ObjectiveThe aim of this study was to determine the status of glycemic control and identify factors associated with poor glycemic control among diabetic out-patients.ResultsA hospital based cross-sectional study was conducted among randomly selected 384 (126 type 1 and 258 type 2) diabetic adults attending a hospital in Northeast Ethiopia from January 1 to April 30, 2017. Of the total participants, 70.8% had poor status of glycemic control (defined as mean fasting blood glucose level above 130 mg/dl). In the multivariate analysis, rural residence (AOR = 2.61, 95% CI 1.37–4.96), low educational level (AOR = 7.10, 95% CI 2.94–17.17) and longer duration of diabetes (AOR = 2.20, 95% CI 1.18–4.08) were significantly associated with increased odds of poor glycemic control. Moreover, merchants (AOR = 3.39, 95% CI 1.16–9.96) were significantly more likely to have poor glycemic control compared to government employee. Diabetic patients receiving oral anti-diabetics (AOR = 5.12, 95% CI 2.10–12.52) or insulin (AOR = 3.26, 95% CI 1.26–8.48) were more likely to be poorly controlled. These results highlight the needed for appropriate management of patients focusing on associated factors identified for poor glycemic control to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.

Background: The effort to reduce the burden of malaria should target transmission in the community by accurate identification of asymptomatic infections. In malaria-endemic areas, asymptomatic malaria infection is still associated with complications. Malaria during pregnancy is characterized by anaemia and placental malaria, leading to low birth weight and perinatal morbidity and mortality. This study aimed to provide reliable data on the burden of asymptomatic malaria among pregnant women in malaria endemic areas of North-Shoa, Ethiopia. Methods: Cross-sectional study was carried out to assess the prevalence and predictors of asymptomatic malaria in pregnant women from November 2018 to January 2019. Multistage sampling technique was employed to include 263 study participants. Data were analysed using SPSS version 20.0 statistical software. In all comparisons, p-values ≤ 0.05 was considered as statistically significant. Results: The prevalence of asymptomatic malaria infection was 5.7% (15/263) and 3.4% (9/263) by using microscopy and RDTs, respectively. Plasmodium falciparum was a dominant species 9 (3.4%) and Plasmodium vivax accounted for 6 (2.3%) of Plasmodium infections as detected by microscopy. Multivariate analysis showed that ITN usage and haemoglobin level had a statistically significant association with Plasmodium infection after adjusting other possible factors. Compared to those who were using ITN always, the odds of Plasmodium infection was 18.16 times higher (95% CI 1.84-179.07) in pregnant women who were not using ITN, and 5.19 times higher (95% CI 0.55-49.21) in pregnant women who were using ITN sometimes. Asymptomatic malaria infected pregnant women were 3.78 times (95% CI 0.98-14.58) more likely to be anaemic compared to non-infected pregnant women. Conclusion: The present study showed asymptomatic malaria is prevalent in pregnant women and it has statistically significance association with the haemoglobin level of pregnant women. This indicates pregnant women have to be screened for asymptomatic malaria to avoid health consequences of malaria infection during pregnancy for the mother and fetus.

BackgroundAnemia is a common finding in patients with diabetes, even in the absence of kidney disease and is a risk factor for adverse outcomes, including all-cause and cardiovascular mortality. Despite this, relatively little is known about the burden of anemia among adults with diabetes in sub-Saharan Africa. The aim of this study was to determine the prevalence of anemia and its association with renal disease among diabetic adult outpatients attending a hospital in Northeast Ethiopia.MethodsA cross-sectional study was conducted among 412 diabetic adults at the diabetes clinic of Dessie Referral hospital in Northeast Ethiopia, from January to April 2018. Each patient provided a blood sample for hemoglobin and serum creatinine levels and urine for albuminuria. Anemia was defined by World Health Organization criteria (<13 g/dl for men and <12 g/dl for women). Glomerular filtration rate (GFR) was estimated using the 4-variable Modification of Diet in Renal Disease (MDRD) equation. Chronic kidney disease (CKD) was classified into 5 stages based on the eGFR and albuminuria.ResultsAnemia was present in 26.7% of the participants, and CKD in 43.0%. Anemia was more prevalent in patients with CKD (39.5%) than those without CKD (17.0%; P < 0.001). The prevalence of anemia increased with stage of CKD, from 22.6% at stage 1 to 100% at stage 4. Fifteen percent of the patients had anemia below the treatment threshold of 11 g ⁄dl. In multivariate analysis, older age (AOR = 2.41, 95% CI 1.11–5.21); type 2 diabetes (AOR = 2.40, 95% CI 1.14–5.08); presence of hypertension (AOR = 3.78, 95% CI 1.35–10.57); high systolic BP (AOR = 1.05, 95% CI 1.02–1.08); serum creatinine (AOR = 12.80, 95% CI 3.90–87.98) and low GFR (AOR = 9.50, 95% CI 4.05–22.28) were independently associated with greater odds for the presence of anemiaConclusionsAnemia is commonly present among diabetic adults attending our diabetes outpatient clinic in Northeast Ethiopia, including those without kidney disease. Our findings highlight the need for incorporating anemia screening into routine diabetes care to enable early detection and treatment of anemia and hence improve the overall care of patients with diabetes.

Background: Intestinal parasitic infections (IPIs) are major health problems in many developing countries. School children between the ages of 5 and 15 years suffer the highest infection rate and parasitic burden that are attributed to poor sanitation and hygiene. In Ethiopia, the prevalence of IPIs among school children is high (ranging from 66.7% to 83.8%). Methods: School-based cross-sectional study was conducted in two primary schools at Harbu Town, Northeast Ethiopia from February to May, 2018. Systematic random sampling technique was employed to select study participants from the two school compounds. The sample size was determined by a single population proportion statistical formula and the minimum numbers of study participants defined were 400 school children. Sociodemographic and risk factor-related information were collected using structured questionnaire. Data about detection and identification of intestinal parasites were obtained from laboratory examination of stool specimen by using wet mount and formol-ether concentration techniques. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. The data were processed and analyzed using SPSS version 20 software. Results: Out of a total of 400 study participants, 86 (21.5%) were found with one or more IPIs. Six different types of intestinal parasites were identified, Entamoeba histolytica was the most 33 (8.3%) detected parasite followed by Hymenolopis nana 19 (4.8%) and Schistosoma mansoni 19 (4.8%). The least identified parasite was Giardia lamblia, detected only from four study participants. Male study participants showed 2.42 times risk (AOR = 2.42, 95% CI = 1.25-4.7, P = 0.009) of acquiring parasitic infection than female. Presence of water body near to home and having contact with water bodies showed 7.64 (AOR= 7.64, 95% CI= 3.3-17.8, P= 0.000) and 4.6 (AOR=4.6, 95% CI: 2.04-10.57, P= 0.000) times risk of infection with parasitic infection among school children, respectively. Conclusion: IPIs were highly prevalent health problem among the two primary school children in Harbu Town. Sex, availability of water bodies near to house and contact with water bodies were having significant association with the prevalence of IPIs.

Background Parasitic infections are known causes of morbidity among HIV-infected patients with low CD4 + counts who are on antiretroviral therapy (ART), mainly as a result of immuno suppression. This study aimed to assess the extent of intestinal parasitic infection and related risk factors among HIV-infected patients attending ART clinic at Debretabor General Hospital, Northern Ethiopia. Methods A health facility–based cross-sectional study was conducted on 383 HIV-infected patients attending the ART clinic of Debretabor General Hospital, northern Ethiopia from December 2018 to March 2019. An interview-based structured questionnaire was used to gather sociodemographic and risk-factor data. About 5 g fresh stool and 4 mL venous blood were collected from each patient, then transported and tested in accordance with laboratory-standard operating procedures. Data obtained were entered into SPSS version 22.0 and analyzed. P <0.05 with 95% CI was considered statistically significant. Results The overall prevalence of intestinal parasites was 25.3%, with 18% and 23.8% by direct wet-mount and formol ether–concentration technique, respectively. Eight (2.1%) patients were infected by multiple parasites using the concentration technique. Ascaris lumbricoides was the most frequently identified parasite (n=23, 25.3%). Parasitic infection was significantly higher among illiterates ( P= 0.011), patients with CD4 count <200 cells/mm 3 ( P <0.001), and those who did not have a toilet in their home ( P= 0.049) than their counterparts. Conclusion Relatively higher prevalence of intestinal parasitic infection was found among HIV/AIDS patients. The distribution of intestinal parasites was greatly affected by illiteracy, reduced CD4 + counts, and absence of a toilet. Therefore, HIV/AIDS patients with low CD4 + counts should be diagnosed consistently for intestinal parasites with routine stool examinations, and awareness creation should be advocated to be included as an essential component of ART-monitoring strategies for improved patient care.

Background: Parasitic infections are known causes of morbidity among HIV infected patients with low CD4+ counts who are on antiretroviral therapy; mainly as a result of immune suppression. Thus, this study aimed to assess the extent of intestinal parasitic infection and its related risk factors among HIV infected patients attending ART clinic of Debretabor General Hospital, Northern Ethiopia.Patients and methods: A health facility based cross sectional study was conducted on a total of 383 HIV infected patients attending ART clinic of Debretabor General Hospital, Northern Ethiopia from December 2018 to March 2019. An interview based structured questionnaire were used to gather socio-demographic and risk factor data. About 5 grams of fresh stool specimen and 4 ml of venous blood sample were collected, then transported and tested in accordance with the laboratory standard operating procedures. The obtained data was entered into SPSS version 22.0; and analyzed. P-value <0.05 with 95% confidence interval was considered statistically significant.Result: The overall prevalence of intestinal parasites was 25.3%; with 18% and 23.8% by direct wet mount and formol-ether concentration technique respectively. 8 (2.1%) patients were infected by multiple parasites in concentration technique. Ascaris lumbricoides, 23(25.3%) was the most frequently identified parasite. Parasitic infection was significantly higher among illiterates (P=0.011); patients with a CD4 count of <200 cells/mm3 (P<0.001) and among patients who did not have latrine (P=0.049) than their counter parts.Conclusion: Relatively higher prevalence of intestinal parasitic infection was found among HIV/AIDS patients. The distribution of intestinal parasites is greatly affected by illiteracy, reduced CD4+ counts and absence of toilet. Thus, HIV/AIDS patients with low CD4+ counts should be diagnosed consistently for intestinal parasites and routine stool examination and awareness creation should be advocated to be included as an essential component of the ART monitoring strategy for improved patient care.

Background Glucose-6-phosphate dehydrogenase (G6PD) is cytosolic enzyme, which has a vital role for the integrity and functioning of red blood cells. Lower activity of this enzyme leads to the occurrence of acute haemolytic anaemia after exposure to oxidative stressors like primaquine. Primaquine is an important drug for the radical cure of Plasmodium vivax and blocking transmission of Plasmodium falciparum, and thereby enhancing malaria elimination. However, there is a need to identify G6PD deficient individuals and administer the drug with caution due to its haemolytic side effects. The main objective of this study is to determine the prevalence of G6PD deficiency among malaria-suspected individuals. Methods A facility-based cross-sectional study was conducted from September 2020 to September 2021 in Metehara Health Centre, Eastern Ethiopia. A structured questionnaire was used to collect the socio-demographic and clinical information of the study participants. Capillary and venous blood samples were collected based on standard procedures for onsite screening, dried blood spot preparation, and malaria microscopy. The G6PD enzyme activity was measured by careSTART™ G6PD biosensor analyzer. Data was entered and analysed by SPSS. Results A total of 498 study participants were included in the study, of which 62% (309) were males. The overall prevalence of G6PD deficiency based on the biosensor screening was 3.6% (18/498), of which 2.9% and 4.8% were males and females, respectively. Eleven of the G6PD deficient samples had mutations confirmed by G6PD gene sequencing analysis. Mutations were detected in G267 + 119C/T, A376T, and ChrX:154535443. A significant association was found in sex and history of previous malaria infection with G6PD deficiency. Conclusions The study showed that the G6PD deficient phenotype exists in Metehara even if the prevalence is not very high. G267 + 119C/T mutation is the predominant G6PD variant in this area. Therefore, malaria patient treatment using primaquine should be monitored closely for any adverse effects.

Objective. Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) coinfection increases the incidence of end-stage liver disease which is more severe in immune-compromised HIV-infected patients than HCV infection alone. The aim of this study was to assess HCV infection and the associated risk factors among HIV/AIDS patients attending Dessie Referral Hospital, Northeastern Ethiopia. Methods. A hospital-based cross-sectional study was conducted among 249 HIV-infected adults selected by a systematic random sampling technique from January to March 2018. A structured questionnaire was used to collect sociodemographic and risk factor data. Moreover, the blood specimen was collected and tested for CD4 count and anti-HCV antibody detection according to standard operating procedures. The data obtained were entered into SPSS version 20, and descriptive statistics, bivariate and multivariate logistic regression analyses were performed. A P value ≤0.05 with a corresponding 95% confidence interval was considered as statistically significant. Result. Of a total of 249 HIV-infected study subjects, 120 (48.2%) were male and 129 (51.8%) were females, while the mean (±SD) age and CD4+ cells/mm3 were 39.10 (±11.507) years and 316.08 + 290.607 cells/mm3, respectively. Anti-HCV antibody was detected in 13 (5.2%) patients with higher prevalence rate found in males P = 0.078 and elders >50 years of age P = 0.013 than their counterparts. Age group of >50 years of age (AOR = 9.070, 95% CI: 1.578, 52.117, P = 0.013 ), longer duration of HIV treatment (AOR = 5.490, 95% CI: 1.341, 34.458, P = 0.041 ), WHO clinical stage III/IV (AOR = 12.768, 95% CI: 2.293, 71.106, P = 0.004 ), previous history of hospitalization (AOR = 10.234, 95% CI: 2.049, 51.118, P = 0.005 ), tooth extraction (AOR = 6.016, 95% CI: 1.137, 36.837, P = 0.048 ), and liver disease (AOR = 11.398, 95% CI: 1.275, 101.930, P = 0.029 ) were statistically significant predictors of HCV infection. Conclusion. The prevalence of HCV infection is still higher and causes concern. Therefore, screening of these high-risk groups should be critical to reduce mortality and to improve clinical outcomes.