Hematological predictors of preeclampsia among pregnant women attending ante-natal clinic at Arba Minch General Hospital, South Ethiopia: A comparative cross-sectional study.

Background: Preeclampsia is a kind of pregnancy-related hypertension that affects 5.47 % of pregnancies in Ethiopia and 18.25 % of pregnant women who visit Arba Minch public health facilities for antenatal care. This study sought to identify hematological preeclampsia markers in pregnant women who received prenatal care at Arba Minch General Hospital. Methodology: An institution-based comparative cross-sectional study was done from July 22 to October 30, 2021 at Arba Minch General Hospital. A total of 136 pregnant women were included in the study (46 with preeclampsia and 90 without preeclampsia). Epidata version 4.4. was used to enter data, and SPSS version 25.0 and Stata version17 were used for analysis. An independent sample t-test was used to examine the hematological parameter differences between study groups. Potential hematological markers were determined using receiver operating characteristic (ROC) analysis of the area under the curve (AUC). Statistical significance was defined if P value less than 0.05. Results: A total of 136 pregnant women were studied. The complete blood count analysis showed that there were means differences in Red Cell Distribution (RDW) (p < 0.036), neutrophil-to-lymphocyte ratio (NLR) (p < 0.016) and relative lymphocyte count (Lymp%) (p < 0.047). The ROC analysis of the AUC for RDW, NLR and Lymp% resulted in 0.607, 0.609, 0.600 respectively. Conclusion: RDW, NLR and Lymphocyte count could be potential candidate tools for the diagnosis and screening of preeclampsia. However, the robustness of the markers should be tested with prospective studies assessing changes present in each trimester.

Effect of malaria prevention education on bed net utilization, incidence of malaria and treatment seeking among school-aged children in Southern Ethiopia; cluster randomized controlled trial.

BACKGROUND: School-aged children (SAC) have an increased risk to contract malaria and play a major role in its transmission dynamics. However, their malaria prevention experience is poor. Thus, the effect of malaria prevention education (MPE) on bed net utilization, treatment seeking from a health facility and cumulative incidence of malaria was evaluated in Southern Ethiopia. METHODS: A two arm cluster randomized controlled trial was conducted by recruiting 2038 SAC from 32 schools. Structured questionnaire was used to collect data on socio-demographic, economic, bed net ownership, bed net utilization, whether the participated child suffered from malaria and has got treatment from a health facility. Generalized mixed effect logistic regression using school as random variable was used to assess the effect of the intervention on the outcome variables. RESULTS: The ownership of bed net in households of the control and intervention schools was similar respectively with 84.6 and 88.6% (Crude Odds Ratio (COR): 1.5; 95%CI: 0.5-4.8). The percentage of SAC slept under the bed net the night before the survey was also similar (55.1% versus 54.0%); COR:1.04; 95%CI: 0.5-2.4). Bed net utilization was affected by household size to the bed net ratio ≤ 2 (Adjusted Odds Ratio (AOR) = 1.6; 95%CI:1.3-2.1), bed net utilization at baseline of the study (AOR = 2.3; 95%CI:1.5-3.6), and history of malaria attack in the last twelve months (AOR = 1.3; 95%CI:1.01-1.8). Reported cumulative incidence of malaria and treatment seeking from a health facility by SAC was similar between intervention and control arms: -2.1% (COR = 0.8; 95%CI: 0.5-1.5) and 9.6% (COR = 1.4; 95%CI: 0.4-4.3) respectively. The reported incidence of malaria was affected by altitude (AOR = 0.5; 95%CI: 0.3-0.8), low and medium wealth index (AOR = 0.7; 95%CI: 0.5-0.96 and AOR = 0.7; 95%CI: 0.5-0.98), adequate bed net number for household members (AOR = 0.7; 95%CI:0.5-0.9) and bed net utilization (AOR = 1.3; 95%CI:1.1-1.8). CONCLUSIONS: MPE had no significant effect on the use of malaria prevention measures considered, treatment seeking from a health facility and reported cumulative incidence of malaria though bed net use was associated with malaria incidence. Before organizing any health education program, sustainable implementation efforts have to be warranted especially in SAC, a neglected but relevant vulnerable and reservoirs. TRIAL REGISTRATION: Pan African Clinical Trials Registry PACTR202001837195738, registered 21/01/2020.

Implementation of a malaria prevention education intervention in Southern Ethiopia: a qualitative evaluation.

BACKGROUND: Though school-aged children (SAC) are at high risk of malaria, they are the ones that benefit the least from malaria prevention measures. A cluster randomized controlled trial was conducted to evaluate the effect of malaria prevention education (MPE) on insecticide-treated bed net (ITN) utilization and prompt diagnosis, reported incidence and treatment (PDAT) of malaria. Qualitative evaluation of the implementation of such interventions is vital to explain its effectiveness and will serve as guidance for future interventions. Therefore, this study aimed to evaluate the implementation of the MPE in southern Ethiopia.  METHODS: The trial was registered in Pan African Clinical Trials Registry (PACTR202001837195738) on 21/01/2020. A descriptive qualitative study using semi-structured interview with participants of the MPE was conducted in January 2020 and January 2021. The collected data were transcribed verbatim and analyzed thematically. The analysis of the data was supported by NVivo. RESULTS: The four themes identified after evaluation of MPE training were the setup of the training, challenges for the success of the training, anticipated challenges for practice as per the protocol and experienced immediate influences of the training. Participants appreciated the training: content covered, way of delivery and the mix of the participants. The context specific facilitators to bed net use were the collateral benefits of ITN and perceived at high risk of malaria while its barriers were quality and quantity of the bed nets, bed net associated discomforts, malaria health literacy and housing condition. Severeness of malaria symptoms and malaria health literacy were reported as both barriers and facilitators of the PDAT of malaria. The identified facilitators of PDAT of malaria were health professionals' attitude and exposure to MPE while its barriers were poverty, use of traditional medicine, health facility problems and Coronavirus Disease 2019 (COVID-19) pandemic. CONCLUSION: Low attendance of parents in the training was the major challenge for the success of MPE. National malaria program should ensure the access to malaria prevention measures; and future studies using increased frequency of the intervention embedded with monitoring adherence to the intervention protocol shall be conducted to improve the gains from existing malaria interventions.

Prevalence, intensity and endemicity of intestinal schistosomiasis and soil-transmitted helminthiasis and its associated factors among school-aged children in Southern Ethiopia.

Preventive chemotherapy (PC), the main strategy recommended by the World Health Organization to eliminate soil-transmitted helminthiasis (STH) and schistosomiasis (SCH), should be strengthened through identification of the remaining SCH transmission foci and evaluating its impact to get a lesson. This study was aimed to assess the prevalence of STH/SCH infections, the intensity of infections, and factors associated with STH infection among school-aged children (SAC) in Uba Debretsehay and Dara Mallo districts (previously not known to be endemic for SCH) in southern Ethiopia, October to December 2019. Structured interview questionnaire was used to collect household data, anthropometric measurements were taken and stool samples collected from 2079 children were diagnosed using the Kato-Katz technique. Generalize mixed-effects logistic regression models were used to assess the association of STH infections with potential predictors. A P-value less than 0.05 was considered statistically significant. The prevalence of Schistosoma mansoni in the Dara Mallo district was 34.3% (95%CI 30.9-37.9%). Light, moderate, and heavy S. mansoni infections were 15.2%, 10.9%, and 8.2% respectively. The overall prevalence of any STH infection was 33.2% with a 95% confidence interval (CI) of 31.1-35.3%. The intensity of infections was light (20.9%, 11.3% & 5.3%), moderate (1.1%, 0.1% & 0.4%) and heavy (0.3%, 0% & 0%) for hookworm, whipworm and roundworms respectively. The overall moderate-to-heavy intensity of infection among the total diagnosed children was 2% (41/2079). STH infection was higher among male SAC with Adjusted Odds Ratio (AOR) of 1.7 (95%CI 1.4-2.1); occupation of the household head other than farmer or housewife (AOR = 0.5; 95%CI 0.3-0.8), middle [AOR = 1.1; 95%CI 1.0-1.3] or high [AOR = 0.7; 95%CI 0.5-0.9] socioeconomic status. Dara Mallo district was moderate endemic for S. mansoni; and it needs sub-district level mapping and initiating a deworming campaign. Both districts remained moderate endemic for STH. Evidence-based strategies supplementing existing interventions with the main focus of the identified factors is important to realize the set targets.

Antibacterial, Antifungal, and Cytotoxic Activity of Excoecaria agallocha Leaf Extract.

BACKGROUND: Mangroves contain several bioactive compounds, some of which have been used for centuries as remedies for several ailments. METHODS: Foliar parts of Excoecaria agallocha were extracted in organic solvents and in water using a Soxhlet apparatus and evaluated for antimicrobial activity against nine type-culture pathogens, six clinical isolates, and two fungal pathogens with agar well diffusion assays. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by broth dilution and extracts further subjected to brine-shrimp cytotoxic assays using Artemia salina. Chemical constituents were analyzed with thin-layer chromatography (TLC), gas chromatography-mass spectroscopy (GC-MS), and Fourier-transform infrared spectroscopy (FT-IR). RESULTS AND DISCUSSION: Ethyl acetate extract displayed the broadest antimicrobial activity. Isolates of Staphylococcus aureus were found to be the most susceptible among the clinical and type-culture groups corresponding to inhibition zones: 17.3±1.1 and 23.5±1.3 mm in diameter, respectively. Anticandidal activity was found to be lower against Candida albicans and C. tropicalis (10.3±0.6 and 11.9±0.85 mm diameter). Also, this extract was found to be bactericidal for S. aureus and Micrococcus luteus (MBC:MIC ≤2). C cytotoxic activity LD50 was 521 µg/mL. On GC-MS, squalene [(6E, 10E, 4E, 18E)-2,6,10,15,19,23-hexamethyltetracosa-2,6,10,14,18,22-hexaene] was the major compound. Bioassay-guided (antibacterial) TLC revealed the presence of one major active fraction, F2, with an Rf value of 1.21. FT-IR analysis of this fraction also implied that it was squalene, which might have a functional role in the mechanism of chemical defense.

Prevalence and associated risk factors of asymptomatic malaria and anaemia among school-aged children in Dara Mallo and Uba Debretsehay districts: results from baseline cluster randomized trial.

BACKGROUND: Despite the growing evidence that malaria and anaemia are two interlinked health problems of school-aged children (SAC) in developing countries, there is scarce information about malaria among SAC in Ethiopia. Moreover, anaemia-related studies were more concentrated in easily accessible areas. This study aimed to assess the prevalence of malaria and anaemia and corresponding risk factors among SAC in Dara Mallo and Uba Debretshay districts, in hard to reach areas, so as to inform appropriate integrated interventions for both diseases. METHODS: This study was part of baseline data collected for a cluster-randomized trial registered in Pan African Clinical Trials Registry (PACTR202001837195738). Data were collected from 2167 SAC and their households through face-to-face interview; malaria was diagnosed by using rapid diagnostic test (RDT); haemoglobin concentration was determined using hemoCue hb 301 and adjusted for altitude to determine anaemic status; helminth infections were determined by using kato-katz, and anthropometric measurements were made to determine nutritional status of children. Generalized mixed effects logistic regression model was used to assess the association between predictor variables and malaria and anaemia using school as a random variable. RESULTS: The overall prevalence of malaria was 1.62% (95% CI 1.15-2.27%) (35/2167). Of the 35 children positive for malaria, 20 (57.14%), 3 (8.57%) and 12 (34.29%) were due to Plasmodium falciparum, Plasmodium vivax and mixed infections of P. falciparum and P. vivax, respectively. Malaria was significantly lower among children from literate household head (Adjusted OR = 0.38; 95% CI 0.15-0.95) and residence house located at an altitude range above 1100 masl (AOR = 0.40; 95% CI 0.17-0.94). The prevalence of anaemia was 22.00% (95% CI 20.3-23.8%) (477/2167) and was significantly reduced by eating legumes, nuts or seed group of food in their 24-h dietary diversity recall (AOR = 0.64; 95% CI 0.41-0.99). CONCLUSIONS: The prevalence of malaria was low and unevenly distributed per school while the overall prevalence of anaemia was moderate. It is important to implement integrated interventions targeting both malaria and anaemia, with special emphasis given to children from illiterate households and living at an altitude below 1100 masl. The micronutrient content of locally grown legumes should be further investigated to recommend specific interventions to overcome anaemia.

Catheter-Associated Urinary Tract Infection: Incidence, Associated Factors and Drug Resistance Patterns of Bacterial Isolates in Southern Ethiopia.

INTRODUCTION: Catheter-associated urinary tract infections (CAUTIs) are the most common nosocomial infection and a leading cause of morbidity. The aim of this study was to determine the prevalence, associated factors and antibiogram of the bacterial isolates among CAUTIs patients. METHODS: A facility-based, cross-sectional study was conducted from March to December 2019 at Arba Minch General Hospital, Southern Ethiopia. Clinical and socio-demographic data were obtained using a questionnaire. Clean catch midstream urine samples were collected and inoculated onto blood agar, MacConkey agar, and cysteine lactose electrolyte deficient agar (CLED). The inoculated culture media were incubated in an aerobic atmosphere at 37°C for 24 h. After overnight incubation, the bacterial growth on the respective media was inspected visually and graded for the presence of significant bacteriuria. A significant bacteriuria was considered, if pure culture at a concentration of ≥105 colony forming unit (CFU)/mL. All isolates were further identified using colony morphology and biochemical tests. Antimicrobial sensitivity was determined by modified Kirby-Bauer disc diffusion method. Data were analyzed using SPSS version 25. P-value less than 0.05 was used as statistical significance. RESULTS: The overall incidence of symptomatic CAUTIs was 39/231 (16.8%). Independent predictors of CAUTIs were prolonged (≥7 days) catheterization (AOR = 3.6, 95% CI = 1.0-12.2), diabetes mellitus (AOR = 5.3, 95% CI = 1.4-19.6) and insertion of catheter in surgical ward (AOR = 3.6, 95% CI = 1.08-12.28). The most common bacterial isolates were E. coli 17/42 (40.5%), Klebsiella species 9/42 (21.4%) and Enterococcus species 5/42 (11.9%). High (>80%) drug resistance was observed against cotrimoxazole, cefoxitin and tetracycline. Ciprofloxacin and nitrofurantoin were the most active drugs. The overall prevalence of MDR among isolates was 37/42 (88.1%). Most bacterial isolates 30/42 (71.4%) were biofilm producers. CONCLUSION: High levels of drug resistance were observed to commonly used antibiotics. In our study, biofilm-producing bacterial isolates were the predominant cause of CAUTIs. Therefore, continuous surveillance of antimicrobial resistance patterns is necessary to help physicians in treatment and management of CAUTIs.

Prevalence and Associated Factors of Methicillin Resistance Staphylococcus aureus (MRSA) Among Urinary Tract Infection Suspected Patients Attending at Arba Minch General Hospital, Southern Ethiopia.

BACKGROUND: Urinary tract infection (UTI) is a very frequent infection both in the community and hospital patients, and the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the community setting and infections with this pathogen become a prevalent problem among UTI patients. Therefore, the aim of this study was to determine prevalence and associated factors of methicillin resistance staphylococcus aureus (MRSA) among urinary tract infection suspected patients attending at Arba Minch General Hospital. METHODS: Facility-based cross-sectional study was done at Arba Minch General Hospital from July to October 2020. Midstream urine specimen was collected from outpatients, cultured and biochemical tests were performed to identify the intended pathogen, finally the antibiotic susceptibility pattern of MRSA was done and possible associated factors were determined. The cleaned data were entered and analyzed using SPSS version 21. RESULTS: Four hundred and twenty two (422) adult outpatients were enrolled in this study, of which males accounted for 238 (56.4%) of the participants. The mean and standard deviation age of the participants was 27.4 (SD 27.4 ± 15.6) years. A total of 54 S. aureus isolates were recovered from urine specimen. The prevalence of MRSA among the isolated S. aureus was 23/54 (42.59% (95% CI (35.0, 47.0)). Participants who had previous exposure to UTI (p < 0.002), presence of chronic disease (p < 0.029), and hospitalization (p < 0.006) were statically associated with the prevalence of MRSA. From all the MRSA isolates, 53.7% were resistant against Nitrofurantoin. CONCLUSION: This study revealed that MRSA could be prevalent in isolates from patients suspected of urinary tract infection and exhibiting different resistance pattern for antibiotics commonly used for treatment of staphylococcal infections.

Antibacterial Activity of Rosmarinus officinalis against Multidrug-Resistant Clinical Isolates and Meat-Borne Pathogens.

BACKGROUND: In developing countries, the prevalence of bacterial infections is quite rampant due to several factors such as the HIV/AIDS pandemic, lack of hygiene, overcrowding, and resistance to conventional antimicrobials. Hence the use of plant-based antimicrobial agents could provide a low-cost alternative therapy. Rosmarinus officinalis is reputed as a medicinal plant in Ethiopia; however, its antibacterial activity against many of the clinical isolates remains overlooked. METHODS: Tender foliage of R. officinalis was collected and extracted in ethanol (EtOH) and evaluated for their antimicrobial activity against ten multidrug-resistant (MDR) clinical isolates, human type culture pathogens, and meat-borne bacterial isolates by employing agar well diffusion assay. RESULTS: EtOH extract of R. officinalis efficiently subdued the growth of all tested MDR clinical isolates in varying degrees. Salmonella sp. and Staphylococcus aureus were found to be the most sensitive clinical isolates. Likewise, it efficiently repressed the growth of meat-borne pathogens, particularly, S. aureus and Salmonella sp. showing its potentiality to be used as a natural antibacterial agent in the meat processing industry. The mechanism of antibiosis of plant extract against meat-borne pathogens is inferred to be bactericidal. Chemical constituents of the crude plant extract were analysed by Gas Chromatography-Mass Spectroscopy (GC-MS), Fourier Transform Infrared (FT-IR), and UV-visible spectroscopy showing genkwanin (26%), camphor (13%), endo-borneol (13%), alpha-terpineol (12%), and hydroxyhydrocaffeic acid (13%) as the major compounds. CONCLUSION: Overall results of the present study conclude that R. officinalis could be an excellent source of antimicrobial agents for the management of drug-resistant bacteria as well as meat-borne pathogens.

Magnitude, Diversity, and Antibiograms of Bacteria Isolated from Patient-Care Equipment and Inanimate Objects of Selected Wards in Arba Minch General Hospital, Southern Ethiopia.

INTODUCTION: Patient-care equipment and inanimate objects contaminated with bacteria are a persistent problem in countries like Ethiopia, and remain overlooked. This study aimed to elucidate the magnitude of contaminations, diversity, and antimicrobial-susceptibility patterns of bacterial isolates from selected wards of Arba Minch General Hospital, Ethiopia. METHODS: Samples were inoculated into bacteriological media and identified by biochemical characterization, followed by antimicrobial-susceptibility tests. RESULTS: Of the 99 inanimate objects and items of patient-care equipment examined, 71 (71.7%) showed contamination: 26 (76.4%) from the surgical ward and 22 (66.6%) and 23 (71.8%), respectively, from the pediatric ward and neonatal intensive care unit. In the case of Gram-positive bacteria, coagulase-negative staphylococci (CoNS; 52.2%) were predominant, followed by Staphylococcus aureus (47.7%), whereas common Gram-negative counterparts were Acinetobacter spp. (28.5%) and Klebsiella spp. (23.8%). Antibiograms of S. aureus and CoNS showed 100% and 78% resistance, respectively, against penicillin. Isolates of Acinetobacter spp. showed 100% resistance to ceftriaxone and ampicillin, whereas those of Klebsiella spp. displayed complete resistance against ampicillin and trimethoprim-sulfamethoxazole. All isolates of Citrobacter spp., Enterobacter spp., Salmonella spp., Escherichia coli, and Serratia spp. exhibited 100% resistance to amoxicillin, ampicillin, and trimethoprim-sulfamethoxazole. Overall prevalence of multidrug-resistant bacteria was 57.7%. CONCLUSION: A stringent infection-vigilance program comprising routine sampling from equipment and inanimate objects combined with antimicrobial-resistance surveillance and decontamination efforts must be instituted promptly.

Epistaxis and Its Associated Factors Among Precollege Students in Southern Ethiopia.

BACKGROUND: Epistaxis is one of the most common otorhinolaryngological emergencies affecting the majority of the population in their lifetime, with some of them requiring serious medical attention. This study aimed to assess the prevalence and associated factors of epistaxis among pre-college students in Wolaita Sodo, Ethiopia. METHODS: An institution-based cross-sectional study was conducted. Data were collected using a pre-tested interviewer administered questionnaire. The study participants were selected by systematic random sampling technique. A logistic regression analysis was employed to assess the presence and strength of association factors with epistaxis. An adjusted odds ratio with 95% confidence interval was used to determine the presence and strength of the association at 0.05 level of significance. RESULTS: Of 387 participants, 57.1% of them were male, and the mean age of all participant was 18.05±1.401 SD years. The overall epistaxis prevalence was 108 (27.9%). Blood group O, which accounted for about 43.4% was more prevalent. Blood group O (AOR=3.96, 95% CI=1.5-10.4), participants who drink coffee daily (AOR=2.75, 95% CI=1.0-7.4), and participants who took a bath frequently with both hot and cold-water (AOR=4.55, 95% CI=1.1-18.6) were significantly associated with epistaxis. CONCLUSION: The type of blood group, interval of coffee drinking, and type of bathing were significantly associated with epistaxis. Working on the identified associated factor and increased awareness about epistaxis for the students with effective first aid training is mandatory.

Does cotrimoxazole prophylaxis in HIV patients increase the drug resistance of pneumococci? A comparative cross-sectional study in southern Ethiopia.

BACKGROUND: Infections caused by antibiotic-resistant bacteria results in high rates of morbidity and mortality. Although the prolonged cotrimoxazole (CTX) prophylaxis is arguably associated with the risk of increasing drug resistance in the common pathogens, information regarding its impact on Streptococci pneumoniae / pneumococcus is very limited. OBJECTIVE: This study was conducted to investigate the effect of cotrimoxazole prophylaxis on nasopharyngeal colonization rate and antimicrobial resistance using Streptococci pneumoniae (pneumococcus) as an indicator organism among HIV patients in Arba Minch, Ethiopia. MATERIALS AND METHODS: A comparative cross-sectional study was designed and conducted among HIV patients attending the Anti-Retroviral Treatment (ART) clinic of Arba Minch General Hospital (AMGH) from April 01 to August 31, 2018. A total of 252 participants were systematically selected and clustered into two study groups based on their CTX prophylaxis status, one taking CTX prophylaxis, and the second one, the control group (without prophylaxis). A structured questionnaire was used to collect socio-demographic and clinical data from patients. A nasopharyngeal swab was collected and cultured for pneumococcal isolation and identification in accordance with standard microbiological techniques. An antibiotics sensitivity test was performed according to the CLSI guidelines. Data were analyzed using the Statistical package for social science (SPSS) version 20. The primary outcome was determined using logistic regression analysis. RESULTS: Of the 252 enrolled HIV patients (mean age (37.38± 9.03 years), 144 (57.14%) were males. The overall, nasopharyngeal colonization rate of S. pneumoniae was 13.5% (95% CI: 8.4-15.6). Asymptomatic pneumococcal carriage rates among patients on CTX prophylaxis and the control group were 16.3%, and 10.3% respectively (p-value = 0.03). Regarding the risk factors analyzed, CTX prophylaxis (AOR: 2.2; 95% CI: 1.05-4.9) and gender (AOR: 2.5; 95% CI: 1.09-5.93) were significantly associated with pneumococcal colonization, showing a male preponderance. Cotrimoxazole-resistant pneumococci were 85.7% vs. 47.4% in the prophylaxis group and the control group respectively and it was statistically significant (AOR: 6.7; 95% CI: 1.3-36). Percentages of multi-drug resistant isolates in these two groups were 38.09 and 15.38 respectively (p-value = 0.04). Among the CTX resistant pneumococci isolates, 85% were also found to be co-resistant towards penicillin and was statistically significant. CONCLUSION: The percentage prevalence of nasopharyngeal pneumococci colonization was higher in patients taking CTX prophylaxis. It was noted that CTX prophylaxis eventually results in the selection of cotrimoxazole resistance and multi-drug resistance in pneumococci. There is evidence of existing cross-resistance between cotrimoxazole and penicillin antibiotics. Therefore, CTX prophylaxis must be administered judiciously. Surveillance for antimicrobial susceptibility is warranted where the prophylaxis is common.

Long-lasting insecticide-treated bed net ownership, utilization and associated factors among school-age children in Dara Mallo and Uba Debretsehay districts, Southern Ethiopia.

BACKGROUND: Malaria is one of the major causes of morbidity and mortality among school-age children (SAC) in sub-Saharan Africa. SAC account for more than 60% of the reservoir of malaria transmission, but they are given less emphasis in prioritizing malaria prevention interventions. This study was aimed at assessing the ownership of long-lasting insecticide treated bed nets (LLINs), its utilization and factors associated with ownership of LLINs by households and LLINs utilization among SAC in malaria-prone areas of Dara Mallo and Uba Debretsehay districts in Southern Ethiopia, October to December 2019. METHODS: This study is part of a baseline assessment in a cluster-randomized controlled trial. The data was collected through interview and observation, following a structured questionnaire, of 2261 SAC households. Univariable and multivariable multilevel logistic regressions were used to assess the association between LLINs ownership and utilization and potential predictor variables. Odds ratio (OR) and corresponding 95% confidence interval (CI) were used to determine the strength and statistical significance of association. RESULTS: The ownership of at least one LLIN by households of SAC was about 19.3% (95% CI 17.7-21.0%) but only 10.3% % (95% CI 7.7-13.7%) of these households had adequate access of bed nets to the household members. Ownership of bed net was marginally affected by living in semi-urban area (adjusted OR = 2.6; 95% CI 1.0-6.9) and occupational status of the household head being a civil servant (adjusted OR = 2.7; 95% CI 0.9-7.9). About 7.8% (95% CI 6.7-10.0%) of all SAC participated in the study and 40.4% (95% CI 57.4-66.7%) of children in households owning at least one LLIN passed the previous night under LLIN. LLIN utilization by SAC conditional to presence of at least one net in the household was significantly correlated with education level of mother above grade 6 (adjusted OR = 3.4; 95% CI 1.3-9.3) and the household size to bed net ratio less than or equal to 2 (adjusted OR = 20.7; 95% CI 4.7-132.5). CONCLUSION: Ownership of bed net was lower than universal coverage of at least one bed net for two individuals. It is important to monitor replacement needs and educate mothers with low education level with their SAC on the benefit of consistent utilization of bed nets.

Parents' perception on cause of malaria and their malaria prevention experience among school-aged children in Kutcha district, Southern Ethiopia; qualitative study.

INTRODUCTION: School-aged children become a highly vulnerable group for malaria, yet they are less likely to use malaria prevention interventions. Previous studies exploring perception on cause of malaria mainly focused on pregnant mothers or parents of children under age five years. Exploring parent's perception on cause of malaria and their experiences on the prevention of malaria and associated challenges among school-aged children is important to develop a malaria prevention education package for school-aged children to reduce malaria and malaria related morbidities among school-aged children. METHODS: A descriptive qualitative study is conducted in Kutcha district by recruiting 19 parents of school-aged children for semi-structured interviews, 6 key informants and 6 focus group discussion which consists of parents, health development army and health extension workers. A semi-structured interview guide is used to guide the interview process. The collected data is analyzed thematically with a focus on the three major areas of concern: perceived cause of malaria, experience of malaria prevention and challenges of bed net use for prevention of malaria. RESULTS: Five causes of malaria were identified, namely hunger, mosquito bite, exposure to hot sunshine, poor sanitation and hygiene and eating some sweet foods and unripe maize. Participants perceived that eating sweet foods and unripe maize lead to enlargement of the spleen that ends in malaria while poor hygiene and sanitation leads to either development of the ova of mosquito and the landing of the housefly to contaminate food for consumption. The experiences of malaria prevention were largely influenced by their perceived cause of malaria. The malaria prevention measures undertaken by parents were vectors control measures, homemade herbal remedies and restricting children from eating sweet foods. The challenges of malaria prevention by using bed nets were related to a negative attitude, sleeping behaviors of children; use of bed nets for unintended purposes, shortage of bed nets and delays in the distribution of bed nets. CONCLUSION: There were misconceptions about the cause of malaria and associated experiences of malaria prevention. Control of malaria among school-aged children need health education targeting the challenges and correcting identified misconceptions by parents in Kutcha district and in other similar settings.

Parasitic contamination of raw vegetables and fruits collected from selected local markets in Arba Minch town, Southern Ethiopia.

BACKGROUND: One way that people get infected with intestinal parasites is through the consumption of contaminated vegetables and fruits. This study aimed at determining the prevalence and predictors of parasitic contamination of fruits and vegetables collected from four local markets in Arba Minch town, Southern Ethiopia. METHODS: A cross-sectional study was conducted from 1 to 21 September 2014 to determine the level of parasitic contamination of fruits and vegetables sold in Arba Minch town. A total of 360 samples of different types of fruits and vegetables were soaked in physiological saline, followed by vigorous shaking with the aid of a mechanical shaker for 15 minutes and then examined using the sedimentation concentration technique. RESULTS: Out of the 360 samples examined, 196 (54.4%) were contaminated with at least one type of parasite. Ascaris lumbricoides (20.83%) was the most frequently detected parasite and Isospora belli (3.06%) was the least frequently detected one. It was also observed that decreased parasitic contamination was significantly associated with washing the products before displaying it for selling (P < 0.001). CONCLUSIONS: The findings of this study provide evidence that there is a potentially high risk of acquiring parasitic infections from the consumption of raw vegetables and fruits in Arba Minch, Ethiopia. The authors believe that an effort should be made by the relevant bodies to reduce the rate of contamination of products with medically important parasites by educating the vendors and the community.