Gizachew Yismaw

Micronutrient levels and nutritional status of school children living in Northwest Ethiopia

BackgroundSeveral micronutrients are essential for adequate growth of children. However, little information is available on multiple micronutrient status of school children in Ethiopia. The present study was designed to evaluate the relationship between multiple micronutrient levels and nutritional status among school children.MethodIn this cross-sectional study, anthropometric data, blood and stool samples were collected from 100 children at Meseret Elementary School in Gondar town, Northwest Ethiopia. Serum concentration of magnesium, calcium, iron, copper, zinc, selenium and molybdenum were measured by inductively coupled plasma mass spectrometer. Anthropometric indices of weight-for-age, height-for-age and BMI-for-age were used to estimate the childrens nutritional status. Stool samples were examined by standard microscopic methods for intestinal parasites.ResultsThe prevalence of stunting, underweight, wasting and intestinal parasitoses among school children was 23%, 21%, 11% and18%, respectively. The mean serum levels of magnesium, calcium, iron, copper, zinc, selenium and molybdenum were 2.42±0.32 (mg/dl), 15.31±2.14 (mg/dl), 328.19±148.91 (μg/dl), 191.30±50.17 (μg/dl), 86.40±42.40 (μg/dl), 6.32±2.59 (μg/dl), and 0.23±0.15 (μg/dl), respectively. Selenium deficiency, zinc deficiency and magnesium deficiency occurred in 62%, 47%, and 2% of the school children, respectively. Height-for-age showed significant positive correlation with the levels of copper and molybdenum (p = 0.01) and with the levels of magnesium (p = 0.05).ConclusionDeficiencies of selenium and zinc were high among the school children although the deficiencies were not significantly related with their nutritional status. The prevalence of both malnutrition and intestinal parasitism was not negligible. These calls for the need to undertake multicentre studies in various parts of the country to substantiate the data obtained in the present study so that appropriate and beneficial strategies for micronutrient supplementation and interventions on nutritional deficiencies can be planned.

Bacterial profile and antimicrobial susceptibility pattern in septicemia suspected patients attending Gondar University Hospital, Northwest Ethiopia

BackgroundBacterial blood stream infection constitutes a significant public health problem and it is an important cause of morbidity and mortality in hospitalized patients. The aim of this study was to assess the prevalence of bacterial isolates from septicemia suspected patients and their antimicrobial susceptibility pattern in Gondar University Hospital.MethodsThis laboratory based retrospective study of 390 blood culture and susceptibility tests was conducted in Bacteriology Laboratory of the University of Gondar Teaching Hospital. The samples were collected and processed following standard microbiological techniques as part of the routine clinical management of the patient. Antibiotic susceptibility testing was done on pure culture isolates employing disc-diffusion method for the commonly used antibiotics. The data were analyzed by using SPSS version 16 and the results were summarized by using tables and graphs.ResultsOut of 390 blood culture results, 71 (18.2%) were culture positive. The predominant bacteria isolated from blood culture were Coagulase negative staphylococci 30 (42.3%), followed by S. aureus 17 (23.9%) and Klebiesella spp 9 (12.9%), E. coli 5 (7.0%), Pseudomonas aeroginosa 4 (5.6%) and Salmonella spp. 3 (4.2%). The gram positive and gram negative bacteria constituted 49 (69%) and 22 (31%) of the culture isolates; respectively. The isolates showed high rates of resistance to most antibiotics tested. The range of resistance for Gram positive and Gram negative were from 23.5% – 58.8%, and 20%– 100% respectively.ConclusionsIn the present study most of the pathogens isolated from blood culture showed high rate of resistance to most commonly used antibiotics used to treat bacterial infections. Therefore, rational use of antibiotics should be practiced.

Nutritional status, intestinal parasite infection and allergy among school children in Northwest Ethiopia

BackgroundParasitic infections have been shown to have deleterious effects on host nutritional status. In addition, although helmintic infection can modulate the host inflammatory response directed against the parasite, a causal association between helminths and allergy remains uncertain. The present study was therefore designed to evaluate the relationship between nutritional status, parasite infection and prevalence of allergy among school children.MethodsA cross sectional study was performed involving school children in two elementary schools in Gondar, Ethiopia. Nutritional status of these children was determined using anthropometric parameters (weight-for-age, height-for-age and BMI-for-age). Epi-Info software was used to calculate z-scores. Stool samples were examined using standard parasitological procedures. The serum IgE levels were quantified by total IgE ELISA kit following the manufacturer’s instruction.ResultA total of 405 children (with mean age of 12.09.1 ± 2.54 years) completed a self-administered allergy questionnaire and provided stool samples for analysis. Overall prevalence of underweight, stunting and thinness/wasting was 15.1%, 25.2%, 8.9%, respectively. Of the total, 22.7% were found to be positive for intestinal parasites. The most prevalent intestinal parasite detected was Ascaris lumbricoides (31/405, 7.6%). There was no statistically significant association between prevalence of malnutrition and the prevalence of parasitic infections. Median total serum IgE level was 344 IU/ml (IQR 117–2076, n = 80) and 610 IU/ml (143–1833, n = 20), respectively, in children without and with intestinal parasite infection (Z = −0.198, P > 0.8). The prevalence of self reported allergy among the subset was 8%. IgE concentration was not associated either with the presence of parasitic infection or history of allergy.ConclusionThe prevalence of malnutrition, intestinal parasitism and allergy was not negligible in this population. In addition, there was no significant association between the prevalence of allergy and their nutritional status, and parasite infection. Further research prospective observational and intervention studies are required to address the question of causality between nutritional factors, parasites, and allergy.

A five-year antimicrobial resistance pattern of Shigella isolated from stools in the Gondar University hospital, northwest Ethiopia.

Shigellosis is a global health problem. However, developing countries, where there is poor hygiene and unsafe water supplies, are especially affected. In the last two decades Shigella isolates have become increasingly resistant to many commonly used drugs. We investigated the antibiotic susceptibility pattern of Shigella isolated from stool specimens processed over five years in the bacteriology laboratory of the University of Gondar Teaching Hospital in northwest Ethiopia. Stool specimens were processed using standard bacteriological methods and data on bacterial culture, isolation and antimicrobial sensitivity were collected in the laboratory logbook. From a total of 2891 cultures stool specimens, 214 yielded Shigella. The overall sensitivity of Shigella to the commonly used antibiotics was: gentamicin (92.1%), ciprofloxacin (91.1%), chloramphenicol (47.2%), cotrimoxazole (26.6%), ampicillin (20.1%) and tetracycline (14%). About 46% of the isolates were resistant to at least three of the most commonly used drugs and 1.4% were resistant to all the commonly used drugs. The results demonstrated continued sensitivity of Shigella to gentamicin and ciprofloxacin and widespread resistance to tetracycline, ampicillin and cotrimoxazole. It is recommended that the use of gentamicin and ciprofloxacin be strictly regulated in the treatment of severe cases in regions where shigellosis is endemic and where the occasional epidemics result in high mortality.

Sexually transmitted infections based on the syndromic approach in Gondar town, northwest Ethiopia: a retrospective study

BackgroundSexually transmitted infections are among the most common causes of illnesses in the world and have far reaching health, social and economic consequences. They are important because of their magnitude, potential complications and interactions with HIV/AIDS. Though the problem may be generally similar to other developing countries, there is scarce information on the incidence and prevalence of sexually transmitted infections in Ethiopia. This study was then aimed to determine the magnitude of sexually transmitted infections among patients visiting a clinic in Gondar town, Northwest Ethiopia.MethodsMedical records of patients who visited the clinic from January 2011 to December 2011 were reviewed. Sociodemographic and clinical data were extracted using data extraction form. The data were entered and analyzed using SPSS version 16 statistical package. Descriptive statistics and Chi-square tests were carried out.ResultsA total of 1071 clients visited the clinic during the study period. Among these, 383 (35.8%) had complained symptoms of sexually transmitted infections. The mean (SD) age of the patients was 26.8 ± 7.4 years. The commonest chief complaints were vaginal discharge (38.4%) and urethral discharge (13.6%). Seventy seven percent of the cases did not bring their sexual partners for treatment.ConclusionThere was a high magnitude of STIs in the clinic according to the syndromic approach. However, the actual prevalence of STIs and the associated factors in the community need to be determined through further studies. The results of this study also urge the need for evaluation of the syndromic approach and test for antimicrobial resistance.

Assessment of hepatitis B virus and hepatitis C virus infections and associated risk factors in HIV infected patients at Debretabor hospital, South Gondar, Northwest Ethiopia

Objective To assess hepatitis B and hepatitis C virus infections and associated risk factors among HIV infected patients at Debretabor hospital.

Prevalence of tuberculosis and treatment outcome among university students in Northwest Ethiopia: a retrospective study

BackgroundUniversities tend to be highly congregate settings, both in the classroom and in residences, and thus provide special opportunities for large number of persons to be exposed to a person with tuberculosis (TB). Despite the high prevalence of TB in Ethiopia, the TB prevalence and the treatment outcome among students have never been studied. Therefore, this study was aimed at determining the prevalence and treatment outcome of TB among students at University of Gondar from January 2007 to December 2011.MethodsData on age, sex, TB type, category, and treatment outcome of students with TB was collected from medical records of University of Gondar Hospital, TB Directly Observed Treatment Short Course (DOTS) clinic. All TB cases diagnosed with smear, culture, and/or radiography were included in the study.ResultsDuring the five year study period in the university, there were an average of 36 students with TB per year out of a mean of 10,036 enrolled students. Smear positive pulmonary TB, smear negative pulmonary TB, and extra pulmonary TB, respectively, were observed in 46 (25.4%), 81 (44.8%) and 54 (29.8%) of the cases. The prevalence of all forms of TB per 100,000 populations in the University ranged from 297.6 in 2009 to 404 in 2011, respectively. The prevalence of TB in the Social Sciences and Humanities Faculty was higher than the one observed in the Medical College. The overall treatment outcome was classified as cured in 36 (19.9%), completed in 91 (50.3%), defaulted in 9 (5%), failed in 3 (1.7%), died in 1 (0.6%), and transferred out in 41 (22.7%) of the cases. Treatment success rate (TSR) among students in University was generally low ranging from 58.1% in 2009 to 82.9% in 2011 with a mean TSR of 70.2%.ConclusionThe prevalence of TB is higher in comparison to the national figure among students in University of Gondar. Active surveillance systems could be important to get a clear picture of the TB situation in such settings. Assessing the factors associated with the high prevalence to gear the TB control strategy could also be essential.

Total Lymphocyte Count as surrogate marker for CD4 Cell Count in HIV-Infected Individuals in Gondar University Hospital, Northwest Ethiopia.

BackgroundThe high cost of CD4 count estimation in resource-limited countries is a major challenge in initiating patients on highly active antiretroviral therapy (HAART). Therefore, assessment of inexpensive and simple laboratory diagnostic marker is mandatory to diagnose immuno-suppression.ObjectiveTo evaluate utility of total lymphocyte count (TLC) as surrogate marker for CD4 count in HIV-infected patients.Materials and MethodsIn this cross sectional study, 400 ART-naive HIV-positive patients enrolled in Gondar University Hospital, from March 2011 to May 2011, were tested for CD4 count & TLC. The cutoffs were determined as: 200 cells/μL for CD4 count and 1200 cells/μL for TLC by using BD FACS count and CELL DYN 1800 Flow Cytometrys respectively. Spearman correlation between TLC and CD4 cell count were assessed. Sensitivity, specificity, positive and negative predictive values for different age a group, TLC ≤1200 was computed for CD4 count ≤200 cells/cu.mm.ResultsAmong 400 ART naive HIV infected patients, 278 (69.5%) were females. The mean age of the study participants was 33.7. TLC and CD4 count were positively correlated (r = 0.33, p = 0.001). A TLC of ≤1200 cells/m m3 was found to have a sensitivity (32.86%), specificity (95.33%), PPV (79.7%), and NPV (71.9%) for predicting a CD4 count of <200 cells/mm3.ConclusionThis study showed that low sensitivity and specificity of TLC as a surrogate measure for CD4 count. Moreover, CD4 cell counts of < 200 cells/mm3 were found in 96 cases (24%) with TLCs of ≤1200 cells/mm3. Thus, 1 in 4 individuals would have been deprived of needed treatment. Therefore, we recommend keep on expansion of access to CD4 counter.

Seroprevalence of hepatitis B and C virus infection among patients attending serology laboratory of Gondar University Hospital

BackgroundHepatitis B virus (HBV) and hepatitis C virus (HBV) infections accounts for substantial proportions of the world wide liver disease. The two hepatotropic virus share common modes of transmission and their co-infection are common. Patients with dual HBV and HCV infection have more severe liver disease and are at increased risk of progression to hepatic cell carcinoma. This study was aimed to assess the prevalence of HBV and HCV among patients attending serology laboratory of Gondar University Teaching Hospital.MethodsA retrospective study was conducted from January 2007 to December 2011 at serology laboratory of Gondar University Teaching Hospital. Data were cross checked for completeness, entered and analyzed using SPSS version 16 statistical package.ResultsFrom the total of 2,684 clinicaly suspected hepatitis patients, 563 (20.98%) were positive for HBsAg and anti-HCV test. Of all, 14.4% were seropositive for HBV (male= 7.89% female=6.27%) (p-value=0.011) while 12.4% were seropositive for HCV (male =7.6% and female=4.13%) (p-value<0.001). The co-incidence of HBV and HCV were found to be 36 (6.39%) (male=3.9% and female=2.4%) (p-value <0.001). Majority of HBV (30.2%) and HCV (30.7%) infections were detected among age group of 25–34 years old (p-value=0.36) and 15–24 years old (p-value<0.001) respectively.ConclusionThe overall prevalence of HBV and HCV is high. Males and younger age groups were more affected. Community awareness about the transmission and prevention of viral hepatitis infection should be strengthened by giving health education and herd immunization.

Evaluation of SD BIOLINE H. pylori Ag rapid test against double ELISA with SD H. pylori Ag ELISA and EZ-STEP H. pylori Ag ELISA tests

BackgroundHelicobacter pylori antibody titters fall very slowly even after successful treatment. Therefore, tests detecting H. pylori antibody lack specificity and sensitivity. On the other hand, H. pylori stool antigen tests are reported as an alternative assay because of their reliability and simplicity. However, the comparative performance of H. pylori stool antigen tests for detecting the presence of the bacterium in clinical specimens in the study area is not assessed. Therefore, in this study we evaluated the performance of SD BIOLINE H. pylori Ag rapid test with reference to the commercially available EZ- STEP ELISA and SD BIOLINE H. pylori Ag ELISA tests.MethodsStool samples were collected to analyse the diagnostic performance of SD BIOLINE H. pylori Ag rapid test kit using SD H. pylori Ag ELISA kit and EZ- STEP ELISA tests as a gold standard. Serum samples were also collected from each patient to test for the presence of H. pylori antibodies using dBest H. pylori Test Disk. Sensitivity, specificity, predictive values and kappa value are assessed. P values < 0.05 were taken statistically significant.ResultsStool and serum samples were collected from 201 dyspeptic patients and analysed. The sensitivity, specificity, positive and negative predictive values of the SD BIOLINE H. pylori Ag rapid test were: 95.6% (95% CI, 88.8–98.8), 92.5% (95%CI, 89–94.1%), 86.7% (95% CI, 80.5–89.6), and 97.6% (95% CI, 993.9–99.3) respectively.ConclusionThe performance of SD BIOLINE H. pylori Ag rapid test was better than the currently available antibody test in study area. Therefore, the SD BIOLINE Ag rapid stool test could replace and be used to diagnose active H. pylori infection before the commencement of therapy among dyspeptic patients.