Feasibility of Malaria Elimination in Ethiopia

BACKGROUND: The problem of malaria is very severe in Ethiopia where it has been the major cause of illness and death for many years. The purpose of this review article is to assess the feasibility of malaria elimination in Ethiopia.METHOD: To compile this review article, different relevant research articles related to the topic from open access journals were searched using different searching engines such as Google scholar, Science direct, and Pub Med using different key words and phrases.RESULT: Based on review of the literature, Ethiopia has been trying to control and eliminate malaria for more than 60 years. To assess feasibility of malaria elimination, the WHO assessment tools/recommendations for elimination of malaria were used. Based on WHO parameters, the country has achieved remarkable progress on the fight against malaria during the most recent decades. Malaria morbidity and mortality have been reduced dramatically with intensive use of insecticide residual spray, long lasting insecticide treated nets, chemotherapies, improved diagnosis and case management, improved quality of laboratories, continued support from malaria partners, and political commitment of the Ethiopian government towards malaria prevention and control. Hence, the past achievements and current activities, have led to consider the possibility of malaria elimination in Ethiopia at least by 2030 or beyond.CONCLUSION: Considering the triumphs achieved so far and the current undertaking efforts, malaria could possibly be eliminated from Ethiopia once and for all

Magnitude of Intestinal Parasitosis and Associated Factors in Rural School Children, Northwest Ethiopia

BACKGROUND: Intestinal parasitoses are among the most commonly encountered infections among school children in poor regions of the world. Up to 600 million school children are living in areas where there is high transmission of parasitic worms. Intestinal parasitic infection has been found to have a great effect on nutritional and cognitive status, school absenteeism and dropouts among school age children. This study aimed at determining the prevalence of intestinal parasites infections and associated factors among children in a rural primary school, Northwest Ethiopia.METHODS: A cross-sectional study was conducted in May 2016 among Gob Gob Primary School children. The study participants were provided with labeled stool cups to give stool specimen. The stool samples were processed via direct wet mount and formal-ether concentration techniques. A structured questionnaire was used to collect demographic data and data on factors associated with intestinal parasitic infection through face-to-face interview.RESULTS: Out of the 273 school children, 84(30.8%) were infected with at least one parasite species. Higher proportion of intestinal parasitic infection was recorded for boys (38.9%), the age group 6-10 years (38.9%), children with untrimmed finger nails (36.4%) and among those whose drinking water was from a stream (56.1%). The predominant species identified were A. lumburicoides 28(33.3%), H. nana 12(14%), E. histolytica/dispar 11(13%), G. lamblia 9(11%), hookworms 7(8.3%), Taenia spp 6(7%), E. vermicularis 6(7%), T.trichuria 4(4.8%) and S. stericoralis 1(1.2%).CONCLUSION: This study showed that intestinal parasites were prevalent among the school children in focus. Ascaris lumbricoides was the predominant species.

The Prevalence of Malaria in Tselemti Wereda, North Ethiopia: A Retrospective Study

BACKGROUND: A significant segment of the world’s population is at risk of contracting malaria infection at any one time. In Ethiopia, sustained control efforts have been made in the past decade to fight malaria. Yet, it remains as the major cause of morbidity, mortality and socioeconomic problems in the country. The intensified control of malaria can further be augmented by analyzing health facility based malaria data. Hence, the aim of this study was to determine the magnitude of malaria infection in Northwest Ethiopia.METHODS: A retrospective record review was conducted in Northwest Ethiopia from February-April 2016. All blood film results reported between January 2013 and December 2015 in the seven health centers were extracted and analyzed.RESULTS: A total of 41,773 patients with chief malaria complaint were screened for malaria in the three years period. The overall prevalence of microscopically confirmed malaria was 28.1%. Males (29.5%) were more affected by malaria than females (26.5%). Malaria was also higher in the age group >15 years (32.6%) followed by 5-15 years (29.3%) and under-five children (20.5%). Plasmodium falciparum, Plasmodium vivax and mixed infectionsaccounted for 58.2%, 35.5% and 6.3%, respectively. The highest prevalence of confirmed malaria cases was observed during spring (35.6%) and summer (25.1%). Higher prevalence of slide positive malaria was recorded in Dima (46.1%), Cherecher (45.3%) andFyel wuha (35.3%) health centers.CONCLUSION: Malaria specific outpatient cases were high in the study area. Both plasmodia species were of public health significance in the area with predominance of Plasmodiumfalciparum

Barriers in the implementation of isoniazid preventive therapy for people living with HIV in Northern Ethiopia: a mixed quantitative and qualitative study

Abstract Background Isoniazid preventive therapy is a key public health intervention for the prevention of tuberculosis disease among people living with HIV. Despite the confirmed efficacy of isoniazid preventive therapy and global recommendations existing for decades, its implementation remains limited. In resource constrained settings, few have investigated why isoniazid preventive therapy is not implemented on full scale. This study was designed to investigate the level of isoniazid preventive therapy implementation and reasons for suboptimal implementation in Tigray region of Ethiopia. Methods A review of patient records combined with a qualitative study using in-depth interviews and focus group discussions was conducted in 11 hospitals providing isoniazid preventive therapy in the Tigray Region. The study participants were health providers working in the HIV clinics of the 11 hospitals in the province. Health providers were interviewed about their experience of providing isoniazid preventive therapy and challenges faced during its implementation. All conversations were audio-recorded. Record review of 16,443 HIV patients registered for care in these hospitals between September 2011 and April 2014 was done to determine isoniazid preventive therapy utilization. Data were collected from April to August 2014. Results Fifty health providers participated in the study. Overall isoniazid preventive therapy coverage of the region was estimated to be 20 %. Isoniazid stock out, fear of creating isoniazid resistance, problems in patient acceptance, and lack of commitment of health managers to scale up the program were indicated by health providers as the main barriers hindering implementation of isoniazid preventive therapy. Conclusion Implementation of isoniazid preventive therapy in Tigray region of Ethiopia had low coverage. Frequent interruption of isoniazid supplies raises the concern of interrupted therapy resulting in creation of isoniazid resistance. Health managers, drug suppliers and partners working in HIV and tuberculosis programs should be committed to ensure an uninterrupted supply of isoniazid and full scale implementation of isoniazid preventive therapy to eligible people living with HIV

Factors associated with treatment initiation delay among new adult pulmonary tuberculosis patients in Tigray, Northern Ethiopia.

BackgroundDelayed treatment initiation of Tuberculosis patients results in increased infectivity, poor treatment outcome, and increased mortality. However, there is a paucity of evidence on the delay in new adult pulmonary Tuberculosis patients to initiate treatment in Tigray, Northern Ethiopia.ObjectiveTo assess the factors associated with treatment initiation delay among new adult pulmonary tuberculosis patients in Tigray, Northern Ethiopia.MethodsThe study design was cross-sectional. A total of 875 new adult pulmonary tuberculosis patients were recruited from 21 health facilities from October 2018 to October 2019. Health facilities were selected by simple random sampling technique and tuberculosis cases from the health facilities were consecutively enrolled. Data were collected using structured questionnaire within the first 2 weeks of treatment initiation. Delay was categorized as patient, health system and total delays. Data were analyzed using SPSS version 21 and logistic regression was used to identify factors associated with the odds of delays to initiate treatment. A p-value of less than 0.05 was reported as statistically significant.ResultsThe median patient, health system and total delays were 30, 18 and 62 days, respectively. Rural residence, being poor, visiting non-formal medication sources, being primary health care and the private clinic had higher odds of patient delay whereas being HIV positive had lower odds of patient delay. Illiteracy, first visit to primary health care and private clinic had higher odds of health system delay whereas a visit to health facility one time and have no patient delay had lower odds of health system delay.ConclusionThe median patient delay was higher than the median health system delay before initiating treatment. Hence, improved awareness of the community and involving the informal medication sources in the tuberculosis pathways would reduce patient delay. Similarly, improved cough screening and diagnostic efficiency of the lower health facilities would shorten health system delay

Burden of lower respiratory infections in the Eastern Mediterranean Region between 1990 and 2015: findings from the Global Burden of Disease 2015 study

Mokdad AH, Moradi-Lakeh M, El Bcheraoui C, et al. Burden of lower respiratory infections in the Eastern Mediterranean Region between 1990 and 2015: findings from the Global Burden of Disease 2015 study. INTERNATIONAL JOURNAL OF PUBLIC HEALTH. 2018;63(Suppl. 1):97-108.We used data from the Global Burden of Disease 2015 study (GBD) to calculate the burden of lower respiratory infections (LRIs) in the 22 countries of the Eastern Mediterranean Region (EMR) from 1990 to 2015. We conducted a systematic analysis of mortality and morbidity data for LRI and its specific etiologic factors, including pneumococcus, Haemophilus influenzae type b, Respiratory syncytial virus, and influenza virus. We used modeling methods to estimate incidence, deaths, and disability-adjusted life-years (DALYs). We calculated burden attributable to known risk factors for LRI. In 2015, LRIs were the fourth-leading cause of DALYs, causing 11,098,243 (95% UI 9,857,095-12,396,566) DALYs and 191,114 (95% UI 170,934-210,705) deaths. The LRI DALY rates were higher than global estimates in 2015. The highest and lowest age-standardized rates of DALYs were observed in Somalia and Lebanon, respectively. Undernutrition in childhood and ambient particulate matter air pollution in the elderly were the main risk factors. Our findings call for public health strategies to reduce the level of risk factors in each age group, especially vulnerable child and elderly populations