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

Undernutrition, intestinal parasitic infection and associated risk factors among selected primary school children in Bahir Dar, Ethiopia

Abstract Background Monitoring of undernutrition and parasitic infection are essential to design appropriate intervention strategies. The aim of this study was to assess the prevalence of undernutrition, intestinal parasitic infection and their associated risk factors among school children in Bahir Dar, Ethiopia. Methods A school-based cross-sectional survey was conducted from February to June 2014 among 382 students selected from primary schools in Bahir Dar. The study subjects were selected by a systematic random sampling method. Sociodemographic data from students and their family/guardians were obtained using structured questionnaire. Height and weight of the students were measured using a standard calibrated balance. Fresh fecal samples were collected and processed using formalin-ether concentration technique. The data were analyzed using SPSS version 20.0 statistical software. Results The overall prevalence of undernutrition was 41.6% (18.3% stunted, 26.7% thinness and 25.9% underweight). Meal frequency ≤ 3 times a day (AOR=4.11; 95% CI: 2.23–7.59) and family monthly income <500 birr (AOR=5.87; 95% CI: 2.61–13.23) were important predictors of undernutrition. The risk of stunting was increased among students with meal frequency ≤ 3 times a day (AOR=5.56; 95% CI: 2.97–10.41) and age ranges from 9-10 years (AOR=3.02; 95% CI: 1.41–6.47). The odds of thinness was significantly increased among students with parasitic infection (AOR=1.92; 95% CI: 1.15–3.19) and family monthly income <1500 birr (AOR=2.69; 95% CI: 1.16–6.26). The likelihood of being underweight was increased among students infected with intestinal parasites (AOR=2.43; 95% CI: 1.40–4.22). The overall prevalence of intestinal parasitosis was 52.4%. The risk of parasitic infection was significantly increased among students with unclean fingernails (AOR=4.96; 95% CI: 2.79–8.82) and irregular hand washing habit (AOR=8.05; 95% CI: 4.66–13.89). Conclusions This study revealed that undernutrition and intestinal parasitic infection were public health problems among school children in the study areas. These results highlight the importance for integrated efforts to address undernutrition and parasitic infection

Prevalence of intestinal parasitic infections and associated risk factors among students at Dona Berber primary school, Bahir Dar, Ethiopia

Abstract Background Intestinal parasitic infections are still one of the major health concerns in developing countries. Monitoring of intestinal parasitic infection and associated risk factors are essential for intervention strategies. Therefore, the aim of this study was to assess the prevalence of intestinal parasitic infection and associated risk factors among students at Dona Berber primary school, Bahir Dar, Ethiopia. Methods School based cross-sectional study was conducted among students at Dona Berber primary school from October 2015 to June 2016. Three hundred fifty nine students were involved in the study by providing stool specimens and detailed personal information. Students were selected by stratified and systematic random sampling method. Fresh stool samples were collected from each student and processed by formal-ether fecal concentration technique. Data were analyzed using SPSS version 20.0 statistical software and p value <0.05 were used as statistically significant. Results Among the 359 students participated in the study, 235 (65.5%) were infected by one or more intestinal parasites. The rates of single and double parasitic infections among students were 49.6% and 16.2%, respectively. The most prevalent parasite detected in the study was E. histolytica/dispar (24.5%) followed by hookworm (22.8%). Among the different variables assessed in the study, family size of 6 (AOR = 4.90; 95% CI, 2.03–11.83), irregularly shoe wearing habit (AOR = 2.85; 95% CI, 1.53–5.32) and unclean finger nail (AOR = 3.68; 95% CI, 1.87–7.26) were independently predict intestinal parasitic infections. Student drinking well water (AOR = 2.51; 95% CI, 2.30–4.86) and unclean finger nail (AOR = 4.42; 95% CI, 2.55–7.65) were strongly associated with E. histolytica/dispar infection. Likewise, irregular shoe wearing habit (AOR = 14.13; 95% CI, 7.06–28.29) was strongly associated with hookworm infections. Conclusion High prevalence of intestinal parasitic infection among the study participants demands improvement of health education, environmental sanitation and quality of water sources

Prevalence and Associated Risk Factors of Human Intestinal Protozoan Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis

Background. Human intestinal protozoan parasitic infections (HIPPIs) are a series of public health problems in developing countries like Ethiopia. The overall prevalence of HIPPIs in Ethiopia is not known. Therefore, this systematic review and meta-analysis study is aimed at determining the overall prevalence of HIPPIs in Ethiopia. Methods. Articles written in English were searched from online public databases. Searching terms used were “prevalence,” “intestinal protozoan parasite,” “associated factors,” and “Ethiopia.” We used Stata version 14 for meta-analysis and Cochran’s Q test statistics and the I2 test for heterogeneity. Result. A total of 286 articles were reviewed, but only 45 of them fulfilled the inclusion criteria. The pooled prevalence of HIPPIs in Ethiopia was 25.01% (95% CI: 20.08%-29.95%) where Entamoeba histolytica/dispar is the most prevalent (14.09%, 95% CI: 11.03%-17.14%) followed by Giardia lamblia (10.03%, 95% CI: 7.69%-12.38%) and Cryptosporidium spp. (5.93%, 95% CI: 2.95%-8.91%). This meta-analysis showed that family size (OR: 3.7, 95% CI: 1.45-5.85), source of drinking water (OR: 3.33, 95% CI: 1.30-5.36), open field defecation (OR: 2.91, 95% CI: 1.60-4.21), handwashing habit (OR: 2.82, 95% CI: 2.01-3.63), playing with soil (OR: 2.15, 95% CI: 1.01-3.29), the habit of eating raw vegetables (OR: 1.77, 95% CI: 1.03-2.51), and fingernail trimming (OR: 1.70, 95% CI: 0.89-2.25) were strongly associated with the HIPPIs in Ethiopia. High heterogeneity on the prevalence of HIPPIs was observed among studies within and among regions (I2>99% and P≤0.01). Conclusion. The prevalence of HIPPIs was significantly high among the Ethiopian population. Family size, source of drinking water, open field defecation, handwashing habit, the habit of eating raw vegetables, and fingernail trimming habits were significantly associated with HIPPIs

Prevalence of Schistosoma mansoni and S. haematobium in Snail Intermediate Hosts in Africa: A Systematic Review and Meta-analysis

Background. Schistosomiasis is caused by Schistosoma mansoni and S. haematobium in Africa. These schistosome parasites use freshwater snail intermediate hosts to complete their lifecycle. Varied prevalence rates of these parasites in the snail intermediate hosts were reported from several African countries, but there were no summarized data for policymakers. Therefore, this study was aimed to systematically summarize the prevalence and geographical distribution of S. mansoni and S. haematobium among freshwater snails in Africa. Methods. Literature search was carried out from PubMed, Science Direct, and Scopus which reported the prevalence of S. mansoni and S. haematobium among freshwater snails in Africa. The pooled prevalence was determined using a random-effect model, while heterogeneities between studies were evaluated by I2 test. The meta-analyses were conducted using Stata software, metan command. Results. A total of 273,643 snails were examined for the presence of S. mansoni and S. haematobium cercaria in the eligible studies. The pooled prevalence of schistosome cercaria among freshwater snails was 5.5% (95% CI: 4.9–6.1%). The pooled prevalence of S. mansoni and S. haematobium cercaria was 5.6% (95% CI: 4.9–6.3%) and 5.2% (95% CI: 4.6–5.7%), respectively. The highest pooled prevalence was observed from Nigeria (19.0%; 95% CI: 12.7–25.3%), while the lowest prevalence was reported from Chad (0.05%; 95% CI: 0.03–0.13). Higher prevalence of schistosome cercaria was observed from Bulinus globosus (12.3%; 95% CI: 6.2–18.3%) followed by Biomphalaria sudanica (6.7%; 95% CI: 4.5–9.0%) and Biomphalaria pfeifferi (5.1%; 95% CI: 4.1–6.2%). The pooled prevalence of schistosome cercaria obtained using PCR was 26.7% in contrast to 4.5% obtained by shedding cercariae. Conclusion. This study revealed that nearly 6% of freshwater snails in Africa were infected by either S. haematobium or S. mansoni. The high prevalence of schistosomes among freshwater snails highlights the importance of appropriate snail control strategies in Africa

Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysis

Background: Drug-resistant tuberculosis continues to be a global public health threat. Ethiopia is one of the high-burden countries for tuberculosis and multi-drug resistant tuberculosis. The estimated annual incidents of tuberculosis were 119 per 100,000 populations in 2021 and the prevalence of multi-drug resistance tuberculosis is about 0.7% among newly diagnosed cases in Ethiopia. On time detection of rifampicin resistance is essential for the management of the disease and earlier treatment initiation. Among the different diagnostic tests; Xpert is widely used for the rapid detection of Mycobacterium tuberculosis and rifampicin resistant in the country. The prevalence of rifampicin resistance-pulmonary tuberculosis varied from locality to locality and the estimated national prevalence of rifampicin resistance pulmonary tuberculosis is not available in the country. Therefore, the aim of this meta-analysis was to summarize the results of available studies and generate pooled prevalence estimate of rifampicin resistance pulmonary tuberculosis in Ethiopia. Methods: Literature search was carried out using PubMed and Scopus public databases. Original articles conducted in Ethiopia and those containing a prevalence report of rifampicin resistance pulmonary tuberculosis diagnosed by Xpert Mycobacterium tuberculosis/rifampicin resistance assay were included in the meta-analysis. All retrospective and prospective studies published until May 2022 were screened in the study. The methodological qualities of included article were assessed using Joanna Briggs Institute quality assessment tool for cross-sectional studies. Random effect model was used to determine the pooled prevalence of rifampicin resistance pulmonary tuberculosis. Subgroup analysis and regression were carried out across regional states and study designs. Heterogeneity across studies was assessed using I2 test. The data were analyzed using STATA version 14. Result: A total of 1570 titles were identified and 34 studies met the inclusion criteria. Of the total 17,292 pulmonary tuberculosis patients who were identified from the included articles, 1669 were rifampicin resistance pulmonary tuberculosis. The pooled prevalence of rifampicin resistant among pulmonary tuberculosis patients diagnosed with Xpert Mycobacterium tuberculosis/rifampicin resistance assay was 9.67% (95% CI: 8.11–11.24). The highest pooled prevalence was from Oromia11.84% (95% CI: 4.49–19.2%) and the lowest rifampicin resistance was identified in Amhara Regional State, 8.51% (95% CI: 5.96–11.06%). The pooled prevalence rates of rifampicin resistant among pulmonary tuberculosis patients were 10.18% (95% CI: 6.85–13.51) and 9.57% (95% CI: 7.68–11.47) in prospective and retrospective types of cross-sectional studies. Conclusion: Our study showed that the pooled prevalence of rifampicin resistance among pulmonary tuberculosis patients was 9.67%. This showed that the occurrence of rifampicin resistance pulmonary tuberculosis among Mycobacterium tuberculosis patients remains high in Ethiopia. Regional state wise, rifampicin resistance variation was small. Further meta-analysis of factors associated with rifampicin resistance among pulmonary tuberculosis patients as well as among extrapulmonary Mycobacterium tuberculosis cases should be carried out

Prevalence of Malaria among Adults in Ethiopia: A Systematic Review and Meta-Analysis

Background. Malaria is one of the leading causes of mortality and morbidity in tropical and subtropical regions. The bulk of the global malaria burden is in sub-Saharan African countries, including Ethiopia. Malaria adversely affects the health of the peoples as well as the economic development of many developing countries including Ethiopia. Methods. This review article was reported according to PRISMA guidelines. Related published articles were searched from online public databases, such as PubMed, Google Scholar, and ScienceDirect. The search approach used to retrieve related articles were “prevalence,” “malaria,” “adults,” and “Ethiopia.” The quality of articles was assessed using Joana Brigg’s Institute (JBI) critical appraisal checklist. The meta-analysis was computed using STATA version 14. The pooled prevalence estimates with 95% confidence interval were analyzed using a random-effect model, and the possible source of heterogeneity across studies was indicated through subgroup analysis, inverse of variance (I2), and time series analysis. The presence of publication bias was evaluated using funnel plots and Egger’s regression test. Results. Out of 144 studies collected, only eight full-text articles were screened and included in the final quantitative meta-analysis. The pooled prevalence of malaria among adults in Ethiopia was 13.61%. Subgroup analysis based on types of malaria cases showed that the prevalence of malaria among symptomatic and asymptomatic adults was 15.34% and 11.99%, respectively. Similarly, regional subgroup analysis showed that the highest malaria prevalence was recorded in Southern Nations, Nationalities, and Peoples’ Region (SNNPR) (16.17%) followed by Oromia Regional State (13.11%) and Amhara Regional State (12.41%). Discussion and Conclusion. The current systematic review and meta-analysis showed that the pooled prevalence of malaria among adults was found to be greater than the general population and nearly equal to pregnant women. Therefore, the current prevention and control measures, which are related to both vectors and parasites, should be strengthened