Risk factors for multidrug resistant tuberculosis patients in Amhara National Regional State.

Background: Multidrug resistant tuberculosis(MDR-TB) is becoming a major threat to tuberculosis control programs in Ethiopia.Objectives: To determine risk factors of MDR-TB patients in Amhara National Regional State, Ethiopia.Methods: Case-control study was conducted from May 2013 to January 2014. Resistance to rifampicin and isoniazid were done molecularly using line probe assay. TB patients infected with MDR-M.tuberculosis and non MDR-M.tuberculosis strain were considered as cases and controls, respectively. Data was collected using structured questionnaire with face to face interview. Patients’ clinical record review was also done.Multivariate analysis was computed to determine the risk factors of MDR-TB.Results: A total of 153 MDR-TB and equal number of non MDR-TB patients’ participated in the study. Patients who had TB treatment failure (AOR=13.5,CI=2.69-70), cavitations on chest x-ray (AOR=1.9,CI=1.1-3.38) and contact with MDR-TB patients (AOR=1.4,CI=0.19-0.39) were more likely to be MDR-TB patients. Low monthly income (AOR=1.1,CI=0.34-0.47),alcohol consumption (AOR=1.5,CI=0.2-0.98) and young age (AOR=2.9,CI=1.07-7.68) were the other risk factors of MDR-TB.Conclusions: TB treatment failure, cavitation on chest X-ray, contact with MDR-TB patients and low socioeconomic status were important risk factors for development of MDR-TB. Therefore, strict adherence to directly observed therapy, appropriate management of TB patients and advice on the value of nutrients are helpful to control the spreading of MDR-TB.Key words: Risk factors, MDR-TB, Ethiopia

The status of rabies in Ethiopia: A retrospective record review

Background: Rabies, a viral disease that affects all warm-blooded animals, is widespread in many regions of the world. Human rabies, transmitted by dogs is an important public health issue in Ethiopia. To-date, effective rabies control program still remains to be a reality and needs to be strengthened..Objective: Reviewing of recorded data to generate information on the status of rabies in Ethiopia for the year 2001-2009.Methods: A retrospective data were used from the Ethiopian Health and Nutrition Research Institute rabies case record book registered between 2001 and 2009.Results: The fatal human cases during the period of study were 386 humans with annual range of 35 to 58. The over all post exposure treatment for humans was 17,204 within and around Addis Ababa. During the same period, 20,414 suspected rabid animals were clinically examined; nevertheless, only 10%were positive for rabies. Among 3,460 animal brains investigated in the laboratory with FAT, 75% were confirmed as rabies positive. The production and distribution of anti-rabies vaccine reached 130,673 treatment doses for human vaccine and 85,055 doses for animal vaccine respectively in the period of 2001-2009.Conclusion: The recorded data showed the underestimate of rabies diagnosis, post exposure prophylaxis and fatal human cases, which could be attributed due to the absence of national rabies surveillance system. Therefore, It is of paramount importance to assess and map the national picture of rabies within a given time interval to launch a national rabies control strategy. [Ethiop. J. Health Dev. 2010;24(2):127-132

Study on knowledge, attitude and dog ownership patterns related to rabies prevention and control in Addis Ababa, Ethiopia

The study was conducted from May 2003 to August 2003 in Addis Ababa with the objective of understanding the distribution of stray and owned dogs, dog ownership patterns and attitudes of people towards rabies and its prevention and control methods. A total of 2390 households were selected from 6 Sub Cities of Addis Ababa using stratified random sampling and were interviewed using structured questionnaires. From the total households interviewed, 969 (40.5%) of them were known to own one or more dogs, and the total number of owned dogs was estimated to be 225,078. Male dogs make up 1042 (78.4%) of the total owned dogs. Almost half of all the dogs 463 (47.8%) were tied only for some time during the day whereas 320 (33.1%) of the dogs were not tied at all and freely move from place to place and contribute to high dog bites in human beings and for the widespread occurrence of canine rabies in Addis Ababa. Six hundred fifty five (67.6%) of the interviewed households who owned dogs had a well fenced house. Most of the owned dogs 856 (88.4%) get their food from their owners and only 321 (33.3%) of the owners reported that they let their dogs to be vaccinated while the majority of the owners 644 (66.5%) do not let their dogs vaccinated regularly. A significant proportion of the interviewed households 2,323 (97.2%), (P < 0.05) indicated that they have the knowledge that dogs, cats and other animals can transmit rabies to humans and 1,752 (73.4%) of the households replied that rabies can be transmitted through bite, scratch and lick to open wounds. Analysis of the list of 2400 post exposure human antirabies treatments recorded at the EHNRI Zoonoses Laboratory from February 2002 to October 2003 showed that the most common animals involved in biting people were dogs. A total of 2198 (91.6%) people were bitten by dogs during the same period and most of them, 2053 (85.5%) were bitten on their hands and legs. All the above data indicated the need for a strong and coordinated rabies control activities to be conducted in the city

Comparison of cryopreservative effect of different levels of omega-3 egg-yolk in citrate extender on the quality of goat spermatozoa

The objective of the present study was to compare quality of chilled and frozenthawed goat semen processed in citrate extender containing 3 different levels (2.5, 5 and 10%) of omega-3 egg-yolk (EY). Ejaculates were collected from five adult goats using artificial vagina. Quality of fresh semen, processed semen after 3 hrs of chilling and 24 hrs of freezing was assessed based on live sperm %age, abnormality (determined by eosin-nigrosin stain) and general and progressive motility (evaluated by CEROS computer assisted semen analyzer). The result showed a significant (P<0.05) decrease in post-chilled live sperm %age from the fresh sample for extenders using 2.5 and 5% EY but not for the 10%. Moreover, a significantly lower percentage general and progressive motility was recorded using the 2.5% EY compared to the others that showed post-chilled sperm motility non-significantly different from the fresh sample. After chilling, 5% EY showed significantly lower percent sperm abnormalities compared to others. However, the abnormalities increased after freezing to a level non-significantly different from the 10% EY that sustained to demonstrate higher live sperm %age and motility than both 2.5 and 5% EY. An overall increase in post-thawed live sperm %age, general and progressive motility was observed with increase in concentration of EY added. Thus, though the difference with the 5% EY is in magnitude, the 10% omega-3 EY in citrate extender is preferred compared to 2.5% for superior post-thawed goat semen quality, extended without washing seminal plasma

Effects of resynchronization with progesterone and prostaglandin F2• on estrus response and pregnancy rate in beef cattle

This experiment was designed to compare the estrus response and pregnancy rate of cows first synchronized using CIDR with cows that were resynchronized after failing to display estrus. Estrus response and pregnancy rate were also compared between cows resynchronized with either CIDR or prostaglandin F2• (PGF2•). Initially, 140 Brangus cows were synchronized with CIDR. About 30 days after Artificial Insemination (AI), cows were checked for pregnancy using ultrasound and those that remain open were divided into two groups and resynchronized with either CIDR or two injections of PGF2• at 11 days interval. All cows were observed visually for estrus response for a period of 2 h at 12 h interval, starting immediately after CIDR removal or after the second injection of PGF2•. Cows were in estrus when they mounted if at least 3 times during the period of observation. Following removal of CIDR and second injection of PGF2•, cows were inseminated 60 and 70 h later, respectively. There were no significant differences (p>0.05) in estrus response and pregnancy rate between cows initial synchronization and resynchronization with CIDR protocol. Although, statistically not significant there was relatively higher percentage of estrus response (81.6 vs. 70%) and pregnancy rate (30.6 vs. 28.0%) in cows resynchronized with CIDR than cows resynchronized with PGF2•

Alpha-linolenic acid supplementation in Tris extender can improve frozen–thawed bull semen quality

The study was conducted to evaluate the effects of α-linolenic acid (ALA) on frozen–thawed quality and fatty acid composition of bull sperm. For that, twenty-four ejaculates obtained from three bulls were diluted in a Tris extender containing 0 (control), 3, 5, 10 and 15 ng/ml of ALA. Extended semen was incubated at 37°C for 15 min, to allow absorption of ALA by sperm cell membrane. The sample was chilled for 2 h, packed into 0.25-ml straws and frozen in liquid nitrogen for 24 h. Subsequently, straws were thawed and evaluated for total sperm motility (computer-assisted semen analysis), membrane functional integrity (hypo-osmotic swelling test), viability (eosin-nigrosin), fatty acid composition (gas chromatography) and lipid peroxidation (thiobarbituric acid-reactive substances (TBARS)). A higher (p < 0.05) percentage of total sperm motility was observed in ALA groups 5 ng/ml (47.74 ± 07) and 10 ng/ml (44.90 ± 0.7) in comparison with control (34.53 ± 3.0), 3 ng/ml (34.40 ± 2.6) and 15 ng/ml (34.60 ± 2.9). Still, the 5 ng/ml ALA group presented a higher (p < 0.05) percentage of viable sperms (74.13 ± 0.8) and sperms with intact membrane (74.46 ± 09) than all other experimental groups. ALA concentration and lipid peroxidation in post-thawed sperm was higher in all treated groups when compared to the control group. As such, the addition of 5 ng/ml of ALA to Tris extender improved quality of frozen–thawed bull spermatozoa

Importance of Ethnicity, CYP2B6 and ABCB1 Genotype for Efavirenz Pharmacokinetics and Treatment Outcomes: A Parallel-group Prospective Cohort Study in two sub-Saharan Africa Populations.

We evaluated the importance of ethnicity and pharmacogenetic variations in determining efavirenz pharmacokinetics, auto-induction and immunological outcomes in two African populations. ART naïve HIV patients from Ethiopia (n = 285) and Tanzania (n = 209) were prospectively enrolled in parallel to start efavirenz based HAART. CD4+ cell counts were determined at baseline, 12, 24 and 48 weeks. Plasma and intracellular efavirenz and 8-hydroxyefvairenz concentrations were determined at week 4 and 16. Genotyping for common functional CYP2B6, CYP3A5, ABCB1, UGT2B7 and SLCO1B1 variant alleles were done. Patient country, CYP2B6*6 and ABCB1 c.4036A>G (rs3842A>G) genotype were significant predictors of plasma and intracellular efavirenz concentration. CYP2B6*6 and ABCB1 c.4036A>G (rs3842) genotype were significantly associated with higher plasma efavirenz concentration and their allele frequencies were significantly higher in Tanzanians than Ethiopians. Tanzanians displayed significantly higher efavirenz plasma concentration at week 4 (p<0.0002) and week 16 (p = 0.006) compared to Ethiopians. Efavirenz plasma concentrations remained significantly higher in Tanzanians even after controlling for the effect of CYP2B6*6 and ABCB1 c.4036A>G genotype. Within country analyses indicated a significant decrease in the mean plasma efavirenz concentration by week 16 compared to week 4 in Tanzanians (p = 0.006), whereas no significant differences in plasma concentration over time was observed in Ethiopians (p = 0.84). Intracellular efavirenz concentration and patient country were significant predictors of CD4 gain during HAART. We report substantial differences in efavirenz pharmacokinetics, extent of auto-induction and immunologic recovery between Ethiopian and Tanzanian HIV patients, partly but not solely, due to pharmacogenetic variations. The observed inter-ethnic variations in efavirenz plasma exposure may possibly result in varying clinical treatment outcome or adverse event profiles between populations

Liver Enzyme Abnormalities and Associated Risk Factors in HIV Patients on Efavirenz-Based HAART with or without Tuberculosis Co-Infection in Tanzania.

To investigate the timing, incidence, clinical presentation, pharmacokinetics and pharmacogenetic predictors for antiretroviral and anti-tuberculosis drug induced liver injury (DILI) in HIV patients with or without TB co-infection. A total of 473 treatment naïve HIV patients (253 HIV only and 220 with HIV-TB co-infection) were enrolled prospectively. Plasma efavirenz concentration and CYP2B6*6, CYP3A5*3, *6 and *7, ABCB1 3435C/T and SLCO1B1 genotypes were determined. Demographic, clinical and laboratory data were collected at baseline and up to 48 weeks of antiretroviral therapy. DILI case definition was according to Council for International Organizations of Medical Sciences (CIOMS). Incidence of DILI and identification of predictors was evaluated using Cox Proportional Hazards Model. The overall incidence of DILI was 7.8% (8.3 per 1000 person-week), being non-significantly higher among patients receiving concomitant anti-TB and HAART (10.0%, 10.7 per 1000 person-week) than those receiving HAART alone (5.9%, 6.3 per 1000 person-week). Frequency of CYP2B6*6 allele (p = 0.03) and CYP2B6*6/*6 genotype (p = 0.06) was significantly higher in patients with DILI than those without. Multivariate cox regression model indicated that CYP2B6*6/*6 genotype and anti-HCV IgG antibody positive as significant predictors of DILI. Median time to DILI was 2 weeks after HAART initiation and no DILI onset was observed after 12 weeks. No severe DILI was seen and the gain in CD4 was similar in patients with or without DILI. Antiretroviral and anti-tuberculosis DILI does occur in our setting, presenting early following HAART initiation. DILI seen is mild, transient and may not require treatment interruption. There is good tolerance to HAART and anti-TB with similar immunological outcomes. Genetic make-up mainly CYP2B6 genotype influences the development of efavirenz based HAART liver injury in Tanzanians

Fecal Progestin Extraction and Analysis for Non-invasive Monitoring of Ovarian Cycle in Beef Cows

The aims of the present study were to determine presence of immunoreactive progestins in feces, correlate fecal progestins with plasma progesterone (P4) concentrations and subsequently assess the role of fecal progestins in monitoring estrous cycle in Kedah Kelantan (KK) beef cows. A total of 12 cycling cows were subjected to blood and matched fecal sampling twice a week for 9 weeks. The concentrations of plasma P4 and fecal progestins extracted using a modified technique, were determined by a P4 radioimmunoassay (RIA) kit. There was a significant positive correlation between the concentrations of fecal progestins and plasma P4 (r = 0.6, P<0.01), as tested for the whole group except one animal. High performance liquid chromatographic separation of fecal extracts and subsequent radioimmunoassay revealed presence of four immunoreactive progestins against the P4 antibodies. These results imply that the non-invasive measure of fecal progestins using a DSL-3900 RIA kit can be used to monitor the ovarian activity in beef cows

Tuberculous lesions not detected by routine abattoir inspection: the experience of the Hossana municipal abattoir, southern Ethiopia

Summary The efficacy of the meat inspection procedures implemented for the detection of tuberculous cattle was evaluated by testing for bovine tuberculosis in 751 animals. The study involved routine inspection at slaughter, collection of tissues for detailed examination in the laboratory, and bacteriological investigation to identify Mycobacterium bovis. Of the 751 carcasses examined, 34 (4.5%) were found to have tuberculous lesions. Routine abattoir inspection detected only 29.4% of the carcasses with visible lesions. Eighty-four percent of the tuberculous lesions were found in the lungs and thoracic lymph nodes, 11.5% in the lymph nodes of the head, and the remaining 4.5% in the mesenteric and other lymph nodes of the carcasses. In addition, M. bovis was isolated from a carcass that presented no gross tuberculosis lesions. The low sensitivity of routine abattoir inspection demonstrates that existing necropsy procedures should be improved