Basic coagulation parameters and platelet count among malaria patients attending at Addis Zemen Primary Hospital, Northwest Ethiopia.

BACKGROUND: Malaria is an intravascular parasitic-related blood disease that causes bleeding, coagulopathy, and thrombocytopenia. However, limited data shows the effect of Plasmodium species infection on basic coagulation parameters and platelet count. Thus, this study aimed to assess basic coagulation parameters and platelet count among malaria patients. METHOD: A cross-sectional study was conducted among 240 study participants (120 cases and 120 controls) from June 1, 2021, to February 30, 2022. A convenient sampling technique was employed to select study participants. The blood sample was collected by a trained laboratory technologist for platelet counts, prothrombin time (PT), partial thromboplastin time (PTT), international normalization ratio (INR), blood film, and serological testing. The collected data were analyzed in SPSS version 23. Data were analyzed by the Mann-Whitney U test, Kruskal Wallis H, and Spearman's rank-order correlation tests. Descriptive findings were presented through median, tables, and chart. In all cases, a P-value < 0.05 was considered statistically significant. RESULTS: The percentage of mild, moderate, and high malaria parasitemia levels per microliter of blood was 21.7%, 20%, and 58.3%, respectively. The overall median malaria parasitemia was 10,304 per microliter of blood. Among malaria patients, 77.5%, 61.7%, and 51.7% had prolonged PT, INR, and APTT, respectively as compared to control. Moreover, 26.7% of Plasmodium-infected participants had mild thrombocytopenia as compared to the control group (P < 0.001). CONCLUSION: The value of PT, APTT, and INR were significantly elevated, whereas the level of platelet count was inversely reduced when the malaria parasitemia level increased as compared to controls (p < 0.001).

Evaluation of urine sample for diagnosis of visceral leishmaniasis using rK-39 immunochromatographic test in Northwest Ethiopia.

BACKGROUND: Visceral leishmaniasis is the most severe form of leishmaniasis which ranks second in mortality and fourth in morbidity. Parasitological diagnostic techniques with splenic aspirate remain the gold standard. However, sample collection is risky, painful, and difficult. Alternatively, serological techniques provide good diagnostic accuracy using serum sample that is difficult for applying on small children and in the field. So, finding alternative non-invasive and self-collected samples like urine is very important. Thus, the study aimed to evaluate the diagnostic performance of the rK-39 strip test using urine for diagnosis of visceral leishmaniasis. METHODS: A multicenter institutional-based cross-sectional study was conducted from November 2019 to March 2021 at Northwest Ethiopia. Sociodemographic information was collected using a structured questionnaire. Blood sample and midstream urine sample were collected for rK-39 test. Data were entered into Epi-data version 4.2 and analyzed using SPSS version 24.0. Diagnostic performance parameters of urine-based rK-39 rapid test, i.e. sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios (LR+/-), and diagnostic accuracy were determined on contingency table by using serum-based rK-39 test result as a reference. An agreement between urine and serum-based rK-39 test was statistically determined by kappa value. RESULT: In total, 300 subjects, age ranged between 7 and 60 years, were included in the study. The overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of urine-based rK-39 test were found to be 98.0% (95% CI: 93.0% - 99.8%), 95.5% (95% CI: 91.6% - 97.9%), 91.6% (95% CI: 85.2%- 95.4%), 98.9 (95% CI: 96.0%- 99.7%), and 96.33% (95% CI: 93.53-98.16%), respectively. Additionally, there was a strong agreement between the results obtained on rK-39 ICT using urine and serum samples (kappa = 0.92; P < 0.001). CONCLUSION: Urine-based rK-39 ICT had an excellent high sensitivity, specificity and strong agreement with serum-based rK-39 ICT results. This indicates that urine sample would be a promising noninvasive and easy to collect sample for diagnosis of VL in field and rural settings.

Sero-prevalence of Toxoplasma gondii and associated risk factors among psychiatric outpatients attending University of Gondar Hospital, Northwest Ethiopia.

BACKGROUND: Toxoplasmosis is caused by an obligatory intracellular coccidian protozoan organism, Toxoplasma gondii. It has a worldwide distribution, affecting one-third of the world population. Psychiatric patients have a higher risk of exposure to Toxoplasma gondii infection due to lack of good personal hygiene. The burden of toxoplasmosis among psychiatric patients in Ethiopia has not been studied extensively. Thus, the study aimed to determine the seroprevalence of Toxoplasma gondii and associated risk factors among psychiatric outpatients at the University of Gondar Comprehensive and Specialized Hospital Psychiatric clinic. METHODS: A cross-sectional study was conducted at the University of Gondar Comprehensive and Specialized Hospital from February to May 2018. Venous blood was collected from 304 study participants (152 psychiatric outpatients and 152 control groups). Anti-toxoplasma antibodies were determined using Onsite Toxo immunoglobulin G (IgG) and immunoglobulin M (IgM) Rapid Test. A Chi-square test was carried out to compare the two groups and a logistic regression analysis was conducted to check the association between variables. P-value less than 0.05 was taken as statistically significant. RESULTS: The seroprevalence rate of anti-Toxoplasma gondii IgG antibodies was 33.6, and 16.4% in the psychiatric outpatients and the control samples, respectively. Anti-Toxoplasma gondii IgM sero-prevalence was 1.3% in the former patients and 3.9% in the latter group. Owing cat (AOR = 2.862 95% CI = 1.445-5.666 P = 0.003), cleaning cat excreta (AOR = 2.966 95% CI = 1.317-2.652 P = 0.007), and farming (AOR = 2.058 95% CI = 1.018-4.163 P = 0.045) were found to be significantly associated with the sero-prevalence of anti-Toxoplasma gondii IgG antibody. CONCLUSIONS: This study highlighted that, the prevalence of anti-Toxoplasma gondii IgG antibodies was significantly higher in psychiatric outpatients than the control group (p = 0.001). Cat ownership, cleaning of cat excreta, and farming were found to be statistically significantly associated with the seroprevalence of anti-Toxoplasma gondii IgG antibody.