BackgroundYellow Fever (YF) is a viral hemorrhagic disease transmitted by aedes mosquito species. Approximately, 200,000 cases and 30,000 deaths occur worldwide every year. In Ethiopia, the last outbreak was reported in 1966 with 2200 cases and 450 deaths. A number of cases with deaths from unknown febrile illness reported from South Ari district starting from November 2012. This investigation was conducted to identify the causative agent, source of the outbreak and recommend appropriate interventions.MethodsMedical records were reviewed and Patients and clinicians involved in managing the case were interviewed. Descriptive data analysis was done by time, person and place. Serum samples were collected for serological analysis it was done using Enzyme-linked Immunosorbent Assay for initial screening and confirmatory tests were done using Plaque Reduction and Neutralization Test. Breteau and container indices were used for the entomological investigation to determine the risk of epidemic.ResultsA total of 141 Suspected YF cases with 43 deaths (CFR = 30.5%) were reported from November 2012 to October 2013 from South Omo Zone. All age groups were affected (mean 27.5, Range 1–75 Years). Of the total cases, 85.1% cases had jaundice and 56.7% cases had fever. Seven of the 21 samples were IgM positive for YF virus. Aedes bromeliae and Aedes aegypti were identified as responsible vectors of YF in affected area. The Breteau indices of Arkisha and Aykamer Kebeles were 44.4% and 33.3%, whereas the container indices were 12.9% and 22.2%, respectively.ConclusionThe investigation revealed that YF outbreak was reemerged after 50 years in Ethiopia. Vaccination should be given for the affected and neighboring districts and Case based surveillance should be initiated to detect every case.
Background Dengue Fever (DF) is underrecognized mosquito borne viral disease prevalent in tropical and subtropical regions. In 2013, Ethiopia reported the first confirmed DF outbreak in Dire Dawa city which affected 11,409 people. During the outbreak investigation, we determined factors associated with DF and implemented control measures. Methods We conducted a 1:2 un-matched case control study from October 7–15/2015. Case was any person with fever of 2–7 days and more than two symptoms: headache, arthralgia, myalgia, rash, or bleeding from any part of the body. We recruited participants using purposive sampling from health facilities and used structured questionnaire to collect data. Multiple logistic regression analysis was conducted to control confounders and to identify factors associated with DF. Sixty-nine serum-samples were tested by Enzyme-Linked Immunosorbent Assay (ELISA). Results We enrolled 210 participants (70 cases and 140 controls) in the study. Females accounted for 51.4% of cases and 57.1% of controls. The mean age was 23.7 ± 9.5 standard deviation (SD) for cases and 31.2 ± 13 SD for controls. Close contact with DF patient (Adjusted odds ratio [AOR] =5.36, 95% confidence interval [CI]: 2.75–10.44), nonuse of bed-nets (AOR = 2.74, 95% CI: 1.06–7.08) and stagnant water around the village (AOR = 3.61, 95% CI: 1.31–9.93) were independent risk factors. From the samples tested, 42 were confirmed positive. Conclusions Individuals who live with DF patient, around stagnant water and do not use bed nets are at high risk of contracting the disease. Health education on DF prevention was given and mosquito breeding sites were drained. Strong vector prevention strategies are recommended by enhancing the existing malaria prevention and control program. Electronic supplementary material The online version of this article (10.1186/s12889-019-7015-7) contains supplementary material, which is available to authorized users.
Cases of malnutrition-related diabetes mellitus conforming to the description of the protein deficient pancreatic diabetes type in Ethiopian patients were compared with Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetic. Fourteen of 39 malnutrition-related diabetes mellitus patients had fat malabsorption compared with only two of ten Type 1 diabetic patients and one of nine control subjects. Xylose absorption was normal favouring a pancreatic cause for the malabsorption. Plasma C-peptide during oral glucose tolerance test was significantly lower than that in Type 2 diabetic patients and normal control subjects (p less than 0.01 to 0.001) and was also consistently but not significantly higher than in Type 1 diabetic patients. Glucagon secretion patterns were similar in malnutrition-related and Type 1 diabetic patients. Of 23 new malnutrition-related diabetic patients treated with glibenclamide after nutritional rehabilitation and insulin treatment, only three responded, 14 were unresponsive but remained ketosis free for over eight days while another six developed ketoacidosis or significant ketonuria within two to six days during the trial. Sixteen unselected Type 1 diabetic patients who discontinued their insulin therapy all developed frank ketoacidosis after a mean of 5.5 days. The similarity of the malnutrition-related and Type 1 diabetes mellitus in age of onset, insulin requirement for diabetic control and appearance of ketosis-proneness in some cases, together with the similarity of C-peptide and glucagon secretion patterns suggest that the protein deficient pancreatic diabetes variant of malnutrition-related diabetes mellitus may be Type 1 diabetes mellitus modified by the background of malnutrition rather than an aetiologically separate entity.(ABSTRACT TRUNCATED AT 250 WORDS)
Preventing zoonotic diseases requires coordinated actions by government authorities responsible for human and animal health. Constructing the frameworks needed to foster intersectoral collaboration can be approached in many ways. We highlight 3 examples of approaches to implement zoonotic disease prevention and control programs. The first, rabies control in Ethiopia, was implemented using an umbrella approach: a comprehensive program designed for accelerated impact. The second, a monkeypox program in Democratic Republic of the Congo, was implemented in a stepwise manner, whereby incremental improvements and activities were incorporated into the program. The third approach, a pathogen discovery program, applied in the country of Georgia, was designed to characterize and understand the ecology, epidemiology, and pathogenesis of a new zoonotic pathogen. No one approach is superior, but various factors should be taken into account during design, planning, and implementation.
Globally, 10,000-100,000 human anthrax incidences occur annually with significant number of cases from Chad, Ethiopia, Zambia, Zimbabwe and India. Even though anthrax is a reportable disease in Ethiopia, data have not been analyzed and interpreted for public health intervention. During the past five years, 2009-2013, human and animal anthrax surveillance data were officially requested and received from the Ethiopian Public Health Institute and the Ministry of Agriculture respectively (Reference). The data were analyzed by time and place using micro soft Excel and Epi- info 7.3.1. A total of 5,197 human and 26,737 animal anthrax cases (human to animal ratio 1:5) were reported from 2009 to 2013 with 86 human anthrax deaths (Case Fatality Rate:1.7 %). The National human prevalence was found to be 1.3 per 100,000 populations per five years, while it was 6.7, 2.3, 1.5 and 0.2 in Tigray, Amhara, SNNP and Oromia regions respectively. Zero human case was reported from pastoralist regions with 55-216 animal cases (Afar, Somali and Benshangul Gumuz). The human prevalence was high in May followed by February (0.20 and 0.15 per 100,000 populations per year respectively) This data analysis revealed that less number of human anthrax cases were reported than animal cases (ratio 1:5) in Ethiopia. The pastoralist areas where humans and animals co-exist closely did not report a single human case for the last five years. To determine the magnitude of anthrax in Ethiopia both human and animal surveillance system should be strengthened giving due attention to pastoralist areas. Prevention intervention should be in place in areas where the prevalence of the disease is high. Keywords: Animal, Anthrax, Ethiopia, Human, Surveillance.
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