Treatment outcomes of childhood tuberculosis in Addis Ababa: a five-year retrospective analysis

Abstract Background Tuberculosis (TB) kills one child every 5 min. Childhood TB is given low priority in most national health programmes particularly in TB-endemic areas. TB among children is an indicator of a recent transmission of the disease in the community. Treatment outcome results serve as a proxy of the quality of treatment provided by a health care system. In Ethiopia, data on treatment outcomes of childhood TB are limited. The aim of the study was to determine the treatment outcomes of childhood TB in a hospital setting in Addis Ababa. Methods The study was conducted during June to August 2014. The data of 491 children treated for TB in Zewditu Memorial Hospital during a 5 year (2009–2013) was analysed. TB was diagnosed using standard methods. Demographic and clinical data including type of TB, TB-HIV co-infection and treatment outcomes were collected from registry of the TB clinic. Treatment outcome definitions are used according to the World Health Organization. Results Of the 491 children, 272(55.4 %) were females, 107(21.8 %) were under 5 year old, 454(92.5 %) of them were new cases. The types of TB were extra-pulmonary tuberculosis (EPTB) 243(49.5 %) and 248(50.5 %) pulmonary tuberculosis (PTB). Of the PTB cases, 42(16.9 %) were sputum smear positive. Of the 291 children tested for HIV, 82(28.2 %) were positive. The overall treatment success rate was 420(85.5 %) and the poor treatment outcome was 71(14.5 %). Of the children with poor treatment outcome, 9(1.8 %) died, 3(0.6 %) defaulted from treatment, 2(0.4 %) were treatment failure and 55(11.2 %) were transferred out. Males and females had similar treatment success rates of 85.8 % and 85.3 %, respectively. Infants under one year had significantly lower treatment success rate of 72.7 % compared to those above 1 years of age of 86.5 % (P < 0.001). Treatment success rate ranged from 78.0 to 92.6 % during the study period. Associated factors for treatment outcome were age above 5 years (AOR = 0.59, 95 % CI: 0.62–0.97) and seropositive for HIV infection (AOR = 6.66, 95 % CI: 3.07–14.47). Conclusions The treatment success rate in this study is 85.5 %. The outcome of treatment varied with age, and presence of HIV infection. In order to the further improve of treatment success rate, continuous follow up with frequent support of patients during treatment course and strengthen the recording system are strongly recommend

Patterns and Magnitude of Defaulting from Leprosy Treatment in Jimma Health Centre

No abstract - Available on PD

Trends of HIV Seropositivity among Blood Donors over Six Years Period (1995-2000) in Jimma Zone, Southwest Ethiopia

Background: Since few years back HIV/AIDS has become a threat to globaldevelopment. Developing countries especially those in the sub-Saharan area are highly victimized by the tolls of its morbidity and mortality. Circumstantial evidences and reports from sentinel studies indicate that the problem is progressing from time to time. However, there is no adequate information in Ethiopia as to what the trend of the infection looks like in healthy population over a period of time. The objective of this study was to determine the trend of HIV positivity among blood donors at the Jimma Hospital Blood Bank. Methods: A retrospective cross-sectional study was carried out among blood donors during the period of January 1995 to December 2000 at Jimma hospital blood bank, Jimma zone, Southwest of Oromiya, to determine the trend of HIV seropositivity and associated factors. All subjects who donated their blood at Jimma hospital blood bank during the specified period were included in the study. Data on socio-demographic variables, and serologic status of the subjects were abstracted from their records using structured questionnaire. The data were cleaned edited and entered in to computer and analysis was done using SPSS version 7.5. Results: A total of 3394 subjects donated blood over the last six years, 3020 were male and 360 were female. The prevalence of seropositivity tended to decrease from 1995 some how until 1999 and started to rise in 2000 this difference in the prevalence of seropositivity was statistically significant (P&lt;0.05). The study revealed that 189 (5.6%) donors were positive for HIV upon screening by ELISA method. The sex specific prevalence of HIV infection was 9.3% for females and 5.8% for males. This difference in the sex specific prevalence of HIV infection was statistically significant (P=0.002, OR = 0.565, 95%CI =0.395-0.810). There is also a statistically significant difference in the prevalence of HIV infection along the years (P =0.003). The age specific prevalence is highest in the age group of 18-30 followed by that of the age group of 31-40 as compared to other age groups, this difference was statistically significant (P =0.028). Single subjects showed the highest (5.8%) prevalence followed by Married ones (5.6%), the difference was not statistically significant (P&gt;0.05). Pertaining the literacy status, the highest prevalence (7.2%) was observed in those subjects who attended Junior secondary and high school followed by those who attended grades 1-6(5.4%), the difference was not statistically significant (P&lt;0.05). Seropositivity was higher(6.9%) among Christians as compared to Muslims (4.1%) and the difference was statistically significant (P &lt;0.001, OR =1.68, 95%CI=1.25-1.27). Conclusion: Based on the results of the study, appropriate recommendations were made.Ethiop J Health Sci Vol. 11, No. 2 July 200

Assessment of the Bacteriological Quality of Milk at Dairy Farms and Individual Breeders in Jimma Town, South West Ethiopia

BACKGROUND: Food-borne diseases are major public health concern worldwide. Many people around the world acquire food poisoning due to consumption of raw, contaminated milk which are spread either from infected cows, by handling or during milk processing. The aim of this study was to assess the sanitary standards of dairy farm as well as individual breeding areas in Jimma town, evaluate the hygienic practices of milk handlers and to determine the bacteriological quality of milk at dairy farms and individual breeders. METHODS: A cross-sectional study was conducted from January to July2001. In the study, survey using interview methods using structured questionnaire and close assessment concerning cleanliness and design of the barn, status of animal health, hygienic practices and health status of the milk handlers was made. In addition, bacteriological investigation on the quality of milk, sterility of the milk utensils and containers was made. Standard laboratory procedures including gram staining, culture and biochemical tests were employed to identify potential bacterial pathogens. RESULTS: Of all the milk samples tested for quality, only 52/60 (86.7%) of the milk samples tested were found to be free of any pathogenic microorganisms and acceptable for consumption while 9/13 (69.2%) of milk containers were bacteriologically unacceptable for utilization. Staphylococcus aureus was the commonest bacterial pathogen isolated from freshly drawn milk (in 13.9%) of cases while the 3 klebsiella species (K. pneumoniae, K. ozanae &amp; K. oxytoca) were isolated from collection cans (bulk) and milking utensils (in 7 and 5 cases respectively). Some milk samples contained multiple pathogens. Polymicrobial isolation was observed in 2 cases of each in freshly drawn milk, milking utensils and milk from bulk cans. In addition, on environmental assessment, cows were not regularly checked for animal diseases. CONCLUSION: Consumption of raw milk from market is potentially dangerous for health. Thus, proper boiling of the milk is recommended. The farm managers and individual breeders must take corrective measures so as to produce milk for human consumption that meets the existing milk standard, which is free of harmful bacterial pathogens. The cows should be regularly checked at animal clinics.Ethiop J Health Sci. Vol. 13, No. 1 January 200

Seroprevalence of HBsAg and its risk factors amoung pregnant women in Jimma, Southwest Ethiopia

No Abstract Available Ethiop.J.Health Dev. Vol.19(1) 2005: 45-5

The prevalence of thermotolerant Campylobacter species in food animals in Jimma Zone, Southwest Ethiopia

Background: Thermotolerant Campylobacter spp. is known to occur in the intestinal systems of a wide variety of domestic and wild animals. Although Campylobacter jejuni and Campylobacter coli cause acute diarrhoeal diseases in humans worldwide, they mostly manifest themselves in an apparently healthy carrier state in other mammalian species. However, little is known about the presence of campylobacter bacteria in various food animals as possible sources of infection to humans in Ethiopia. Objective: The aim of this study is to determine the prevalence of thermotolerant Campylobacter spp. in various food animals in Jimma zone, southwest Ethiopia.Methods: A cross-sectional study was conducted in urban and rural farm animal settings in Jimma, southwest Ethiopia in the period between January 2004 to April 2004. Fecal specimens were collected from 485 various food animals (cattle, n=205; poultry, n=191; pigs, n=18; sheep n=71) and cultured using standard methods. Results: Campylobacter spp. were isolated from 192 (39.6%) out of 485 fecal specimens taken from various urban and rural farm animals. The highest isolation rate was recorded among chickens (68.1%), followed by pigs (50.0%), sheep (38.0%) and cattle (12.7%). Among the 192 thermophilic campylobacters isolated, 135 (70.3%) were identified to be C. jejuni, 51 (26.6%) were C. coli and 6 (3.1%) were C. lari. C. jejuni was the most prevalent species in chickens (80.8%), followed by sheep (59.3%) and cattle (53.8%). All isolates found in pigs were identified to be C. coli (100%). Conclusion: The results of this study indicate that thermophilic campylobacters are very frequent among various food animals in Ethiopia, suggesting possible risks of infection to people through the consumption of contaminated animal products or through contact with infected animals. Ethiopian Journal of Health Development Vol. 19(3) 2005: 225-22

Hepatitis C virus and Human Immunodeficiency Virus coinfection among attendants of Voluntary Counseling and Testing Centre and HIV follow up clinics in Mekelle Hospital

Introduction: Hepatitis C virus remains a large health care burden to the world. HIV and HCV coinfection is major global health concern worldwide. However, there is limited information on the prevalence of HCV/HIV co-infection in Ethiopia. The aim of the study was to assess the magnitude of HIV/HCV coinfection and the potential risk factors in attendants of voluntary counseling and testing centre and HIV follow up clinics of Mekelle hospital. Methods: A cross sectional seroprevalence survey of HCV infection was carried out on 300 HIV negative and positive subjects attending voluntary counseling and testing (VCT) center and HIV follow up clinics of Mekelle hospital, Ethiopia from December 2010-February 2011. Serum samples were tested for anti-HCV antibodies using immunochromatographic test. Results: Of the 300 study participants, 126(42%) were HIV negative and 174(58%) HIV seropositive from VCT and HIV follow up clinics, respectively. The overall anti-HCV prevalence was 18(6.0%). There were no significant differences in HCV seroprevalence among the different categories of age and sex (p&gt; 0.05). Of the 174 persons with HIV, 16 (9.2%) cases had antibodies to HCV, where as among 126 HIV negative subjects 2 (1.58%) were HCV seropositive (p= 0.006, OR= 6.28, 95% CI= 1.42-27.82). Conclusion: Accordingly, there was a significant difference in sero-positivity of HCV between HIV positive and HIV negative participants. No apparent risk factor that caused HCV infection was inferred from this study.Pan African Medical Journal 2013; 14: 10

Therapeutic Efficacy of Artemether-Lumefantrine for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Northern Ethiopia

Introduction. Multidrug resistance of Plasmodium falciparum is spreading throughout Africa. This has posed major challenges to malaria control in sub-Saharan Africa. Objective. The aim of the study was to evaluate the efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in North Ethiopia. Methods. This prospective study was undertaken during August–November 2009 on 71 malaria patients that fulfilled the inclusion criteria set by the WHO. Patients were followed up for 28 days. Thick and thin blood films were prepared by Giemsa stain for microscopy to determine parasite density. A standard six-dose regimen of artemether-lumefantrine was administered over three days and was followed up with clinical and parasitological evaluations over 28 days. Results. The cure rate (ACPR) was found to be high (97.2%) in this study. The parasite and fever clearance time was also rapid. Artemether-lumefantrine for the treatment of acute uncomplicated Plasmodium falciparum malaria in the study area showed 97.2% cure rate and only 2.8% failure rate. Conclusion. The result showed that the drug could continue as first line for the treatment of uncomplicated Plasmodium falciparum malaria in the study area. The efficacy of artemether-lumefantrine needs to be carefully monitored periodically in sentinel sites representing different areas of the country

Microbial Flora and Food Borne Pathogens on Minced Meat and Their Susceptibility to Antimicrobial Agents

BACKGROUND: Food-borne pathogens are the leading cause of illness and death in developing countries. Changes in eating habits, mass catering, unsafe food storage conditions and poor hygiene practices are major contributing factors to food associated illnesses. In Ethiopia, the widespread habit of raw beef consumption is potential cause for food borne illnesses. The present study aimed at investigating the microbial quality of meat available in common retail shops, restaurants and abattoir of Jimma City and determining susceptibility pattern of bacterial isolates. METHOD: A total of 165 samples from food establishments, butcher shops and a slaughter houses were processed and analyzed for the presence of indicator bacterial and potential food pathogens using standards methods. Antimicrobial susceptibility test was performed for Salmonella, Shigella and Staphylococcus aureus isolates using Kirby-Bauer disk diffusion method. RESULTS: A total of 165 samples were collected from twenty four hotels and five butchers and an abattoir. Various food borne pathogens were isolated in 13 (43.3%) and indicator organisms in 29 (96.7%) out of the thirty food establishments (hotels, butchery and abattoir). Overall, ten different bacterial species were isolated which included, proteus spp 89 (53.9%), E. coli 44 (26.6%), Providencia spp 23 (13.9%) Citrobacter spp 15(9%), Pseudomonas spp 9 (5.5%), Klebsiella spp 2 (1.2%), Enterobacter spp 2 (1.2%), Salmonella spp 2(1.2%), and Shigella species 1 (0.6%). Out of the 44 E. coli isolates 37 (84%) were thermo tolerant E. coli and out of the gram positive organisms identified 20 (12.1%) were Staphylococcus aureus isolates. From the two Salmonella isolates one was susceptible against all 12 tested antimicrobials, while the other to all the 11 except cephalexin. Shigella dysentery was resistant only to co-trimoxazole and tetracycline. Out of the 20 S. aureus isolates, 90% showed resistance to oxacillin, 85% to ampicillin, 65% to erythromycin, 60% to amoxicillin, 35% to streptomycin, and 20% to vancomycin and all isolates were sensitive to co-trimoxazole (100%). In this study, 90% (18/20) of the S. aureus isolates were Methicillin Resistant Staphylococcus aureus. CONCLUSION: In this study high percentage of indicator organisms as well as food borne pathogens were identified, which shows unhygienic condition of handling and processing in the food establishments. Our data also confirmed the presence of resistant food pathogens; particularly Staphylococcus aureus isolates which are Methicillin Resistant Staphylococcus aureus and multidrug resistant that emphasizes close follow up in the utilization of antibiotics. Therefore, meat handlers and sellers should be educated on the adverse effect of lack of proper personal, environmental hygiene and sanitation. In addition, consumers should be made aware of the risk of consuming raw and inadequately cooked meat