Five years malaria trend analysis in Woreta Health Center, Northwest Ethiopia

Background: An estimated 68% of the Ethiopian population, living in 75% of the landmass, is at risk of contracting malaria at any time making it the leading public health problem. The temporal analysis of malaria data could be important to evaluate the performance of malaria prevention programmes. Thus, the aim of this study was to determine the trend of malaria at Woreta Health Center (WHC) over a period of five years.Methods: We analyzed the records of 8,057 presumptive malaria patients registered in 2012 to 2016. The following patient data were retrieved from laboratory registration logbook for analysis: sex, age, residence, blood film (BF) microscopy result, type of malaria parasite identified, year and month when the patients visited WHC. Logistic regression was employed to assess the association between potential associated factors and positive BF result; p < 0.05 was considered significant.Results: Among the total presumptive individuals, 4447(55.2%) were females. The prevalence of malaria in each year ranged from 4.1% to 6.7%. The overall prevalence of malaria was 5.4% (95%CI: 4.9%-5.9%). The two most important species of malaria parasite identified were P. falciparum at 233(53.7%) and P. vivax at 184(42.4%). Relatively higher proportions of cases were documented in the months of November, December and June (11.1%, 8.1% and 7.2%, respectively). Patients who visited the health center in the month of December were >4 times more likely to be infected as compared with those who came to the health center in September [AOR: 4.2, 95%CI (2.374-7.560)]. Females were 1.3 times more likely to be infected than males, [AOR: 1.3, 95%CI (1.101-1.638)]. Similarly, patients in the age group above 15 were 1.9 times more likely to be infected than individuals < 5, [AOR: 1.9 95%CI (1.498-2.455), p value 0.000].Conclusion: In the studied area, malaria remains a major public health challenge. Hence, interventions to decrease the impact of the disease have to be evaluated and strengthened.Keywords: Malaria, trend analysis, Ethiopi

Bacterial isolates and their antimicrobial resistance profile among patients presumptive for meningitis at a referral hospital, northwest Ethiopia

Background: Bacterial meningitis remains as a major cause of mortality and morbidity in many developing countries, including Ethiopia. Data on the type and antimicrobial resistance profile of the isolates from cerebrospinal fluid (CSF) is limited in Ethiopia and particularly in the study area. Therefore, the aim of this study was to identify bacterial pathogens from CSF and to determine their antimicrobial resistance profile at Felege Hiwot Referral Hospital (FHRH). Methods and Materials: A hospital-based cross-sectional study was conducted on 176 CSF samples collected from patients presumptive for meningitis at FHRH. Cerebrospinal fluid was collected by an experienced clinician aseptically and inoculated on blood, chocolate and MacConkey agars. Bacteriological culture and identification of the isolates was done following the conventional bacteriological procedure. Antimicrobial susceptibility testing (AST) was performed using the disk diffusion method. Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 23 for Windows. Descriptive statistics were used to present and summarize the findings. Results: Of the 176 study participants, 112 (63.6%) were males and 70 (39.8%) were infants. The mean age of the study participants was at 14.3 years. Eight (4.5%) CSF samples were found bacteriological culture positive. Of these, gram-negative isolates accounted for five cases (62.5%), including three E. coli, and one case each of K. pneumoniae and P. aeruginosa. The remaining three isolates were S. aureus. In this study, the overall multi-drug resistance (MDR) rate was at 75%. Gentamicin and ciprofloxacin were found effective against S. aureus. Similarly, gram-negative isolates were found sensitive to ceftazidime and ceftriaxone. Conclusions: In this study, the bacterial isolation rate from CSF was relatively low (4.5%). S. aureus, E. coli, K. pneumoniae and P. aeruginosa were identified and nearly one third of them were found to be multi-drug resistant which should be of concern to relevant stakeholders. A large-scale study is warranted. [Ethiop. J. Health Dev. 2020; 34(1):14-21] Key words: Bacterial meningitis, Cerebrospinal fluid, types of bacterial isolates, antimicrobial resistance &nbsp

Why has Africa reported relatively few COVID-19 cases so far? A web-based survey

Abstract Background: Africa’s first COVID-19 case was identified in Egypt on 14 February 2020. Since then, almost all African countries have reported cases. The pandemic is transitioning to more widespread community transmission in most African countries, underscoring the need to further scale-up COVID-19 testing with a much wider geographic coverage. In Africa, the expected devastation caused by COVID-19 has been ‘delayed’ compared to some European countries and the USA. The reason behind this is not well understood. The aim of this Google survey was to collect speculations about the phenomena in Ethiopia, in particular. Methods: This web-based survey used Google Forms to collect data from 28 April to 13 May 2020. Participants from the general public with different expertise were invited via email to take part in the survey. Participants’ voluntarism to fill in the form, and their age, sex and educational status, were recorded. In addition, they were asked whether they worried about COVID-19 and the role of lockdowns to minimize the transmission rate of the disease in Africa. Multiple suggestions about the possible reasons behind the relative low number of COVID-19 case and fatalities were recorded, and the collected data were summarized using a Microsoft Excel spreadsheet. Results: A total of 102 participants took part in the web-based survey. Respectively, 92.1% and 64.4% of the participants worried about COVID-19 in Africa and believed that lockdowns could contain the disease in Africa. As for the question why, Africa still has a low number of COVID-19 cases and fatalities compared to other continents, participants reported the following points as the main factors: poor COVID-19 screening practice in the continent (71.3%); God is saving Africa (33.7%); Africans are immune to the virus (18.8%); and poor connection to the rest of the world (18.8%). Conclusions: There is a big concern about COVID-19 in Africa. Timely and accurate epidemiological data is one of the most important tools to inform and drive the COVID-19 response on the continent. Until researchers know exactly what is going on with COVID-19 in Africa, its member states need to keep on measuring and testing. [Ethiop. J. Health Dev. 2020; 34(4):313-316] Key words: COVID-19, SARS-CoV-2, Afric

Risky sexual behaviour and associated factors among students of Debre Tabor University, Northwest Ethiopia: a cross-sectional study

Introduction: Youth are the foundation of any society. Neglecting their sexual and reproductive health leads to high social and economic crisis. However, there is limited information on the sexual and reproductive health aspects of University students in Ethiopia. Thus, the aim of this study was to assess risky sexual behaviours and associated factors among students of Debre Tabor University.Methods and materials: A cross-sectional survey was conducted between 1February and 30 March 2014 using self-administered structured questionnaire to collect data on socio-demographic, sexual and associated risk behaviours among 394 University students. Descriptive and stepwise logistic regression model was carried out using SPSS version 21. A p value of < 0.05 and 95% CI was considered to test statistical significance.Results: A total of 394 students were enrolled in the study. Among these, 347 (88.1%) provided complete responses. About 97 (28.4%) study participants had sexual experience at the mean age of 18.9 years (SD 1.9 years). Out of these, 59 (62.1%) had sexual contact with their regular friends. Female students under the age of 18 were less likely to start sexual intercourse compared with males [AOR=0.2, 95%CI (0.7-0.9)]. Students who had symptoms of sexually transmitted infection (STI) were 16 times more likely to have early sexual contact compared to those students who had no symptoms [AOR = 16.4, 95% CI (1.4-193]. Not using condom at the first [AOR= 3.2 95%CI (1.2-10.5)] and last [AOR= 3.8, 95%CI (1.2-13.6)] sexual engagement were significant predictors of having multiple sexual partners.Conclusions: This study revealed risky sexual behaviours among Debre Tabor University students. Thus, continuous and intensified public health strategies on health education and reproductive health services are required to address the sexual and reproductive health needs of the students.Key words: Risky sexual behaviours, University students, Debre Tabo

Magnitude of Cryptococcal Antigenemia among HIV Infected Patients at a Referral Hospital, Northwest Ethiopia

BACKGROUND: Cryptococcosis is one of the common opportunistic fungal infections among HIV infected patients living in Sub-Saharan Africa, including Ethiopia. The magnitude of thedisease at Felege Hiwot Referral Hospital (FHRH) in particular and in Ethiopia at large is not well explored.METHODS: A retrospective document review and analysis was done on records of 137 HIV infected patients who visited FHRH ART clinic from 1 Sep to 30 Dec 2016 and had registered data on their sex, age, CD4 count and cryptococcal antigen screening result. The cryptoccocal antigen (CrAg) detection was done by the IMMY CrAg® LFA (Cryptococcal Antigen Lateral Flow Assay) kit from patient serum as per the manufacturer’s instruction. All data were entered, cleared, and analyzed using SPSS v20. Descriptive data analysis and cross tabulation were done to assess factors associated with cryptococcal antigenemia. Statistical significance was set at p-value less than or equal to 0.05.RESULTS: More than half of the participants, 54.7% (75/137), included in the study were females. The median age of the participants was 32.0 years (ranged: 8-52 years). The mean CD4 count was 51.8 with SD of 26.3 (range 3-98). All the patients were HIV stage IV. The proportion of positive cryptococal antigen from serum test was at 11.7% (95% CI: 7.3-18.1%). The IMMYCrAg® LFA result was found statically associated with patient sex (p= 0.045). However, it was not associated with patient age group and the CD4 count (P>0.05)CONCLUSIONS: This study provided baseline data on the magnitude of cryptococcal antigenemia among HIV positive patients that is not touched before in the studied area. The results of the study showed that this opportunistic fungal infection is an important health concern among HIV patients. Further studies with sound design employing adequate sample size should be considered.

The epidemiology of smear positive pulmonary tuberculosis at Felege Hiwot Referral Hospital, Northwest Ethiopia: A five year retrospective study

Background: Globally, tuberculosis (TB) continues to cause considerable morbidity and mortality. Ethiopia is among the 22 high TB burden countries reported. Currently, data regarding the magnitude of TB and associated factors have been released at different health facilities as part of service auditing. However, such data are not universally available that this study was carried out to determine the prevalence of smear positive tuberculosis and its associated risk factors at FelegeHiwot Referral Hospital (FHRH) over a period of five years.Methods: We analyzed all the records of 12,442 presumptive TB patients registered at FHRH from 2011 to 2015. Data on patient’s sex, age, residential address and sputum smear microscopy results were extracted from laboratory registration logbook. All data were entered, cleaned and analyzed using SPSS version 22 for windows. The proportion and trend of smear positive TB over the five years period was calculated and the overall prevalence of TB in these years was determined. Logistic regression model was used to analyze the association between TB positivity and potential associated variables; p < 0.05 was considered to be significant.Results: TB suspected patients were found to be characterized as male 7052 (56.7%), within the age group of 15-29 years of age 4105 (33.0%) and were from rural settings7841 (63.0). The number of presumptive TB patients visiting FHRH over the five years period was quite variable. However, the prevalence of smear positive TB in each year was almost consistent, ranging from 4.2% to 6.5%. The prevalence of smear positive TB among new and follow up patients was at 5.2% and 4.5%, respectively. The proportion of overall burden of smear positive pulmonary TB was estimated at 5.2% and was found significantly associated with age group between 15-29 (AOR: 0.45, 95% CI, 0.23-0.77), 30-44 (AOR:0.22, 95% CI, 0.15-0.32) and 45-59 (AOR:0.38, 95% CI, 0.26-0.56).Conclusions: In the studied area high prevalence of smear positive TB was documented over the five years period; which implies inconsistent measures being taken to reduce the burden of the disease. Hence, interventions to decrease prevalence of TB and thereby its impacts need to be evaluated and strengthened. [Ethiop. J. Health Dev. 2017;31(3):155-160]Keywords: TB, Trend, Felege Hiwot Referral Hospita

Drug resistance patterns of bacterial isolates from infected wounds at Bahir Dar Regional Health Research Laboratory Center, Northwest Ethiopia

Background: An increased antibiotic resistance of bacterial isolates from wound infections is a major therapeutic challenge. The aim of this study was to identify bacterial isolates associated with wound infection and to determine their current antimicrobial susceptibility profile.Methods: This is a retrospective cross-sectional study in which we analyzed the records of 380 wound swab culture results that have been processed at Bahir Dar Regional Health Research Laboratory Center in the period of 1 January 2013 to 30 December 2015. Swabs from different wound types were collected aseptically and analyzed using standard bacteriological procedures. Antimicrobial susceptibility testing was performed using disc diffusion technique as per the standard protocol. Demographic and bacteriological data were collected using a data extraction sheet. The data were cleaned, entered and analyzed using SPSS version 22.Results: The overall bacterial isolation rate was at 61.6% (234/380). More than half 123 (52.6%) of the isolates were gram positive and 111 (47.4%) were gram negatives. The predominant isolates were S. aureus at 100 (42.7%) followed by E. coli, 33 (14.1%), P. aeruginosa, 26 (11.1%) and S. pyogenes, at 23 (9.8%). The proportion of multidrug resistant (MDR) bacterial pathogens was at 54.3%. Out of these, 35 (15.1%) of the isolates were resistant to more than five drugs. The highest resistance rate at (85.9%) was documented for ampicillin by gram-negative isolates. Whereas the highest resistance rate among gram positive isolates was against erythromycin (31.1%). The resistance rate of S. aureus for penicillin was at 69.7%.Conclusions: High frequency of mono and multi-drug resistant bacterial pathogens were documented. Thus, an alternative method to the causative agent and antimicrobial susceptibility testing surveillance in areas where there is no culture facility is needed to assist health professionals for the selection of appropriate antibiotics. [Ethiop. J. Health Dev. 2016;30(3):112-117]Keywords: Wound infection, bacterial isolates, and antimicrobial susceptibility profil

Profile and treatment outcomes of patients with tuberculosis in Northeastern Ethiopia: a cross sectional study.

Background: Data on the epidemiology of tuberculosis and its treatment outcomes were incomplete in the study area and this study was done to fill this gap. Methods: Institution based cross sectional study was conducted from January 2011 to December 2014. A total of 949 TB patients who were on treatment in North Eastern Ethiopia, Eastern Amhara region were included. Data was analyzed using SPSS version 20. Frequency, percentages and means were used to present data. To assess the associations of treatment outcomes with sex, age, type of TB and human immunodeficiency virus (HIV), logistic regression was used. Results: The proportion of smear positive and negative pulmonary TB, and extra pulmonary TB were 187/949 (19.7%), 322/949 (33.9%) and 440/949 (46.4%), respectively. Treatment success rate was 853/949 (89.9%). Smear positive pulmonary TB and TB/HIV co-infections were significantly associated with unsuccessful treatment outcome, P 64 0.002. Conclusion: Extra pulmonary TB was the most prevalent types of TB followed by smear negative pulmonary TB. Treatment success rate was above the WHO target of 85%. The causes for the high proportion of smear negative PTB and EPTB should be further investigated. Special emphasis should be put on smear positive PTB patients and TB/HIV co-infected patients to decrease unsuccessful treatment outcome and TB transmissions

Tuberculosis Lymphadenitis and Human Immunodeficiency Virus Co-infections among Lymphadenitis Patients in Northwest Ethiopia

BACKGROUND: Tuberculosis and human immunodeficiency virus (HIV) are among the major health problems in Ethiopia. This study assessed the proportion of tuberculosis lymphadenitis (TBLN), HIV infection and their co-infection among TBLN presumptive individuals at the selected hospitals in NorthwestEthiopia.METHODS: Institution based cross sectional study was carried out. Data on demographic and clinical variables were collected with standardized questionnaire. Microbiological culture was done on specimen obtained by fine needle aspirates. The HIV status was determined by rapid anti-HIV antibody test. Data was entered and scrutinized using SPSS version 20 statistical packages. A stepwise logistic regression model was used. The result was considered as statistically significant at P<0. 05.RESULTS: A total of 381 lymphadenitis patients were included in the study. The overall prevalence of TBLN and HIV were at 250(65.6%) and 9(2.4%), respectively and their co-infection was at 6(2.4%). Based on the cytological examination, 301(79.0%) of them were diagnosed as TBLN. The age group, (P=0.01) and residency, (P=0.01) were found significantly associated with TBLN. Similarly, unsafe sex was also statistically significant for HIV infection (P=0.007).CONCLUSION: Tuberculosis lymphadenitis is the leading cause of TB and lymphadenitis in the region. However, TBLN-HIV coinfection was promisingly low. High rate of discrepancy was noticed between cytological and culture results. Hence, the TBLN diagnostic criteria shall pursue revision

Performance of Laboratory Professionals Working on Malaria Microscopy in Tigray, North Ethiopia

Background. Microscopic analysis of stained blood smear is the most suitable method of malaria diagnosis. However, gaps were observed among clinical laboratory professionals in microscopic diagnosis of malaria. Methods. A cross-sectional study was conducted in December 2015 among 46 laboratory professionals. Data was collected via on-site assessment and panel testing. The slide panel testing was composed of positive and negative slides. The kappa score was used to estimate the agreement between participants and reference reader. Results. The overall agreement between the study participants and the reference reader in malaria detection was 79% (kappa = 0.62). Participating in refresher training on malaria microscopy (Adjusted Odds Ratio (AOR = 7, CI = 1.5–36.3)) and malaria epidemic investigation (AOR = 4.1 CI = 1.1–14.5) had statistical significant association with detection rate of malaria parasites. Conclusion. Laboratory professionals showed low performance in malaria microscopy. Most of the study participants were graded “in-training” in laboratory diagnosis of malaria