Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

Introduction. Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method. Institutional based cross-sectional study was conducted at University of Gondar Hospital from March to May, 2017. Stool samples were taken from each participant and examined by direct microscopy and concentration technique. Descriptive statistics was performed and chi-square test was used to show the association between variables. P values of <0.05 were considered statistically significant. Results. Intestinal parasites were detected in 50 (19.6%) among a total of 256 pulmonary tuberculosis suspected patients who were included in the study, whereas the prevalence of pulmonary tuberculosis was 16.8% (43/256). Pulmonary tuberculosis and intestinal parasite coinfection was detected in 5 (2.0%) of the participants. The most prevalent intestinal parasites infection in this study was Ascaris lumbricoides, 15 (5.85%), followed by Entamoeba histolytica/dispar, 14 (5.46%), and Hookworm, 13 (5.1%). Conclusion. The prevalence of intestinal parasites and their coinfection rate with pulmonary tuberculosis among pulmonary tuberculosis suspected patients were considerable

Magnitude of Helicobacter pylori among Dyspeptic patients attending at University of Gondar Hospital, Gondar, Northwest Ethiopia

Background: Helicobacter pylori (H.pylori) infection is predominantly acquired in childhood from family members. The infection can cause dypepepsia, chronic and acute gastritis and gastric cancer. Dyspepsia is the most common illness in the Ethiopian population visiting outpatient department of health facilities, and it has also been associated with H.pylori infection. The aim of this study was to assess the magnitude of H.pylori and its associated factors among dyspeptic patients who visited University of Gondar Hospital Outpatient Department.Materials and Methods: An institutional-based cross-sectional study was conducted on 354 dyspeptic patients. A systematic random sampling technique was employed to select study participants. Data were collected by using structured questionnaire via face-to-face interview. H.pylori infection was diagnosed using stool antigen test method. The data were entered into Epi info version 3.5.3 and transferred to Statistical Package for Social Sciences version 20. Both Bivariable and  multivariable binary logistic regression analyses were performed to see the effect of independent variables on the dependent variable.Result: Of the total study participants, 201(56.8%), 195(55.1%) and 182(51.4%) were married, urban residents and females, respectively. The overall magnitude of H.pylori infection was 37.6%. In bivariable logistic regression analysis, sex and marital status were significantly associated with H.pylori infection, but in multivariable logistic regression analysis only marital status was significantly associated with H.pylori infection.Conclusion: The magnitude of H.pylori infection is high indicating that it is a public health problem in the study to area. According to this study, none of the variables were significantly associated with H.pylori infection. Hence, effective preventive, control and screening strategies need to be designed to reduce the burden of the disease.Keywords: Associated factor, Dyspepsia, Helicobacter pylor

Evaluation of Intestinal Parasite Infection in Low and High Coverage of Graduated Households, Northwest Ethiopia: A Comparative-Based Crosssectional Study

Intestinal parasite infections are widely distributed and affect various segments of the population in Ethiopia as in many developing countries. The government launched an innovative program called Health Extension Program to increase the coverage of primary health care services, mainly by producing model households using model-family training. The aim of this study was to evaluate the intestinal parasite infection in low and high coverage of graduated households. Method. A community-based crosssectional study was conducted from February to June, 2019. A total of 478 participants were enrolled in this study by using a multistage sampling technique. Data were collected by using pretested and semistructured questionnaire. Five grams of stool specimen was collected, and samples were processed using a direct wet mount and Kato Katz technique. Data were coded, entered, and cleaned using statistical package for social science (SPSS) version 20. A Chi-square test was employed to compare the two groups. P value < 0.05 were taken as statistically significant. Result. The prevalence rate of IPIs was 39% and 20.5% in LCGHH and HCGHH, respectively. A. lumbricoides was the predominant parasite, detected in 14.6% and 8.8% followed by S. mansoni 6.3% and 2.1% in LCGHH and HCGHH districts, respectively. LCGHH had significantly higher prevalence of A. lumbricoides, S. mansoni, and hookworm infections than the HCGHH district (P<0.05). Thirteen (18.8%) study participants in LCGHH and four (11.7%) in HCGHH showed heavy infection with the four common soil-transmitted helminths (A. lumbricoides, S. mansoni, hookworm, and T. trichiura). Among study participants who were positive for S. mansoni, 53.3% in LCGHH and 20% in HCGHH had heavy infection for the Kato thick smear used. Conclusion. The prevalence of IPIs is significantly higher in LCGHH than in the HCGHH district. Producing more model households by giving model family training to nonmodel households and strengthening the information, education, and communication package are crucial in the implementation of the HEP to decrease the prevalence of IPIs especially in LCGHH districts

Prevalence, Intensity, and Associated Factors of Schistosoma mansoni among School Children in Northwest Ethiopia

Background. Schistosomiasis is one of the Neglected Tropical Diseases in Ethiopia, and its burden may show variations from time to time across different regions. Thus, this study was aimed at determining the prevalence, intensity, and associated risk factors of Schistosoma mansoni (S. mansoni) among schoolchildren in Northwest Ethiopia. Methods. A school-based cross-sectional study was conducted. A multistage sampling technique was used to select the study participants. Stool specimens were collected and examined using two-slide Kato-Katz method. Data were analyzed using SPSS version 20 software. Multivariate logistic regression analysis was used to identify risk factors. p values less than 0.05 were taken as statistically significant. Result. A total of 786 schoolchildren were participated in this study. The prevalence of S. mansoni was 33.5%. The mean egg count of the parasite among the infected study participants was 523.665 eggs per gram (epg) of stool. Thirty-seven, 42, and 21 percent of the study participant’s infection were due to light, moderate, and heavy infection intensities, respectively. Age of 8-11 years old (AOR=1,687, 95%CI=1.163,2.892), 5th-8th grade level (AOR=2.280, 95%CI=1.348,3.856), residing in Chuahit District (AOR=95.559, 95%CI=12.945,705.419), and using untreated water for domestic supply (AOR=1.724, 95%CI=1.457,2.148) were found to be risk factors for S. mansoni infection. Conclusion. High prevalence of S. mansoni and relatively higher proportion of moderate intensity of infection in this study imply that schistosomiasis is still one of the major public health problems in Northwest Ethiopia. It is also highlighted that study sites, provision of water supply, age, and grade level of the schoolchildren were identified as a risk factors for the disease

Schistosoma mansoni and soil-transmitted helminths among preschool-aged children in Chuahit, Dembia district, Northwest Ethiopia: prevalence, intensity of infection and associated risk factors

Abstract Background Intestinal schistosomiasis and soil-transmitted helminthiasis are the major public health problems globally. Compared with any other age group, pre-school aged children and school-aged children are the most exposed. There are few studies showing the burden of intestinal schistosomiasis, and soil-transmitted helminthiasis among pre-school aged children in Ethiopia. Hence, this study aimed to assess the prevalence of schistosoma mansoni and soil-transmitted helminths and associated risk factors among preschool aged children of Chuahit and surrounding Kebeles, Northwest Ethiopia. Methods A community based cross sectional study was conducted from February 2 to March 27 2015. Four hundred one preschool-aged children were included in the study by using two stage cluster sampling technique. Pretested structured questionnaire was employed to collected data via face-to-face interview technique. A single stool specimen was collected, and a portion of the sample was processed by Kato Katz method. Results Of the total children, 141 (35.2 %) harbored one or more intestinal helminthes. Schistosoma mansoni was found in 45 (11.2 %) of preschool age children. Ascaris lumbricoides was the predominant isolate, 77 (19.2 %) followed by S. mansoni, 45 (11.2 %). The least parasites isolated were Tania species, 2 (0.5 %). After adjusting for other variables, being mothers who did not have the habit of washing hands after toilet (AOR = 7.3, 95%CI: 2.97–17.95), being occupationally housewife mothers (AOR = 8.9, 95%CI: 2.27–25.4), using protected spring water as a main family source of water (AOR = 3.9, 95%CI: 1.2–12.3) and child habit of not wearing shoe (AOR = 1.91, 95%CI: 1.01–3.64) were significantly associated with high prevalence of soil-transmitted helminthiasis among preschool-age children in Chuahit. Conclusion The current study showed that relatively higher level of STH and S. mansoni among preschool-aged children in Chuahit. This finding calls for a need of public health education, promotion of women education and provision of safe water to reduce the burden of soil-transmitted intestinal helminthiasis and schistosomiaisis

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

Background. Malaria is one of the most public health important and life-threatening parasitic infections caused by the protozoan parasite. Since children are immunologically naive to the malaria parasite, they are the main vulnerable groups. During malaria infection, they might have a complication of anemia, cerebral malaria, coma, respiratory distress, and a decrease in cognitive and behavioral improvement. Therefore, this review was aimed at determining the pooled prevalence of malaria among children in Ethiopia. Methods. The current systematic review and meta-analysis were conducted based on the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline. Electronic bibliographic databases such as Google Scholar, PubMed, and Science Direct were used for searching relevant literature. Besides, the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. Using the STATA 14 software, the pooled Meta logistic regression was computed to present the pooled prevalence with a 95% confidence interval (CI). Result. The overall estimated pooled prevalence of malaria among children in Ethiopia was 9.07 (95% CI: 6.32, 11.82). Subgroup analysis based on malaria signs and symptoms showed that the pooled prevalence of malaria among asymptomatic and symptomatic children was 6.67% (95% CI: 0.36, 12.98) and 27.17% (95% CI: 18.59, 35.76), respectively. Conclusion. The findings revealed a high prevalence of malaria among children in Ethiopia. As a result, still there is a need of improving and rechecking the existing malaria prevention and control measures of the country

The Prevalence of Intestinal Parasites and Their Associated Factors among Diabetes Mellitus Patients at the University of Gondar Referral Hospital, Northwest Ethiopia

Background. Worldwide, more than one-sixth of the population is infected by intestinal parasites, of which the majority live in developing countries. On the other hand, the prevalence of diabetes mellitus has been increasing over recent decades in developing countries. Patients with diabetes mellitus encountered impaired immunity and suffer from the consequences of infection particularly intestinal parasitic infection. Objective. This study is aimed at assessing the prevalence of intestinal parasites and associated factors among diabetes mellitus patients at the University of Gondar Referral Hospital, Northwest Ethiopia. Methods and Materials. An institutional-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Referral Hospital from February 15 to March 30, 2018. A total of 234 diabetes mellitus patients were enrolled. A systematic random sampling technique was used to select study participants. Sociodemographic and clinical data were collected using a semistructured questionnaire. A 5-gram stool sample was collected to identify parasitic infection using a direct wet mount and formal-ether concentration technique. Data was entered and analyzed by using SPSS version 20. A p value of ≤0.05 was considered as statistically significant. Result. In the current study, the overall prevalence of intestinal parasite infection among diabetics was 45 (19.2%). The parasites identified in this study were Ascaris lumbricoides 15 (6.41%), Entamoeba histolytica/dispar 9 (3.85%), Hookworm 9 (3.85%), Schistosoma mansoni 7 (3%), Enterobius vermicularis 3 (1.3%), and Giardia lamblia 2 (0.9%). Poor educational background (AOR=3.62; 95% CI (1.038, 12.65); p=0.043), poor hygiene and sanitation (AOR=4.67; 95% CI (1.82, 12.07); p=0.001), and inappropriate latrine usage (AOR=5.41; 95% CI (1.43, 20.56); p=0.013) were significantly associated with the prevalence of intestinal parasitic infection among diabetes mellitus patients. Conclusion. The overall prevalence of intestinal parasitic infection among diabetes mellitus patients was relatively high. There should be continued prevention, control, and management of intestinal parasitic infection in such a study population

Malaria Parasitemia in Febrile Patients Mono- and Coinfected with Soil-Transmitted Helminthiasis Attending Sanja Hospital, Northwest Ethiopia

Background. Malaria is a life-threatening disease associated with high morbidity and mortality. Helminths are among the most widespread infectious agents prevalent in tropical and subtropical regions of the developing world. Malaria and soil-transmitted helminthiasis (STHs) are coendemic and major public health problems in Ethiopia. The effects of helminth coinfection on malaria parasitemia remained poorly understood. Therefore, the objective of this study was to assess malaria parasitemia among malaria-monoinfected and malaria-soil-transmitted helminthiasis–coinfected febrile patients attending Sanja Hospital, Northwest Ethiopia. Methods. A cross-sectional study with parallel groups was conducted to assess malaria parasitemia among malaria-monoinfected and malaria-soil-transmitted helminthiasis–coinfected febrile patients in Sanja Hospital from January to March 2019. Double population proportion formula was used for sample size calculation, and convenient sampling technique was used to select 134 study participants. Data were entered and analyzed by using the Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics, independent t-test, and one-way analysis of variance (ANOVA) were performed. A P value of <0.05 was considered as statistically significant. Results. From 134 malaria-positive study participants, 67 were malaria-monoinfected and 67 were malaria-STHs–coinfected patients. Out of 67 malaria STHs-coinfected patients, 54 (80.6%) were infected with hookworm followed by Ascaris lumbricoides 11 (16.4%) and Strongyloides stercoralis 2 (3%). The mean Plasmodium parasite density was significantly higher in malaria-STHs–coinfected patients than in patients infected with only Plasmodium parasites (P=0.027). The intensities of hookworm infection showed a positive association with Plasmodium parasite densities (F=6.953, P=0.002). Conclusions. Infections with STHs, especially hookworm, were positively associated with Plasmodium parasite density. The current study finding also revealed that increased worm burden of hookworm as expressed by egg intensity had significantly increased Plasmodium parasite density

A 7-Year Trend of Malaria at Primary Health Facilities in Northwest Ethiopia

Background. Malaria is a severe parasitic disease that can progress to complications of the nervous system, respiratory distress, renal problems, metabolic acidosis, and hypoglycemia which can result in death in case of delay or absence of appropriate treatment. Even though health service facilities and vector control strategy in the community are implemented as control measures, variations in temperature and rainfall that can affect the life cycle of parasite are among the factors of malaria prevalence over the years. The aim of this trend analysis was to assess the prevalence and the impact of malaria over the seasons and years. Methods. A cross-sectional study using retrospective information was conducted at two health centers Gorgora and Chuahit in Dembia district. The data was collected from lab logbooks routinely diagnosed and registered for seven years. A systematic sampling technique was used by taking patient results from lab logbooks during the first ten days of every month. Data were entered directly into the EpiData Entry software version 3.1 and analysed with the SPSS software version 20. Moreover, a chi-square test with a level of significance set at less than 5% was used. Results. From a total of 11,879 clients that participated, 56.6% were males. The overall malaria prevalence in the last seven years was 21.8%, and the dominant parasite was P. falciparum which accounted for 15.6% of the participants which was threefold higher than P. vivax in the seven-year trend. Moreover, at Gorgora health center, the prevalence which was 15% at the beginning of the study (2012) rose to 33.9% and 30.5% in 2017 and 2018, respectively. In the analysis of the seven years, October and September in which the prevalence of malaria was 32.6% and 27.2%, respectively, constituted the peak months. High malaria prevalence was observed in autumn (September to November) season, and the least was observed in spring (March to May) with the prevalence of (17.8%) (p≤0.001). Malaria attack showed significant variability among different age groups, and the age group 15-29 and males were the most affected (p≤0.001). Conclusion. In this study, malaria transmission remained high, which affected males more than females. Thus, appropriate season-based bed net use, health education, immediate patient treatment, and stagnant water drainage methods are needed to alleviate the problem