Teferi Gemetchu

Praziquantel side effects and efficacy related to Schistosoma mansoni egg loads and morbidity in primary school children in north-east Ethiopia.

A total of 611 Schistosoma mansoni infected primary school children from three schools in north-east Ethiopia were treated with praziquantel at 40 mg/kg body weight in a single dose. Pre-treatment, 40.4% had no presenting symptoms and 30-40% had nausea, abdominal cramps and/or bloody-mucoid diarrhoea. None of the pre-treatment symptoms was related to nutritional status, intensity of S. mansoni egg excretion, or to the presence of other concomitant intestinal parasitic infections. During the first 4-6 h post-treatment observation period, 90 (14.7%) children self-presented with severe gastro-intestinal symptoms. Children who self-presented with severe symptoms had a higher mean age and mean S. mansoni egg excretion compared with children who did not self-present. The following day a total of 529 (86.6%) children, including all who self-presented during the first 4-6 h post-treatment, reported for clinical check-up and were subjected to a structured questionnaire interview on symptoms they had experienced over the time lapse following treatment. Among these, 91.5% reported one or more treatment related symptoms which were at times severe. Abdominal cramps (86.9%), diarrhoea with blood and/or mucus (49.5%), dizziness (31.2%) and vomiting (24.9%) were the most common treatment related symptoms. Skin rash with oedema were observed in four cases. Among treatment related symptoms, the combination of abdominal cramps with vomiting, bloody diarrhoea, vomiting alone and general weakness were significantly higher among the malnourished. A proportion of these symptoms increased with increasing categories of S. mansoni egg excretion before and after adjusting for nutritional status and concurrent intestinal parasitic infections. Overall, the cure rate of praziquantel, among 541 children who had stool examination 5 weeks after treatment was 83.2% and this rate decreased with increasing pre-treatment egg counts. In conclusion, most of the treatment related symptoms were mild. However, some of the objective symptoms were at times severe and may reduce drug compliance in primary health care based population chemotherapy.

Cutaneous leishmaniasis in south-western Ethiopia: Ocholo revisited.

The borough of Ocholo, on the western side of the Ethiopian Rift Valley, is an endemic focus for Leishmania aethiopica infection and has been surveyed thrice between 1987 and 1990. In 1989, 3022 inhabitants (> 95% of the population) were interviewed and examined. The overall prevalence of localized cutaneous leishmaniasis (LCL) was 3.6-4.0%, with a peak value of 8.5% in the 0-10 years old age group. In half of the patients the active disease was estimated to last for 9.6 +/- 6 months; in 10%, it exceeded 3 years. Scars of LCL were present in 34.3% of the residents. Leishmanin skin tests were positive in 54% of 120 school-children without signs of the disease. Therefore, in Ocholo a minimum of 71.6% of the population has been exposed to L. aethiopica infection. Two cases of the diffuse form of cutaneous leishmaniasis were observed. In this highland biotope, Phlebotomus pedifer was found to be the major, and possibly the only, vector for L. aethiopica.

The use of DNA hybridization for the detection of Leishmania aethiopica in naturally infected sandfly vectors

Hybridization with kinetoplast deoxyribonucleic acid (kDNA) probes was used to detect Leishmania aethiopica in naturally infected sandflies in south-west Ethiopia, an endemic area for cutaneous leishmaniasis. 396 sandflies were dissected; microscopy revealed flagellates in the midgut of 5 Phlebotomus pedifer. The infecting flagellates were confirmed as L. aethiopica by isoenzyme typing. Gut specimens for all dissected sandflies were hybridized with total L. aethiopica kDNA as well as with a cloned kDNA probe specific for L. aethiopica. Samples from sandflies which were found to be infected microscopically also hybridized with the L. aethiopica kDNA probes. One additional sandfly hybridized but was not shown to be infected by microscopical examination. Hybridization experiments with 65 whole squash-blotted sandflies gave results that correlated very well with results obtained using microscopy. Our results indicate that DNA probing is a useful method to detect Leishmania infection in sandfly midguts as well as in whole squash-blotted sandflies, and can be used to follow changes of infection rate. DNA probing is therefore an alternative to microscopy in large-scale epidemiological studies as well as monitoring control programmes aimed at human leishmaniasis.

Ticks and tick-borne parasites associated with indigenous cattle in Didtuyura Ranch, southern Ethiopia

Tick populations were monitored between October 1991 and September 1992 at monthly intervals on 10 Boran (Bos indicus) heifers at Didtuyura ranch, Yabelo district, Ethiopia. Twelve different tick species in four genera were identified from a total of 16 026 specimens collected. Of all the ticks collected, Rhipicephalus spp. constituted 84.7%, Amblyomma spp. 9.9%, Boophilus spp. 4.8% and Hyalomma spp. 0.24%. The ventral parts of cattle were found to be the most favoured feeding sites for most of the ticks collected. The size ranges of the standard ticks collected were 4–8 mm; 9–16 mm; 4–8 mm and 8–13 mm for R. pulchellus, A. variegatum, B. decoloratus and A. gemma, respectively, while their respective male to female sex ratios were 2:1; 3.2:1; 1:5.4 and 2.6:1. Packed cell volume (PCV) values of blood samples taken from 600 cattle were monitored monthly during the study period. There was a reduction in PCV during the dry season of the year but generally the values were within the normal range of 32–40%. The parasites causing anaplasmosis, babesiosis and theileriosis (T. mutans) were detected by microscopic examination of blood smears and serologically (ELISA) at seroprevalence rates of 94.68%, 77.19% and 30.9% respectively.RésuméAu ranch de Didtuyura, district de Yabelo en Ethiopie, les populations des tiques ont fait l’objet de suivi sur 10 génisses de zébu (Bos indicus), entre septembre 1991 et octobre 1992, avec un mois d’intervalle entre les observations. A partir de 16.026 specimens de tiques collectées, on a identifié douze espèces différentes, réparties en quatre genres. De toute la collection des tiques échantillonnées on a dénombré 84,7% de Rhipicephalus spp., 9,9% d’Amblyoma spp., 4,8 % de Boophillus spp. et 0,24% de Hyalomma spp. Les parties de la région ventrale du corps des animaux constituaient des sites les plus préférés de prise de repas pour la plupart des tiques collectées. La taille des tiques normales se rangeait respectivement entre 4–8 mm; 9–16 mm; 4–8mm et 8–13mm pour R. pulchellus, A. variegatus, B. decoloratus et A. gemma, tandis que le rapport respectif du nombre de mâles par rapport aux femelles par espèce, était de 2:1; 3,2:1; 1:5,4 et de 2,6:1. Le volume du culot plasmatique de sang prélevé sur 600 animaux était aussi mesuré mensuellement pendant toute la durée de l’étude. Il a été constaté une diminution du volume du culot plasmatique pendant la saison sèche mais ces valeurs se situaient généralement dans la fourchette des valeurs normales qui sont de l’ordre de 32–40%. Les examens microscopiques par frottis de sang et sérologiques par méthodes (ELISA) ont révélé 94,68%; 77,19% et 30,9% de cas de séropositivité pour l’anaplasmose, la babésiose et la théilériose (T. mutans) respectivement.

Detection of Plasmodium falciparum sporozoites in naturally infected anopheline species using a fluorescein-labelled DNA probe.

A dot blot hybridization method was developed to detect Plasmodium falciparum sporozoites in naturally infected mosquitoes. A fluorescein-labelled oligomer was used as a probe. Initial non-specific hybridization was found to correlate with the presence of blood in the mosquitoes. This was eliminated by allowing digestion of the engorged blood by keeping the mosquitoes in cages for 48 h before processing. The limit of detection of the hybridization assay was estimated to be about 500 sporozoites. The assay was evaluated on 198 indoor resting blood fed female Anopheles gambiae s.l mosquitoes collected from three malaria hypo- and meso-endemic areas in Ethiopia. An application of the polymerase chain reaction (PCR) amplifying a fragment of the K1-14 gene of P. falciparum was used as a reference method. P. falciparum sporozoites were detected in four specimens (2%) by hybridization assay and by PCR alike. The results of this study indicate that the hybridization method can be potentially valuable in large scale epidemiological studies for detection of P. falciparum sporozoites in naturally infected anopheline species.

Altitudinal distribution of tsetse in the Finchaa river valley (western part of Ethiopia)

A year round ecological study of Glossina morsitans submorsitans variety ugandensis was carried out from September 1980 to August 1981 in the Finchaa river valley in the western part of Ethiopia. Two sampling methods, namely vehicle patrol and screen/handnet capture were employed. The latter was more efficient. The effect of various environmental factors (e.g. altitude, climate, vegetation etc.) that determine the eco-distribution of this species of tsetse were analysed. The most significant finding was that tsetse were distributed far above the previously known altitude limits.