Bacterial profile and antimicrobial susceptibility pattern of neonatal sepsis in Felege-Hiwot Referral Hospital, Bahir Dar, northwest Ethiopia: A cross-sectional study design

AbstractBackground: Neonatal sepsis is a life-threatening medical condition that occurs when host and pathogen interaction leads to organ/tissue damage. Determining the bacterial profile and the antimicrobial susceptibility pattern, and associated factors, in certain geographic regions is vital for rapid empirical medical decisions.Objective: To assess the bacterial profile, antimicrobial susceptibility pattern, and factors associated with neonatal sepsis, in Felege-Hiwot Referral Hospital, Ethiopia.Methods: A facility-based cross-sectional study was conducted from April 2018 to July 2018. A total of 412 neonates were included in the study. Socio-demographic and clinical data were collected using a structured and pre-tested questionnaire. About 2ml of blood sample was withdrawn from each participant, and processed for bacterial identification and susceptibility testing, following 2017 Clinical and Laboratory Standards Institute guidelines. Data were analysed using Statistical Package for the Social Sciences version 23. Logistic regressions were used to determine the association between independent variables and dependent variables in relation to bacterial profiles and antimicrobial susceptibility patterns. Odds ratios, and their 95% confidence intervals, were calculated, and the results were considered statistically significant at a p-value less than 0.05.Results: Of the 412 neonates who were enrolled, 41.3% (170/412) were positive for blood culture. Klebsiella pneumoniae, 28.2% (48/170) was the predominant isolate, followed by Staphylococcus aureus, 24.7% (42/170). The majority of the isolates developed resistance to ampicillin and penicillin. The overall proportion of multidrug resistance was 78.2% (133/170). Preterm (<37 weeks) [AOR = 2.049; 95% CI: 1.151, 3.647], low birth weight (<2,500gm) [AOR = 2.357; 95% CI: 1.352, 4.109], prolonged rupture of membrane (≥18 hours) [AOR = 4.282; 95% CIL: 1.615, 11.354], and caesarean section modes of delivery [AOR = 2.826; 95% CI: 1.618, 4.936] showed statistical association with bacteriologically confirmed neonatal sepsis.Conclusions: The majority (78.2%) of presumptive neonatal sepsis cases tested positive for blood culture. Klebsiella pneumoniae and Staphylococcus aureus were the leading isolates recovered from neonatal sepsis cases. Most of the bacterial isolates from NS cases were resistant to multiple classes of antibiotic. Auspiciously, majority of these isolates were susceptible to ciprofloxacin; as such this replication inhibitor antibiotic could be a choice of physicians for empirical treatment decision. Since it is a single facility based study, further study is recommended. [Ethiop. J. Health Dev. 2021; 35(1):18-28]Key words: Bacteria; neonate; early-onset neonatal sepsis; late-onset neonatal sepsi

The Impact of Climate Change and Variability on Africa's Renewable Energy Development :A Hybrid Uncertainty Approach

This dissertation presents advanced methods that could be used to assess various impact of climate change to hydropower and reliability assessment of wind resource using alternative reservoir operation that maximizes the firm generation of integrated wind and hydropower. The first component of this study introduces a hybrid approach of risk based climate change impact assessment. This method combines uncertainties in historical climate variability with uncertainties in climate predictions to conduct more comprehensive climate change impact assessment on hydropower. Results from this study, illustrated in Zambezi and Congo River basins, indicate that the single basecase approach of delta-change technique substantially underestimates the potential impact of climate change. Particularly, assessments for water resource systems in areas with high natural hydroclimatic variability the combined effect natural variability and climate change is more pronounced. The second component utilizes the concept of Empirical Orthogonal Functions (EOFs) analysis technique to access the join spatio-temporal patterns of interannual variability hydropower generation between different power pools in Africa. EOF analysis of annual streamflow and hydropower generation was carried out followed by investigation of the resulting dominant spatial patterns to identify locations of existing and future potential hydropower sites which indicate a homogeneous or a heterogeneous pattern of variability. Results indicated a distinct out-of-phase pattern of variability between Southern and West African Power pools. Furthermore, the method was extended to conducted potential impact of climate change induced change in inter-annual variability. The third component presents a reliability assessment method of wind-hydropower integration. A water resources model combined with a single node power grid system model accompanied by a genetic algorithm solver is implemented to determine optimum operation strategy for each storage reservoir aiming at maximizing the 90th percentile power generation over the entire simulation period. This model is tested on the hydropower system in the Zambezi basin to demonstrate how storage reservoirs could be used to offset wind power intermittence in South Africa. Results show an increased level of wind penetration, a reduced level of coal power utilization and less cycling requirement in power system as a result of better regulation that is achieved through the combined operation.</p

Methicillin-resistant Staphylococcus aureus with genotyping method among human immunodeficiency virus positive pediatric patients in Northwest Ethiopia: A cross-sectional study design

Abstract Background: Increasing evidence suggests that methicillin-resistant Staphylococcus aureus (MRSA) infections are becoming more prevalent throughout the human immunodeficiency virus (HIV) infected community. However, there is scarcity of data about the prevalence of MRSA among HIV positive pediatric patients in the study area. Objectives: To determine the prevalence and types of MRSA among S. aureus isolates of HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia. Methods: Pediatric patients who attended the clinic from December 2013 to April 2014 were included in the study. Genotype MRSA VER 3.0 was used for characterization of S. aureus isolates. This detected methicillin-resistance-mediating mecA and mecC genes and the bicomponent cytotoxic virulence factor Panton–Valentine leukocidin (PVL). Data were analyzed using SPSS version 20. Results: Among 126 S. aureus isolates, 37.3% and 11.9% were mecA and Panton–Valentine leukocidin gene positive, respectively. Patients of FHRH (P = 0.04) and DRH (P = 0.02) have statistical significance for mecA gene. Panton–Valentine leukocidin gene positive strains were about 97% less likelihood to be mecA gene positive (P = 0.001). Conclusion: A high prevalence of pathogenic MRSA strains among HIV positive pediatric patients was observed. Most of the MRSA types were hospital acquired. Hence, strict hygienic approaches by healthcare workers in hospitals should be implemented. In addition, screening and treatment of MRSA for HIV positive pediatric patients is recommended. [Ethiop. J. Health Dev. 2018;32(3):00-000] Key words: MRSA, pediatrics, HIV, Ethiopi

Assessment of core teaching competency of health professional educators in Ethiopia:an institution-based cross-sectional study

OBJECTIVES: Understanding the competency of educators is key to informing faculty development, recruitment and performance monitoring. This study aimed to assess the core teaching competency of nursing, midwifery and biomedical educators, and associated factors in Ethiopia. DESIGN: An institution-based cross-sectional study was conducted in January 2020 using structured tools adapted from the WHO’s nurse and midwifery educator competency frameworks. SETTING: Two health science colleges and nine student practice sites in Ethiopia. PARTICIPANTS: All classroom instructors and clinical preceptors of nursing, midwifery and biomedical technician training programmes, and all the graduating class students. MEASURES: Overall teaching competency scores, teaching domain competency scores, competency gaps and performance gaps of educators were outcome measures. Past training on teaching skills courses, teaching experiences and sociodemographic characteristics of educators are associated factors. RESULTS: Most educators were not trained in teaching methods (82%). The teaching competency scores of classroom instructors and clinical preceptors were 61.1% and 52.5%, respectively. Competency gaps were found in using active learning methods, performance assessment, feedback and digital learning. Professional background of classroom instructors had a significant and strong association with their competency score (p=0.004; V=0.507). Age and teaching experience of clinical preceptors had significant associations with their competency score (p=0.023 and p=0.007, respectively) and had strong associations (V=0.280 and 0.323, respectively). Sex of students and their perceptions of how well the educators give education resources had a significant and strong association (p<0.001; V=0.429). CONCLUSIONS: Nursing, midwifery and biomedical educators lacked the competency to undertake important teaching roles, which could contribute to the low quality of education. More attention should be given to strengthening faculty development

Rubella virus sero-prevalence and associated factors among non-vaccinated pregnant women in Northwest Ethiopia

Abstract Background: Rubella virus infection during pregnancy is associated with adverse fetal outcomes and reproductive failures. In Ethiopia, little is known about the extent of the disease and rubella vaccination is not widely available. The main aim of this study was to assess the sero-prevalence of the rubella virus infection and its associated risk factors among pregnant women. Methods: An institution based cross-sectional study was conducted in the antenatal clinics of Debre Markos and Debre Tabor hospitals of Amhara Region, Northwest Ethiopia from March to June2015. Study participants were recruited until the calculated sample size was achieved at both hospitals. Data on socio-demographic and factors associated with rubella virus infection were collected through a structured questionnaire. A 5ml blood sample was also collected from all study participants and tested for Immunoglobulin (Ig) G and IgM antibodies against rubella virus infection using enzyme immune assay (EIA) test at the Amhara Regional Health Research Laboratory Center, Bahir Dar. Data were analyzed using SPSS version 21 and frequencies, chi-square tests and Odds ratio were computed using a p value &lt; 0.05 as a level of significance. Result: A total of 401 pregnant mothers were screened for rubella virus infection. The mean age of the study participants was 26.4 year (SD= 5.4) and the overall sero-prevalence of rubella anti-IgG was 46.4%. In connection, the sero-prevalence of anti-IgM among anti-IgG sero-positive cases was 3.2%. Pregnant women at first trimester (OR=2.49, 95% CI= 1.14-5.42) and HIV sero-status (OR= 0.33, 95% CI= 0.15-0.76) were factors found to be significantly associated with rubella anti-IgG sero-prevalence (p&lt;0.05). Conclusion: The sero-prevalence of rubella virus infection among pregnant women was considered to be low, showing the high risk of a new infection. In addition to a comprehensive surveillance approach and efforts to determine rubella susceptibility profile among school-aged girls and women of childbearing age, it is also important to consider rubella vaccine in a national vaccination program. [Ethiop. J. Health Dev. 2018;32(3):00-000] Keywords: Rubella virus, unvaccinated, sero-prevalence, pregnant women, risk factors, Ethiopi

Perbandingan Performa Algoritma Minimax Dengan Optimasi MTD(f) dan Optimasi Alpha Beta Pruning Pada Permainan Nine Men’s Morris

Implementasi algoritma dari pemanfaatan teknologi dapat diterapkan pada suatu permainan. Algoritma Minimax, MTD(f) dan Alpha Beta Pruning merupakan algoritma yang dapat diterapkan pada sebuah permainan.Permainan yang akan diterapkan algoritma merupakan permainan Nine Men’s Morris. Nine Men’s Morris merupakan permainan papan strategi yang dapat dimainkan oleh dua orang pemain yang memiliki 18 buah bidak dan 24 titik untuk meletakkan bidak pada papan permainan. Algoritma Minimax biasanya digunakan untuk menentukan langkah terbaik dalam sebuah permainan, algoritma MTD(f) dan Alpha Beta Pruning digunakan sebagai optimasi dari pencarian langkah tersebut. Tujuan dari penelitian ini adalah untuk membandingkan performa algoritma Minimax optimasi MTD(f) dan Minimax optimasi Alpha Beta Pruning pada permainan Nine Men’s Morris sebagai lawan dari pemain, sehingga komputer dapat mengambil langkah dan strategi dalam permainan. Jadi pokok permasalahan dalam penelitian ini adalah untuk mengetahui performa dari algoritma Minimax optimasi MTD(f) dan Minimax optimasi Alpha Beta Pruning pada permainan Nine Men’s Morris dengan parameter perbandingan waktu respon dan jumlah node. Metodologi yang digunakan adalah metodologi prototyping. Berdasarkan hasil pengujian menunjukkan bahwa algoritma Minimax dengan optimasi MTD(f) menghasilkan waktu respon yang lebih singkat dan jumlah node yang lebih sedikit jika dibandingkan dengan algoritma Minimax dengan optimasi Alpha Beta Pruning

Menstrual hygiene practice among adolescent girls in Ethiopia : a systematic review and meta-analysis

Adolescent girls face several challenges relating to menstruation and its proper management. Lack of adequate sanitary products, inadequate water supply, and privacy for changing sanitary pads continue to leave adolescent girls with limited options for safe and proper menstrual hygiene in many low-income settings, including Ethiopia. These situations are also compounded by societal myths, stigmas surrounding menstruation, and discriminatory social norms. This systematic review and meta-analysis aimed to estimate the pooled proportion of safe menstrual hygiene management among adolescent girls in Ethiopia using the available studies. Methods We searched PubMed, Google Scholar, African Journal Online (AJOL), Hinari, Science Direct, ProQuest, Direct of Open Access Journals, POPLINE, and Cochrane Library database inception to May 31, 2021. Studies reporting the proportion of menstrual hygiene management among adolescent girls in Ethiopia were considered. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. Since the included studies revealed considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled proportion of menstrual hygiene management (MHM). Results Of 1,045 identified articles, 22 studies were eligible for analysis (n = 12,330 participants). The pooled proportion (PP) of safe MHM in Ethiopia was 52.69% (95%CI: 44.16, 61.22). The use of commercial menstrual absorbents was common 64.63% (95%CI: 55.32, 73.93, I2 99.2%) followed by homemade cloth 53.03% (95%CI: 22.29, 83.77, I2 99.2%). Disposal of absorbent material into the latrine was the most common practice in Ethiopia 62.18% (95% CI: 52.87, 71.49, I2 98.7%). One in four girls reported missing one or more school days during menstruation (PP: 32.03%, 95%CI: 22.65%, 41.40%, I2 98.2%). Conclusion This study revealed that only half of the adolescent girls in Ethiopia had safe MHM practices. To ensure that girls in Ethiopia can manage menstruation hygienically and with dignity, strong gender-specific water, sanitation, and hygiene (WASH) facilities along with strong awareness creation activities at every level are needed

Drug resistance patterns of bacterial isolates from infected wounds at Bahir Dar Regional Health Research Laboratory Center, Northwest Ethiopia

Background: An increased antibiotic resistance of bacterial isolates from wound infections is a major therapeutic challenge. The aim of this study was to identify bacterial isolates associated with wound infection and to determine their current antimicrobial susceptibility profile.Methods: This is a retrospective cross-sectional study in which we analyzed the records of 380 wound swab culture results that have been processed at Bahir Dar Regional Health Research Laboratory Center in the period of 1 January 2013 to 30 December 2015. Swabs from different wound types were collected aseptically and analyzed using standard bacteriological procedures. Antimicrobial susceptibility testing was performed using disc diffusion technique as per the standard protocol. Demographic and bacteriological data were collected using a data extraction sheet. The data were cleaned, entered and analyzed using SPSS version 22.Results: The overall bacterial isolation rate was at 61.6% (234/380). More than half 123 (52.6%) of the isolates were gram positive and 111 (47.4%) were gram negatives. The predominant isolates were S. aureus at 100 (42.7%) followed by E. coli, 33 (14.1%), P. aeruginosa, 26 (11.1%) and S. pyogenes, at 23 (9.8%). The proportion of multidrug resistant (MDR) bacterial pathogens was at 54.3%. Out of these, 35 (15.1%) of the isolates were resistant to more than five drugs. The highest resistance rate at (85.9%) was documented for ampicillin by gram-negative isolates. Whereas the highest resistance rate among gram positive isolates was against erythromycin (31.1%). The resistance rate of S. aureus for penicillin was at 69.7%.Conclusions: High frequency of mono and multi-drug resistant bacterial pathogens were documented. Thus, an alternative method to the causative agent and antimicrobial susceptibility testing surveillance in areas where there is no culture facility is needed to assist health professionals for the selection of appropriate antibiotics. [Ethiop. J. Health Dev. 2016;30(3):112-117]Keywords: Wound infection, bacterial isolates, and antimicrobial susceptibility profil

Polyamine stress at high pH in Escherichia coli K-12

BACKGROUND: Polyamines such as spermine and spermidine are required for growth of Escherichia coli; they interact with nucleic acids, and they bind to ribosomes. Polyamines block porins and decrease membrane permeability, activities that may protect cells in acid. At high concentrations, however, polyamines impair growth. They impair growth more severely at high pH, probably due to their increased uptake as membrane-permeant weak bases. The role of pH is critical in understanding polyamine stress. RESULTS: The effect of polyamines was tested on survival of Escherichia coli K-12 W3110 in extreme acid or base (pH conditions outside the growth range). At pH 2, 10 mM spermine increased survival by 2-fold, and putrescine increased survival by 30%. At pH 9.8, however, E. coli survival was decreased 100-fold by 10 mM spermine, putrescine, cadaverine, or spermidine. At pH 8.5, spermine decreased the growth rate substantially, whereas little effect was seen at pH 5.5. Spermidine required ten-fold higher concentrations to impair growth. On proteomic 2-D gels, spermine and spermidine caused differential expression of 31 different proteins. During log-phase growth at pH 7.0, 1 mM spermine induced eight proteins, including PykF, GlpK, SerS, DeaD, OmpC and OmpF. Proteins repressed included acetate-inducible enzymes (YfiD, Pta, Lpd) as well as RapA (HepA), and FabB. At pH 8.5, spermine induced additional proteins: TnaA, OmpA, YrdA and NanA (YhcJ) and also repressed 17 proteins. Four of the proteins that spermine induced (GlpK, OmpA, OmpF, TnaA) and five that were repressed (Lpd, Pta, SucB, TpiA, YfiD) show similar induction or repression, respectively, in base compared to acid. Most of these base stress proteins were also regulated by spermidine, but only at ten-fold higher concentration (10 mM) at high pH (pH 8.5). CONCLUSION: Polyamines increase survival in extreme acid, but decrease E. coli survival in extreme base. Growth inhibition by spermine and spermidine requires neutral or higher pH. At or above pH 7, spermine and spermidine regulate specific proteins, many of which are known to be regulated by base stress. High pH amplifies polyamine stress; and naturally occurring polyamines may play an important role in base stress

Tuberculosis Lymphadenitis and Human Immunodeficiency Virus Co-infections among Lymphadenitis Patients in Northwest Ethiopia

BACKGROUND: Tuberculosis and human immunodeficiency virus (HIV) are among the major health problems in Ethiopia. This study assessed the proportion of tuberculosis lymphadenitis (TBLN), HIV infection and their co-infection among TBLN presumptive individuals at the selected hospitals in NorthwestEthiopia.METHODS: Institution based cross sectional study was carried out. Data on demographic and clinical variables were collected with standardized questionnaire. Microbiological culture was done on specimen obtained by fine needle aspirates. The HIV status was determined by rapid anti-HIV antibody test. Data was entered and scrutinized using SPSS version 20 statistical packages. A stepwise logistic regression model was used. The result was considered as statistically significant at P&lt;0. 05.RESULTS: A total of 381 lymphadenitis patients were included in the study. The overall prevalence of TBLN and HIV were at 250(65.6%) and 9(2.4%), respectively and their co-infection was at 6(2.4%). Based on the cytological examination, 301(79.0%) of them were diagnosed as TBLN. The age group, (P=0.01) and residency, (P=0.01) were found significantly associated with TBLN. Similarly, unsafe sex was also statistically significant for HIV infection (P=0.007).CONCLUSION: Tuberculosis lymphadenitis is the leading cause of TB and lymphadenitis in the region. However, TBLN-HIV coinfection was promisingly low. High rate of discrepancy was noticed between cytological and culture results. Hence, the TBLN diagnostic criteria shall pursue revision