Studies on faster methods of laboratory diagnosis of tuberculosis and analysis of phenotypic and genetic characteristics of multi-drug resistant tubercle bacilli with emphasis on their in vitro and in vivo response to isoniazid

To improve the diagnostic value of polymerase chain reaction (PCR) for the diagnosis of tuberculosis, an efficient and simple method of clinical sample pretreatment for PCR has been compared with two other methods used for this purpose and the data have shown better results with the added advantage that the method developed in this work is simpler, faster and uses safer chemicals. In addition to this, a simple absorption technique which improves the specificity of enzyme-linked immunosorbent assay (ELISA) has been developed. Serum samples from TB patients and normal subjects showed more discriminatory results leading to better diagnosis after the sera were absorbed with M vaccae antigen. Using xylene as a single major lytic agent a technique has been developed in this work which enables large scale extraction of DNA from mycobacteria in a matter of three hours. Catalase activity of drug resistant tubercle bacilli were analysed and compared with results from genetic studies using the catalase gene probe. Because all catalase negative strains (except one) gave positive hybridization signal with the catalase gene, catalase negativity in this case was shown to be due to a point mutation rather than to gene deletion. In one case, however, a unique band was demonstrated. The genetic patterns of the strains were investigated using the IS6110 insertion sequence probe also. In this thesis, 4 out of 21 isoniazid resistant tubercle bacilli were shown to grow better in the presence of isoniazid than in its absence. A highly isoniazid resistant strain which is also resistant to streptomycin and thiacetazone was catalase negative and its growth was not enhanced by isoniazid and had a diminished virulence for the guineapig. On the other hand another multi-drug-resistant strain to the above drugs and rifampicin had high catalase activity, its growth was enhanced by isoniazid and it had high virulence for the guineapig. To assess the enhancing effect of isoniazid on isoniazid resistant strains in vivo, guineapigs infected with isoniazid resistant tubercle bacilli were treated with isoniazid, and it has been shown that animals receiving treatment lost more weight than the control group. In general, the work covered in this thesis should be of value for the diagnosis of tuberculosis in situations where microscopy and culture fail to provide the desired result due to low sensitivity, in the former case, or due to delay of results as with culture. The studies on the drug-resistant tubercle bacilli could provide new insights to understand more about this field at this time when multi-drug resistant TB is becoming, as never before, an increasing concern

Effects of training practices on employees’ performance in east Addis Ababa District of Commercial Bank of Ethiopia

Training is the act of enhancing the knowledge, skill, and attitude of an individual for doing a particular job. In the present situation training is increasingly viewed as a means of not only fostering the growth of the individual employee but as an integrated part of organizational growth. Employee performance is normally looked at in terms of outcome. This research examined the effects of training practice on employee performance in commercial bank of Ethiopia (CBE) at East Addis Ababa District. To achieve the objectives of this study descriptive survey and explanatory research design was used. Data was collected through questionnaire from a sample of 234 those were selected using simple random sampling method and interview for managers of CBE. The data collected from the questionnaire were analyzed using inferential and descriptive Statistical tools such as mean, standard deviation, correlation, and multiple regression analysis. The results of this study indicate that, training practice dimension such as (need assessment, training objectives, training methods, selection of trainees and trainers, implementation of training program and evaluation and feedback) have positive and significant relationship with and have significantly contribute 58.4% to employee’s knowledge, skills and attitudes. On the other hand, employee’s knowledge, skills and attitudes have positive and significant relationship with and contribute 61.3% to employee performance. Based on the findings of the study, the researchers recommend starting need assessment. to analyzing organization, task and people level, doing the training evaluation and feedback before, during and after training; reassessing training objectives and design as much as possible SMARTER objectives.Keywords: Attitudes, employee performance, knowledge, skills and training proces

Detection and Molecular Characterization of 9000-Year-Old Mycobacterium tuberculosis from a Neolithic Settlement in the Eastern Mediterranean

Background: Mycobacterium tuberculosis is the principal etiologic agent of human tuberculosis. It has no environmental reservoir and is believed to have co-evolved with its host over millennia. This is supported by skeletal evidence of the disease in early humans, and inferred from M. tuberculosis genomic analysis. Direct examination of ancient human remains for M. tuberculosis biomarkers should aid our understanding of the nature of prehistoric tuberculosis and the host/pathogen relationship.Methodology/Principal Findings: We used conventional PCR to examine bone samples with typical tuberculosis lesions from a woman and infant, who were buried together in the now submerged site of Atlit-Yam in the Eastern Mediterranean, dating from 9250-8160 years ago. Rigorous precautions were taken to prevent contamination, and independent centers were used to confirm authenticity of findings. DNA from five M. tuberculosis genetic loci was detected and had characteristics consistent with extant genetic lineages. High performance liquid chromatography was used as an independent method of verification and it directly detected mycolic acid lipid biomarkers, specific for the M. tuberculosis complex.Conclusions/Significance: Human tuberculosis was confirmed by morphological and molecular methods in a population living in one of the first villages with evidence of agriculture and animal domestication. The widespread use of animals was not a source of infection but may have supported a denser human population that facilitated transmission of the tubercle bacillus. The similarity of the M. tuberculosis genetic signature with those of today gives support to the theory of a long-term co-existence of host and pathogen

Routine health management information system data in Ethiopia: consistency, trends, and challenges.

Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector. Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys. Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources. Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions. Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions

Communication patterns among extension personnel and farmers: a case of Dire Dawa administrative council, Ethiopia

One of the most inhibiting forces to successful development is lack of effective communication within and between different actors. Likewise, communication in extension organizations takes place within the organization and outside the organization among different actors. Hence, the overall objective of the study was to assess the communication patterns among extension personnel and between farmers. The specific objectives were: to explore the relationship between personal and socio- psychological factors that affect effectiveness of communication among extension personnel and farmers; to investigate the institutional factors that affect effectiveness of communication among extension personnel and farmers; and to identify communication methods and media used by extension personnel. The research design was cross-sectional survey. The study used a multi-stage stratified sampling to select respondents. A total of 120 farmers, 30 VEWs, and 23 SMSs were selected for the study. Data were collected from both primary and secondary sources using self administered questionnaires, interview schedule, group discussion, semi- structured interview, informal discussions, and observations. Data were analyzed using simple descriptive statistics (percentage and frequency), chi-square, and correlation. The results of the study revealed that communication apprehension level had relation with some of personal factors of the extension personnel and weak communication existed between extension personnel and other organizations, and farmers’ contact with the extension personnel was inadequate. The results further pointed out that transportation, lack of improved technologies and relevant information, and involvement of VEWs in non-extension activities were important problems that affect communication among extension personnel and with farmers.ii Utilization of communication methods and media by the extension personnel was insignificant. Comprehensive training, establishing rural development task force, co- ordinated field visit program, and improve the work relationship to different organizations are among the recommendations drawn to improve effectiveness of communication patterns among extension personnel and farmers in the study area.Sasakawa Africa Fun

Prevalence of drug resistant tuberculosis in Arsi Zone, Ethiopia

Background: Wide spread of occurrence of multi-drug resistance tuberculosis is becoming a major challenge to effective tuberculosis control. Thus, it is imperative to monitor the sensitivity of anti-TB drugs regularly. Objective: To determine the prevalence resistance to anti-TB drugs in a well established control program area in Arsi zone. Methods: A health institution based cross-sectional study was designed in Arsi zone Oromia Region, Ethiopia. Patients who have never been treated and previously treated with anti-tuberculosis treatment: isoniazid, streptomycin, thiacetazone, rifampicin and ethambutol were included in the study. Culture positive specimens were tested for susceptibility testing to the anti–tuberculosis drugs using a proportion method with Loweinsten – Jensen medium. Results: The over all resistance to one or more of the anti–tuberculosis drugs was 19.5% (38/195). Primary and acquired resistance were 18.2% (32/172) and 31.6% (6/19), respectively. Multi drug resistance tuberculosis (isoniazid and rifampicin) was absolutely nil in both cases. Conclusion: A wider use of Directly Observed Treatment Short course in the area may contribute to the control of the incidence of drug resistance. (Ethiopian Journal of Health Development, 2001, 15(1): 11-16

Soil Fertility Assessment and Mapping under Different Land Use Types along Toposequence at Danka Watershed in Dinsho Districts of Bale Highland Oromia, Southeastern Ethiopia

Soil fertility assessment and mapping bases, to increase fertilizer usage efficiency, decision-makers, planners, and soil management in undulating slopes farming of Ethiopian highlands like Bale Highland. The study aimed to assess and map soil fertility status along toposequence under different land use types at the Danka watershed of Dinsho District Bale Highland, Southeastern Ethiopia. Following the initial reconnaissance field survey, 54 composite soil samples were prepared from the three land use types (natural forest, grazing, and cultivated) at three slope positions lower (0 - 10%), middle (10 - 15%), and upper (15 - 30%) at a soil depth of 0 to 20 cm. Finally, the laboratory results were interpolated using the IDW interpolation technique in ArcGIS software 10.5 for the soil fertility status map and further analyzed using R software 4.1.1 Version for mean separation. The study findings indicate that the soil texture class of the study was loam to clay loam, clay loam, and clay to clay loam at the upper, middle, and lower slope positions, respectively. The finding revealed that the values varied from 5.81 – 6.66, 2.07 – 6.25%, 0.13 – 0.71%, 2.83 – 17.56 gm/kg, and 14.04 -38.80 cmol (+)/kg) for the soil pH, organic matter, total nitrogen, available phosphorus, and CEC, respectively. In this study, most of the soil fertility status of the Danka watershed was as follows: natural forest > grassland > cultivated land use types and lower slope > middle slope > upper slope positions. In conclusion, the main factors contributing to the area's declining soil fertility status were monocropping, total crop residue removal, soil erosion, nutrient leaching, and inadequate soil management. The results of the current study offer the basis for the work of farmers, planners, decision-makers, and other agriculture-related stakeholders. Integrated soil fertility management with biophysical soil conservation measures is advisable for cultivated land at all slope positions. Further, a study on slope position-based crop response fertilizer rating for agricultural precision and ensuring food security is recommended in undulating fields of the Danka watershed

The impact of adopting artificial cattle insemination technology by smallholder farmers on their wellbeing: The case of Yem Special District, Ethiopia

AbstractThis study investigated the impact of adopting artificial cattle insemination technology (ACI) by smallholder farmers on their well-being in the case of Yem special district. Using three-stage sampling techniques, cross-sectional data were collected from 361 household head that include adopter and non-adopter of ACI. The propensity score matching method was used to estimate the impact of adopting ACI on the welfare of households. The method was checked for covariate balancing with a standardized bias, t-ratio, and joint significance-level tests. Moreover, sensitivity analysis of the estimated effect of adoption to unobserved selection bias was checked using Rosenbaum bounds procedure. We employed STATA Version 13 software to run the estimation and diagnostic tests. The results revealed that ACI adoption practices have a positive impact on the wellbeing of households. The results indicate that the adoption of ACI technology on average increases income from milk, livestock, and the total consumption of households by 62.742, 31.215, and 11,325.694 Birrs per year, respectively, compared to non-adopters at a 1% significant level. The sensitivity analysis shows that the estimated impact was insensitive to unobserved selection bias

Evaluation of Microscopic Observation Drug Susceptibility Assay for Detection of Multidrug-Resistant Mycobacterium tuberculosis

Early detection of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is of primary importance for both patient management and infection control. Optimal methods for identifying drug-resistant Mycobacterium tuberculosis in a timely and affordable way in resource-limited settings are not yet available. This study prospectively evaluated a low-technology but rapid drug susceptibility testing method, the microscopic observation drug susceptibility assay (MODS), in the concurrent detection of M. tuberculosis and its susceptibilities to isoniazid and rifampin (two drugs defining multidrug-resistant M. tuberculosis) directly from sputum specimens. Sputum samples were collected from 262 smear-positive TB patients in Addis Ababa, Ethiopia. To undertake MODS, 100 μl of decontaminated samples was inoculated into a 24-well plate containing 1 ml of 7H9 broth with and without appropriate drugs. The assay uses an inverted-light microscope to detect characteristic mycobacterial growth in liquid culture. Of 262 smear-positive patients, MODS detected 254 (96.9%) and culture in Löwenstein-Jensen medium detected 247 (94.3%) (P = 0.016). For the 247 cultures, the sensitivity, specificity, and accuracy of MODS for detecting MDR-TB were 92.0, 99.5, and 98.8%, respectively, using the method of proportion as a reference (concordance, 98.8%; kappa value, 0.932). Results for MODS were obtained in a median time of 9 days. MODS is an optimal alternative method for identifying MDR-TB in a timely and affordable way in resource-limited settings

Colorimetric Phage-Based Assay for Detection of Rifampin-Resistant Mycobacterium tuberculosis

Tests based on bacteriophage replication enable rapid screening of Mycobacterium tuberculosis for drug resistance. We describe a novel broth-based colorimetric method for detecting phage replication. When clinical isolates were tested by this novel method, high concordance was observed with both the traditional phage assay and gene mutation analysis for detection of resistance to rifampin