Sero-prevalence and risk factors of hepatitis B virus and human immunodeficiency virus infection among pregnant women in Bahir Dar city, Northwest Ethiopia: a cross sectional study

The rostrum dace is a rheophilous Cyprinid fish endemic to some French catchments. Particularly vulnerable to its habitat degradation, the rostrum dace appears to be a patrimonial species. Morphometric features were used to identify populations in a heavily impounded river, the Viaur River. A total of 176 fish, spread over 7 stations, were photographed and then released. A linear discriminant analysis correctly classified more than 80% of the individuals. Significant relationships were found between the morphological differences and (i) the geographical distance, and (ii) the number of artificial barriers (i.e. dams and weirs) between the stations. These results show that discrete dace morphological units occur in the Viaur River and therefore suggest a fragmentation of the population. Although further investigations (e.g. genetics, life history traits, etc.) are necessary to refine these results, conservation measures should be undertaken to preserve this endemic species in the Viaur River

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 About 2ml of blood sample was withdrawn from each participant, and processed for bacterial identification and susceptibility testing, following 2017 Clinical and Laboratory Standards Institute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

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

Economic Contribution of Gum and Resin Resources to Household Livelihoods in Selected Regions and the National Economy of Ethiopia

Ethiopia has one of the largest dry forest and woodland resource bases in the Horn of Africa, predominated by diverse Acacia, Boswellia, Commiphora, and Sterculia species, with an estimated annual production potential of over 300,000 tonnes of commercial gums and resins. However, until recently, less than 1% of this potential has been tapped and traded while the resource bases are degrading fast. Shortage of locality-specific case studies typifying the state of gum and resin production and marketing systems and nationwide socio-economic significance of the resources has delayed development of value-added commercialization of the commodities and integrated management of the resource bases. A study aimed at exploring the value chain of traded gums and resins and their contribution to rural livelihood and national economy was conducted in 11 purposively selected localities in five National Regional States within the major gum-belts in Ethiopia. Two major cities, central for product processing and marketing, were also assessed. A questionnaire survey was administered to 135 randomly selected households, and key stakeholder interviews, group discussions, and field observations were carried out following the value chain (from producers to exporters). Results showed that one or more of the seven gums and resins (frankincense, myrrh, opopanax, hagar, gum arabic, gum talha, and gum gumero) were produced and traded at the studied districts. While frankincense marketing dominated the northern part, gum arabic, myrrh, and opopanax are most popular in the south and southeastern part of the country. About 93% of the interviewed households engaged in collecting, marketing, or both activities. Gums and resins contributed up to 14% of the average annual cash income of the households. However, a significant difference (P < 0.001) was found in the amount collected and income generated per household and locality. Strong correlation was observed between cash income from gums and resins and off-farm activities (R = 0.74) and other types of non-timber forest products like honey (R = 0.72, α = 0.01). However, weak correlation was observed between incomes from gums and resins and crop and livestock production. Despite the observed inefficient value chain, the gum and resin resources have considerable contributions to the national economy. For instance, the annual average revenue from three districts in Tigray National Regional State was USD 882,000 in 2010. Between 2002 and 2010, about 2,306 tonnes of different gums and resins were traded and average revenue of USD 3,220,542 was obtained in one district in the same region. At the national level, between 1997 and 2010 about 6,174 tonnes of gum arabic and about 33,865 tonnes of other gums and resins were exported, and more than USD 72 million were generated. Responding to what sort of institutional arrangement governs the value chain and use of gums and resins resources at the present situations, about 41% of the respondents asserted customary and national legal arrangements, while 56% mentioned alternative systems as means of conflict resolution. Key policy and development interventions that could enhance the socio-economic importance of the gum and resin value chain at the local and national levels, while also increasing responsibility and commitment towards long-term management of the resource bases, have been recommended

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&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

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

Health impacts of bedbug infestation: A case of five towns in Amhara Region, Ethiopia

Background: Bedbug is a wingless human blood-sucking bug that generally infests houses and beds. Bedbug infestation is prevalent across the country. Despite its prevalence, however, there is scarce information on the epidemiological, psychological, social and public health impacts of the infestation. This lack may arise from the absence of sufficient research in the area. The impetus for this study arose from this recognition. This study therefore assessed the extent of bedbug infestation in five towns in Amhara Regional State, Ethiopia, and its impact on public health in the areas considered in this study.Methods: A community-based cross sectional study was conducted in five towns of Amhara Regional State from 1 March 2015 to 30 June 2016. Bedbug inspection was done following the Michigan manual for prevention and control of bedbug recommendation. The presence of a living or dead bedbugs, their eggs, their skin discarded in shedding, and their fecal stains or droppings were taken as an infestation. In addition, data from households were collected using pretested, structured and interviewer-administered questionnaire. The data were analyzed using SPSS version 20. Both bivariate and multivariate logistic regressions were computed to identify associated factors.Results: From the 203 residential institutions surveyed, evidence of prevalence of bedbugs was located in 75.9% (154) houses. From among the infested residents, 87%, 83.1%, and 71.4% had faced one or more psychological, social and health impacts, respectively. Residential institutions in Bahir Dar town administration were 3.4 times more likely to be infested by bedbug than those in Amanuel town (AOR: 3.4; 95% CI: 1-11). The chances that residents of Kobo town administration had to be infested by bedbug were 41 times more than that of the residents in Amanuel town (AOR: 41; 95%CI: 8-206). However, no statistically significant difference was observed between the rates of bedbug infestation and the type of residential institutions.Conclusions: Bedbug infestation was found to be a major public health problem in Bahir Dar, Woreta and Kobo towns. A significant psychological, social and health impact was observed in the communities. Thus, aggressive public health promotion campaigns against bedbug are recommended to empower the communities and equip them with preventive strategies. Moreover, an effective pest management strategy also needs to be made a priority health agenda, in the particular areas of study. A larger study is recommended to assess more in-depth impacts of bedbug infestation on public health [Ethiop. J. Health Dev. 2017;31(4):251-258]Keywords: Bedbug infestation, Ethiopi

Knowledge and practice on magnitude, diagnosis, treatment and prevention strategies of Hepatocellular Carcinoma in Ethiopia: A Systematic Review

Introduction: In Ethiopia, hepatocellular carcinoma (HCC) is the most common cancer with 100% fatality rate. HCC cases in low income countries die within few months following diagnosis. There is lack of information on the burden, risk factors, diagnosis modalities, surveillance strategies and treatment approaches to HCC in Ethiopia.Objective: To analyze the existing evidence related to burden, risk factors, diagnosis modalities, surveillance strategies, and treatment and prevention strategies of HCC in Ethiopia.Methods: All studies done on HCC in Ethiopian irrespective of year of publication and study types were included. Literatures were retrieved from electronic database of PubMedand Cochrane library during September/2016 to January 2/2017. Key words and mesh terms such as ‘hepatocellular carcinoma’, ‘hcc’, ‘hepatoma’, ‘malignant hepatoma’, ‘hepatocarcinoma’ were used to search for documents. Besides, we searched for articles, guidelines and reviews from world health organizations, lancet and Google scholar sites. Each of the retrieved studies was assessed by two authors for inclusion based on the eligibility criteria, and for quality using the critical appraisal checklist. Qualitative data were synthesized for analyzing the theories of studies. Medley reference manager was used to manage citations.Results: A total of 1448 literatures were retrieved. Eight studies fulfill the eligibility criteria, however, only three were full-fledged articles. HCC is clinically characterized by exhaustion, loss of appetite, rapid loss of weight, epigastric pain, right upper abdominal quadrant pain with a rapidly growing mass, jaundice, and ascites with or without hepatomegaly and splenomegaly. Data on HCC proportion among liver disease patients lies between 16.1%-19.2%. Cirrhosis followed by hepatotoxic indigenous drugs and viral hepatitis were found to be as major risk factor for HCC. In Ethiopia, there is no surveillance activity and no standard staging systems. Furthermore, there was no policy frame -work for management of HCC.Conclusion: As compared to other countries, Ethiopia is far behind in addressing HCC. There is no national policy framework and guideline for the management of HCC. Moreover, HCC is a neglected cancer that is considered as a death penalty by the community. Health professionals working in health facilities and health offices should share the data they have to the scientific community and policy makers, for further searching solutions and informed decision, respectively. An intensified public health strategy on health education and early case detection is of critical importance. In addition concerted effort should be made to develop HCC prevention and treatment modality.Key words: Hepatocellular Carcinoma, Ethiopi