Borrelia recurrentis in head lice, Ethiopia.

Since the 1800s, the only known vector of Borrelia recurrentis has been the body louse. In 2011, we found B. recurrentis DNA in 23% of head lice from patients with louse-borne relapsing fever in Ethiopia. Whether head lice can transmit these bacteria from one person to another remains to be determined.

Multispacer sequence typing relapsing fever Borreliae in Africa.

BACKGROUND: In Africa, relapsing fevers are neglected arthropod-borne infections caused by closely related Borrelia species. They cause mild to deadly undifferentiated fever particularly severe in pregnant women. Lack of a tool to genotype these Borrelia organisms limits knowledge regarding their reservoirs and their epidemiology. METHODOLOGY/PRINCIPAL FINDINGS: Genome sequence analysis of Borrelia crocidurae, Borrelia duttonii and Borrelia recurrentis yielded 5 intergenic spacers scattered between 10 chromosomal genes that were incorporated into a multispacer sequence typing (MST) approach. Sequencing these spacers directly from human blood specimens previously found to be infected by B. recurrentis (30 specimens), B. duttonii (17 specimens) and B. crocidurae (13 specimens) resolved these 60 strains and the 3 type strains into 13 species-specific spacer types in the presence of negative controls. B. crocidurae comprised of 8 spacer types, B. duttonii of 3 spacer types and B. recurrentis of 2 spacer types. CONCLUSIONS/SIGNIFICANCE: Phylogenetic analyses of MST data suggested that B. duttonii, B. crocidurae and B. recurrentis are variants of a unique ancestral Borrelia species. MST proved to be a suitable approach for identifying and genotyping relapsing fever borreliae in Africa. It could be applied to both vectors and clinical specimens.

Patch testing and contact allergens in Ethiopia--results of 514 contact dermatitis patients using the European baseline series.

BACKGROUND: Patch testing is essential to diagnose allergic contact dermatitis. Dermatologists in many countries use a baseline (standard) series covering the major allergens responsible for allergic contact dermatitis in their population, with the addition of relevant allergens for the individual patient. However, a baseline series has not yet been developed for Ethiopia. Our objective in this study is to identify common contact allergens to form the basis of a future baseline series in Ethiopia. METHODOLOGY: We patch tested 514 subjects with dermatitis according to the recommended procedure using the European baseline series for 1 year. RESULTS: 52.7% of the tested subjects showed positive reaction for at least one allergen tested. The top five contact allergens identified were nickel sulfate, fragrance mix I, cobalt chloride, p-tert-butylphenolformaldehyde (PTBP) resin and potassium dichromate. Positive reactions to nickel and PTBP were commoner in females. PTBP positivity was strongly associated with foot eczema. Positive test reactions were commoner in cement workers, notably to potassium dichromate, which was also a commoner allergen in patients presenting with hand dermatitis. There were no reactions to several allergens, including neomycin, benzocaine, budesonide, primin and quaternium-15. CONCLUSION: Comparable patch test results with other countries have been shown and the European baseline series can be used as a baseline series in Ethiopia with some modification.

Community dermatology in Debre Markos: an attempt to define children's dermatological needs in a rural area of Ethiopia.

BACKGROUND: Skin diseases are very common in rural and urban areas in developing countries. Knowledge of the real frequency of the dermatological problems of Ethiopian children could help plan future intervention for early diagnosis and low cost "good practice" therapies. METHODS: We involved in the project two primary Ethiopian schools, attended by 1765 children from grade 1 to grade 4, who were screened to assess their general skin health conditions. All children were examined naked in good day light. To record data we used an EPIinfo questionnaire. RESULTS: A total of 1104 children were screened. We registered a total number of 1086 dermatological problems, 876 of them were of infective origin mainly represented by fungal infections (36.1%). Tinea capitis represented 76% of the cases, tinea corporis 27% and tinea unguium 8%. Head lice affected 345 children. Viral infections accounted for 12%, most of them were warts. CONCLUSIONS: We think our work highlights the general health and living conditions of Ethiopian school children. The dermatological problems affecting most of the children could improve just by better skin hygiene conditions. The presence at the community level of health workers trained to perform a correct and early diagnosis and distribute efficacious, low-cost therapies would be a relevant step forward. We think this project could help draw attention and interest to these issues.

Patch test reaction on Ethiopian subjects with eczema.

BACKGROUND: Allergic contact dermatitis is a common condition with an incidence of 1-10% in the general population. An increasing number of allergens in the environment are responsible for the condition. These allergens can be identified using patch testing. Many countries have a standard series of common allergens used for patch testing. There is no standard series of allergens in Ethiopia, and our objective was to obtain baseline data for common allergens for future standardization. METHODS: One hundred and eighty-one subjects with eczema were patch tested using 17 selected allergens from Chemotechnique Diagnostics AB employing a standard procedure. RESULTS: Positive patch test reactions were detected in more than 60% of subjects, the most common allergen being nickel, followed by fragrance mix and butylphenolformaldehyde. A higher incidence of positive reactions was seen in females. CONCLUSIONS: A high incidence of positive patch test reactions was identified in the study population, and the introduction of patch testing in Ethiopia is essential for the management of allergic contact dermatitis.