BackgroundThe quality of drinking water has always been a major health concern, especially in developing countries, where 80 % of the disease cases are attributed to inadequate sanitation and use of polluted water. The inaccessibility of potable water to large segment of a population in the rural communities is the major health concern in most part of developing countries. This study was designed to evaluate the physico-chemical and bacteriological qualities of drinking water of different sources in the study area.MethodsThe study was conducted at Serbo town and selected kebeles around the same town in Kersa district of Jimma Zone, southwest Ethiopia. Socio-demographic characteristics of the study populations were gathered using structured and pre-tested questionnaires. Standard microbiological methods were employed for determination of bacterial load and detection of coliforms. Physico-chemical analyses [including total dissolved substances (TDS), total suspended substances (TSS), biological oxygen demand (BOD), nitrate and phosphate concentrations, turbidity and electrical conductivities] were conducted following guidelines of American Public Health Association and WHO. Correlations among measured parameters of water samples collected from different water sources were computed using SPSS software (version 20).ResultOnly 18.1 % (43/237) of the study population had access to tap water in the study area. More than 50 % of the community relies on open field waste disposal. Members of the family Enterobacteriaceae, Bacillus and Pseudomonas were among dominant bacterial isolates in the water samples. All water samples collected from unprotected water sources were positive for total coliforms and fecal coliforms (FC). Accordingly, FC were detected in 80 % of the total samples with counts ranging between 0.67 and 266.67 CFU/100 ml although 66.67 % of tap water samples were negative for FC. The recorded temperature and pH ranged between 20.1–29.90 °C and 5.64–8.14, respectively. The lowest and highest mean TDS were 116 and 623 mg/l, respectively. Furthermore, the mean concentration of TSS ranged between 2.07 and 403.33 mg/l. Turbidity, electric conductivity, and nitrate concentration of the water samples ranged, respectively, between 0.01–65.4 NTU, 30.6–729 μS/cm, and below detection limit to 95.80 mg/l. In addition, the mean dissolved oxygen values were found to be between 1.62 and 10.71 mg/l; whereas BOD was within the range of 8–77 mg/l. In all water samples, the concentrations of zinc were within the WHO maximum permissible limits (3 mg/l) although the lead concentration in about 66.7 % of the samples exceeded the maximum permissible limit (0.01 mg/l).ConclusionThe present study has revealed that some of the bacteriological data and physico-chemical parameters of the different water sources had values beyond the maximum tolerable limits recommended by WHO. Thus, it calls for appropriate intervention, including awareness development work and improving the existing infrastructure in order to minimize the potential hea...

SummaryBackgroundChloroquine remains the mainstay of treatment for Plasmodium vivax malaria despite increasing reports of treatment failure. We did a systematic review and meta-analysis to investigate the effect of chloroquine dose and the addition of primaquine on the risk of recurrent vivax malaria across different settings.MethodsA systematic review done in MEDLINE, Web of Science, Embase, and Cochrane Database of Systematic Reviews identified P vivax clinical trials published between Jan 1, 2000, and March 22, 2017. Principal investigators were invited to share individual patient data, which were pooled using standardised methods. Cox regression analyses with random effects for study site were used to investigate the roles of chloroquine dose and primaquine use on rate of recurrence between day 7 and day 42 (primary outcome). The review protocol is registered in PROSPERO, number CRD42016053310.FindingsOf 134 identified chloroquine studies, 37 studies (from 17 countries) and 5240 patients were included. 2990 patients were treated with chloroquine alone, of whom 1041 (34·8%) received a dose below the target 25 mg/kg. The risk of recurrence was 32·4% (95% CI 29·8–35·1) by day 42. After controlling for confounders, a 5 mg/kg higher chloroquine dose reduced the rate of recurrence overall (adjusted hazard ratio [AHR] 0·82, 95% CI 0·69–0·97; p=0·021) and in children younger than 5 years (0·59, 0·41–0·86; p=0·0058). Adding primaquine reduced the risk of recurrence to 4·9% (95% CI 3·1–7·7) by day 42, which is lower than with chloroquine alone (AHR 0·10, 0·05–0·17; p<0·0001).InterpretationChloroquine is commonly under-dosed in the treatment of vivax malaria. Increasing the recommended dose to 30 mg/kg in children younger than 5 years could reduce substantially the risk of early recurrence when primaquine is not given. Radical cure with primaquine was highly effective in preventing early recurrence and may also improve blood schizontocidal efficacy against chloroquine-resistant P vivax.FundingWellcome Trust, Australian National Health and Medical Research Council, and Bill & Melinda Gates Foundation.

BackgroundChloroquine is an anti-malarial drug being used to treat Plasmodium vivax malaria cases in Ethiopia. However, emergence of chloroquine resistant strains of the parasite has challenged the current efficacy of the drug. Therefore, the aim of this study was to assess the effectiveness of chloroquine against P. vivax strains in one of the malaria endemic areas of Ethiopia, namely Halaba district, located in South Nations and Nationalities Peoples Region (SNNPR) of South EthiopiaResultsAmong 87 malaria patients enrolled in the study, only 80 of them completed the 28-days follow-up. Seven of them dropped from the study for different reasons. Among those study participants that completed their follow-up, 69 were classified under the category of adequate clinical and parasitological response (ACPR). However, the remaining 11 cases were considered as under treatment failure mainly due to recurrence of parasitemia on day 7 (four patients), day 14 (six patients), and day 21 (one patient). The age of all cases of treatment failures was found to be less than 20 years. The load of parasitemia of patients with treatment failure on day of admission (4709.4/μl) was higher than day of recurrence (372.37/μl). Parasite reduction ratio (PRR) of treatment failure cases was 12.6/μl.ConclusionThis report revealed the rise in treatment failure (13% [95% CI = 0.074 - 0.217]) as compared to earlier reports from Ethiopia. It signals the spreading of chloroquine resistant P. vivax (CRPv) strains to malaria endemic areas of Ethiopia. It is recommended that all concerned bodies should act aggressively before further expansion of the current drug resistant malaria.

Despite rigorous effort made to control malaria for more than a century, it is still among the main public health problems in least developed regions of the world. Majority of deaths associated with malaria occur in sub-Sahara Africa among biologically risked groups. Thus, this study was designed to assess the incidence of severe malaria syndromes among children in Pawe Hospital, Northwest Ethiopia. Children seeking medication for malaria infection in Pawe Hospital during the study period were recruited. Sociodemographic characteristics, physical, hematological, and clinical features of complicated malaria were assessed following standard parasitological and clinical procedures. A total of 263 children were found malaria positive. Among these, 200 were infected with Plasmodium falciparum. Most of the severe malaria symptoms were observed among children infected with P. falciparum and P. vivax. The study showed that significant number of the children developed severe life threatening malaria complications. This calls for prompt early diagnosis and effective treatment of patients to reduce mortality and complications associated with malaria in the study site.

BackgroundPaper currency is used for every type of commerce and plays an important role in the life of human beings. However, the combination of its widespread use and constant exchange make paper currency a likely agent for disease transmission. Thus, the aim of this study was to evaluate the microbial load and safety of Ethiopian paper currencies collected from some food vendors in Jimma town.MethodsStandard microbiological methods were used for the enumeration of various microbial groups, isolation and characterization of pathogenic bacteria and their growth potential in selected weaning foods. A total of 100 samples of Ethiopian paper currencies, consisting of five denominations, from street food venders, hotels and cafeterias in Jimma town were collected aseptically. Sterile cotton swabs moistened with buffered peptone water solution were used for swabbing and the swabs were separately soaked into 10 ml sterile buffered peptone water solution.ResultsMean microbial counts of Aerobic mesophilic bacteria, Staphylococci, Enterobacteriaceae, coliforms and Aerobic bacterial spores were (log CFU/cm2) 6.32, 4.43, 3.14, 2.98 and 3.78, respectively. However, mean counts of Yeasts and Moulds were below detectable levels. There was statistically significant variation (p < 0.05) among the mean counts of microbes isolated from samples of paper currencies. The predominantly isolated microbial groups were Staphylococcus spp. (34.06%) followed by Bacillus spp. (31.88%), Enterobacteraceae (13.39%), Micrococcus spp. (9.55%) and Streptococcus spp. (9.03%). Overall, 25% and 10% of the samples were positive for S. aureus and Salmonella spp, respectively. In challenge study, Salmonella spp. and S. aureus reached the infective dose within 12 to 18 hours of inoculation.ConclusionThus, paper currencies could be considered as one of the possible vehicles for transmission of disease causing microorganisms. Poor handling practices and personal hygiene of the food vendors could contribute to the observed microbial counts. Thus, it calls for awareness development on the potential risks associated with poor handling of paper currencies at all level of the food establishments.