The Sanitary Conditions of Food Service Establishments and Food Safety Knowledge and Practices of Food Handlers in Bahir Dar Town

Background: Lack of basic infrastructure, poor knowledge of hygiene and practices in food service establishments can contribute to outbreaks of foodborne illnesses. The aims of this study were to investigate the food safety knowledge and practices of food handlers and to assess the sanitary conditions of food service establishments in Bahir Dar town.Methods: A cross-sectional study was conducted in Bahir Dar in May 2011 and data were collected using questionnaire and observation checklist on employees’ knowledge of food hygiene and their practices as well on sanitary conditions of the food service establishments.Results: The median age of the food handlers was 22 years and among the 455 subjects 99 (21.8%) have had food hygiene training. Sixty six percent of the establishments had flush toilets whereas 5.9% of the establishment had no toilet. Only 149 (33.6%) of the establishments had a proper solid waste collection receptacle and there was statistically significant association between the sanitary conditions and license status of the establishments (p=0.01). Most of all, knowledge gap in food hygiene and handling practice was observed. In addition, there was statistically significant difference between trained (professional) handlers and non-trained handlers with regard to food hygiene practices (p<0.05). While more than 50% of the handlers prepare meals ahead of the peak selling time, more than 50% of the left over was poorly managed.Conclusion: This study revealed poor sanitary conditions and poor food hygiene practices of handlers. Educational programs targeted at improving the attitude of food handlers and licensing and regular inspections have been recommended

Bacteriology and Antimicrobial Susceptibility of Otitis Media at Dessie Regional Health Research Laboratory, Ethiopia

Background: Otitis media is a major health problem of children in low income countries.Objectives: This study was done to determine the bacterial isolates and antimicrobial susceptibility of otitis media from children and adults.Methods: A retrospective record was analyzed on culture results of discharging ears at Dessie Regional Health Research Laboratory in the period 2003-2010. Antimicrobial susceptibility tests were performed using disc diffusion technique as per the standard Kirby-Bauer method.Results: Out of 897 discharging ear samples, 469 were from children and 428 from adults. Of these, 823 (91.7%) had aerobic bacteria isolated. The most frequent isolates were Proteus spp. 223 (26.5%), S. aureus 203 (24.6%), Pseudomonas spp. 148 (18%) and E. coli 146 (17.7%). Proteus spp. were the most common isolates in children compared to adults (p=0.001). Norfloxacin, ciprofloxacin and gentamicin revealed high level of sensitivity whereas high resistance rates were observed for amoxycillin, tetracycline and erythromycin (p=0.001). Antibiograms of isolates showed that 598 (72.6%) of isolates were resistant to two and more antimicrobials.Conclusion: Otitis media linked with high levels of multiple antibiotic  resistant bacteria is a major health concern in all age groups of the study population. There is a need for culture and susceptibility test facilities for appropriate antimicrobial therapy of otitis media and antimicrobial resistant infections. [Ethiop. J. Health Dev. 2011;25(2):161-167

Bacteriological and Physicochemical Quality of Drinking Water and Hygiene- Sanitation Practices of the Consumers in Bahir Dar City, Ethiopia

BACKGROUND: Lack of safe drinking water, basic sanitation, and hygienic practices are associated with high morbidity and mortality from excreta related diseases. The aims of this study were to determine the bacteriological and physico-chemical quality of drinking water and investigate the hygiene and sanitation practices of the consumers in Bahir Dar City, Ethiopia. METHODS: A cross sectional prospective study was conducted in Bahir Dar City from October-December, 2009. Water samples were collected from 35 private taps and 35 household water containers for bacteriological analysis. The turbidity, pH, temperature and turbidity were measured immediately after collection. Finally, the hygiene-sanitation practices of the consumers were surveyed using interview. RESULTS: Twenty seven (77.1%) of the household water samples had high total coliforms counts. Twenty (57.1%) household water samples and 9 (25.7%) of the tap water samples had no residual free chlorine. Sixteen (45.7%) household water samples had very high risk score to thermotolerant coliforms. Eight (22.9%) tap water samples had low risk score for total coliforms whereas 21(60%) tap water had very low risk score for thermotolerant coliforms. Twelve (34.3%) of the consumers collect water without contact with their hand and 9(25.7%) wash their hands with soap after visiting toilet. CONCLUSION: Water supplies at tap and household water containers were contaminated with bacteria. Poor sanitation, low level of hygiene, uncontrolled treatment parameters are the causes for contamination. Control of physico-chemical parameters and promoting good hygiene and sanitation are recommended. KEYWORDS: Bacteriology, physicochemical, tap water, household, Bahir Da

In situ characterization of local chicken eco-type for functional traits and production system in Fogera Woreda, Amhara Regional State

A study on characterization of local chicken eco-type for functional traits and production system was conducted at Fogera woreda of the Amhara National Regional state. Fogera woreda is one of the eight woredas bordering Lake Tana and it is predominantly classified as woinadega ecology while the annual temperature ranges form 22ºC to 29ºC. The survey report based on 72 household having chickens revealed that the flock size rage from 1 to 39. The nutritional management practices in the study area were of scavenging (main practice) and supplementary feeding. Wells and tap were the major sources of water. Most of the respondents (59.7%) used separate houses constructed exclusively for poultry. The flock management was without separation of sex or age groups and mating was random and nonseasonal. The prices of live chickens were affected by plumage color, comb type and seasonal demands (holidays and fasting seasons). Disease and shortage of supplementary feeds were the two major production barriers of expanding poultry production. Out of the 100 birds studied, the following plumage color pattern was observed in their respective proportions: complete white (Netch) (23%), complete black (Tikure) (7%), complete red (key) (39%), white with black or red tips (Netch Teterma) (4%), grayish mixture (Gebsima) (5%), red with white trips (key teterma) (2%), black with white tips (Tikure teterma) (2%) white with Brest part golden color (Libework) (8%), multi color (Anbsema) (2%), white with red strips (seran) (4%), and red brownish (Kokima) (4%). In term of body shape, most of the chicken population observed had a body shape of wedge and a crest (Gutya) head profile. Almost all of the male chicken had spur, while only half of the female chicken had spur. No shank feather was observed both in Male and Female chicken. For mature hens and cocks, the average shank length was 7.25 cm and 9.32 cm, respectively. The average body length was 17.75 cm and 21 cm for female and male, respectively. The ratio of cock to hen was found to be 1:3.21. On the other hand, the effective population size (Ne) and rate of change in inbreeding coefficient (F) per year were 3.9 and 1.95, respectively. The monitoring data revealed that average number of eggs laid per clutch per hen was 13.19, while the average number of eggs incubated was 12.97, average number of chicks hatched was 10.23, the average number of chicks weaned was 7.63, the average of hen’s age was 19.20 months and average weight of hens was 1.21 kg. The performance of egg production characters egg weight, yolk color, yolk weight albumin weight, shell weight and shell thickness were, 44.89m, 9.06, 16.28 gm, 22.13 gm, 5.52 gm, and 0.45 cm, respectively. On the other hand, the dressing percentage was found to be 58.5% for male and 49.38% for Female. All these findings indicated that the local eco-type, despite the relatively high temperature (it goes up to 30ºC) and the swampy (wet land) Fogera plain have good potential for egg and meat production. Thus they could be used in other places with similar weather and environmental conditions

Immunological and hematological reference values for apparently healthy HIV-negative adults in Bahir Dar Town, Ethiopia

Background: Immunological and hematological reference values differ among different human beings with respect to sex, ethnicity, nutrition, altitude and health conditions. These could not be exceptional in the Ethiopian heterogeneous population. However, there are no nationally established reference values.Objective: The aim of the study was to determine reference values of immunological and hematological parameters for apparently healthy HIV-negative adults in Bahir Dar Town.Methods: A cross-sectional study was conducted from May to June, 2010 in Bahir Dar Town. Adults of both sexes above 18 years of age were recruited from the voluntary HIV counselling and testing centre in Felege Hiwot referral hospital. CD4+ and CD8+ T cells were enumerated using FACS count (Becton Dickinson) and hematological analyses were performed using Cell-DYN 1800 (Abbott Lab. USA).Results: A total of 405 adults consisting of 238 (58.7%) males and 167 (41.3%) females with the median age of 24(range 18 to 60) years were recruited. The median, mean (± SD) and 95% percentile ranges of immunological and hematological values were determined. The mean (±SD) values were: CD4+ T cells, 799 ± 218 (females) and 676 ± 235.6 (males); CD8+ T cells, 582 ±247 (females) and 659.5 ± 343 (males); CD4/CD8, 1.53±0.59 (females) and 1.19 ± 0.49 ( males); erythrocyte counts (1012/liter), 4.9±0.4 (female) and (5.4±0.5 male); hemoglobin (g/dl), 14.7±2 (females) and 16.5±1.8 (males); haematocrit (%), 44±4 (females) and 49±4.5 (males); platelets (109/litre), 277 ± 20 (both sex); absolute leukocyte (WBC) counts 6.6±3.6 x109/liter (both sexes); lymphocyte, 2.15±.59 x109/liter (both sexes); granulocytes (neutrophils), 3.7±1.6 x109/liter (both sexes).Conclusions: Absolute CD4+ T cell counts were lower than the reference value, which Ethiopia has adopted for HIV/AIDS therapy. Females had higher CD4+ T cell counts than males. Thus, considering these differences may be important in the process of using the national ART laboratory guideline for HIV/AIDS therapy. Establishing local reference values could have paramount importance for quality of health care in the clinical management of patients

Bacteriological and physico-chemical quality of drinking water sources in a rural community of Ethiopia

Background: Accesses to safe water is a universal need however, many of the world’s population lack access to adequate and safe water. Consumption of water contaminated causes health risk to the public and the situation is serous in rural areas.Objectives: To assess the bacteriological and physico-chemical quality of drinking water sources in a rural community of Ethiopia.Methods: Water samples were collected from tap, open springs, open dug wells and protected springs for bacteriological analysis of total coliforms and thermotolerant coliforms. The turbidity, pH and temperature were measured immediately after collection.Results: Most drinking water sources were found to have coliform counts above the recommended national and international guidelines and had high sanitary risk scores. There was a statistically significant difference among water sources with respect to TC and TTC (p < 0.05) and there was a statistically significant positive correlation between coliform counts and sanitary risk scores (p < 0.01). Most water sources didn’t satisfy the turbidity values recommended by WHO.Conclusion: The water sources were heavily contaminated which suggested poor protection and sanitation practice in the water sources. Source protection strategies as well as monitoring are recommend for this community.Keywords: Coliforms; physico-chemical; rural community; water qualityAfrican Health Sciences 2013; 13(4): 1156- 116

Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town

Background: Diarrheal disease and its complications remain a major cause of morbidity and mortality in children. The prevalence and antibiogram of E. coli as causative agents of diarrhea vary from region to region, and even within countries in the same geographical area.Objectives: To determine the serotype and antimicrobial susceptibility of E. coli in children under-five years of age.Methods: A cross-sectional study was conducted among 422 children with diarrhea from December 2011 to February 2012. Identification of E. coli and antimicrobial susceptibility testing were done following standard procedures.Results: The overall isolation rate of E. coli was 48.3%. Poly 2 sero-groups, poly 3 sero-groups, poly 4 sero-groups and E. coli O157:H7 accounted for 80 (39.2%), 40 (19.6%), 25 (12.3%), and 59 (28.9%) of the isolates, respectively. Poly 2 sero- groups, constituting isolates belonging to enteropathogenic E. coli were the most commonly isolated serotypes. E. coli exhibited high levels of antimicrobial resistance to ampicillin (86.8%), tetracycline (76%) and cotrimoxazole (76%). Low levels of resistance to ciprofloxacin (6.9%) and norfloxacin (9.3%) were documented.Conclusion: High prevalence of diarrheagenic E. coli compounded by alarming antimicrobial resistances is a serious public health problem. Regular determination of antibiogram and public education are recommended.Keywords: E. coli, antimicrobial susceptibility, diarrhea, Ethiopi

Nearly one in every six HIV-infected children lost from ART follow-up at Debre Markos Referral Hospital, Northwest Ethiopia: A 14-year retrospective follow-up study.

BackgroundAlthough antiretroviral therapy (ART) significantly improves the survival status and quality of life among human immunodeficiency virus (HIV)-infected children, loss to follow-up (LTFU) from HIV-care profoundly affecting the treatment outcomes of this vulnerable population. For better interventions, up-to-date information concerning LTFU among HIV-infected children on ART is vital. However, only a few studies have been conducted in Ethiopia to address this concern. Thus, this study aims to identify the predictors of LTFU among HIV-infected children receiving ART at Debre Markos Referral Hospital.MethodsAn institution-based retrospective follow-up study was done among 408 HIV-infected children receiving ART at Debre Markos Referral Hospital between 2005 and March 15, 2019. Data were abstracted from the medical records of HIV-infected children using a standardized data abstracted checklist. We used Epi-Data Version 3.1 for data entry and Stata Version 14 for statistical analysis. The Kaplan-Meier survival curve was used to estimate the survival time. A generalized log-rank test was used to compare the survival curves of different categorical variables. Finally, both bi-variable and multivariable Cox proportional hazard regression models were used to identify the predictors of LTFU.ResultsOf 408 HIV-infected children included in the final analysis, 70 (17.1%) children were LTFU at the end of the study. The overall incidence rate of LTFU among HIV-infected children was found to be 4.5 (95%CI: 3.5-5.7) per 100-child years of observation. HIV-infected children living in rural areas (AHR: 3.2, 95%CI: 2.0-5.3), having fair or poor ART drug adherence (AHR: 2.3, 95%CI: 1.4-3.7), children started ART through test and treat approach (AHR: 2.7, 95%CI: 1.4-5.5), and children started protease inhibiter (PI)-based ART regimens (AHR: 2.2, 95%CI: 1.1-4.4) were at higher risk of LTFU.ConclusionThis study found that one in every six HIV-infected children lost form ART follow-up. HIV-infected children living in rural areas, having fair or poor ART drug adherence, started ART based on test and treat approach, and taking PI-based ART regimens were at higher risk of LTFU

Factors affecting institutional delivery in Ethiopia: A multi-level analysis

Background: Childbirth is a complex process that requires the safest care to prevent maternal and neonatal complications. The proportion of births occurring at health institutions in Ethiopia is still below expected (26%), which significantly contribute to a large number of maternal deaths. Hence, identifying factors affecting institutional delivery is crucial. Objectives: The main objective of this study was to assess factors affecting institutional delivery among women who had a live birth in Ethiopia within five years preceding Ethiopian Demographic and Health Survey 2016. Method: The 2016 Ethiopian demographic and health survey data were used to identify factors associated with institutional delivery. As the data has nested structure, a multilevel logistic regression model was used for analysis by taking a nationally representative sample of 7193 women nested within 645 clusters. Result: A significant heterogeneity was observed between clusters for institutional delivery which explains about 53.5% of the total variation. Individual-level variables: higher-level women education (AOR = 5.74; 95% CI 2.7–9.73), parity 5, and more (AOR = 0.39; 95% CI 0.32–0.49) and the number of ANC visit four and greater visit (AOR = 6.74; 95% CI 4.11–11.04) were significantly associated with institutional delivery. Community-level variables, Community media exposure (AOR = 1.80; 95% CI 1.31–2.4) and community antenatal coverage (AOR = 1.97; 95% CI 1.18–3.30) had a significant effect on institutional delivery. Conclusion: The effort to promote institutional delivery should pay special attention to multiparous and less educated women

The effect of physical water quality and water level changes on the occurrence and density of <i>Anopheles</i> mosquito larvae around the shoreline of the Koka reservoir, central Ethiopia

Entomological studies to determine the effect of the physical characteristics of mosquito larval breeding water bodies and reservoir water level changes on the occurrence of Anopheles mosquito larvae were conducted in two villages at Koka reservoir in central Ethiopia between August and December 2007. Of the two study villages, Ejersa is located close to the reservoir, and Kuma is 5 km away from it. Data on the type, number and physical characteristics of Anopheles larval breeding habitat, species composition and densities of anopheles mosquitoes in and around the study villages were investigated and recorded. Meteorological and reservoir water level data were compared with availability of Anopheles larval breeding sites and densities. Entomological data, derived from weekly larval collections, showed that Anopheles pharoensis Theobald, Anopheles gambiae s.l. Giles, Anopheles coustani Laveran and Anopheles squamosus Theobald were breeding in the study area. The mean larval density of An. gambiae s.l. in this study was higher in slightly turbid and shallow aquatic habitat than in turbid and relatively deep aquatic habitat. The density of An. pharoensis in habitat with floating vegetation and with relatively shady conditions was significantly higher than that of less shaded aquatic habitat and greater emergent vegetation. There was also a positive correlation between the occurrence of Anopheles larvae with the water and daily minimum atmospheric temperature. Similarly at Ejersa, over the sampling period, there was a positive correlation between falling reservoir water levels and the number of positive breeding habitats. These results confirm that physical characteristics of the water bodies play an important role in the species composition, total Anopheles larval count, and the density of Anopheles mosquitoes. Suitable breeding habitat in the vicinity of the reservoir village was strongly associated with the reservoir. This is particularly important for An. pharoensis and An. gambiae s.l. which are important vectors of malaria in the area