Cogan’s anterior internuclear ophthalmoplegia in young Ethiopian: A case report and review of literature

Introduction: Lesions in medial longitudinal fasciculus (MLF) produce internuclear ophthalmoplegia (INO) with characteristic horizontal gaze abnormality. Here, the author reports a rare clinical spectrum of internuclear ophthalmoplegia called Cogan’s anterior internuclear ophthalmoplegia in young Ethiopian suspected to have multiple sclerosis. To the best of the author’s knowledge, this is the first report in non-white population near the equator.Case presentation: A 19-year-old female Ethiopian patient presented with bilateral internuclear ophthalmoplegia. Attempted convergence was abnormal. The patient regained normal ocular mobility after six months of follow-up.Conclusion: Isolated reversible internuclear ophthalmoplegia in a previously healthy young patient could be an initial manifestation of a serious illness like multiple sclerosis. Though the incidence of multiple sclerosis in non-white population near the equator is low, high index of suspicion and close follow up are warranted.KEYWORDS Medial longitudinal fasciculus lesion; Internuclear ophthalmoplegia; Horizontal gaze abnormality; Multiple sclerosi

Ocular morbidity among refugees in southwest Ethiopia

Background: Low vision and blindness are recognized as one of the major  public health problems worldwide, especially in developing countries. The prevalence and cause of blindness and low vision vary from region to region, among different age and population groups in a country or  geographical region. The objective of this study is thus to determine the causes of blindness and ocular morbidity among refugees in Southwest Ethiopia.Methods: A cross-sectional clinic based study was conducted on 1,054 refugees in Southwest Ethiopia. A basic anterior and posterior segment examination was done by ophthalmologists with Magnifying Loupe 2.5X and Direct Ophthalmoscope. Data were analyzed using SPSS version 16.0.Results: The most common causes of ocular morbidity identified were trachoma 547(21.2%), cataract 501(19.4%), refractive error 353(13.7%), conjunctivitis 240(9.3%), glaucoma 130(5.1%) and climatic droplet keratopathy 112(4.4%). The overall prevalence of blindness was 26.2% and the prevalence of childhood blindness was 0.7%. The prevalence was higher among females (16.9%) than males (9.3%) and age groups 60 years and above (15.9%) than other age groups (10.3%) (P<0.05). The overall prevalence of low vision was 25.8% and the prevalence of low vision in pediatric age group was 0.9%. The leading causes of blindness were cataract 112(40.6%), trachomatous corneal opacity 58(21.0%) and glaucoma 49(17.8%). The commonest cause of low vision was cataract 102(37.6%) followed by trachomatous corneal opacity 49(18.1%) and refractive error 35(12.9%).Conclusions: There is a very high burden of blinding eye diseases among refugees. Integrated multidisciplinary intervention strategies for the  prevention and control of blindness and low vision in the study settings should be initiated.Key words: Blindness, low vision, ocular morbidity, refugees, Ethiopi

Rapid trachoma assessment in Kersa District, Southwest Ethiopia

Background: Trachoma is the leading cause of infectious blindness worldwide. Though trachoma can be treated with antibiotics (active trachoma) or surgery (trachomatous trichiasis), it is still endemic in most parts of Ethiopia. Despite the prevalence of this infectious disease in different parts of the country, district level data is lacking. This study was thus conducted to assess the prevalence estimate of trachoma and its risk factors in Kersa District, Southwest Ethiopia.Methods: A community based cross sectional Rapid Assessment of Trachoma was conducted using a WHO guideline. Six sub-districts were selected from Kersa District based on primary high risk assessment and from each sub-district; 21-27 households were randomly selected. Active trachoma for children aged 1-9 years, trachomatous trichiasis for people above 15 years old and environmental risk factors for trachoma were assessed. Data were analyzed using SPSS version 16.Results: The overall prevalence estimate of active trachoma was 25.2% (95% CI: 20.7-30.4%). Forty three percent of children had unclean faces, 11.5% of households had water source at more than half hour walking distance, 18.2% did not have functional latrine, and 95.3% of the households had solid waste disposal within a distance of 20 meters. Households with environmental risk factors were at an increased risk to active trachoma, but the association was not statistically significant (p>0.05). The prevalence estimate of trachomatous trichiasis inclusive of “trachoma suspects” was 4.5%.Conclusion: Trachoma is endemic in Kersa District with active trachoma being a public health problem in the studied sub-districts. Hence, SAFE strategy should be implemented.Keywords: Trachoma, Trichiasis, Preventable blindness, SAFE strateg

Bacterial isolates and their antimicrobial susceptibility pattern among patients with external ocular infections at Borumeda hospital, Northeast Ethiopia

Background: Bacteria are major cause of ocular infections and possible loss of vision. The emergence of antimicrobial resistant bacteria increases the risk of treatment failure with potentially serious consequences. The aim of this study was to determine the prevalence of bacterial isolates and their antimicrobial susceptibility pattern among patients with external ocular infections. Methods: A cross sectional study was conducted among 160 patients with external ocular infections at Borumeda hospital, Northeast Ethiopia. Socio-demographic and clinical data were collected using structured questionnaire. External ocular specimens were collected using sterile swabs and inoculated on MacConkey agar, Chocolate agar and Blood agar culture Medias. Presumptive isolates were further identified by a series of biochemical tests. The antimicrobial susceptibility patterns of the isolates were determined by disk diffusion method. Result: The overall prevalence of bacterial pathogens among external ocular samples was 59.4 %. The majority of the isolates (93.7 %; 89/95) were Gram positive and the other 6.3 % (6/95) Gram negative bacteria. The proportion of coagulase negative Staphylococci among the Gram positive bacterial isolates was 53.7 % (n = 51/95). All Gram positive isolates were susceptible for vancomycin but 67.4 % (n = 60/95) of them were resistant against amoxicillin. Moreover, drug resistance to tetracycline, norfloxacylin, ceftriaxone and ciprofloxacin were observed among Gram negative bacteria isolates. Conclusion: The prevalence of bacterial pathogens among external ocular samples was high and the predominant isolate was coagulase negative Staphylococci. Exceptionally high amoxicillin resistance was observed among Gram positive bacterial isolates that may dictate to conduct drug susceptibility test routinely.Birtukan Shiferaw, Baye GelawEmail author, Abate Assefa, Yared Assefa and Zelalem Addi

High-density DArTSeq SNP markers revealed wide genetic diversity and structured population in common bean (Phaseolus vulgaris L.) germplasm in Ethiopia

Abstract Introduction Common bean is one of the widely consumed food security crop in Africa, Asia, and South America. Understanding genetic diversity and population structure is crucial for designing breeding strategies. Materials Two hundred and eighty-nine germplasm were recently collected from different regions of Ethiopia and introduced from CIAT to estimate genetic diversity and population structure using 11,480 DArTSeq SNP markers. Results The overall mean genetic diversity and polymorphic information content (PIC) were 0.38 and 0.30, respectively, suggested the presence of adequate genetic diversity among the genotypes. Among the geographical regions, landraces collected from Oromia showed the highest diversity (0.39) and PIC (0.30). The highest genetic distance was observed between genotypes collected from SNNPR and CIAT (0.49). In addition, genotypes from CIAT were genetically more related to improved varieties than the landraces which could be due to sharing of parents in the improvement process. The analysis of molecular variance revealed that the largest proportion of variation was due to within the population both in geographical region (63.67%) and breeding status (61.3%) based classification. Model-based structure analysis delineated the 289 common bean genotypes into six hypothetical ancestoral populations. Conclusions The genotypes were not clustered based on geographical regions and they were not the main drivers for the differentiation. This indicated that selection of the parental lines should be based on systematic assessment of the diversity rather than geographical distance. This article provides new insights into the genetic diversity and population structure of common bean for association studies, designing effective collection and conservation for efficient utilization for the improvement of the crop

Socio-demographic correlates of unhealthy lifestyle in Ethiopia: a secondary analysis of a national survey

Background: Multiple lifestyle risk factors exhibit a stronger association with non-communicable diseases (NCDs) compared to a single factor, emphasizing the necessity of considering them collectively. By integrating these major lifestyle risk factors, we can identify individuals with an overall unhealthy lifestyle, which facilitates the provision of targeted interventions for those at signifcant risk of NCDs. The aim of this study was to evaluate the socio-demographic correlates of unhealthy lifestyles among adolescents and adults in Ethiopia. Methods: A national cross-sectional survey, based on the World Health Organization’s NCD STEPS instruments, was conducted in Ethiopia. The survey, carried out in 2015, involved a total of 9,800 participants aged between 15 and 69 years. Lifestyle health scores, ranging from 0 (most healthy) to 5 (most unhealthy), were derived considering factors such as daily fruit and vegetable consumption, smoking status, prevalence of overweight/obesity, alcohol intake, and levels of physical activity. An unhealthy lifestyle was defned as the co-occurrence of three or more unhealthy behaviors. To determine the association of socio-demographic factors with unhealthy lifestyles, multivariable logistic regression models were utilized, adjusting for metabolic factors, specifcally diabetes and high blood pressure. Results: Approximately one in eight participants (16.7%) exhibited three or more unhealthy lifestyle behaviors, which included low fruit/vegetable consumption (98.2%), tobacco use (5.4%), excessive alcohol intake (15%), inadequate physical activity (66%), and obesity (2.3%). Factors such as male sex, urban residency, older age, being married or in a common-law relationship, and a higher income were associated with these unhealthy lifestyles. On the other hand, a higher educational status was associated with lower odds of these behaviors. Conclusion: In our analysis, we observed a higher prevalence of concurrent unhealthy lifestyles. Socio-demographic characteristics, such as sex, age, marital status, residence, income, and education, were found to correlate with individuals’ lifestyles. Consequently, tailored interventions are imperative to mitigate the burden of unhealthy lifestyles in Ethiopia.Yalemzewod Assefa Gelaw, Digsu N. Koye, Kefyalew Addis Alene, Kedir Y. Ahmed, Yibeltal Assefa, Daniel Asfaw Erku, Henok Getachew Tegegn, Azeb Gebresilassie Tesema, Berihun Megabiaw Zeleke, and Yohannes Adama Melak

High seroprevalence of anti-SARS-CoV-2 antibodies among Ethiopian healthcare workers

BACKGROUND: COVID-19 pandemic has a devastating impact on the economies and health care system of sub-Saharan Africa. Healthcare workers (HWs), the main actors of the health system, are at higher risk because of their occupation. Serology-based estimates of SARS-CoV-2 infection among HWs represent a measure of HWs' exposure to the virus and could be used as a guide to the prevalence of SARS-CoV-2 in the community and valuable in combating COVID-19. This information is currently lacking in Ethiopia and other African countries. This study aimed to develop an in-house antibody testing assay, assess the prevalence of SARS-CoV-2 antibodies among Ethiopian high-risk frontline HWs. METHODS: We developed and validated an in-house Enzyme-Linked Immunosorbent Assay (ELISA) for specific detection of anti-SARS-CoV-2 receptor binding domain immunoglobin G (IgG) antibodies. We then used this assay to assess the seroprevalence among HWs in five public hospitals located in different geographic regions of Ethiopia. From consenting HWs, blood samples were collected between December 2020 and February 2021, the period between the two peaks of COVID-19 in Ethiopia. Socio-demographic and clinical data were collected using questionnaire-based interviews. Descriptive statistics and bivariate and multivariate logistic regression were used to determine the overall and post-stratified seroprevalence and the association between seropositivity and potential risk factors. RESULTS: Our successfully developed in-house assay sensitivity was 100% in serum samples collected 2- weeks after the first onset of symptoms whereas its specificity in pre-COVID-19 pandemic sera was 97.7%. Using this assay, we analyzed a total of 1997 sera collected from HWs. Of 1997 HWs who provided a blood sample, and demographic and clinical data, 51.7% were females, 74.0% had no symptoms compatible with COVID-19, and 29.0% had a history of contact with suspected or confirmed patients with SARS-CoV-2 infection. The overall seroprevalence was 39.6%. The lowest (24.5%) and the highest (48.0%) seroprevalence rates were found in Hiwot Fana Specialized Hospital in Harar and ALERT Hospital in Addis Ababa, respectively. Of the 821 seropositive HWs, 224(27.3%) of them had a history of symptoms consistent with COVID-19 while 436 (> 53%) of them had no contact with COVID-19 cases as well as no history of COVID-19 like symptoms. A history of close contact with suspected/confirmed COVID-19 cases is associated with seropositivity (Adjusted Odds Ratio (AOR) = 1.4, 95% CI 1.1-1.8; p = 0.015). CONCLUSION: High SARS-CoV-2 seroprevalence levels were observed in the five Ethiopian hospitals. These findings highlight the significant burden of asymptomatic infection in Ethiopia and may reflect the scale of transmission in the general population

Pursuing climate resilient coffee in Ethiopia – a critical review

This paper provides a multi-scalar examination of the Ethiopian coffee sector and its pursuit of climate resilience. Concern is growing about the potential impact of climate change on Arabica coffee in Ethiopia and the 25 million livelihoods it supports. Arabica coffee has a relatively narrow envelope of climatic suitability and recent studies suggest that the area of bioclimatically suitable space for the species in its native Ethiopia could decline dra- matically in the coming decades. We adopt a critical perspective on resilience that reflects on the situated nature of the ecology/science of coffee and climate change and the operation of social, economic, and discursive power across scales, paying particular attention to the differentiated impacts of climate change and associated resi- lience strategies. This analysis begins by reviewing Ethiopia’s Climate Resilient Green Economy strategy and argues that the current lack of attention to coffee is inappropriate considering the coffee sector’s vulnerability to climate change, economic importance and association with forests. The paper then examines the contemporary coffee sector which provides the context for reflecting on three potential responses to the threat climate change poses; a spatial response from farmers, adaptive farm management responses such as changing shade levels and the development of the country’s genetic resources to cultivate improved varieties. The analysis explores the disconnect between the interventions emerging from national and international institutions and the local con- text. The multi-scale approach highlights the presence of complex normative trade-offs associated with pursing climate resilience strategies and reinforces the importance of appreciating the dynamics which influence deci- sion-making in the country