Wubet Birhan

Soil transmitted helminths and schistosoma mansoni infections among school children in zarima town, northwest Ethiopia

BackgroundIn Ethiopia, because of low quality drinking water supply and latrine coverage, helminths infections are the second most predominant causes of outpatient morbidity. Indeed, there is a scarcity of information on the prevalence of soil transmitted helminths and Schistosomiasis in Ethiopia, special in study area. Therefore, the aim of this study was to determine the prevalence and associated risk factors of soil transmitted helminths and intestinal Schistosomiasis.MethodsCross-sectional study was conducted among 319 school children of Zarima town from April 1 to May 25, 2009. A pre-tested structured questionnaire was used to collect socio-demographic data and possible risk factors exposure. Early morning stool samples were collected and a Kato Katz semi concentration technique was used to examine and count parasitic load by compound light microscope. Data entry and analysis was done using SPSS-15 version and p-value < 0.05 considered statistically significant.ResultsOut of 319 study subjects, 263 (82.4%) of the study participants infected with one or more parasites. From soil transmitted helminths, Ascaris lumbricoides was the predominant isolate (22%) followed by Hookworms (19%) and Trichuris trichiura (2.5%). Schistosoma mansoni was also isolated in 37.9% of the study participants. Hookworm and S. mansoni infections showed statistically significant associations with shoe wearing and swimming habit of school children, respectively.ConclusionPrevalence of soil transmitted helminths (STH) and S.mansoni was high and the diseases were still major health problem in the study area which alerts public health intervention as soon as possible.

Effect of malaria on HIV/AIDS transmission and progression

Malaria and HIV are among the two most important global health problems of developing countries. They cause more than 4 million deaths a year. These two infections interact bidirectionally and synergistically with each other. HIV infection increases the risk of an increase in the severity of malaria infection and burdens of malaria, which in turn facilitates the rate of malaria transmission. Malaria infection is also associated with strong CD4+ cell activation and up-regulation of proinflammatory cytokines and it provides an ideal microenvironment for the spread of the virus among the CD4+ cells and for rapid HIV-1 replication. Additionally, malaria increases blood viral burden by different mechanisms. Therefore, high concentrations of HIV-1 RNA in the blood are predictive of disease progression, and correlate with the risk of blood-borne, vertical, and sexual transmission of the virus. Therefore, this article aims to review information about HIV malaria interactions, the effect of malaria on HIV transmission and progression and the implications related to prevention and treatment of coinfection.

Knowledge, attitude and practices related to visceral leishmaniasis among residents in Addis Zemen town, South Gondar, Northwest Ethiopia

BackgroundVisceral leishmaniasis (VL), commonly known as kala-azar is a systemic disease caused by parasitic protozoan species of genus Leishmania and transmitted by species of Phlebotomus (sand flies). It is a poverty-related disease and associated with malnutrition, displacement, poor housing, weakness of the immune system and lack of resources. For the success of prevention and control programs of any disease, the most important prerequisite is community participation. Therefore, this study was aimed to assess the knowledge, attitude and practice of residents towards VL in Addis Zemen town, south Gondar, Northwest Ethiopia.MethodsCommunity based cross-sectional study was conducted among residents in Addis Zemen town from February to March 2012. A total of 346 households were selected by using simple random sampling techniques from three kebeles in the town. Data was collected using structured Questionnaire. For knowledge, attitude and practice variables each right response was given a score of 1 while a wrong or unsure response was scored 0. Data were double entered and analyzed using SPSS-15 statistical software. The frequency distribution of both dependent and independent variables were worked out.ResultsFrom a total of 346 study participants (136 males and 210 females), 87.6% heard of the disease kala-azar. From participants who heard about kala-azar 93.5% males and 86.7% females had awareness about the disease. The majority (95.7%) of participants had favourable attitude towards the treatment of kala-azar whereas 14.8% didn’t use anything to prevent it. More than half of the respondents (68.6%) did practice proper methods for the prevention and control of kala-azar in the study area.ConclusionIn general our findings showed that the residents had good awareness and favourable attitude about the disease, but their overall practice about prevention and control of the disease was low. Therefore, our investigation call for continued and strengthened behavioral change communication and social mobilization related activities.

Methicillin resistant Staphylococcus aureus in Ethiopia: a meta-analysis

BackgroundThe burden of methicillin resistant Staphylococcus aureus is a major public health concern worldwide; however the overall epidemiology of multidrug resistant strains is neither coordinated nor harmonized, particularly in developing countries including Ethiopia. Therefore, the aim of this meta-analysis was to assess the burden of methicillin resistant Staphylococcos aureus and its antibiotic resistance pattern in Ethiopia at large.MethodsPubMed, Google Scholar, and lancet databases were searched and a total of 20 studies have been selected for meta-analysis. Six authors have independently extracts data on the prevalence of methicillin resistant Staphylococcus aureus among clinical isolates of Staphylococcus aureus. Statistical analysis was achieved by using Open meta-analyst (version 3.13) and Comprehensive meta-analysis (version 3.3) softwares. The overall prevalence of methicillin resistant Staphylococcus aureus and its antibiotic resistance pattern were pooled by using the forest plot, table and figure with 95% CI.ResultsThe pooled prevalence of methicillin resistant Staphylococcus aureus was 32.5% (95% CI, 24.1 to 40.9%). Moreover, methicillin resistant Staphylococcus aureus strains were found to be highly resistant to penicillin, ampicillin, erythromycin, and amoxicillin, with a pooled resistance ratio of 99.1, 98.1, 97.2 and 97.1%, respectively. On the other hand, comparably low levels of resistance ratio were noted to vancomycin, 5.3%.ConclusionThe overall burden of methicillin resistant Staphylococcus aureus is considerably high, besides these strains showed extreme resistance to penicillin, ampicillin, erythromycin and amoxicillin. In principle, appropriate use of antibiotics, applying safety precautions are the key to reduce the spread of multidrug resistant strains, methicillin resistant Staphylococcus aureus in particular.

Diagnostic performance of rapid diagnostic tests for the diagnosis of malaria at public health facilities in north-west Ethiopia.

To assess the performance of RDTs against nested polymerase chain reaction (nPCR) for the diagnosis of malaria in public health facilities in north‐western Ethiopia.

Association of anemia and renal function test among diabetes mellitus patients attending Fenote Selam Hospital, West Gojam, Northwest Ethiopia: a cross sectional study

BackgroundAnemia is a common problem in diabetic patients. Diabetic patients have a greater severity of anemia as the level of Glomerular Filtration Rate (GFR) decreases compared to non-diabetic patients. Despite these facts, anemia is unrecognized and largely untreated in patients with diabetes in Ethiopia particularly in those patients attending Fenote Selam Hospital. Therefore, this study was aimed to assess the association of anemia and renal function test among diabetes mellitus patients attending Fenote Selam Hospital, North West of Ethiopia.MethodsAn Institutional -based cross-sectional study was conducted from February 2012 to April 2012 on diabetes mellitus (DM) patients. Systematic random sampling technique was used to get the total sample size of 384 patients. A total of seven ml of venous blood was collected from diabetes mellitus patients; two ml was collected by EDTA anticoagualted vacutainer test tube for haemoglobin determination and 5 ml venous blood was collected by plain vacutainer tube for creatinine and Blood urea nitrogen determination. The data were double entered and analyzed using SPSS-16 statistical software. The degree of association between independent and dependent variables was assessed using bivariate and multivariate logistic regression analysis in terms of P-value and odds ratio with 95% confidence interval.ResultsOut of the total 384 DM patients included in the study 73 (19%) were anemic. Fifty three (13.8%), forty eight (12.5%), and two hundred eighty three (73.7%) DM patients had an estimated GFR <60 ml/min/1.73 m, 60 – 90 ml/min/ 1.73 m, and > 90 ml/min/1.73 m respectively. One hundred eleven (28.9%) diabetic patients had increased urine albumin level. There was a statistically significant association between anaemia and Glomerular filtration rate (P<0.05) with Odds ratio of 8.58 and CI (10.21, 49.94). As the glomerular filtration rate increase, the risk to be anemic will decrease dramatically.ConclusionThe study showed that there was a significant association between anaemia and Glomerular filtration rate in DM patients. Therefore, DM patients should be strictly monitored for renal failure and anemia for proper management of diabetes patients.

Haematological and immunological reference intervals for adult population in the state of Amhara, Ethiopia

Reference intervals (RIs) currently being used in Ethiopia are derived from western populations. Thus, this study aimed to establish locally derived haematological and immunological RIs.

Proportion and predictors of transfusion-transmissible infections among blood donors in North Shewa Zone, Central North Ethiopia

Background Transfusion-transmissible infections (TTIs) pose a significant challenge for the availability and safety of blood transfusion. The aim of this study was to investigate the prevalence and risk factors for TTIs among blood donors in North Shewa zone, central North Ethiopia. Methods A retrospective survey of blood donors’ medical records was conducted from April 2014 to June 2017 to assess the presence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis infections. Descriptive statistics such as percentage, median and interquartile range were used to summarize the data. Results Out of 8460 donations, 207 (2.4%, 95% CI 2.06–2.71%) had serological evidence of infection with at least one pathogen. Four of the blood donors (0.047%) had co-infection with more than one pathogen; 2HIV/HBV and 2HIV/syphilis. The overall prevalence of HBV, HCV, HIV, and syphilis among the donors were 1.2% (95% CI 0.98–1.45%), 0.32% (95% CI 0.2–0.44%), 0.25% (95% CI 0.14–0.35%), and 0.71% (95% CI 0.53–0.89%) respectively. Male sex was significantly associated with higher risk of HBV (OR 1.75, 95% CI 1.1–2.8) and syphilis sero-reactivity (OR 4.5, 95% CI1.9–10.5). Farmers and older donors were found to be at a higher risk for syphilis seropositivity. Conclusion The prevalence of TTIs among blood donors in North Shewa zone was relatively low compared to those of other geographic places in Ethiopia. However, TTIs remain a concern for the availability and safety of blood transfusion as they are still prevalent in the study area. Therefore, more efforts are required to ensure the safety of blood supply and transfusions.

Reference intervals of routine clinical chemistry parameters among apparently healthy young adults in Amhara National Regional State, Ethiopia

Background Clinical laboratory reference intervals (RIs) are essential for clinical diagnosis, treatment and therapeutic monitoring. Locally established RIs are required to correctly interpret clinical laboratory results. In Ethiopia, clinical laboratory test results are interpreted based on RIs derived from a western population. Methods A multicenter cross-sectional study was conducted among blood donors in Amhara National Regional State, Ethiopia from March 2016 to May 2017. A total of 1,175 apparently healthy study participants were included in the study from four blood banks in the region. All clinical chemistry parameters were analyzed using Mindray BS-200E full automated clinical chemistry analyzer. The 95% RIs were estimated using reference limits at 2.5th percentile for the lower reference limit and 97.5th percentile for the upper reference limit. Kolmogorov–Sminorv and Wilcoxon rank-sum tests were used to check data distribution normality and whether partitions were needed between variables, respectively. Results RIs established include: ALT 5.13–42.88 U/L for males and 4.3–37 U/L for females; AST 12.13–46.88 for males and 10–43.8 U/L for females; ALP 77.2–475.8 U/L for males and 89–381 U/L for females; amylase 29–309.8 U/L for males and 29–287.9 U/L for females; GGT 7–69.8 U/L for males and 6–39.1 U/L for females; total bilirubin 0.11–1.18 mg/dl for males and 0.08–0.91 mg/dl for females; creatinine 0.48–1.13 mg/dl for males and 0.47–1.09 mg/dl for females; total cholesterol 78.13–211.75 mg/dl for males and 83.6–202.7 mg/dl for females; total protein 5.7–9.7 g/dl for males and 5.6–9.47 for females; triglycerides 36–221.9 mg/dl for males and 35.3–201.5 mg/dl for females; urea 12–43 mg/dl for males and 10–38.7 mg/dl for females; and uric acid 2.7–6.9 mg/dl for males and 2.1–5.9 mg/dl for females. Conclusion This study has established RIs for routine clinical chemistry parameters. These RIs are important as they support the interpretation of clinical laboratory results for medical decision making and other health-related activities.

In vivo efficacy of artemether–lumefantrine against uncomplicated Plasmodium falciparum malaria in Dembia District, northwest Ethiopia

Background Artemether–lumefantrine (AL) has been used as a first-line treatment for uncomplicated Plasmodium falciparum malaria in Ethiopia since 2004. Antimalarial drug resistance is one of the major obstacles for malaria control and curtails the lifespan of several drugs. Thus, continued monitoring of the efficacy of AL is of great public health importance in malaria endemic areas. Objective This study aimed to investigate the therapeutic efficacy and safety of AL for the treatment of uncomplicated P. falciparum malaria in the Dembia district, northwest Ethiopia. Methods A prospective study was conducted from April 2015 to February 2016 at Kola Diba Health Center (KHC) in the Dembia district to determine the therapeutic efficacy and safety of AL for the treatment of uncomplicated P. falciparum monoinfection. Patients were treated with the six-dose regimen of AL over 3 days and followed up for 28 days as per the World Health Organization protocol. Results Of the total 80 patients enrolled in the AL efficacy study, 75 patients completed the 28 days follow-up. None of the participants reported major adverse events. No early treatment failure or late clinical failure were observed during the study, but there were 6 (8.0%) late parasitological failures. The uncorrected per protocol cure rate of AL was 92.0 (95% CI: 85.7–98.3). Treatment with AL cleared parasitemia and fever in >95% of the patients by day 3. Conclusion This study showed that AL is well tolerated and remains efficacious for treatment of uncomplicated P. falciparum malaria in northwest Ethiopia. However, the observed late parasitological failures in this study are of a concern and warrant continued monitoring of drug efficacy as per the World Health Organization recommendations.