BackgroundMalaria is one of the most serious public health problems in the world, and is a major public health problem in Ethiopia. Over the past years, the disease has been consistently reported as the first leading cause of outpatient visits, hospitalization and death in health facilities across the country. This study aimed to assess malaria prevalence trend in the Kombolcha Health Centre.MethodsA retrospective study was carried out in the Kombolcha Health Centre, north-central Ethiopia. Malaria cases reported from 2009 to 2016 were carefully reviewed from the laboratory record books. Interventions that had been taken in each year were collected from the district health bureau and head of Kombolcha Health Centre using checklists.ResultsA total of 27,492 blood films were examined from malaria-suspected patients in the Kombolcha Health Centre from 2009 to 2016. Malaria was confirmed and reported in 2066 (7.52%) of the examined blood films with 258 mean annual cases of. Minimum and maximum cases were reported in 2009 and 2010, respectively. Plasmodium falciparum and P. vivax accounted 60.2% and 35.5% of the cases, respectively. Male patients were more affected (n = 1407; 68.1%) than female ones (n = 659; 31.89%). The highest malaria prevalence (n = 1440; 69.69%) was seen in the 15–45 years age group, followed by those 5–14 years old (n = 303; 14.67%), and finally patients under five years old (n = 217; 10.5%). Malaria cases were at a peak in spring and reduced in the winter season.ConclusionAlthough the current malaria control strategies are effective in decreasing the morbidity and mortality, malaria is still among major public health problems in Ethiopia. Plasmodium falciparum is the dominant species in the study area. However, in recent years P. vivax cases are increasing, indicating that attention should also be given to this species. The efficacy of chloroquine for P. vivax should be evaluated in the study area. Control activities should be continued and scale up.
Background Malaria is among the leading causes of mortality and morbidity among under five children in developing countries. Ethiopia has set targets for controlling and eliminating malaria through at-risk group interventions. However, the disease remains a serious public health concern in endemic areas like in Wollo, Northeast Ethiopia. Therefore, this study aimed to determine malaria prevalence, risk factors and parasite density among under five children in Ziquala district. Method A facility—based cross-sectional study was conducted in Ziquala hospital, and Tsitsika, Mishra and Hamusit health centers in Ziquala district, Northeast Ethiopia, from January 2022 to April 2022. The study enrolled a total of 633 under five children using a systematic sampling technique. A capillary blood sample was collected from each child to prepared thin and thick blood smears. Smears were then stained with 10% Giemsa and examined under light microscope. A pretested structured questionnaire was used to collect on socio-demographic data, parental/caregiver knowledge, and malaria determining factors. Bivariable and multivariable logistic regression analysis was done to identify factors associated with malaria. Result The overall prevalence of malaria among children visiting Ziquala district health institutions was 24.6% (156/633). Plasmodium falciparum, P. vivax, and mixed infection (both species) accounted for 57.1%, 38.5%, and 4.5% of the cases, respectively. Regarding to parasite load, moderate parasitemia was the most common, followed by low and high parasitemia with the proportion of 53.8%, 31.4% and 14.7% parasite density, respectively. Malaria infection was linked to irregular utilization of insecticide-treated bed nets (AOR = 5.042; 95% CI: 2.321–10.949), staying outside at night (AOR = 2.109; 95% CI: 1.066–4.173), and parents not receiving malaria health education in the past six months (AOR = 4.858; 95% CI: 2.371–9.956). Conclusion Malaria was prevalent among children under the age of five enrolled in the study. The local government should focus on regular insecticide treated net utilization, reducing the risk of mosquito bites while sleeping outdoors at night and increasing public understanding of malaria prevention and control through health education would also help to minimize the burden of malaria.
Introduction Carbapenemase-producing Enterobacteriaceae are by far the most public health and urgent clinical problems with antibiotic resistance. They cause longer hospital stays, more expensive medical care, and greater mortality rates. This systematic review and meta-analysis aimed to indicate the prevalence of carbapenemase-producing Enterobacteriaceae in Ethiopia. Methods This systematic review and meta-analysis was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Electronic databases like PubMed, Google Scholar, CINAHL, Wiley Online Library, African Journal Online, Science Direct, Embase, ResearchGate, Scopus, and the Web of Sciences were used to find relevant articles. In addition, the Joanna Briggs Institute quality appraisal tool was used to assess the quality of the included studies. Stata 14.0 was used for statistical analysis. Heterogeneity was assessed by using Cochran’s Q test and I2 statistics. In addition, publication bias was assessed using a funnel plot and Egger’s test. A random effect model was used to estimate the pooled prevalence. Sub-group and sensitivity analysis were also done. Results The overall pooled prevalence of carbapenemase-producing Enterobacteriaceae in Ethiopia was 5.44% (95% CI 3.97, 6.92). The prevalence was highest [6.45% (95% CI 3.88, 9.02)] in Central Ethiopia, and lowest [(1.65% (95% CI 0.66, 2.65)] in the Southern Nations and Nationalities People Region. In terms of publication year, 2017–2018 had the highest pooled prevalence [17.44 (95% CI 8.56, 26.32)] and 2015–2016 had the lowest [2.24% (95% CI 0.87, 3.60)]. Conclusion This systematic review and meta-analysis showed a high prevalence of carbapenemase-producing Enterobacteriaceae. So, to alter the routine use of antibiotics, regular drug susceptibility testing, strengthening the infection prevention approach, and additional national surveillance on the profile of carbapenem resistance and their determining genes among Enterobacteriaceae clinical isolates are required. Systematic review registration PROSPERO (2022: CRD42022340181).
Background Streptococcus pneumoniae infection is still the world’s most serious public health problem among children under the age of five. Nasopharyngeal carriage rate of Streptococcus pneumoniae has been identified as an important risk factor for the acquisition of community acquired respiratory tract infection. To date, little is known about the nasopharyngeal infection and antimicrobial susceptibility pattern of Streptococcus pneumoniae among preschool children in Ethiopia. Objective The aim of this study was to assess the prevalence of nasopharyngeal carriage and antimicrobial susceptibility pattern of Streptococcus pneumoniae among preschool children. Methods A cross-sectional study was conducted from September 2021 to April 2022. A total of 418 preschool children were enrolled using a multistage sampling technique. Nasopharyngeal swab was collected and transported to Medical Microbiology Laboratory at Debre Berhan comprehensive specialized hospital using skim-milk tryptone glucose glycerol transport media. The swab was inoculated on blood agar plates supplemented with 5µg/mL gentamycin and incubated at 37°C for 24–48 hours under 5% CO2 using a candle jar. Identification of Streptococcus pneumoniae was performed using Gram stain, catalase test, optochin test and bile solubility test. Antimicrobial sensitivity tests were done using a modified Kirby-Bauer disk diffusion method. Data were entered into the statistical package Epi data 4.0.0.6 and transferred to and analyzed using SPSS software version-23. A P -value ≤0.05 with 95% CI was considered to be statistically significant. Results The prevalence of Streptococcus pneumoniae nasopharyngeal carriage was 29.9% (125/418). The overall rate of multidrug resistance was 86 (68.8%), with tetracycline (68.8%) and TMP-SMX (68%). Among risk factors, young age and passive smoking were associated with pneumococcal carriage. Conclusion The present study revealed a substantially lower prevalence of Streptococcus pneumoniae nasopharyngeal carriage. High antimicrobial resistance was observed for most antimicrobial drugs tested. Younger age groups and passive smokers were at risk of Streptococcus pneumoniae nasopharyngeal carriage.
Background: T1DM is a chronic organ-specific T-cell-mediated autoimmune disease characterized by the selective destruction of βcells in the islets of Langerhans, resulting in insulin deficiency and hyperglycemia. Genes for cytotoxic T lymphocyte-associated antigen 4 have been hypothesized as possible contender genes for T1DM vulnerability. However, it has not been studied in the Ethiopian population yet. Objective: The aim of the study was to investigate CTLA-4 exon 1 was linked to A49G polymorphism with T1DM and its biological features of CTLA-4 among T1DM patients, in Ethiopia. Methods: A case-control study was done from December 2019 to March 2020 on 210 study participants (105 T1DM patients and 105 healthy controls). Polymerase Chain Reaction amplification with forward and reverse primers was followed by restriction fragment length polymorphism and gel electrophoresis to determine gene polymorphism. Bioinformatics data of SNP was retrieved from National Centers for Biotechnology Information databases. The chi-square test and logistic regression were used. Statistical significance was defined as a P-value of less than 0.05. Results:The CTLA-4 (+A49G) gene polymorphism was observed on 56 (26.7%) study participants, 39 (18.57%) of T1DM patients, and 17 (0.08%) were controls. In T1DM and controls, the frequency of the A allele was 73.3% and 89.5%, while the G allele was 26.7% and 10.5%, respectively. The G allele was found to be associated with T1DM (OR=3.1; 95% CI, 1.82 −5.32; P=0.001). Statistical analysis revealed an association between the likelihood of T1DM and GG genotype of the CTLA-4 (+A49G) gene polymorphism (OR=3.11; 95% CI, 1.37-10.90; P=0.01). Further in silico analyzed the SNP to assess its biological features. Conclusion:The study showed as CTLA-4 (+A49G) gene polymorphism is linked with T1DM in the Ethiopian population.
Background In people living with the human immunodeficiency virus, haematological abnormalities have been linked to an increased risk of disease progression and mortality. Hematological parameters may have a positive or negative impact on antiretroviral therapy. The aim of this study was to assess the immuno-haematological abnormalities of HIV-infected patients before and after the initiation of highly active antiretroviral therapy in the antiretroviral therapy clinics of six health facilities in Dessie, Northeast Ethiopia. Methods A facility-based cross-sectional study was conducted from April to May 30, 2021, at the antiretroviral therapy clinics of six health facilities in Dessie Town. A total of 378 HIV-infected patients taking highly active antiretroviral treatment for at least 6 months by using a consecutive sampling technique were included. A well-organized questionnaire was used to collect socio-demographic and clinical information. Immune-haematological parameters were tested using a Mindray BS-300 hematology analyzer and a BD FACS count CD4 analyzer. Statistical analysis was performed using SPSS version 25 statistical software. Statistical significance was defined as a P-value of 0.05 with a 95% confidence interval. Results Leukopenia was found in 26.7% and 16.5%, neutropenia in 16.5% and 9.4%, lymphopenia in 20% and 3.1%, and thrombocytopenia in 25.9% and 7.1% of HIV patients before and after HAART initiation, respectively. There was a significant difference in total white blood cell, absolute neutrophil, red blood cell, hemoglobin value, mean cell volume, mean cell haemoglobin, mean cell haemoglobin concentration, red cell distribution width, platelet and CD4+ T cell counts in HIV patients before and after the initiation of HAART with P < 0.05. Conclusion and Recommendation Anemia, leukopenia, neutropenia, lymphopenia, and thrombocytopenia were the most common haematological abnormalities found in this study before and after HAART initiation. The prevalence of thrombocytopenia, immunosuppression, and viral load was reduced considerably after starting HAART.
Background Hematological reference intervals (RIs) are affected by inherent variables like age, sex, genetic background, environment, diet and certain circumstances such as pregnancy signifying the need for population specific values. This study was designed to establish RIs for common hematological parameters of apparently healthy pregnant and non-pregnant women from Northeast Ethiopia. Method This community based cross-sectional study recruited 600 pregnant and non-pregnant women in South Wollo Zone, Northeast Ethiopia from June to August 2019. Complete blood count was performed for eligible participants using Mindary BC-3000 plus hematology analyzer. The mean, median, and 2.5th and 97.5th percentile reference limits with 90% CI were determined using SPSS version 23. Result The established selected 2.5th–97.5th percentiles RIs for pregnant women were: WBC: 4.0–13.2x109/L; RBC: 3.45–4.67x1012/L; Hgb: 10.1–13.7g/dL; HCT: 33.5–46.5%; MCV: 85-104fL; MCH: 27.5–33.0pg; MCHC: 30.3–33.7g/dL and Platelet count: 132-373x109/L. The respective values for non-pregnant women were 3.6–10.3; 4.44–5.01; 12.4–14.3; 38.4–50.1; 86–102; 27.1–32.4, 30.4–34.1, 173–456. A statistically significant difference between pregnant and non-pregnant women was noted in all hematological parameters except MCHC. The mean and median value of WBC count, MCV, MPV and PDW increased, whereas mean values of HCT and Platelet count decreased as gestational period advances. Conclusion The observed difference from other studies signify the necessity for using trimester specific RIs and separate RI for pregnant and non-pregnant women. Thus, we recommend the health facilities in the study area to utilize the currently established RIs for pregnant and non-pregnant women for better care.
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