Do local environmental changes resulting from the construction of microdams lead to increased malaria transmission in Tigray, Ethiopia?

To investigate the impact of microdams on local microclimate and malaria transmission and in order to develop appropriate methods for the control of this disease, a longitudinal microclimatic, entomological, and clinical study was conducted. The study took place in two topographically similar villages: Deba, near a microdam and Maisheru, 3-4km away, in Tigray, northern Ethiopia, where an extensive dam construction is in progress in epidemic prone areas. The weather was recorded in both villages, on the dam embankment and at different mosquito habitats. A community-led larval intervention study followed the impact assessment phase in the dam village. There was a 3.1 times greater prevalence of an enlarged spleen and 2-5.5 times higher incidence of falciparum malaria in children under 10 years of age in the dam village compared to the remote village, indicating a greater level of exposure experienced in the dam village. Anopheles arabiensis, which was highly anthropophilic, partially exophilic, and showed early biting peak (19:00-20:00hr), was 6.5-8 times more abundant in the dam village compared to the remote village and this was even higher during the dry season (xl6) when a second peak in density was observed in the former. This corresponded to when the fields were irrigated indicating that transmission of malaria was no longer restricted to the rainy season in the dam village compared to the remote village. Despite DDT spraying and prompt treatment of clinical cases with Fansidar at a community level, the findings demonstrated that dams have the potential to increase transmission of malaria parasites. The dam not only created abundant mosquito breeding sites throughout the year, but also resulted in significant microclimate changes; notably elevated minimum atmospheric temperature, the influence weakening with distance from the dam. The dam site was 1.5 ºC warmer than the dam village and that of the dam village was 1.3 ºC higher than the remote village and was especially pronounced (>3.5 ºC) in the cool/dry season. Mean air temperature recorded under vegetation was 1.7 ºC lower than outside and the dam provided numerous cool and humid microhabitats elsewhere by raising the water table, increasing water seepage, saturating the soil and promoting abundant growth of vegetation. Indoor temperature was relatively stable with higher minima and lower maxima than outdoors and on the average 2.8-3.4 ºC warmer than outdoors. The warming effect of the dam, together with profuse breeding sites, suitable indoor and outdoor resting microhabitats may have contributed to the extended and dramatic increased risk of malaria observed in near dam communities in the Ethiopian highlands in Tigray. Most importantly the larval intervention study, which involved minimal community participation, showed a49% relative reduction in An. arabiensis abundance in the dam village compared with the pre-intervention period. Thus, if dams could be constructed further away from settlements and if serious and sustainable community-led environmental management measures could be introduced as a package, it would be possible to mitigate the impact of microdams to an appreciable extent and calls for an integrated approach to malaria control, in fringe areas of malaria, such as the Tigray highlands, particularly nearmicrodams. Key words: Dams, microclimate, mosquito ecology, Ethiopia, Tigray, malaria, Anopheles arabiensis, highland fringes

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

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 < 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<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

Characterization of Mosquito Breeding Sites in and in the Vicinity of Tigray Microdams

BACKGROUND: Malaria vector control in Ethiopia has a history of more than 50 years, but malaria remains a major cause of morbidity and mortality in Ethiopia. Thus, targeting the control program on the larval stage is of paramount importance. This study aimed to characterize the aquatic habitats of vector mosquito larvae associated with micro-dams. METHODS: Cross-sectional larval survey was conducted on six micro-dams in Tigray, Northern Ethiopia in 2005/06. The study area on each dam was divided into eight zones. Immature stages of mosquitoes were collected using standard dippers. The physico-chemical characteristics of the aquatic habitats were measured onsite. RESULTS: A total of 301 aquatic habitats were surveyed for mosquito larvae; in 32.56% (n=301) only Anopheles, in 27.91% only Culex, both genera were found mixed in 21.59% and no mosquito larvae were found in 17.94%. The findings depicted that dissolved oxygen (r = 0.34, p =0.04), pH (r = 0.35, p =0.03), conductivity (r = 0.36, p =0.03), vegetation (F = 3.54, p =0.002), microhabitat (F = 2.65, p =0.04), fauna and bottom surface of the water body were positively associated and important in explaining the presence and abundance of Culex. On the other hand, dissolved oxygen (r = 0.39, p =0.02), pH (r = 0.42, p =0.008), vegetation (F = 5.6, p =0.000), water transparency (F = 2.72, p =0.00), rainfall (F = 2.22, p = 0.027) and fauna were positively associated and important in explaining the presence and abundance of Anopheles. CONCLUSION: The findings of this study suggest that both biotic (vegetation and fauna) and abiotic (chemical and physical) factors play a significant role in larvae’s habitat preference in both Culex and Anopheles. KEYWORDS: Anopheles, breeding, characteristics, Culex, larvae, mosquito, Northern Ethiopi

Spread and Control of the Dynamics of HIV/AIDS-TB Co-infection in Ethiopia: A Mathematical Model Analysis

In this work we considered a nonlinear deterministic dynamical system to study the dynamics of HIV/AIDS-TB co-infection in Ethiopia. We found the system exhibit disease free equilibrium point and endemic equilibrium point. For the reproduction number  the disease-free equilibrium point is locally asymptomatically stable and the endemic equilibrium point is locally asymptomatically unstable. We calculate basic reproduction number of the HIV/AIDS-TB co-infection dynamical system which depends on six parameters. Using real data collected from different sectors in Ethiopia we found that the numerical value of the basic reproduction number is. This shows that HIV/AIDS–TB co-infection spread in the society. Using sensitive analysis, we identify the most influential control parameter is the HIV/AIDS-TB co-infection transmission rate. The HIV/AIDS-TB co-infection transmission rate which numerical value to be 0.021. But the real value of is 0.74, to be 0.74 in to 0.021 by fixing the number of contacts for HIV/AIDS-TB co-infection we decrease the effective number of contacts for HIV/AIDS-TB co-infection 74 to 21.  We also perform numerical simulation based on real data collected from different health sectors in Ethiopia. &nbsp

Lived Experiences of Divorced Women in Rural Ethiopia. A Special Focus in Hulet Ejju Enessie Woreda: Addis Zemen Kebele

Based on life-story interviews with women, this paper analyzes post -divorce experiences of rural divorced women. The study attempted to investigate the economic and social impacts of divorce on divorced women. In addition, the study investigated the impacts of parental divorce on the psychological well-being of divorced women; specifically, how they manage to adapt to their new lives after legal dissolution were examined. Data collection primarily relies on in-depth interviews supplemented with document analysis and observation of case proceeds in Hulet Ejju Enessie Woreda family court. Unstructured questionnaires were developed incorporating open-ended questions. The data were gathered from purposively selected interviewees specifically, used snowball sampling technique. The study employed phenomenological research design which includes solely qualitative approach. Thematic qualitative analysis technique has been employed to analyze the data. The study concluded that divorce caused various difficulties including financial, social and psychological problems for the participants. In addition, the participants developed a wide range of survival strategies in the face of difficulties and challenges they experienced which attested to their agency during and after the divorce process

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

Profile and treatment outcomes of patients with tuberculosis in Northeastern Ethiopia: a cross sectional study.

Background: Data on the epidemiology of tuberculosis and its treatment outcomes were incomplete in the study area and this study was done to fill this gap. Methods: Institution based cross sectional study was conducted from January 2011 to December 2014. A total of 949 TB patients who were on treatment in North Eastern Ethiopia, Eastern Amhara region were included. Data was analyzed using SPSS version 20. Frequency, percentages and means were used to present data. To assess the associations of treatment outcomes with sex, age, type of TB and human immunodeficiency virus (HIV), logistic regression was used. Results: The proportion of smear positive and negative pulmonary TB, and extra pulmonary TB were 187/949 (19.7%), 322/949 (33.9%) and 440/949 (46.4%), respectively. Treatment success rate was 853/949 (89.9%). Smear positive pulmonary TB and TB/HIV co-infections were significantly associated with unsuccessful treatment outcome, P 64 0.002. Conclusion: Extra pulmonary TB was the most prevalent types of TB followed by smear negative pulmonary TB. Treatment success rate was above the WHO target of 85%. The causes for the high proportion of smear negative PTB and EPTB should be further investigated. Special emphasis should be put on smear positive PTB patients and TB/HIV co-infected patients to decrease unsuccessful treatment outcome and TB transmissions

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<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

Wound healing effect of aqueous extracts of Brucea antidysenterica and Croton marcostachyus from Northwest Ethiopia in albino mice

Back ground: The practice of traditional medicine to treat wound and bleeding disorders in Ethiopia is based on use of numerous herbs. In Ethiopia, the traditional healers use the leaves of Brucea antidysenterica and Croton marcostachyus for wound healing purposes. But no scientific study is reported on the in vivo evaluation of the pharmacological effect of the two selected plants collected locally from Zegie and around Lake Tana monasteries, Northwest Ethiopia. Objective: The purpose of this study was to evaluate the wound healing effects of Brucea antidysenterica and Croton marcostachyus on a mouse model. Methods: 50mg/ml and 100mg/ml of Brucea antidysenterica and 50mg/ml and 100mg/ml of Croton marcostachyus leaf aqueous extract solutions were applied on the 1.5cm inflicted wound on the trunk part of the mice of different groups. The degree of wound healing as a percentage was calculated from the wound diameter for each experimental animal. Result: The aqueous extract 50mg/ml and 100mg/ml of Brucea antidysenterica and Croton marcostachyus achieved a relatively higher degree of wound healing percent compared to the control group. Moreover, the 100mg/ml aqueous leaf extract of Croton marcostachyus and Brucea antidysenterica have shown higher degree of wound healing percent compared to the 50mg/ml concentrations of the two plants. Conclusion: The current study concluded that the aqueous extracts of Brucea antidysenterica and Croton marcostachyus possess excellent wound healing potential. Hence, the results of the current study support the traditional use of leaf extracts of Croton marcostachyus and Brucea antidysenterica as remedies for wound healing. Further studies are required to isolate the active compounds and determine safety margin of the plant extracts. Key words: Wound healing, Brucea antidysenterica, Croton marcostachyu