Bacterial contamination and antibiogram of isolates from health care workers’ fomites at Felege Hiwot Referral Hospital, northwest Ethiopia

Background: Health care workers’ fomites are highly predisposed to bacterial contamination in the health care setting and are potential sources of hospital-acquired infections. However, there is scarcity of data on the status of bacterial contamination and antibiogram of isolates from HCWs’ fomites in Ethiopia. This study determined the bacterial contamination and antibiogram of isolates from health care workers’ fomites at Felege Hiwot Referral Hospital, Ethiopia.Methods: A cross-sectional study was conducted from February to April 2017 in different wards of the hospital. From 422 health care workers’ fomites, surface samples were swabbed using a simple-rinse method. Data from participants were collected by face-to-face interviews using a structured questionnaire. Bacterial colonies were counted and species were identified using standard bacteriological techniques. Drug susceptibility testing was performed using a disk diffusion technique. Chi-square test was computed to ascertain the association between variables. Regression analysis was computed to identify the independent risk factors.Results: Overall, 243 (57.6%) fomites were contaminated with aerobic bacteria. Working in medical (AOR=5.2, 95% CI=1.85-14.8) and gynecology (AOR=3.1, 95% CI=1.5-6.43) wards and intensive care units (AOR=16, 95% CI=2.1-17.9), and poor laundering of HCWs’ uniforms (AOR=1.3, 95% CI=1.34-3.72), were significantly associated with bacterial contamination. Staphylococcus aureus (19.2%) was the predominant pathogen, followed by Klebsiella pneumoniae (6.4%). The proportion of K. pneumoniae (P<0.001) and E. coli (P=0.014) was significantly highest in mobile phones and white coats, respectively. S. aureus isolates were resistant to penicillin (82.7%) and co-trimoxazole (53.1%). K. pneumoniae isolates were 100% resistant to ampicillin. E. coli isolates were 87.5% resistant to co-trimoxazole. Overall, 204 (88.3%) of the isolates were multidrug-resistant. The overall multidrug-resistant rates among S. aureus, K. pneumoniae and E. coli isolates were 88.9%, 92.6% and 100%, respectively.Conclusions: Bacterial contamination of health care workers’ fomites is a major health care problem in the study area. Multidrug-resistant isolates are alarmingly high in pathogenic bacteria. Therefore, hospital HCWs need to implement proper handling of fomites to reduce contamination and the spread of drug-resistant pathogens. [Ethiop.J. Health Dev. 2019; 33(2):128-141]Keywords: Health care workers, bacterial contamination, antibiogram, fomites, health-care associate infections, Ethiopi

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.

Yelemat Tirufat: An Overview of the initiative and lessons of experience from selected livestock development interventions in Ethiopia

A national consultative Workshop on “Are We Ready for Yelemat Tirufat?”, financed by the International Livestock Research Institute (ILRI) and organised jointly by Ethiopia’s Ministry of Agriculture, ILRI, the International Center for Agricultural Research in the Dry Areas (ICARDA), the International Centre of Insect Physiology and Ecology (icipe) and Land O’Lakes Venture37, was held on 24 and 25 December 2022, in Bahir Dar, Ethiopia

Xpert MTB/RIF assay for the diagnosis of Mycobacterium tuberculosis and its Rifampicin resistance at Felege Hiwot and Debre Tabor Hospitals, Northwest Ethiopia: A preliminary implementation research

Background: The World Health Organization endorsed GeneXpert MTB/RIF (Xpert) assay for the diagnosis of tuberculosis (TB) and multidrug resistant tuberculosis (MDR-TB) in 2010. However, the practice of using this novel diagnostic method is still limited in a high TB and human immunodeficiency virus (HIV) burden settings, including Ethiopia. Therefore, we conducted this study aimed at describing the first implementation status of Xpert assay in the diagnosis of TB and MDR-TB at Felege Hiwot Referral Hospital (FHRH) and Debre Tabor General Hospital (DTGH), Northwest Ethiopia.Methods: We analyzed the records of 1922 (FHRH=544 and DTGH=1378) presumptive TB patients diagnosed using Xpert test from 1 November 2015 to 30 April 2016 at FHRH and DTGH, Northwest Ethiopia. All patients who had registered data on their sex, age, HIV status, presumptive MDR-TB status and Xpert results were included for analysis. Data were retrieved directly from GeneXpert result registration log book using data extraction sheet. Data were entered, cleaned, and analyzed using SPSS statistical software package; p < 0.05 was considered to be significant.Results: Overall Xpert assay properly diagnosed 14.6% of the cases (258/1922). Among these, rifampicin (RIF) resistance was detected at 9.3% (24/258). In the studied settings, clinical data showed that 81.0% (1556/1922) of the cases were MDR- TB. Among the study subjects, 888 (46.2 %) of them were HIV positive. However, TB-HIV co-infection rate was at 41.9% (108/258). Of the total patients registered, 1005 (52.3%) of whom were males. The mean age of patients was 31.1 years with SD of 17.5. Significant predictors of the Xpert test were: age (p=0.000), sex (p=0.009), HIV status (p=0.003) and presumptive MDR-TB (p=0.000).Conclusions: In the studied areas, large proportion of clinically TB suspected patients were wrongly diagnosed with MDR-TB. Therefore, the use of Xpert assay in health settings with no culture facility will decrease the unnecessary use of anti-TB drugs and improve rapid TB, and MDR-TB detection and proper management of the cases. [Ethiop. J. Health Dev. 2016;30(2):60-65]Keywords: TB, GeneXpert, MTB/RIF assay, Northwest Ethiopi

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Focused antenatal care utilization and associated factors in Debre Tabor Town, northwest Ethiopia, 2017

Abstract Objective Attending antenatal care helps to reduce the occurrence of maternal morbidity and mortality by providing chances for health promotion and information about danger signs, birth preparedness and where to seek care for pregnancy complications. Therefore identifying factors affecting the utilization of focused ANC service is of supreme importance. Results A total of 317 mothers who had a history of antenatal care for their last birth during the previous 6 months were included in the study from which 112 (35.3%, 95% CI 30.6, 40.4) of mothers attended focused antenatal care services. Age of mother [AOR = 4.7, 95% CI 1.87, 11.88], Educational status [AOR = 2.5, 95% CI 1.00, 6.19], history of still birth [AOR = 13.1, 95% CI 2.14, 80.20] and planned pregnancy [AOR = 3.7, 95% CI 1.23, 11.12] were found to be major predictors for focused ANC service utilization. Proportion of focused antenatal care was low (35.3%). Age of mother, education, history of stillbirth and planned pregnancy were identified as predictors affecting focused antenatal care service utilization. Encouraging women’s educational status, behavioral change communication at grass root level and improving the capacity and quality of ANC service are some of the recommendations forwarded

Assessing multifunctionality and climate smartness of landscapes in Ethiopia

Integrated implementation of various land management options is the key for successful land restoration programs. Integrated sustainable land management (SLM) practices could improve land restoration success and enhance multiple ecosystem services generated by the landscape. Implementation of land and water management options at landscape level can cause tradeoffs due to conflicting land uses and varying needs of land users. It is thus essential to assess the climate-smartness of those landscapes to sustain the benefits associated with the management practices. We used various in-situ data, empirical and the Integrated Valuation of Ecosystem Services and Trade-offs (INVEST) models to assess the multifunctionality of landscapes and evaluate the associated benefits enjoyed in selected landscapes of Ethiopia. We employed a climate smartness landscape index to determine the climate-smartness of those landscapes by integrating multifunctional services provided by the landscapes due to the various interventions. We obtained a positive change in multiple ecosystem services due to land restoration efforts in four watersheds in Ethiopia. The result is substantiated by both modelling results and in-situ observation data. Even though the land management activities conducted in the study watersheds brought a positive impact, the optimal scenario shows that there are still opportunities to further enhance the magnitude and multifunctionalities of ecosystem services that would be obtained in the optimal land management scenario. All watersheds analysed in this study showed climate smartness at the landscape level, with some level of difference among them. Gudoberet and Aba Gerima watersheds showed more climate smartness than the Anjeni and Debre Mewi. The study shows that investigating the multiple functions of more than five ecosystem services can be designated as multifunctional landscapes

A 5 year trend analysis of malaria prevalence with in the catchment areas of Felegehiwot referral Hospital, Bahir Dar city, northwest-Ethiopia: a retrospective study

Abstract Background Malaria is one of the killer diseases in Ethiopia and it is still the first leading cause of death in health facilities. However, there is no information yet regarding the trends of malaria prevalence at health institution and particularly at Felegehiwot referral Hospital. Hence , knowing the trends of malaria prevalence at each health facilities is essential to design appropriate interventions. Therefore, the present study addressed the above gaps. Results Overall, 14,750 blood films were diagnosed for malaria. Of these, 740 (5%) were confirmed with microscope. Plasmodium falciparum and Plasmodium vivax accounted for 397 (53%) and 331 (45%), respectively. Age groups >20 year (p < 0.02) and males (p < 0.025) were significantly affected. Conclusions In conclusion, P. falciparum was predominant as compared to P. vivax. Hence, it needs close monitoring and intervention measures for control activities