A zoonotic focus of cutaneous leishmaniasis in Addis Ababa, Ethiopia

<p>Abstract</p> <p>Background</p> <p>Cutaneous leishmaniasis (CL) is endemic in the highlands of Ethiopia, and almost always caused by <it>Leishmania aethiopica</it>. Hitherto, Addis Ababa (the capital city of Ethiopia) was not considered endemic for CL, mainly due to absence of epidemiological and field ecological studies. This report summarizes the preliminary epidemiological investigation that proved the existence of active transmission in southeastern Addis Ababa.</p> <p>Results</p> <p>Active case finding surveys were conducted in 3 localities, Saris, Kality, and Akaki, which are found in and around Bulbula-Akaki river gorges. During the surveys conducted in January 2005 - May 2006, a total of 35 cases with 9 active and 26 healed skin lesions were identified. Eighteen of the cases (51.4%) were found in Saris; while 10 (28.6%) and 7 (20%) cases were from Kality and Akaki respectively.</p> <p>Ten colonies of rock hyraxes (<it>Heterohyrax brucei</it>) were identified in the vicinities of the 3 localities. Three of the 48 hyraxes (6.3%) trapped from the surroundings harbored natural infections of <it>Leishmania aethiopica</it>. Confirmation of the <it>Leishmania </it>species of the 3 isolates was achieved by PCR amplification and RFLP analysis of the ribosomal DNA internal transcribed spacer (ITS) sequences. Based on sandfly species composition and proximity of resting sites to human settlements, <it>Phlebotomus longipes </it>is circumstantially proven to be the vector of CL in south east Addis Ababa.</p> <p>Conclusion</p> <p>The study proves the existence of isolated zoonotic foci of CL in south eastern Addis Ababa, with <it>P. longipes </it>as the likely vector and <it>H. brucei </it>as the natural reservoir host.</p

Why do people not attend for treatment for trachomatous trichiasis in Ethiopia? A study of barriers to surgery.

BACKGROUND: Trachomatous trichiasis (TT) surgery is provided free or subsidised in most trachoma endemic settings. However, only 18-66% of TT patients attend for surgery. This study analyses barriers to attendance among TT patients in Ethiopia, the country with the highest prevalence of TT in the world. METHODOLOGY/PRINCIPAL FINDINGS: Participants with previously un-operated TT were recruited at 17 surgical outreach campaigns in Amhara Region, Ethiopia. An interview was conducted to ascertain why they had not attended for surgery previously. A trachoma eye examination was performed by an ophthalmologist. 2591 consecutive individuals were interviewed. The most frequently cited barriers to previous attendance for surgery were lack of time (45.3%), financial constraints (42.9%) and lack of an escort (35.5% in females, 19.6% in males). Women were more likely to report a fear of surgery (7.7% vs 3.2%, p<0.001) or be unaware of how to access services (4.5% vs 1.0% p<0.001); men were more frequently asymptomatic (19.6% vs 10.1%, p<0.001). Women were also less likely to have been previously offered TT surgery than men (OR = 0.70, 95%CI 0.53-0.94). CONCLUSIONS/SIGNIFICANCE: The major barriers to accessing surgery from the patients' perspective are the direct and indirect costs of surgery. These can to a large extent be reduced or overcome through the provision of free or low cost surgery at the community level. TRIAL REGISTRATION: ClinicalTrials.gov NCT00522860 and NCT00522912

Intestinal parasitic infections in Western Abaya with special reference to Schistosomiasis mansoni

Abstract: A cross sectional investigation on the distribution and prevalence of intestinal parasitic infections was undertaken in Western Abaya, North Omo, in January 1995. As the area is potentially irrigable for modern agriculture, emphasis was placed to explore on the endemicity of schistosomiasis, including malacological assessments. Five percent of the whole population on 1473 people, in 16 villages of the area, were parasitologically examined for intestinal parasites. Among the intestinal parasitic infections, hookworm was demonstrated in all of the villages with prevalences ranging from 4.1% (Algie) to 75% (Wajifo). The majority of the villages (10/16=62.5%) had hookworm prevalences of over 50%. Schistosoma mansoni infections were found in 11 villages with prevalences of up to 53% with more males than females being affected (P&lt;0.001). Infected Biomphalaria sudanica snails with infection rates of up to 2.1% at two sites of Lake Abaya were also found. The importance of the dominant, S. mansoni and hookworm infections in the potentially irrigable area of Western Abaya and feasible measures of their control are discussed. [Ethiop. J. Health Dev. 1999;13(1):21-26

Breeding Sites of Aedes aegypti

Background and Objectives. Entomological survey was carried out from May-June to September-October 2014 to investigate the presence of dengue vectors in discarded tires and artificial water containers in houses and peridomestic areas. Methods. A cross-sectional immature stage survey was done indoors and outdoors in 301 houses. Mosquito larval sampling was conducted using pipette or dipper depending on container types. Larvae were identified morphologically and larval indices were also calculated. Results. A total of 750 containers were inspected, and of these 405 were positive for mosquito larvae. A total of 1,873 larvae were collected and morphologically identified as Aedes aegypti (n=1580: 84.4%) and Culex (n=293: 15.6%). The larval indices, house index, container index, and breteau index, varied from 33.3 to 86.2, from 23.2 to 73.9, and from 56.5 to 188.9, respectively. Conclusion. Aedes aegypti is breeding in a wide range of artificial containers. To control these mosquitoes, the integration of different methods should be taken into consideration

Human-biting activities of Anopheles species in south-central Ethiopia.

BACKGROUND: Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are the key malaria vector control interventions in Ethiopia. The success of these interventions rely on their efficacy to repel or kill indoor feeding and resting mosquitoes. This study was undertaken to monitor human-biting patterns of Anopheles species in south-central Ethiopia. METHODS: Human-biting patterns of anophelines were monitored for 40 nights in three houses using human landing catches (HLC) both indoors and outdoors between July and November 2014, in Edo Kontola village, south-central Ethiopia. This time coincides with the major malaria transmission season in Ethiopia, which is usually between September and November. Adult mosquitoes were collected from 19:00 to 06:00 h and identified to species. Comparisons of HLC data were done using incidence rate ratio (IRR) calculated by negative binomial regression. The nocturnal biting activities of each Anopheles species was expressed as mean number of mosquitoes landing per person per hour. To assess malaria infections in Anopheles mosquitoes the presence of Plasmodium falciparum and P. vivax circumsporozoite proteins (CSP) were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: Altogether 3,408 adult female anophelines were collected, 2,610 (76.6 %) outdoors and 798 (23.4 %) indoors. Anopheles zeimanni was the predominant species (66.5 %) followed by An. arabiensis (24.8 %), An. pharoensis (6.8 %) and An. funestus (s.l.) (1.8 %). The overall mean anopheline density was 3.3 times higher outdoors than indoors (65.3 vs 19.9/person/night, IRR: 3.3, 95 % CI: 1.1-5.1, P = 0.001). The mean density of An. zeimanni, An. pharoensis and An. funestus (s.l.) collected outdoors was significantly higher than indoors for each species (P < 0.05). However, the mean An. arabiensis density outdoors was similar to that indoors (11.8 vs 9.4/person/night, IRR: 1.3, 95 % CI: 0.8-1.9, P = 0.335). The mean hourly human-biting density of An. arabiensis was greater outdoors than indoors and peaked between 21:00 and 22:00 h. However, An. arabiensis parous population showed high indoor man biting activities during bedtimes (22:00 to 05:00 h) when the local people were indoor and potentially protected by IRS and LLINs. All mosquito samples tested for CSP antigen were found negative to malaria parasites. CONCLUSIONS: Results show much greater mosquito human-biting activities occurring outdoors than indoors and during early parts of the night, implying higher outdoor malaria transmission potential in the area. However, high bedtime (22:00 to 05:00 h) indoor biting activities of parous An. arabiensis suggest high potential intervention impact of IRS and LLINs on indoor malaria transmission

Insecticide resistance in Anopheles arabiensis (Diptera: Culicidae) from villages in central, northern and south west Ethiopia and detection of kdr mutation

<p>Abstract</p> <p>Background</p> <p><it>Anopheles arabiensis </it>is the major vector of malaria in Ethiopia. Malaria vector control in Ethiopia is based on selective indoor residual spraying using DDT, distribution of long lasting insecticide treated nets and environmental management of larval breeding habitats. DDT and pyrethroid insecticides are neurotoxins and have a similar mode of action on the sodium ion channel of insects. It was therefore necessary to verify the insecticide susceptibility status of <it>An. arabiensis</it>, to better understand the status of cross-resistance between DDT and the pyrethroids in this species as well as to detect a resistant gene.</p> <p>Methods</p> <p>Standard WHO insecticide susceptibility tests were conducted on adults reared from larval and pupal collections from breeding sites at three villages namely: Sodere in the Rift Valley, Gorgora in the north and Ghibe River Valley in the south west of Ethiopia. The occurrence of cross-resistance between pyrethroids and DDT was determined using a DDT selected laboratory colony originally collected from Gorgora. Phenotypically characterized mosquitoes were tested for the presence of knockdown resistance (<it>kdr</it>) alleles using the standard polymerase chain reaction assay.</p> <p>Results</p> <p>All <it>An. gambiae </it>s.l. specimens assayed by PCR were identified as <it>An. arabiensis</it>. The knockdown and mortality results showed <it>An. arabiensis </it>resistance to DDT in all villages, resistance to deltamethrin and permethrin in the Ghibe River Valley and permethrin resistance in Gorgora. Bioassay susceptibility tests also indicated the presence of cross-resistance between DDT and permethrin, but not between DDT and deltamethrin. The knockdown resistance <it>(kdr) </it>mutation of leucine to phenylalanine in the sodium ion channel gene was detected in populations from Gorgora and the Ghibe River Valley.</p> <p>Conclusion</p> <p>Since <it>An. arabiensis </it>shows high levels of resistance to DDT in all villages tested and varying pyrethroid resistance in Gorgora and the Ghibe River valley, precautionary measures should be taken in future vector control operations. Moreover, the status of resistance in other locations in Ethiopia and the spread of resistant gene (s) should be investigated.</p

Diversity and altitudinal distribution of phlebotomine sand flies (Diptera: Psychodidae) in visceral leishmaniasis endemic areas of northwest Ethiopia

Background: The Leishmaniases are caused by the protozoan parasites of the genus Leishmania and are transmitted to humans by the bite of infected female phlebotomine sand flies. Both visceral and cutaneous leishmaniases are widely distributed in different parts of Ethiopia. The aim of this study was to determine the diversity and altitudinal distribution of phlebotomine sand flies from Kafta Humera to Gondar town in northwest Ethiopia. Methods: Seven localities were selected with distinct altitudinal variations between 550 meters above sea level (ma.s.l) and 2,300ma.s.l. In each locality, sand flies were collected using standard CDC light traps and sticky traps during the active sand fly season from December 2012 to May 2013. Shannon-Weiner species diversity index and Jaccard’s coefficient were used to estimate species diversity and similarity between altitudes and localities, respectively. Results: A total of 89,044 sand flies (41,798 males and 47, 246 females) were collected from the seven localities/towns throughout the study period. Twenty-two species belonging to 11 species in the genus Phlebotomus and 11 species in the genus Sergentomyia were documented. Of these, Sergentomyia clydei (25.87%), S. schwetzi (25.21%), S. africana (24.65%), S. bedfordi (8.89%), Phlebotomus orientalis (6.43%), and S. antennata (4.8%) were the most prevalent species. The remaining 10 Phlebotomus species and six Sergentomyia were less frequent catches. In CDC light trap and sticky trap, higher species diversity and richness for both male and female sand flies was observed at low altitude ranging from 550 to 699ma.s.l in Adebay village in Kafta Humera district whereas low species richness and high evenness of both sexes was also observed in a altitude 1,950- 2,300ma.s.l. Conclusion: The results revealed that the presence of leishmaniasis vectors such as P. orientalis, P. longipes, P. papatasi, and P. duboscqi in different altitudes in northwest Ethiopia. P. orientalis a vector of L. donovani, was occurred between altitude 500- 1100ma.s.l, the area could be at high risk of VL. P. longipes a vector of L. aethiopica , was recorded in the highland area in Tikil-Dingay and Gondar town, implicating the possibility of CL transmission. Hence, further investigation into vector competence in relation to leishmaniasis (VL and CL) in the region is very vital

Which nets are being used: factors associated with mosquito net use in Amhara, Oromia and Southern Nations, Nationalities and Peoples' Regions of Ethiopia.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.BACKGROUND: There has been recent large scale-up of malaria control interventions in Ethiopia where transmission is unstable. While household ownership of long-lasting insecticidal nets (LLIN) has increased greatly, there are concerns about inadequate net use. This study aimed to investigate factors associated with net use at two time points, before and after mass distribution of nets. METHODS: Two cross sectional surveys were carried out in 2006 and 2007 in Amhara, Oromia and SNNP regions. The latter was a sub-sample of the national Malaria Indicator Survey (MIS 3R). Each survey wave used multi-stage cluster random sampling with 25 households per cluster (224 clusters with 5,730 households in Baseline 2006 and 245 clusters with 5,910 households in MIS 3R 2007). Net ownership was assessed by visual inspection while net utilization was reported as use of the net the previous night. This net level analysis was restricted to households owning at least one net of any type. Logistic regression models of association between net use and explanatory variables including net type, age, condition, cost and other household characteristics were undertaken using generalized linear latent and mixed models (GLLAMM). RESULTS: A total of 3,784 nets in 2,430 households were included in the baseline 2006 analysis while the MIS 3R 2007 analysis comprised 5,413 nets in 3,328 households. The proportion of nets used the previous night decreased from 85.1% to 56.0% between baseline 2006 and MIS 3R 2007, respectively. Factors independently associated with increased proportion of nets used were: LLIN net type (at baseline 2006); indoor residual spraying (at MIS 3R 2007); and increasing wealth index at both surveys. At both baseline 2006 and MIS 3R 2007, reduced proportion of nets used was independently associated with increasing net age, increasing damage of nets, increasing household net density, and increasing altitude (>2,000 m). CONCLUSION: This study identified modifiable factors affecting use of nets that were consistent across both surveys. While net replacement remains important, the findings suggest that: more education about use and care of nets; making nets more resistant to damage; and encouraging net mending are likely to maximize the huge investment in scale up of net ownership by ensuring they are used. Without this step, the widespread benefits of LLIN cannot be realized