: 1.36–4.07)] year old participants. The figure was however significantly lower among female [AOR 0.64 (95% CI: 0.45–0.91)] and unknown HIV status [AOR 0.38(95% CI: 0.24–0.61)] participants of the study. In addition, the odd of RIF resistance was significantly low among HIV unknown case [AOR 0.14 (95% CI: 0.02–0.96)]. It was also learnt that there was progressively decline of invalid or error Xpert result from 4.7% to 2.0% in the course of the study period (X2, 25.54; P = 0.001). Conclusion The study confirms the high prevalence of TB, RIF resistance and TB/HIV co-infection among the study participants. Age, sex, and HIV status of the study participants were predictor factors for MTB detection while HIV status was associated with RIF resistance. Therefore, the results of the study indicate that there is the need for collaborative and intensified prevention of TB and HIV in the study area. The ongoing supervision and mentoring to improve the performance of Xpert in the institution need to be promoted.