Background: The appropriate drug for the treatment of schistosomiasis is praziquantel. However, low cure rate and existence of drug resistance both in vivo and in vitro were reported in different endemic areas. Hence, the aim of this study was to evaluate the effectiveness of praziquantel for Schistosoma mansoni (S. mansoni) treatment. Methods: A cross-sectional study was conducted in Sanja General Primary School, North Gondar Zone, Amhara region, Northwest of Ethiopia, from March to April, 2017. A total of 245 participants were selected using systematic random sampling. A stool specimen was collected from each participant and examined for S. mansoni ova load count using Kato-Katz technique. Two hundred four infected participants were treated with a single oral dose of praziquantel 40 mg/kg. Four weeks later post-treatment, stool specimens were collected from 176 study participants. The samples were collected using similar procedures like the pre-treatment phase to see egg reduction and cure status. Data were entered and analyzed using SPSS version 20.0 Pearson chi-square (χ 2) was used to determine the association of effectiveness of the drug with the average egg count, age group, and sex. P value ≤ 0.05 at 95% CI was considered statistically significant. Results: Pre-treatment prevalence of S. mansoni infection was 83.3% (204/245) with geometric mean egg count of 357.8. In those not cured post-treatment, the prevalence and egg per gram in geometric mean egg count were 13.1% and 77.6 respectively. After 4 weeks of administration of praziquantel, the cure rate was 86.9% with egg reduction rate of 78.3%. Effectiveness of the drug was not statistically associated with sex, age group, and pre-treatment intensity of infection. Conclusion: S. mansoni prevalence was high. Praziquantel is an effective drug for the treatment of S. mansoni. This high prevalence of S. mansoni requires mass drug administration of praziquantel.

Background. In Ethiopia, despite various public health intervention approaches have been implemented to eliminate malaria, its public health problem remains considerable. There are such numerous studies; however, investigating the trend of malaria infection in various settings is paramount for area-specific evidence-based interventions, evaluating ongoing malaria control programs. Hence, since the trend of malaria infection in Maksegnit has not yet been documented, this study is aimed at assessing the seven-year trend of malaria in Maksegnit Health Center. Methods. An institutional-based retrospective study was conducted to assess the trend of malaria prevalence over the last seven years (2014-2020) using recorded blood smear reports in the laboratory logbook in Maksegnit Health Center, Northwest Ethiopia. Result. Over the last seven years, a total of 28217 clinically malaria-suspected individuals were requested for blood film examination at Maksegnit Health Center. Of whom, microscopically confirmed malaria case was found in 4641/28217 (16.4%). A significant seasonal and interannual variation of malaria cases was observed ( P < 0.001 ). The highest prevalence was observed in years 2014 (25.5%) and 2020 (25.1%), while the minimum annual prevalence was seen in 2017/18 (6.4%). The month of October (25.5%) had the highest number of malaria cases documented, while February had the least (4.7%). Males and individuals under the age group of 15-45 were the most affected segments of the population. A significant interannual fluctuating prevalence of malaria cases was recorded ranging from 25.5% to 6.4% ( P < 0.001 ). Conclusion. Malaria is still a public health threat in the study area despite significant fluctuating patterns of malaria was observed in the last seven years. In particular, a bounced back trend of malaria from 2018 to 2020 is alarming. Thus, the implementation of ongoing intervention approaches should be reconsidered, and uninterrupted efforts of the concerned bodies are still needed.

Purpose To study intestinal parasitosis and its association with viral load and CD4+ T cell count in HIV-infected individuals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods A cross-sectional study was conducted from March to June 2019. Three hundred and sixteen study participants were selected using systematic random sampling technique. Sociodemographic and clinical data were collected using structured questionnaire. Stool samples were collected and examined using direct saline, formol ether concentration technique and modified acid fast staining. CD4+ T cell counts and viral load were determined by fluorescence-activated cell sorting (BD FACS) and COBAS Ampliprep/COBAS TaqMan HI2CAP assay, respectively. Data were entered into Epi Data 3.1 and transferred to SPSS version 20 software for analysis. Bivariable and multivariable analyses were performed using a binary logistic regression model. P values of less than 0.05 were considered statistically significant. Results The overall prevalence of intestinal parasitosis was 24.7% (78/316). The most commonly detected parasite was Cryptosporidium species with 5.4% (17/316), followed by Ascaris lumbricoides with 5.1% (16/316). There was a significant association with low CD4+ T cell count (AOR: 3.207; 95% CI: 1.237, 8.317), high viral load (AOR: 2.933; 95% CI: 1.326, 6.489), individuals aged 31–40 years (AOR: 0.305; 95% CI: 0.124, 0.751) and individuals aged 41–50 years (AOR: 0.261; 95% CI: 0.101, 0.671). Conclusion In this study, prevalence of intestinal parasitic infections was high and was associated with low CD4+ T cell count and high viral load. Therefore, screening of HIV patients, especially those with low CD4+ T-cell count and high viral load, particularly for opportunistic intestinal parasitic infections would be of utmost importance in the efforts to prevent and control opportunistic infections in HIV patients.

BackgroundInfectious diarrhea is a common problem in the developing world, especially among people living with HIV/AIDS. Traditional diagnostic methods such as stool culture and microscopic examination are limited by resources and poor sensitivity. The use of molecular diagnostics for enteropathogen detection in this region of sub-Saharan Africa has not been fully explored. We sought to identify risk factors and characterize enteropathogens from diarrheic stools of HIV-positive patients in Gondar, Ethiopia using multiplex molecular panels targeting key infectious agents.MethodsA cross-sectional study of 100 stool samples was performed. Samples were collected consecutively from HIV- positive patients presenting with diarrhea at University of Gondar Hospital clinic, a major center in NW Ethiopia. Genomic DNA was extracted from stool and processed using a multiplex molecular panel Allplex™ [Seegene, Canada]. Correlations between patient characteristics, symptoms, public health risk factors, and enteropathogen type (s) were studied. Eighty-six samples were successfully analyzed by molecular methods.ResultsThe mean age was 35 with 43% male. Eighty percent lived in an urban area, 18% had access to well water only, and 81% practiced proper hand hygiene. The majority of patients (72%) were receiving HAART with a median CD4 cell count of 362/μL. Multiple pathogens were detected in 94% of specimens, with an average of 5 enteropathogens per sample. Common bacteria, viruses, and parasites detected were Shigella spp./enteroinvasive E. coli (80%), enterotoxigenic E. coli (73%), Norovirus (16%) and B. hominis (62%). CD4 cell count < 500/ μL was associated with the presence of viruses (p = 0.004) and the absence of STEC (p = 0.010). The use of HAART or CD4 levels was not associated with the number of enteropathogens detected.ConclusionsDiarrheic stool from HIV-positive outpatients in Gondar, Ethiopia had on average 5 enteropathogens present in their stool. Shigellaspp./enteroinvasive E. coli and enterotoxigenic E. coli are the major pathogens, not dissimilar to immunocompetent individuals in low income countries.

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Background: Schistosomiasis is one of the great neglected tropical diseases with socio-economic and health problem worldwide. In Ethiopia numerous studies reported S. mansoni is high among school-age and preschool age children. Though intensive prevalence studies are conducted the snail distribution and infectivity status and human infection rate dynamics in Ethiopian context remains poorly understood. Thus the purpose of the current study was to assess distribution of snail and risk factors of Schistosoma mansoni infection in proximity to water contact points in Gorgora town, Western Dembia District, Northwest Ethiopia. Method: A Community based cross-sectional study was conducted in Gorgora Town from March to May 2020. A total of 385 study participants were selected by systematic random sampling technique. Stool sample was collected and examined by Kato-Katz technique. Malacological survey was done from sampling sites showing signs of human activity near Lake Tana shoreline. Live snails collected in plastic bucket containing water and weed were transported within four hours to the University of Gondar, Medical parasitology laboratory for identification and determination of infection. Data was entered with EPI Data version 4.4.2.1. Data analysis was carried out using SPSS version 20.0 and STATA version 15.0. p-value ≤ 0.05 was reported as statistically significant. Spatial distribution analysis was done using ArcGIS system for Geographical Information System (GIS). Result: The overall prevalence of S. mansoni infection was 36.6% (CI: 32-41.9) with intensity of 30.5%, 27.0% and 42.6% for light, moderate, and heavy, respectively. Among the different fresh water snails collected on the basis of shell morphology 546(%) were Biomphalaria pfeifferi, 310(28.1%) were Bulinus spp, 101(9.1%) were Lymnaea, and 147(13.3%) were Bivalve. Schistosome infection in Biomphalaria spp. was 0.0%. Swimming frequency and proximity to water body were observed to be the most associated risk factor to S. mansoni infection. Conclusion: The study showed that S. mansoni is an ongoing health problem in Gorgora. Different fresh water snails with a potential of transmitting diseases of human and veterinary importance that requires attention had been identified. Longitudinal and molecular study on Biomphalaria pfeifferi infection rate as well as susceptibility to schistosome infection is recommended.