Podoconiosis and soil-transmitted helminths (STHs): double burden of neglected tropical diseases in Wolaita zone, rural southern Ethiopia

Background Both podoconiosis and soil-transmitted helminth (STH) infections occur among barefoot people in areas of extreme poverty; however, their co-morbidity has not previously been investigated. We explored the overlap of STH infection and podoconiosis in Southern Ethiopia and quantified their separate and combined effects on prevalent anemia and hemoglobin levels in podoconiosis patients and health controls from the same area. Methods and Principal Findings A two-part comparative cross-sectional study was conducted in Wolaita zone, southern Ethiopia. Data were collected from adult patients presenting with clinically confirmed podoconiosis, and unmatched adult neighborhood controls living in the same administrative area. Information on demographic and selected lifestyle factors was collected using interviewer-administered questionnaires. Stool samples were collected and examined qualitatively using the modified formalin-ether sedimentation method. Hemoglobin level was determined using two different methods: hemoglobinometer and automated hematology analyzer. A total of 913 study subjects (677 podoconiosis patients and 236 controls) participated. The prevalence of any STH infection was 47.6% among patients and 33.1% among controls (p<0.001). The prevalence of both hookworm and Trichuris trichiura infections was significantly higher in podoconiosis patients than in controls (AOR 1.74, 95% CI 1.25 to2.42, AOR 6.53, 95% CI 2.34 to 18.22, respectively). Not wearing shoes and being a farmer remained significant independent predictors of infection with any STH. There was a significant interaction between STH infection and podoconiosis on reduction of hemoglobin level (interaction p value = 0.002). Conclusions Prevalence of any STH and hookworm infection was higher among podoconiosis patients than among controls. A significant reduction in hemoglobin level was observed among podoconiosis patients co-infected with hookworm and ‘non-hookworm STH’. Promotion of consistent shoe-wearing practices may have double advantages in controlling both podoconiosis and hookworm infection in the study area

Effect of inter- and intra-row spacing on yield and yield components of mung bean (Vigna radiata L.) under rain-fed condition at Metema District, northwestern Ethiopia

Abstract Background The study was conducted in 2017 main cropping season at two locations in North Gondar Zone, Ethiopia, to determine the optimum inter- and intra-row spacing of mung bean for maximum yield and yield components. The experiment was laid in a randomized complete block design with three replications in a factorial arrangement of four inter-row (20, 30, 40 and 50 cm) and three intra-row (5, 10 and 15 cm) spacing using mung bean variety Rasa (N-26). Results Significant interaction effect of inter- and intra-row spacing was observed for days to maturity, number of branches per plant, number of pods per plant, grain yield, harvest index, days to flowering, plant height and aboveground dry biomass yield. The highest grain yield (1882.67 kg ha−1) was obtained at interaction of 40 × 10 cm spacing, while the lowest (1367.8 kg ha−1) was obtained from 20 × 5 cm spacing. However, the result of economic analysis showed that the maximum net benefit was obtained at spacing of 40 × 15 cm. Conclusions Based on agronomic performance and economic analysis, use of 40 × 15 cm is promising for mung bean production in Metema District and similar agroecologies

Correction: Developing a patient flow visualization and prediction model using aggregated data for a healthcare network cluster in Southwest Ethiopia.

[This corrects the article DOI: 10.1371/journal.pdig.0000376.]

Immunocytochemical detection of Mycobacterium Tuberculosis complex specific antigen, MPT64, improves diagnosis of tuberculous lymphadenitis and tuberculous pleuritis

Background: A rapid, sensitive and accurate laboratory diagnosis is of prime importance in suspected extrapulmonary tuberculosis (EPTB) cases. However, traditional techniques for the detection of acid-fast bacilli have limitations. The aim of the study was to evaluate the diagnostic value of immunocytochemical staining for detection of Mycobacterium tuberculosis complex specific antigen, MPT64, in aspirates from pleural effusions and lymph nodes, the most common presentations of EPTB. Method: A cross-sectional study was conducted by including patients at Tikur Anbessa Specialized Hospital and the United Vision Medical Services from December 2011 to June 2012. Lymph node aspirates and pleural fluid samples were collected and analyzed from a total of 51 cases (26 tuberculous (TB) pleuritis and 25 TB lymphadenitis) and 67 non-TB controls. Each specimen was subjected to Ziehl-Neelsen (ZN) staining, culture on Lowenstein– Jensen (LJ) medium, cytological examination, Polymerase Chain Reaction (PCR) using IS1081gene sequence as a primer and immunocytochemistry (ICC) with polyclonal anti-MPT64 antibody. All patients were screened for HIV. Result: ICC was positive in 38 of 51 cases and in the 7 of 67 controls giving an overall sensitivity and specificity of 74.5% and 89.5%, respectively. Using IS1081-PCR as a reference method, the sensitivity and specificity, positive and negative predictive value of ICC was 88.1%, 89.5%, 82.2% and 93.2%, respectively. The case detection rate increased from 13.7% by ZN stain to 19.6% by LJ culture, to 66.7% by cytology and 74.5% by ICC. Conclusion: Immunocytochemistry with anti-MPT64 antigen improved detection of TB in pleural effusion and lymph node aspirates. Further studies using monoclonal antibodies on samples from other sites of EPTB is recommended to validate this relatively simple diagnostic method for EPTB

High rate of intestinal parasites among a closed community of Zay populations residing on three islands of Lake Ziway, Ethiopia.

BackgroundSeveral factors including socio-economic and access to health facility influence burden of intestinal parasites. Epidemiological data from hard to reach areas will help to identify high-risk communities for targeted intervention. We, therefore, assessed the magnitude of intestinal parasites among Zay people residing in three islands of Lake Ziway in Ethiopia.MethodsThis cross-sectional survey was conducted in March 2013 on 444 individuals aged 6 months to 85 years. Stool samples were analyzed using wet mount and formol-ether concentration methods. Data were collected using interviewer-administered questionnaire and analyzed using STATA version 10.ResultsAmong the study participants, 52% (321/444) were children under 15 years. While 72.8% were positive for at least one intestinal parasite, single, dual and triple infections were found in 42.1%, 23.9% and 6.3%, respectively. Four types of intestinal parasites were detected in two children. The commonest parasites were Entamoeba histolytica/dispar (51.4%), Schistosoma mansoni (17.8%), Giardia lamblia (14.4%), Trichuris trichiura (10.8%), Taenia species (5.6%), Hymenolopis nana (4.5%), Ascaris lumbricoides (4.1%), Entrobius vermicularis (0.9%), Hookworm (0.7%), and Strongyloides stercoralis (0.2%). Remarkable proportion of study participants (51.3%) had no latrine and >85% of the islanders use the lake water for drinking, cleaning or both. About 36% had no information about waterborne and related diseases, while 31% never heard about bilharziasis. Fishing and farming were the main source of income. In the multivariate model, being in the age group > 15 years (AOR = 0.49; 95%CI = 0.28-0.85) and not using lake water for drinking or washing (AOR = 0.52; 95%CI = 0.28-0.99) had protective effect, after adjusting for education, occupation and hand wash after latrine use.ConclusionThe observed high rate of intestinal parasites (72.8%) in these hard to reach Islanders of Lake Ziway, warrants targeted and sustainable intervention

Clinical and socio-demographic correlates of any soil transmitted helminth infection in Wolaita zone, Southern Ethiopia.

†<p>Multivariate logistic regression adjusting for clinical status, sex, age, education, occupation, shoe wearing habit and stage of disease.</p>*<p>Statistically significant (P<0.05).</p>**<p>Data on stage of disease were available only for podoconiosis patients.</p

Socio-demographic characteristics of podoconiosis patients and neighborhood controls enrolled between January and June 2010 in Wolaita zone, rural Southern Ethiopia.

1<p>P value was calculated using Chi-squared test.</p>2<p>P value was calculated using t test to compare mean difference.</p

Effect of STH and hookworm infections on hemoglobin levels in podoconiosis patients using multivariate regression.

*<p>Interaction term.</p>**<p>Adjusted for age, sex, occupation and educational status.</p><p>The <i>reference</i> group for different categories of geohelminth infections was defined to include the following:</p>†<p>For any STH infections: Podoconiosis patients uninfected by any species of geohelminth.</p>††<p>For hookworm infection: Podoconiosis patients uninfected by any species of geohelminth, and patients infected with non hookworm geohelminths.</p>†††<p>For non-hookworm STH and hookworm: Podoconiosis patients uninfected by any species of geohelminth, and patients infected with only one species.</p

Prevalence of anemia among podoconiosis patients and controls stratified by sex.

<p>The prevalence of anemia was significantly higher among male and female podoconiosis patients than among controls.</p

Prevalent soil transmitted helminth infections in relation to podoconiosis infection versus control status in Wolaita zone, rural Southern Ethiopia.

†<p>Multivariate logistic regression adjusting for age, sex, educational status, occupation.</p>¥<p>Definition of ‘Any STH’, ‘Double infection’ and ‘Triple infection’ are given in the statistical analysis section.</p>a,b,c,d,e,<p>The reference group for each geohelminth infection included the following:</p><p>^a,b,c,d. For individual species of geohelminths: individuals uninfected by any species <i>or</i> those infected with geohelminth species excluding that under investigation (eg. for hookworm the reference category includes individuals free of hook worm and those infected with non hookworm geohelminths).</p><p>^e For any STH infections: individuals uninfected by either species of geohelminth.</p