Background. With prolonged survival and aging of persons with HIV on combination antiretroviral therapy (ART), hypertension has emerged as a significant cause of morbidity and mortality globally. However, little is known about the burden of this comorbid condition among adults living with HIV in sub-Saharan Africa. In this study, we aimed to determine the prevalence and factors associated with hypertension among HIV-infected patients receiving ART in Northeast Ethiopia. Methods. A cross-sectional study was conducted at the ART clinic of Dessie Referral Hospital, Northeast Ethiopia, between January and May 2018. HIV-infected patients who were on ART for at least 12 months were included in the study. Demographic, clinical, and laboratory data were collected from each participant. Hypertension was defined as a systolic blood pressure (BP) of ≥140 mmHg and/or diastolic BP of ≥90 mmHg or a reported use of antihypertensive medication. Univariable and multivariate analyses were performed to identify factors associated with hypertension. Results. A total of 408 patients were studied with a mean (±SD) age of 37 ± 10.3 years, and 66.9% were female. The prevalence of hypertension was 29.7% (95% CI, 25.3–35.0%). Nearly 75% of the patients with hypertension were previously undiagnosed. In a univariate analysis, older age, male gender, a family history of hypertension, duration of HIV infection, duration on ART, high body mass index, low CD4 count, diabetes, and renal impairment were associated with hypertension. Multivariate analysis revealed older age (AOR = 2.08; 95% CI, 1.13–3.83), male gender (AOR = 1.64; 95% CI, 1.01–2.65), longer duration on ART (AOR = 1.91; 95% CI, 1.14–3.20), high body mass index (AOR = 3.32; 95% CI, 1.13–9.77), and diabetes (AOR = 2.76; 95% CI, 1.29–5.89) as independent risk factors of hypertension. Conclusions. Hypertension is highly prevalent among HIV-infected patients on ART attending our clinic in Northeast Ethiopia but is mostly undiagnosed. These findings highlight the need for integrating hypertension management into routine HIV care to prevent adverse outcomes and improve health of people living with HIV on ART.
Infections due to multidrug-resistant Enterobacteriaceae have become major international public health problem due to the inadequate treatment options and the historically lagged pace of development of novel antimicrobial drugs. Inappropriate antimicrobial use in humans and animals coupled with increased global connectivity aided to the transmission of drug-resistant Enterobacteriaceae infections. Carbapenems are the medications of choice for extended-spectrum beta-lactamase and AmpC producers, but alternatives are currently needed because carbapenem resistance is increasing globally. This review pointed to discuss emerging drug-resistant Enterobacteriaceae, its epidemiology and novel treatment options for infections, which date back from 2010 to 2019 by searching Google Scholar, PubMed, PMC, Hinari and other different websites. The occurrence of carbapenem-resistant Enterobacteriaceae is reported worldwide with great regional variability. The rise of carbapenem-resistant Enterobacteriaceae poses a threat to all nations. Enzyme synthesis, efflux pumps, and porin mutations are the main methods by which Enterobacteriaceae acquire resistance to carbapenems. The major resistance mechanism among these is enzyme synthesis. Most carbapenem resistance is caused by three enzyme groups: Klebsiella pneumoniae carbapenemase (Ambler class A), metallo-ß-lactamases (Ambler class B), and oxacillinase-48 (Ambler class D). Ceftazidime-avibactam, which was newly licensed for carbapenemase producers, is the most common treatment option for infections. Meropenem-vaborbactam, imipenem-relebactam, plazomicin, cefiderocol, eravacycline, and aztreonam-avibactam are recently reported to be active against carbapenem-resistant Enterobacteriaceae; and are also in ongoing trials for different populations and combinations with other antibacterial agents. Overall, treatment must be tailored to the patient's susceptibility profile, type and degree of infection, and personal characteristics.
ObjectiveIntestinal parasitic infection is a serious public health problem throughout the world particularly in developing countries. Like other countries in sub saran region epidemiological data regarding prevalence of intestinal parasites and their associated factors were limited in Ethiopia. So, the main objective of this study was to determine the prevalence of intestinal parasites and associated factors among under five children in Dessie Referral Hospital from August 1, 2017 to December 20, 2017.ResultsIn this research a total of 232 under five children were involved. Out of these study subjects 36 (15.5%) were infected with at least one intestinal parasites. A total of five intestinal parasites were examined and the dominant parasite was E. histolytica 15/232 (6.5%) followed by H. nana 11/232 (4.7%). All age groups were affected by intestinal parasites but children who were at the age of below 2 years and at the age between 2 and 3 years were 4.7 times and 2.6 times at risk of acquiring infection with intestinal parasites in comparison at the age of 3–5 years children.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3888-2) contains supplementary material, which is available to authorized users.
Acinetobacter species, particularly Acinetobacter baumannii , is the first pathogen on the critical priority list of pathogens for novel antibiotics to become a “red-alert” human pathogen. Acinetobacter baumannii is an emerging global antibiotic-resistant gram-negative bacteria that most typically causes biofilm-associated infections such as ventilator-associated pneumonia and catheter-related infection, both of which are resistant to antibiotic therapy. A. baumannii’s capacity to develop antibiotic resistance mechanisms allows the organism to thrive in hospital settings, facilitating the global spread of multidrug-resistant strains. Although Acinetobacter infections are quickly expanding throughout hospital environments around the world, the highest concentration of infections occurs in intensive care units (ICUs). Biofilms are populations of bacteria on biotic or abiotic surfaces that are encased in the extracellular matrix and play a crucial role in pathogenesis, making treatment options more difficult. Even though a variety of biological and environmental elements are involved in the production of A. baumannii biofilms, glucose is the most important component. Biofilm-mediated A. baumannii infections are the most common type of A. baumannii infection associated with medical equipment, and they are extremely difficult to treat. As a result, health care workers (HCWs) should focus on infection prevention and safety actions to avoid A. baumannii biofilm-related infections caused by medical devices, and they should be very selective when using treatments in combination with anti-biofilms. Therefore, this review discusses biofilm formation in A. baumannii , its role in disease pathogenesis, and its antimicrobial resistance mechanism.
Objective The aim of this study was to determine the prevalence of diabetes mellitus and its associated factors among human immunodeficiency virus-infected patients on anti-retroviral therapy in Northeast Ethiopia. Results A facility based cross-sectional study was conducted among 408 HIV-infected adults (≥ 18 years old) attending an ART clinic in Northeast Ethiopia from January to March 30, 2018. The mean (± SD) age of studied patients was 37 ± 10.3 years, and 273 (66.9%) were female. Of the total participants, 36 (8.8%, 95% CI 6.4% to 11.8%) had diabetes and 61 (15.0%, 95% CI 11.5% to 18.6%) had impaired fasting glucose level (111–125 mg/dl). Only fourteen (3.4%) participants knew their diabetes status during data collection. In the multivariate analysis, older age (age > 45 years; AOR = 3.51, 95% CI 1.52–8.10, P = 0.003), a family history of diabetes (AOR = 6.46, 95% CI 3.36–21.29, P < 0.001), duration of ART (AOR = 2.67, 95% CI 1.16–6.17, P = 0.021), and hypertension (AOR = 2.62, 95% CI 1.20–5.72, P = 0.016) were independently associated with increased odds of diabetes. These results highlight the need for regular diabetes screening among HIV-infected patients on ART in order to prevent or reduce disease-related outcomes of these patients in this study setting. Electronic supplementary material The online version of this article (10.1186/s13104-019-4402-1) contains supplementary material, which is available to authorized users.
ObjectivesSchistosomiasis and soil-transmitted helminthes infections are among the widely distributed infections worldwide. In Ethiopia, parasitic helminthic infections and schistosomiasis are among the most predominant causes of outpatient morbidity. Hence there is still lack of epidemiological information in North-Eastern Ethiopia, this study aimed to determine the prevalence and associated factors of Schistosoma mansoni and other helminthes infections at Haike primary school children, Haike, North-East Ethiopia.ResultsThe overall prevalence of S. mansoni and other helminthes infections using formol-ether concentration technique was 85/279 (30.5%). Schistosoma mansoni was the dominant parasites as detected by both direct wet mount and formol-ether concentration technique with 44/52 (84.6%) and 65/85 (76.5%) respectively. Chi square test showed significant association between parasitic infections and age of the school children (p = 0.003). The binary logistic regression analysis was showed strong statistical association (p = 0.00) between swimming habit and parasitic infections (AOR = 6.61, 95% CI 3.31–13.12). Family used lake as source of water showed statistically significant association (AOR = 5.35, 95% CI 2.97–12.32). Furthermore, those who get water from river (AOR = 1.24, 95% CI 0.33–4.66) were more likely to be infected with S. mansoni and geo-helminthes than those who used tap water.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2942-9) contains supplementary material, which is available to authorized users.
Objective Intestinal parasitic infections are among the major cause of diseases of public health problems in sub-Saharan Africa. In Ethiopia, epidemiological information on street dwellers is very limited. So, this study aimed to determine the prevalence and associated factors of intestinal parasite among street dwellers’ in Dessie town, North-East, Ethiopia. Results A cross-sectional study was carried out on street dwellers in Dessie town from November 2017 to February, 2018. Stool specimen was examined by direct wet mount, formol-ether concentration technique and modified Ziehl–Neelsen methods. Majority of study participants were males 220 (89.4%). The mean age of the study participants were 22.85 (SD = 4.78) years. The overall parasite prevalence was 108/246 (43.9%). Among the six different intestinal parasites detected, H. nana 33 (13.4) and E. histolytica 24 (9.8%) were dominant. Multivariate analysis showed, shoe wearing habit (P = 0.035), hand washing habit after toilet (P = 0.035), and history of animal contact (P = 0.016) had statistically significant association with intestinal parasitic infections after adjusting other variables. Although the prevalence of intestinal parasitic infections in this study was lower than previous studies conducted in similar study groups. The prevention and control strategies of intestinal parasites should address the poor segment of populations including street dwellers.
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.
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