Zelalem Addis

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.

Prevalence and antimicrobial resistance of Salmonella isolated from lactating cows and in contact humans in dairy farms of Addis Ababa: a cross sectional study

BackgroundSalmonella are the major pathogenic bacteria in humans as well as in animals. Salmonella species are leading causes of acute gastroenteritis in several countries and salmonellosis remains an important public health problem worldwide, particularly in the developing countries. The situation is more aggravated by the ever increasing rate of antimicrobial resistance strains. Cattle have been implicated as a source of human infection with antimicrobial resistant Salmonella through direct contact with livestock and through the isolation of antimicrobial resistant Salmonella from raw milk, cheddar cheese, and hamburger meat traced to dairy farms. Despiite the presence of many studies on the prevalence and antimicrobial susceptibility pattern of Salmonella in Ethiopia, nothing has been said on the degree of the situation among apparently healthy lactating cows and in contact humans. Hence this study was conducted to determine the prevalence and antimicrobial resistance pattern of Salmonella isolates from lactating cows and in contact humans in dairy farms of Addis Ababa.Methodsa cross sectional study was conducted in Addis Ababa by collecting milk and faecal samples from lactating cows and stool samples from humans working in dairy farms. Samples were pre-enriched in buffered peptone water followed by selective enrichment using selenite cysteine and Rapaport-Vassilidis broths. Isolation and identification was made by inoculating the selectively enriched sample on to Xylose Lysine Deoxycholate agar followed by confirmation of presumptive colonies using different biochemical tests. The Kibry Bauer disk diffusion method was used for antimicrobial sensitivity testing.Results10.7% (21/195) of cows and 13.6% (3/22) of the human subjects sheded Salmonella. 83% resistance to two or more antimicrobials and 100% resistance to ampicillin were observed. Most of the isolates were relatively sensitive to ciprofloxacin, cotrimoxazole, and chloramphenicol.ConclusionHigh proportion of Salmonella isolates developed resistance to the commonly prescribed antimicrobials and this may be a considerable risk in the treatment of clinical cases. So, wise use of antimicrobials must be practiced to combat the ever increasing situation of antimicrobial resistance.

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.

Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, North West Ethiopia.

OBJECTIVE To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among HIV/AIDS patients in Bahir Dar. METHODS Cross-sectional study was conducted among HIV/AIDS patients attending Gambi higher clinic from April1-May 30, 2009. Convenient sampling technique was employed to identify the study subjects and hence a total of 248 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration and modified Ziehl-Neelsen staining technique. RESULTS Out of 248 enrolled in the study, 171(69.0%) (90 males and 81 females) were infected with one or more intestinal parasites. The highest rate of intestinal parasites were observed among HIV/AIDS patients (80.3%, 151/188), and the infection rate of HIV negative individuals was 33.3% (20/60). Cryptosporidum parvum (43.6%), Isospora belli (15.5%) and Blastocystis hominis (10.5%) were opportunistic parasites that were found only in HIV/AIDS patients. CONCLUSIONS Opportunistic parasite infections are common health problem among HIV/AIDS patients in the study area. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients.

Prevalence and Predictors of Maternal Anemia during Pregnancy in Gondar, Northwest Ethiopia: An Institutional Based Cross-Sectional Study

Background. Anaemia is a global public health problem which has an eminence impact on pregnant mother. The aim of this study was to assess the prevalence and predictors of maternal anemia. Method. A cross-sectional study was conducted from March 1 to April 30, 2012, on 302 pregnant women who attended antenatal care at Gondar University Hospital. Interview-based questionnaire, clinical history, and laboratory tests were used to obtain data. Bivariate and multivariate logistic regression was used to identify predictors. Result. The prevalence of anemia was 16.6%. Majority were mild type (64%) and morphologically normocytic normochromic (76%) anemia. Anemia was high at third trimester (18.9%). Low family income (AOR [95% CI] = 3.1 [1.19, 8.33]), large family size (AOR [95% CI] = 4.14 [4.13, 10.52]), hookworm infection (AOR [95% CI] = 2.72 [1.04, 7.25]), and HIV infection (AOR [95% CI] = 5.75 [2.40, 13.69]) were independent predictors of anemia. Conclusion. The prevalence of anemia was high; mild type and normocytic normochromic anemia was dominant. Low income, large family size, hookworm infection, and HIV infection were associated with anemia. Hence, efforts should be made for early diagnosis and management of HIV and hookworm infection with special emphasis on those having low income and large family size.

Prevalence of dyslipidemia among HIV-infected patients using first-line highly active antiretroviral therapy in Southern Ethiopia: a cross-sectional comparative group study

BackgroundData on lipid profile abnormalities among patients receiving highly active antiretroviral treatment in Ethiopia are very limited. The aim of this study was to determine the prevalence of dyslipidemia and characteristics of lipid profiles among patients living with human immunodeficiency virus (HIV) using first-line highly active antiretroviral therapy (HAART) in Southern Ethiopia.MethodsThis cross sectional comparative group study was conducted between March and May 2012, and included 113 HIV infected patients treated for a minimum of one year with first-line HAART regimens that included Efavirenz and Nevirapine (HAART group) and others 113 who had never received HAART (pre-HAART group). Serum lipid profiles were determined after overnight fasting and dyslipidemia was assessed according to the United State National Cholesterol Education program-III guideline. For statistical analysis Chi-square, student’s t-test, and logistic regression were used using Statistical Package for Social Sciences (SPSS) Version 20.ResultNinety-three (82.3%) of HAART and 87 (76.9%) pre-HAART patients had at least one laboratory abnormality, which is compatible with a diagnosis of dyslipidemia. Total cholesterol ≥ 200 mg/dl occurred in 43.4% of HAART and 15.9% pre-HAART patients (p=<0.0001), whereas HDL-cholesterol below 40 mg/dl occurred in 43.4% and in 63.7% respectively, (p=0.002). The LDL-cholesterol ≥ 130 mg/dl occurred in 33.6% of HAART and 15% pre-HAART patients (p=0.001), while triglycerides ≥ 150 mg/dl occurred in 55.8% and 31.0% respectively, (p=0.001). Receiving of HAART was significantly and positively associated with raised total cholesterol, LDL-cholesterol, and triglycerides. The adjusted odds ratio (95% CI) of HAART-treated vs. pre-HAART was 3.80 (1.34-6.55) for total cholesterol ≥ 200 mg/dl; 2.64 (1.31-5.32) for LDL- cholesterol ≥ 130 mg/dl and 2.50 (1.41-4.42) for triglycerides ≥150 mg/dl.ConclusionUse of first-line antiretroviral therapy regimens that contain Efavirenz and Nevirapine were associated with raised total cholesterol, LDL-cholesterol, and triglycerides, an established atherogenic lipid profiles. Lipid profiles should be performed at baseline before commencement of antiretroviral therapy and then periodically through treatment follow-up to monitor any rising trends.

Current status of soil transmitted helminths and Schistosoma mansoni infection among children in two primary schools in North Gondar, Northwest Ethiopia: a cross sectional study

BackgroundSchool age children are one of the groups at high risk for intestinal parasitic infections especially in developing countries like Ethiopia as the supply of good quality drinking water and latrine coverage are poor. Though there are previous data on the prevalence of soil transmitted helminths (STHs) and Schistosoma mansoni infection among these high risk groups current status in the study area is unknown. Therefore, the aim of this study was to determine the current prevalence and associated risk factors of STHs and S. mansoni infections among school children.MethodsA cross-sectional study was carried out in Gorgora and Chuahit towns, North Gondar Zone, North West Ethiopia from January 20 to February 25, 2012 involving 261 school children. A pre-tested and structured questionnaire was used to collect socio-demographic data and possible risk factors. Stool samples were collected and examined for intestinal parasites using Kato Katz method. Chi-square test was used to see if there is association between sociodemographic factors and other risk factors for STH and S. mansoni infection and odds ratio with 95% CI was computed as measures of association. P < 0.05 was taken as statistically significant.ResultsOut of the 261 study participants, 174 (66.7%) were infected with one or more species of intestinal parasites. Ascaris lumbricoides was the predominant isolates (39.8%) followed by Trichuris trichiura (6.1%) and Hookworms (4.9%). Schistosoma mansoni was detected in 33.7% of the children. Among infected individuals, 9.5% were coinfected by S. mansoni and A. lumbricoides and 1.5% with S. mansoni and T. trichiura. Swimming habit (OR: 2.536, 95% CI: 1.122, 5.737, P = 0.022) was significantly associated with S. mansoni infection.ConclusionThe prevalence of STH and S. mansoni was high among school children. This should call for implementation of an integrated strategy to reduce morbidity and control of transmission of STH and S. mansoni.

Determination of hematological and immunological parameters among HIV positive patients taking highly active antiretroviral treatment and treatment naïve in the antiretroviral therapy clinic of Gondar University Hospital, Gondar, Northwest Ethiopia: a comparative cross-sectional study

BackgroundAnemia, leucopenia and thrombocytopenia are the commonest hematological abnormalities resulting from human immunodeficiency virus infection. The use of antiretroviral drugs could positively or negatively affect these disorders. Thus a specific diagnosis and a determination of hematological and immunological parameters are required for initiating and monitoring early treatment to avert disease progression. Therefore, this study aimed to compare hematological and immunological parameters in HIV positive patients taking antiretroviral therapy and those treatment naïve patients in Gondar University Hospital.MethodsA comparative cross-sectional study was conducted on a total of 290 HIV patients from February to May 2012 in Gondar University Hospital. Study subjects were divided in to two groups: 145 HIV positive treatment naïve and 145 on HAART. Data of socio demographic characteristics and clinical conditions of the study subjects was collected using structured pretested questionnaire at their follow up date. Hematological and immunological parameters were collected and processed by cell Dyne 1800 and BD FACS count respectively. The variables compared here were Hematological parameters (Total and differential WBC, RBC, Hgb, HCT, MCV, MCH, MCHC, RDW, PLT, and MPV) and CD4 count. In order to compare means independent sample T-test was conducted using SPSS version 20 statistical software. P- Value < 0.05 was considered as significant.ResultPrevalence of anemia, leucopenia, thrombocytopenia, neutropenia and lymphopenia were 11.7%, 35.9%, 4.1%, 28.3% and 2.1% in patients on HAART and 29.7%, 16.6%, 9%, 14.5% and 2.1% in HAART naïve patients respectively. There was a significant difference in total WBC, RBC, Hgb, MCV, MCH, MCHC, MPV and CD4 counts between patients on HAART and HAART naïve patients.ConclusionPrevalence of anemia was high in HAART naïve patients while leucopenia and neutropenia prevalence was higher in patients on HAART and their prevalence increased as the CD4 count decreased. HIV Patients should be investigated for hematological and immunological changes following with appropriate therapeutic interventions.

Prevalence and antimicrobial susceptibility patterns of Salmonella isolates in association with hygienic status from butcher shops in Gondar town, Ethiopia

BackgroundSalmonella has been recognized as a major cause of food borne illness associated with meat products worldwide. The wide spread of antimicrobial-resistant Salmonella has been a serious global human and animal health problem. The aims of this study were to estimate the prevalence and antimicrobial susceptibility pattern of Salmonella isolates from butcher shops of Gondar town, Ethiopia.MethodsA cross-sectional study was conducted from February to June, 2013 in Gondar town. After receiving written consent from the study participants, raw meat and swab samples from butcher shops’ utensils and meat handlers were collected and tested using standard bacteriological methods. The isolates were identified using colony characteristics, Gram-reaction, biochemical reaction and sugar tests. Antimicrobial susceptibility test was performed using Kirby-Bauer disc diffusion method. Check list was used to record general hygienic conditions and practices in the butcher shops. The data was entered and analyzed using SPSS version 20.0.ResultsButcher shop premises and utensils sanitation and personnel’s hygiene were poor. The overall prevalence of Salmonella was 17.3 %. Salmonella was detected in 32 (35.6 %) meat samples, 13 (23.2 %) hand swabs, 5 (9.1 %) knife swabs, and 3 (5.6 %) chopping board surface swabs. Of the total 53 Salmonella isolates subjected to antimicrobial susceptibility test, 47 (88.7 %), 35 (62.3 %), 19 (35.8 %), 17 (32.1 %) and 16 (30.2 %) of them exhibited resistance to Ampicillin, Amoxicillin, Nitrofuranthoin, Tetracycline, and Sulfamethoxazole-Trimethoprime, respectively. Furthermore; 15 (28.3 %) of the isolates were multidrug-resistant from which highest isolation was recorded from meat samples and 40 (75.5 %) isolates of Salmonella showed resistance to two or more antimicrobial agents tested. Interestingly, all of the isolates were susceptible to Gentamycin and Ceftriaxone.ConclusionThe general sanitary condition of the butcher shops and utensils used and personnel hygiene were not to the recommended standards. Contamination of meat, knives, and meat handlers hand with Salmonella was found high. Furthermore; multidrug-resistant Salmonella is circulating in the butchers’ shop which is strong enough to warrant the revision of butcher shops sanitation policy and treatment regimen for infections implicated by Salmonella in the study area. Further in-depth study including serotyping and antimicrobial resistant gene identification is recommended.

Prevalence and Antimicrobial Susceptibility Pattern of Bacteria Isolated from Mobile Phones of Health Care Professionals Working in Gondar Town Health Centers

Background. Mobile phones of health professionals can harbor various potential pathogens and become exogenous sources of infection for the patients, self, and family members. This study assessed the frequency and antimicrobial susceptibility pattern of bacteria from mobile phones of health care workers. Methods. In this crosssectional study a total of 58 health care professionals mobile phones were swabbed before and after decontamination with 70% alcohol and assessed for contamination with bacteria. Bacterial isolation, identification, and antimicrobial susceptibility test was done as per the standard procedures. Results. About 98% of the mobile phones assessed in this study were contaminated with bacteria. Coagulase negative Staphylococci, S. aureus, and E. coli were the most frequently isolated bacteria. Decontamination with 70% alcohol significantly decreased the rate of contamination from 98.3% to 55.2% . About 17% of the isolates were resistant to two drugs. Conclusion. Appropriate infection prevention measures should be taken to minimize the risk that could be associated with mobile phones since the rate of contamination was high. Decontamination with 70% alcohol was effective in minimizing bacterial contamination of mobile phones so it should be used as a decontaminant agent for these apparatuses.