AIDS and college students in Addis Ababa: A study of knowledge, attitude and behavior

Abstract: To assess the knowledge, attitude and behavior of college students towards acquired immunodeficiency syndrome (AIDS), 1214 students from six colleges in Addis Ababa were interviewed by means of a questionnaire. The results indicated that, although college students in general are well informed about AIDS, there are gaps in their knowledge of some vital information. A relatively low level of awareness about some vital information about the risk factors and the modes of transmission of AIDS was revealed by the study. Similarly, poor attitude and practice towards protection from AIDS was also documented. However, their attitude towards the disease and their protective behaviors did not match the relatively high level of knowledge they have about the disease. Sex, religion, or being in one faculty or another did not show significant difference. But, knowledge about AIDS was found to increase with age. The results of this study were almost similar to the studies conducted on college students of other countries. Four hundred seventy four (39%) students considered themselves as a high risk group and 219 (18%) believed that AIDS is not their problem. More than 315 (30%) admitted that they have one or more lovers and the highest proportion 802 (66%), reported that they did not use condom at all. Radio and television, followed by the print media were the students' best sources of information on AIDS. It is concluded that although college students would have a relatively better access to information on AIDS, compared to the general population, this does not seem to have brought about the necessary behavioral changes required for protection against AIDS. Therefore, the need for offering a more focused AIDS education to college students, much more than what is being currently done through general public information, is justifiable. [Ethiop. J. Health Dev. 1997;11(2):115-123

Evaluation of parasitological methods for the detection of Strongyloides stercoralis among individuals in selected health institutions in Addis Ababa, Ethiopia

Background: Strongyloides stercoralis causes chronic intestinal infection that may lead to disseminated disease during immunosuppression. Therefore, efficient diagnostic methods are essential to detect silent and latent infections. The present study was aimed to compare the efficacy of parasitological methods for the detection of S. stercoralis infection.Methods: A cross-sectional study was conducted on 351 subjects (226 HIV positive and 125 HIV negative) from October 2005 to May 2006. The study participants were selected by systematic random sampling method. Fresh fecal samples were collected from each participant and processed by different parasitological methods.Results: Among the 351 individuals involved in the study, 43(12.3%) were infected by S. stercoralis. The prevalence of S. stercoralis infection was significantly higher among HIV positive subjects (17.3%) as compared with 3.2% in HIV negative subjects (p=0.001). The odd of being infected by S. stercoralis was significantly higher among AIDS patients (OR=6.31; 95% CI, 2.2-18.1) and HIV patients with diarrhea (OR=9.3; 95% CI 4.6-18.9) as compared with respective controls. Agar plate culture showed superior sensitivity (97.7%) than other methods for detection of S. stercoralis. Similarly, agar plate culture showed strong diagnostic agreement with Baermann’s method (kappa = 0.82; 95% CI 0.72 - 0.92) followed by fecal concentration (kappa= 0.67; 95% CI=0.54-0.80).Conclusion: This study revealed that HIV patients were about 6 folds susceptible for S. stercoralis infection. Similarly, agar plate culture showed superior diagnostic efficiency for detections of S. stercoralis infection.Keywords: S. stercoralis, HIV positive, agar plate cultur

Chloroquine-resistant Plasmodium vivax malaria in Serbo town, Jimma zone, south-west Ethiopia

<p>Abstract</p> <p>Background</p> <p>Ethiopia has the highest proportion of vivax malaria, approximately 40% of all malaria infections, in contrast to African countries. Chloroquine (CQ) is the drug of choice for the treatment of <it>Plasmodium vivax </it>infection in the country, although CQ resistant <it>P. vivax </it>(CRPv) has started to challenge the efficacy of the drug. The present study was conducted to assess the current status of CRPv at Serbo, Jimma zone, south-west Ethiopia.</p> <p>Methods</p> <p>A 28-day <it>in vivo </it>therapeutic efficacy test was conducted from October 2007 to January 2008. Recurrence of parasitaemia and the clinical condition of patients were assessed on each visit during the follow-up. The levels of haemoglobin (Hb) in the study participants were determined. The patients' blood drug levels were measured using HPLC. Data was analysed using SPSS for windows version 10.0. HPLC data was computed using Chem Station for LC 3D systems software.</p> <p>Results</p> <p>Of the total 84 patients included in the study, 78 completed their 28-day follow-up, six of whom being excluded for different reasons. In three children (aged 7, 12 and 13 years), parasitaemia reappeared within the 28-days follow-up in spite of adequate absorption of the drug and absence of malaria symptom. In addition, on the day of recurrence of parasitaemia the levels of chloroquine-desethylchloroquine (CQ-DCQ) were above the minimum effective concentration (≥100 ηg/ml) in all the three cases, showing that treatment failure could not be attributed to low level of drug in the patients blood.</p> <p>Conclusion</p> <p>Reappearance of the parasite within the 28 days of follow-up is due to parasite resistance to CQ. The 3.6% (95% CI = -0.038 - 0.0758) prevalence of CRPv malaria in the study area signals the need for launching monitory activities for CQ resistant <it>P. vivax</it>. Moreover, as former report from the same country, Debrezeit, also showed the occurrence of CRPv, survey on CRPv malaria should be made in <it>P. vivax </it>endemic areas in order to estimate the level of burden across the country.</p

Diarrhoea-associated parasitic infectious agents in AIDS patients within selected Addis Ababa Hospitals

Abstract: The aim of the study was to determine the prevalence of gastrointestinal parasites in Acquired Immunodeficiency Syndrome (AIDS) patients with chronic diarrhea. This prevalence was compared with two control groups: Human Immunodeficiency Virus (HIV) seronegative diarrheal patients and HIV seropositive individuals without diarrhoea. Stool specimens from clinically diagnosed hospitalized AIDS patients in some hospitals in Addis Ababa were screened for parasite infection. Of 147 AIDS patients with chronic diarrhoea, 74 (50.3%) were infected with one kind or more of parasites. Out of 56 non-AIDS (seronegative) diarrhoeal patients, 41.1% (23/56) and out of the 43 non-diarrhoeal (seropositive) patients, 41.9% (18/43) were infected by a variety of intestinal protozoa and helminths. The parasites detected in AIDS patients were Cryptosporidium spp, Isospora spp, Blastocystis spp, Ascaris lumbricoides, Giardia lamblia, Strongyloides stercoralis, Taenia spp, Trichuris trichiura, Entamoeba histolytica, and Hook worm spp. Among the intestinal parasites, Cryptosporidium spp was exclusively associated with AIDS patients. The high proportion of the study subjects who had diarrhoea in the absence of identifiable parasitic infections suggests that other infectious agents (eg. Bacteria and Virus) or mechanisms other than infectious agents, are responsible for the diarrhoea. [Ethiop. J. Health Dev. 1999;13(3):169-173

Kidney Stone Disease: An Update on Current Concepts

Kidney stone disease is a crystal concretion formed usually within the kidneys. It is an increasing urological disorder of human health, affecting about 12% of the world population. It has been associated with an increased risk of end-stage renal failure. The etiology of kidney stone is multifactorial. The most common type of kidney stone is calcium oxalate formed at Randall’s plaque on the renal papillary surfaces. The mechanism of stone formation is a complex process which results from several physicochemical events including supersaturation, nucleation, growth, aggregation, and retention of urinary stone constituents within tubular cells. These steps are modulated by an imbalance between factors that promote or inhibit urinary crystallization. It is also noted that cellular injury promotes retention of particles on renal papillary surfaces. The exposure of renal epithelial cells to oxalate causes a signaling cascade which leads to apoptosis by p38 mitogen-activated protein kinase pathways. Currently, there is no satisfactory drug to cure and/or prevent kidney stone recurrences. Thus, further understanding of the pathophysiology of kidney stone formation is a research area to manage urolithiasis using new drugs. Therefore, this review has intended to provide a compiled up-to-date information on kidney stone etiology, pathogenesis, and prevention approaches

Assessment of Clarias gariepinus as a biological control agent against mosquito larvae

Background The emergence and spread of insecticide resistant mosquitoes renewed interest in investigating the use of larvivorous fish as a biological control agent. The potential of Clarias gariepinus fish in controlling Anopheles arabiensis and culicine larvae was assessed under laboratory and semi-field conditions. Results Small size (15?20æcm) C. gariepinus fish consumed greater number of mosquito larvae than the large size fish (25?40æcm) in the multivariate regression model (?æ=æ13.36, 95æ% CIæ=æ4.57, 22.15). The Anopheles larvae consumed was greater in number than the culicines larvae consumed by the fish (?æ=æ12.10, 95æ% CIæ=æ3.31, 20.89). The number of larvae consumed was greater during the night hours than during the light hours (?æ=æ30.06, 95æ% CIæ=æ21.27, 38.85). Amount of supplementary fish food did not cause significant differences in the number of mosquito larvae consumed by the fish among different groups. C. gariepinus was observed to feed on mosquito larvae under laboratory and semi-field conditions. Conclusion C. gariepinus fed on the larvae of An. arabiensis and culicines readily. Hence, it can be used as an alternative mosquito control agent in Ethiopia where the breeding habitats are small and localized

Malaria prevalence pattern observed in the highland fringe of Butajira, Southern Ethiopia: A longitudinal study from parasitological and entomological survey

<p>Abstract</p> <p>Background</p> <p>In Ethiopia, information regarding highland malaria transmission is scarce, and no report has been presented from Butajira highland so far whether the appearance of malaria in the area was due to endemicity or due to highland malaria transmission. Thus this study aimed to determine the presence and magnitude of malaria transmission in Butajira.</p> <p>Methods</p> <p>For parasitological survey, longitudinal study was conducted from October to December 2006. The entomological surveys were done from October to December 2006 and continued from April to May 2007. Both parasitological and entomological surveys were done using standard procedures.</p> <p>Results</p> <p>The parasitological result in all the survey months (October-December) showed an overall detection rate of 4.4% (48/1082) (CI 95%; 3.2-5.7%) malaria parasite. Among infected individuals, 32 (3.0%) of the infection was due to <it>Plasmodium vivax </it>and the rest 16 (1.5%) were due to <it>Plasmodium falciparum</it>. The highest prevalence 39(3.6%) of the parasite was observed in age groups of above 15 years old. Among the total tested, 25(2.3%) of males and 23(2.1%) of females had malaria infection. Among tested individuals, 38(5.3%) and 10 (2.7%) of infection was occurred in Misrak-Meskan (2100 m a.s.l) and Mirab-Meskan (2280 m a.s.l), respectively which was statistically significant (X²= 3.72, P < 0.05). Although the prevalence pattern of <it>Plasmodium </it>species declined from October to December, the trend was non-significant (X²for trend = 0.49, P > 0.05). The entomological survey showed a collection of 602 larvae and 80 adult <it>Anopheles</it>. <it>Anopheles christyi </it>was the dominant species both in the first (45.3%) and in the second (35.4%) surveys; where as, <it>Anopheles gambiae sensu lato </it>comprised 4.7% and 14.6%, in the first and second surveys, respectively. <it>Anopheles gambiae </it><it>s.l </it>comprises 55% of the adult collection, and both species were collected more from outdoors (57.5%). The number of <it>An. christyi </it>was higher in Mirab-Meskan (58. 3%) than Misrak-Meskan (41.7%) (P < 0.05).</p> <p>Conclusion</p> <p>Malaria parasite and its vectors were found to be common during transmission periods in the highland fringes of Butajira. Thus, health education about the risk of malaria and its control programme in the area must be given adequate attention to minimize potential epidemics. In addition, the current study should be complemented from sero-epidemiological, prospective longitudinal and retrospective studies along with metrological and ecological factors, and socio-demographic data before concluding in favour of highland malaria transmission in the area. In light of its abundance, which coincided with the malaria transmission seasons, the possible role of <it>An. christyi </it>as a secondary vector in the highlands must be further investigated by including blood meal sources detection.</p

The prevalence of intestinal parasites in paediatric diarrhoeal and non-diarrhoeal patients in Addis Ababa hospitals, with special emphasis on opportunistic parasitic infections and with insight into the demographic and socio-economic factors

Background: Opportunistic intestinal parasitic infections cause severe diarrhoea specially in infants and in immunocompromised people world wide.Objective: The objective of this study was to assess and determine the prevalence of opportunistic intestinal parasites in paediatric patients with and without diarrhoea in selected hospitals in Addis Ababa. Methods: A cross-sectional study was conducted on 222 children under five years of age who had diarrhoea and on 74 children who had no diarrhoea in selected Hospitals in Addis Ababa. Single stool specimens were collected and screened for intestinal parasitic infections by using direct and concentrated methods. The Modified Ziehl-Neelsen Staining and Modified Water-Ether Sendimentaion methods were used for detecting Coccidial parasites. Results: Of the 222 paediatric diarrhoeal patients, 61(27.5%) were found to be infected with a variety of intestinal parasites and out of 74 children without diarrhoea 11(14.9%) were found to be infected. Among the emerging opportunistic parasites detected in diarrhoeal children were Cryptosporidium parvum (8.1%), Isospora belli (2.3%) and Enterocytozoon bieneusi/ Encephalitozoon intestinalis (0.5%). Other common intestinal parasites detected were Ascaris lumbricoides (0.5%), Trichuris trichiura (0.9%), Giardia lamblia (6.3%), Entamoeba histolytica/ E. dispar (1.4%), Blastocystis hominis (5.9%) and Hymnolepis nana (0.5%). Opportunistic parasites were found to be significantly associated with diarrhoeal and non-breastfed children (

Parasito-haematological features of acute Plasmodium falciparum and P. vivax malaria patients with and without HIV co-infection at Wonji Sugar Estate, Ethiopia

No Abstract.Ethiopian Journal of Health Development Vol. 19 (2) 2005: 132-13

Ex vivo cytokine mRNA levels correlate with changing clinical status of ethiopian TB patients and their contacts over time.

There is an increasing body of evidence which suggests that IL-4 plays a role in the pathogenesis of TB, but a general consensus on its role remains elusive. We have previously published data from a cohort of Ethiopian TB patients, their contacts, and community controls suggesting that enhanced IL-4 production is associated with infection with M. tuberculosis, rather than overt disease and that long-term protection in infected community controls is associated with co-production of the IL-4 antagonist IL-4d2, alongside elevated IL-4. Here, for the first time, we compare data on expression of IFN-gamma, IL-4 and IL-4delta2 over time in TB patients and their household contacts. During the follow-up period, the TB patients completed therapy and ceased to display TB-like symptoms. This correlated with a decrease in the relative amount of IL-4 expressed. Over the same period, the clinical status of some of their contacts also changed, with a number developing TB-like symptoms or clinically apparent TB. IL-4 expression was disproportionately increased in this group. The findings support the hypothesis that elevated IL-4 production is generally associated with infection, but that TB disease is associated with a relatively increased expression of IL-4 compared to IFN-gamma and IL-4delta2. However, the data also suggest that there are no clear-cut differences between groups: the immune response over time appears to include changes in the expression of IFN-gamma, IL-4 and IL-4delta2, and it is the relative, not absolute levels of cytokine expression that are characteristic of clinical status