Mulugeta Kibret

Bacteriological and physicochemical quality of drinking water and hygiene-sanitation practices of the consumers in bahir dar city, ethiopia.

Background Lack of safe drinking water, basic sanitation, and hygienic practices are associated with high morbidity and mortality from excreta related diseases. The aims of this study were to determine the bacteriological and physico-chemical quality of drinking water and investigate the hygiene and sanitation practices of the consumers in Bahir Dar City, Ethiopia. Methods A cross sectional prospective study was conducted in Bahir Dar City from October–December, 2009. Water samples were collected from 35 private taps and 35 household water containers for bacteriological analysis. The turbidity, pH, temperature and turbidity were measured immediately after collection. Finally, the hygiene-sanitation practices of the consumers were surveyed using interview. Results Twenty seven (77.1%) of the household water samples had high total coliforms counts. Twenty (57.1%) household water samples and 9 (25.7%) of the tap water samples had no residual free chlorine. Sixteen (45.7%) household water samples had very high risk score to thermotolerant coliforms. Eight (22.9%) tap water samples had low risk score for total coliforms whereas 21(60%) tap water had very low risk score for thermotolerant coliforms. Twelve (34.3%) of the consumers collect water without contact with their hand and 9(25.7%) wash their hands with soap after visiting toilet. Conclusion Water supplies at tap and household water containers were contaminated with bacteria. Poor sanitation, low level of hygiene, uncontrolled treatment parameters are the causes for contamination. Control of physico-chemical parameters and promoting good hygiene and sanitation are recommended.

Knowledge and beliefs on antimicrobial resistance among physicians and nurses in hospitals in Amhara Region, Ethiopia

BackgroundAntimicrobial resistance (AMR) is a major global public health problem both in hospital and community acquired infections. The present study assessed the knowledge and beliefs on AMR among physicians and nurses in 13 hospitals in Amhara region, Ethiopia, which is a low-income country.MethodsA cross-sectional study using a self-administered questionnaire was applied.ResultsA total of 385 participants (175 physicians and 210 nurses) took part in the study. Sixty five percent of physicians and 98% of nurses replied that they need training on antimicrobial stewardship. Only 48% of physicians and 22.8% of nurses had exposures for local antibiogram data. Overall, 278 (72.2%) of participants were knowledgeable about AMR. Majority of participants agreed or strongly agreed AMR as worldwide and national problem but few considered AMR as problem in their own hospitals. The two most important factors mentioned for AMR development were patients’ poor adherence to prescribed antimicrobials (86%) and overuse of antibiotics (80.5%). The most leading local factors identified for AMR development were: self-antibiotic prescription (53.5%), lack of access to local antibiogram data (12.3%) and prescriber poor awareness about AMR (9.2%). Factors perceived for excessive antibiotic prescriptions were: patient drive (56%), treatment failure (79%), unknown febrile illnesses (39.7%) and upper respiratory tract infections (33.4%).ConclusionMajority of physicians and nurses lack up to-date knowledge on AMR. Unavailability of local antibiogram data, self-prescription by patients and poor awareness on AMR are areas of interventions for prevention and control of AMR.

Prevalence and antibiogram of bacterial isolates from urinary tract infections at Dessie Health Research Laboratory, Ethiopia.

OBJECTIVE To determine the prevalence and antimicrobial susceptibility of bacteria from suspected urinary tract infections. METHODS A retrospective analysis of bacterial pathogens and their antimicrobial susceptibility was done on urine samples at Dessie Regional Laboratory in the period 2003 to 2010. Antimicrobial susceptibility tests were done using disc diffusion technique as per the standard of Kirby-Bauer method. RESULTS The male to female ratio of the patients was 1:1.96. Of the total 1 404 samples, 319 (22.7%) were culture positive. Escherichia coli was the dominant isolate (63.6%) followed by Klebsiella spp. (8.5%) and Proteus spp. (8.2%). The overall resistance rates to erythromycin, amoxycillin, and tetracycline were 85.6%, 88.9% and 76.7%, respectively. The three most frequently isolated bacteria had resistance rates of 80.1%-90.0% to, amoxycillin, and tetracycline and sensitivity rates of 0 to 25% to nitrofurantoin, ciprofloxacin and gentamicin. Antibiogram of isolates showed that 152 (47.85%) isolates were resistance to two and more antimicrobials. CONCLUSIONS In the study area resistance rates to erythromycin, amoxycillin and tetracycline were high. Since most isolates were sensitive to nitrofurantoin and gentamicin, they are considered as appropriate antimicrobials for empirical treatment urinary tract infections.

Reproductive Health Knowledge, Attitude and Practice among High School Students in Bahir Dar, Ethiopia

This study was carried out to investigate the reproductive health knowledge, attitude and practice of high school students in Bahir Dar, Ethiopia. Data were collected using self-administered questionnaire and focus group discussions. The study revealed that the students had high level knowledge of contraceptives and where to obtain contraceptive services; however, level of use was low. Some of the reasons given for not using contraceptives include lack of access to services, carelessness, unplanned sexual intercourse and pressure from sexual partner. The study indicates that young people engage in sexual relationships at an early age without protection or with unsafe non-conventional methods. There was no significant difference between the demographic variables and contraceptive use at first intercourse. Educational level of the respondents was the only demographic variable that had significant association with sexual experience (p < 0.05). We recommend improved access to family planning information and services and family life education programmes based on the needs and experience of these young people as a potential solution to alleviate their reproductive health problems.

Prevalence and Risk Factors of H. pylori from Dyspeptic Patients in Northwest Ethiopia: A Hospital Based Cross-sectional Study

BACKGROUND Gastric cancer is the second leading cause of cancer-related deaths worldwide and infection with H. pylori is considered essential for its development. Helicobacter pylori infects more than 50% of the worlds population with higher prevalence in developing countries than developed countries. The prevalence of H. pylori varies in different societies and geographical locations. The objectives of this study were to estimate the seroprevalence and determine the risk factors of H. pylori infection in dyspeptic patents in Ethiopia. MATERIALS AND METHODS A cross-sectional study involving 209 dyspeptic patients was carried out from February 15 to April 30, 2013. Five to ten ml venous blood was collected from each dyspeptic patient and analyzed for detection of Helicobacter pylori immunoglobulin (IgG). The socio-demographic characteristic, hygienic practices, alcohol consumption, sources of drinking water and types of latrine were also obtained with a pre-tested questionnaire. RESULTS The overall seroprevalence of Helicobacter pylori was 72.2%. There was statistically significant difference in the prevalence of H. pylori among age groups (p=0.02). Seroprevalence of H. pylori was higher in those patients who used unprotected surface water (76.4%) than those with access to piped tap water (65.9%). There was also statistically significant differences in prevalence of H. pylori with the habit of hand washing before meal (p=0.01) and alcohol consumption (p=0.001). CONCLUSIONS The prevalence of H. pylori was high in the study area and increased with age of dyspeptic patients. Alcohol consumption and the type of drinking water are risk factors that have associations with the prevalence of H. pylori. Molecular epidemiological techniques can show a true picture of H. pylori and improvement in the drinking water quality is recommended.

Seroprevalence of hepatitis B and C viruses and risk factors in HIV infected children at the felgehiwot referral hospital, Ethiopia

BackgroundLiver hepatitis due to Hepatitis B (HBV) and hepatitis C virus (HCV) co-infection is the leading cause of morbidity and mortality in HIV infected children and it is more severe in resource poor settings. Data on seroprevalence of HBV and HCV among HIV infected children are scarce in Ethiopia. This study was conducted to determine seroprevalence and risk factors of HBV and HCV and its effect on liver enzyme among HIV-positive children aged 18 months to 15 years attending the paediatric HIV care and treatment clinic at Felege Hiwot referral hospital, Ethiopia.MethodsA cross-sectional study was conducted in May, 2014. Demographic and risk factors were collected using a structured questionnaire. Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies were detected using an enzyme linked immunosorbent assay (ELISA). Alanine aminotransferase (ALT) levels were determined. The results were analyzed using descriptive and logistic regression.ResultsA total of 253 HIV positive children, boys (52.5%) and girls (47.5%) took part in the study. The median age of the children was 11 years. Overall, 19 (7.5%) of HIV infected children were positive either for HBsAg or anti-HCV antibodies. The seroprevalence of HBV and HCV were 2.0% and 5.5%, respectively. All HBsAg positive children were in older age groups (11-15years). Seroprevalence of HCV was higher in children from urban (7.7%) than rural (1.2%) residents (P = 0.02). Overall, 29 (12.1%) of children had elevated ALT. Of these, 31.5% were from HBsAg or anti-HCV antibody positive children whereas 9.8% were from hepatitis B or C virus negative children (P = 0.001). Multivariate logistic regression showed that being positive for HBsAg or anti-HCV antibody (AOR: 4.7(95% CI: 1.5-13.5) was significantly associated with elevated ALT.ConclusionHBV and HCV co-infections are common in HIV positive children. In HIV positive children, HBV and HCV co-infection were associated with elevate ALT. Routine screening for HBV and HCV in HIV infected children should be implemented.

Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town

BACKGROUND Diarrheal disease and its complications remain a major cause of morbidity and mortality in children. The prevalence and antibiogram of E. coli as causative agents of diarrhea vary from region to region, and even within countries in the same geographical area. OBJECTIVES To determine the serotype and antimicrobial susceptibility of E. coli in children under-five years of age. METHODS A cross-sectional study was conducted among 422 children with diarrhea from December 2011 to February 2012. Identification of E. coli and antimicrobial susceptibility testing were done following standard procedures. RESULTS The overall isolation rate of E. coli was 48.3%. Poly 2 sero-groups, poly 3 sero-groups, poly 4 sero-groups and E. coli O157:H7 accounted for 80 (39.2%), 40 (19.6%), 25 (12.3%), and 59 (28.9%) of the isolates, respectively. Poly 2 sero-groups, constituting isolates belonging to enteropathogenic E. coli were the most commonly isolated serotypes. E. coli exhibited high levels of antimicrobial resistance to ampicillin (86.8%), tetracycline (76%) and cotrimoxazole (76%). Low levels of resistance to ciprofloxacin (6.9%) and norfloxacin (9.3%) were documented. CONCLUSION High prevalence of diarrheagenic E. coli compounded by alarming antimicrobial resistances is a serious public health problem. Regular determination of antibiogram and public education are recommended.

Assessment of potential antagonists for anthracnose (Colletotrichum gloeosporioides) disease of mango (Mangifera indica L.) in North Western Ethiopia (Pawe)

Mango (Mangifera indica L.) is considered as one of the most popular fruits among millions of people in the tropical area and increasingly in the developed countries. Anthracnose, caused by the fungus Colletotrichum gloeosporioides, is the most important pre- and post-harvest disease of mango. The objective of this research was to evaluate the prevalence of different promising antagonistic Trichoderma and Bacillus spp. on phyloplane of mango in Ethiopia and to evaluate their antagonistic potential against the pathogen. A total of 19 mango fields were surveyed and anthracnose affected all fields. Culture studies on potato dextrose agar for evaluation of antibiosis activity of Trichoderma spp. and Bacillus spp. revealed that they have inhibitory and lytic effect on C. gloeosporioides, which is an indication of their potential biocontrol agent for management of mango anthracnose as an alternative to chemical control. Significant differences (p < 0.05) were observed among Bacillus isolates in causing lysis of pathogen mycelium, when inoculated on actively growing colony of C. gloeosporioides. Maximum reduction in growth rate of pathogen was observed with Bacillus spp. (B50), which restricted the growth to 2.7 mm compared to 8.3 mm in the control with 67.5% efficacies. There were similar effects (p < 0.05) among Trichoderma spp. in formation of inhibition zones and lysis by varying degrees up to 59.7% efficacies in reducing linear growth of the pathogen in dual culture.

Salmonella spp. and risk factors for the contamination of slaughtered cattle carcass from a slaughterhouse of Bahir Dar Town, Ethiopia

Abstract Objective To assess the prevalence of Salmonella species and associated factors from cattle carcasses in abattoir of Bahir Dar, Ethiopia. Methods A cross-sectional study was conducted among slaughtered cattle carcass samples from Bahir Dar abattoir from December 2012 to February 2013. A total of 300 carcasses from hind limb, abdomen and neck of one hundred cattle were collected and analyzed for the prevalence of Salmonella . An observation checklist was used to collect data on the risk factors for contamination of carcass. Results Out of the total 300 carcass samples, 23 (7.6%) were positive for Salmonella species. Eleven (47.8%), nine (39.1%) and three (13.1%) of the isolates were Salmonella group A, Salmonella arizonae and Salmonella typhi , respectively. Wearing garment during slaughtering, hand-washing after separating intestinal content, washing of the knife before slaughtering, slaughtering on sanitized floor and carcass-washing during slaughter were important risk factors that have statistically significant association with the isolation rate of Salmonella in slaughtered cattle carcasses ( P 2 . Conclusions Unlike other studies, Salmonella group A appears to be the most prevalent species in cattle carcasses in the present study. Among carcass sites, the highest contamination was recorded in the abdomen and the main source of contamination is human and intestinal contents. Therefore, there is a need to maintain proper hygienic practices in Bahir Dar abattoir during slaughtering.

Azithromycin, fluoroquinolone and chloramphenicol resistance of non-chlamydia conjunctival bacteria in rural community of Ethiopia

Aim: To determine profiles of non-chlamydia conjunctival bacteria and their antimicrobial susceptibility from adults who underwent trachomatous trichiasis surgery in rural areas of Ethiopia. Materials and Methods: A cross-sectional study was conducted in rural districts in West Gojjam administrative zone. Conjunctival swabs were collected during surgery and transported using Stuart transport broth (Oxoid, UK). Antibiotic susceptibility of conjunctival isolates was determined using the Kirby-Bauer disc-diffusion method. Results: Non-chlamydia pathogenic bacteria were recovered from conjunctiva of 438 (31%) participants before treatment. The isolated conjunctival bacteria were Staphylococcus aureus, coagulase-negative Staphylococci, Streptococcus group (A, C, F and G), Enterococci, Streptococcus pneumoniae, Moraxella spp., Escherichia coli, Citrobacter spp., Proteus spp., Klebsiella spp., Pseudomonas spp. and Enterobacter spp. Overall, resistance rates of 57.8% to azithromycin and 68.5% to chloramphenicol were found. However, 86-94.4% sensitivity was demonstrated to ciprofloxacin and norfloxacin. Moderate sensitivity rates (61.8-78.4%) were observed to ceftriaxone, tetracycline and cotrimoxazole. Conclusion: Fluoroquinolones that have activity against the majority of bacterial isolates were potent at in vitro. However, unacceptably high levels of resistance to azithromycin and chloramphenicol in rural community indicated a need for further study and antimicrobial resistance surveillance.