Trend in Sero Prevalence of Hepatitis B Virus Infection Among Pregnant Women at a Referral Hospital, Northwest Ethiopia: Five-Year Data Analysis.

BACKGROUND: Pregnant women infected with hepatitis B virus (HBV) have a high rate of mother to child transmission and with adverse effects on their children. Recently, pregnant women were screened for HBV infection at a limited urban health facility of Ethiopia. The trend of HBV infection prevalence from year to year is unknown. Hence, the aim of this study was to determine the trend in sero-prevalence of HBV infection among pregnant women at a Referral Hospital, Northwest Ethiopia, over a period of five years (2015 to 2019). METHODS: The five year retrospective cross-sectional study was conducted from January 2015 to December 2019. A data extraction sheet was used to collect data on the HBV status of pregnant mothers from the Felege Hiwot comprehensive referral hospital's registration book. RESULTS: A total of 7,445 pregnant women were screened for HBV infection resulting in 305 (4.1%) infected women. The mean age of the participants was 25 years with a range of 16 - 42 years old. The highest numbers of partic-ipants were in the age group of 25 - 29 years old (2,945; 39.5%) followed by ≥ 30 years old (2,492; 33.5%). The highest prevalence rate of HBV was observed in the age group of ≥ 30 years old (126; 5.1%) followed by 25 - 29 years old (112; 3.8%). CONCLUSIONS: Even though the numbers of pregnant women screened for HBV infection is decreasing, the overall trend of HBV infection prevalence increased from 2015 to 2019.

Prevalence of Pathogenic Bacteria and Antibiotic Susceptibility Profiles Isolated from Medical Equipment and Inanimate Surface.

BACKGROUND: The hospital environment, especially the intensive care unit, is a leading reservoir of nosocomial bacteria. Equipment and inanimate surfaces are among the most transmission vehicles for nosocomial bacteria. This study is to assess the bacterial profile and antibiotic susceptibility pattern of the isolates from medical equipment and inanimate surfaces at intensive care unit wards in Bahir Dar City government hospital, North West Ethiopia. METHODS: A hospital-based, cross-sectional study was conducted between March 01/2021 and May 30/2021 at Felege Hiwot and Tibebe Gihon Compressive Specialized Hospitals. A total of 158 surface swab samples from the patient bed, table, chair, sphygmomanometer, and stethoscopes were collected. Sterile cotton-tipped swabs moistened with normal saline were used. Using standard protocols, the collected samples were processed at Bahir Dar University, Microbiology Laboratory. All isolates were cultured and identified by using routine bacterial culture, Gram staining, and biochemical tests. Phenotypic antimicrobial susceptibility testing was done on each isolate following the Kirby Bauer disk diffusion method. Data were entered and analyzed using SPSS version 26 and the results were explained by using percentages and tables. RESULTS: In this study, coagulase-negative Staphylococcus, S. aureus, and K. pneumoniae were the most predominant isolated bacteria, which accounted for 52.8%, 47.2%, and 43.2% respectively. Chairs, sphygmomanometers, and patient beds were the most contaminated. Imipenem and clindamycin were the most effective antibiotics for all Gram-negative and Gram-positive isolates, respectively. Among the total isolates, 84 (57.5%) were multidrug resistant and of these, 78.4% were Gram-negative isolates. CONCLUSIONS: Inanimate objectives and key medical devices of the hospital are heavily contaminated with potentially pathogenic bacteria. Additionally, the recovered isolates are multidrug resistant, making the control and prevention strategy more challenging. Thus, the hospital infection prevention and surveillance system must be activated and perform periodic disinfection of objects. Furthermore, large-scale surveillance is desirable.

Iodine status, household salt iodine content, knowledge and practice assessment among pregnant women in Butajira, South Central Ethiopia.

BACKGROUND: Iodine is one of the crucial micronutrients needed by the human body, and is vitally important during pregnancy. This study aimed to determine the relationship between the iodine status of pregnant women and their knowledge, and practices regarding iodized salt. All participants were enrolled in the Butajira nutrition, mental health and pregnancy (BUNMAP) cohort, Butajira, Ethiopia in February-May, 2019. METHODS: In this cross-sectional study, 152 pregnant women without hypertension or known thyroid disease before or during pregnancy were randomly selected from the BUNMAP mother to child cohort (n = 832). Spot urine samples were collected to estimate the level of urinary iodine concentration (UIC). Salt samples were also collected from their homes. The Sandall-Kolthoff (S-K) method was used to measure the level of iodine in the urine samples, and iodometric titration was used to measure the level of iodine in the salt. Data was entered and cleaned using Epi-info version 3.5.3 and then exported to SPSS version 20 for further analysis. Multivariate logistic regression analysis was performed to identify associations in the collected data. RESULTS: The WHO recommended level of iodine for populations of pregnant women is 150-249 F06Dg/L. The median UIC among pregnant women in this study was 151.2 µg/L [interquartile range (IQR) = 85.5-236.2 F06Dg/L], at the low end of this range. About half (49.65%) of the participants were likely to be iodine deficient. There was a significant association between having a formal job (AOR = 2.56; CI = 1.11-5.96) and iodine sufficiency. Based on a cutoff of >15 ppm (mg/kg), 91.7% (95% CI: 87.2-96.2) of the salts collected from the household had adequate iodine content. The median iodine level of the collected salt samples was 34.9 mg/kg (ppm) (IQR = 24.2-44.6 mg/kg). CONCLUSIONS: The UNICEF 2018 guidelines for adequate iodine nutrition in pregnant women include both a recommended median range of 150-249 µg/L, and an upper limit of 20% on the fraction of the population with UIC below 50 µg/L. Because our study population's median level is 151.2 µg/L and the percentage of pregnant women with urinary iodine concentration of less than 50 µg/L is 9.7% (14/145), the women received adequate iodine nutrition. The availability of adequately iodized salt in households is more than 90%, as recommended by WHO. In light of previous iodine deficiency in this region of Ethiopia, the salt iodization program promotes the health of babies and mothers.

Bacterial Uropathogens, Antimicrobial Susceptibility Profile and Associated Factors among Pediatric Patients in Bahir Dar, Northwest Ethiopia.

BACKGROUND: Urinary tract infection (UTI) in the pediatric group may lead to end-stage renal dysfunction later in life. Tracking the type of the isolates and their antimicrobial resistance pattern would impact the management of UTI in these group. The aim of this study was to describe the distribution of bacterial uropathogenes, their antimicrobial susceptibility profile and factors associated with significant bacteriuria (SBU) among pediatric patients at selected facilities in Bahir Dar, Northwest Ethiopia. METHODS: A cross-sectional study was conducted from 1st February to 30th June 2020. About 5-10ml of urine samples were collected from pediatrics presumptive for UTI and a urine sample was considered positive for SBU if a single organism was grown at a concentration of ≥104cfu/ml. Antimicrobial sensitivity testing was performed using the Kirby-Bauer disc diffusion technique. Logistic regression was used to identify factors associated with SBU and statistical significance was set at p-value < 0.05. RESULTS: Of the total 299 study participants, the majority 173 (57.9%) were females. The mean age of the participants was 6.6 years. The proportion of significant bacteriuria was at 49(16.4%). Most, 37 (75.5%) of the isolates were Gram-negative. The most predominant isolate was E. coli, 21(42.9%) followed by P. aeruginosa, 6(12.2%) and coagulase negative staphylococci, 6(12.2%). The level of multi-drug resistance among Gram-positive and Gram-negatives was at 50% and 78.4%, respectively. Participants' sex, circumcision status, having a flank pain and being malnourished were statistically associated with significant bacteriuria. CONCLUSION: Actions to minimize antimicrobial resistance should be strengthened to reduce the impact of UTI among the pediatric group.

Antimicrobial resistance and ESBL profile of Uropathogens among pregnant women at Edna Adan Hospital, Hargeisa, Somaliland.

BACKGROUND: The emergence and spread of antimicrobial resistance (AMR) among uropathogens is increasing, especially in resource limited settings due to a number of reasons. The production of Extended Spectrum ß-Lactamase (ESBL) by some strains of E. coli and methicillin resistant Staphylococcus species, limits the choice of antimicrobials in the treatment of urinary tract infection (UTI) globally. However, little is known about the type of uropathogenes and their current AMR profile among pregnant women in Hargeisa, Somaliland. METHODS: Clean-catch mid-stream urine samples were collected and processed for bacteriological culture and antimicrobial sensitivity testing (AST). Ceftazidime (30µg) and Cefotaxime (30µg) disks were used for ESBL screening as per CLSI guideline and each ESBL screening positive isolate were phenotypically confirmed by a combination disk test. RESULTS: Among 376 study participants, 79 (21.0%) had significant bacteriuria (SBU). Majority at 58(73.4%) of the isolates were Gram-negative. The most predominant isolate was E.coli, 36(45.6%) followed by K. pneumonea 16(20.3%) and S. aureus at 9(11.4 %). The proportion of ESBL producing isolates was 25(32.9%). Gram-negatives showed high level resistance to ampicillin, amoxicillin, cefotaxime, and cephalexin at 87%, 85%, 57%, and 52%, respectively. Previous history of UTI, monthly income, educational status and having dysuria were significantly associated with SBU (p<0.05). CONCLUSION: Relatively high prevalence of uropathogens and an increased level of drug resistance were documented. Therefore, continued surveillance on the type of uropathogens and their AMR pattern is needed to ensure appropriate recommendations for the rational empirical treatment of UTI and for policy input.

Bacteriological quality and associated risk factors of drinking water in Eastern zone, Tigrai, Ethiopia, 2019.

BACKGROUND: Access to safe drinking water is one of the basic human rights and is critical to health. However, much of the world's population lacks access to adequate and safe water. Approximately 884,000, 000 people in the world still do not get their drinking water from safe sources; Sub-Saharan Africa accounts for over one third of this number. It is estimated that 80% of all illnesses in the world are related to use of unsafe and contaminated water. METHODS: A cross-sectional study was conducted from August 1st 2017 to July 30th 2018 in three randomly selected woreda (districts) of Eastern Zone Tigrai. Water samples were examined for total coliforms and thermotelorant coliforms using the most probable number method. Standard biochemical testing was performed on samples that tested positive to identify the genus of bacteria. The contaminant risk of water sources were assessed using the sanitary inspection checklist of the World Health Organization. The results were interpreted using World Health Organization guidelines for drinking water quality. Data was collected using laboratory checklist and sanitary inspection check list. It was entered, cleared and analyzed using SPSS version 21.0 and a variable having a P < 0.05 was considered as statistically significant in all tests. RESULTS: A total of 290 drinking water samples were analyzed for bacteriological quality. A total of 32.4% (n = 94) of water sources showed contamination with faecal and total coliforms. Of these 3.4% (n = 10) samples were contaminated with total coliforms and 29% (n = 84) contaminated with faecal coliforms. The leading water contaminant organisms were Escherichia coli (62.4%), Legionella species (8.5%), and Shigella species (7.5%) respectively. Based on WHO criteria, 15% of water sources were grouped in the very high risk group. Animal excreta and inadequate fencing of water sources were significantly associated with water contamination rate. CONCLUSION: Our findings suggest that most water sources in woredas of Eastern Tigrai are contaminated by faecal coliforms. Therefore, regular sanitary inspection, bacteriological analysis, and adequate fencing should be mandatory to protect drinking water sources from faecal contamination.

Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student's cafeteria, northern Ethiopia, 2018.

BACKGROUND: Food handlers play a significant role in the transmission of foodborne infections. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem globally. Thus, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella colonization among food handlers. METHODOLOGY: A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 where a corresponding 95% confidence interval was considered statistically significant. RESULTS: A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0%). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, no hand washing after using the bathroom, no hand washing after touching dirty materials, no hand washing before food handling, and untrimmed fingernails were significant associated factors identified. None of the Salmonella and Shigella isolates were sensitive to ampicillin, yet low resistance against chloramphenicol, ceftriaxone, and ciprofloxacin was found. CONCLUSION: The present study revealed that the prevalence of Salmonella and Shigella among food handlers was 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, and drinks and could serve as a source of infection to consumers. This indicates that there is a need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students' cafeteria.

Prevalence of Methicillin-Resistant Staphylococcus aureus and Associated Risk Factors among Patients with Wound Infection at Referral Hospital, Northeast Ethiopia.

BACKGROUND: The spectrums of infections due to methicillin-resistant Staphylococcus aureus are manifold and are associated with worse outcomes. A study on the prevalence of these pathogens and their sensitivity patterns will give updated information which is very helpful for health personnel responsible in the management of patients and timely monitoring of the emergence of resistant bacteria. Hence, the study aimed at assessing the prevalence of methicillin-resistant Staphylococcus aureus and associated factors among patients with wound infection at Dessie Referral Hospital. METHOD: A cross-sectional study was conducted among 266 patients at Dessie Referral Hospital from February to May 2016. Wound swab samples were collected aseptically using Levine's technique and transported to Dessie Regional Laboratory by using brain-heart infusion transport media. Isolation of Staphylococcus aureus was done based on cultural and biochemical profiles. Drug susceptibility test was performed using the disc diffusion technique as per the standard and interpreted based on the Clinical and Laboratory Standards Institute guidelines. The data were entered and analyzed by using SPSS version 20. RESULT: Staphylococcus isolates from 266 processed wound swabs were 92 (34.58%). Of these, 26 (28.3%) were identified as methicillin-resistant S. aureus and 66 (71.7%) were methicillin-sensitive S. aureus. The overall prevalence of methicillin-resistant S. aureus among the study population was 9.8%. The isolated methicillin-resistant S. aureus showed full resistance to penicillin (100%) followed by erythromycin and ciprofloxacin (16, 61.5%) and cotrimoxazole and gentamicin (14, 53.8%). From the total S. aureus isolates, 20 (21.7%) of them showed multidrug resistance. Of these methicillin-resistant S. aureus, 18 (69.8%) showed high multidrug resistance. Patients who are farmers in occupation (AOR = 6.1, 95% CI (1.086-33.724)), admitted in the hospital (AOR = 3.56, 95% CI (1.429-8.857)), and have low BMI (<18.5) (AOR = 13.89, 95% CI (4.919-39.192)) were among the risk factors significantly associated with wound infection due to methicillin-resistant S. aureus. CONCLUSION: All methicillin-resistant S. aureus isolates were 100% resistant to penicillin and showed high multidrug resistance. Therefore, antibiotic susceptibility test should be performed prior to treatment.

Prevalence and associated factors of Hepatitis C virus and human immunodeficiency virus infections among voluntary counseling and testing clients attending private health facilities in Bahir Dar city, North West Ethiopia 2014.

OBJECTIVE: Although incredible progress has been made in treatment and prevention of Hepatitis C virus and human immunodeficiency virus infections, the epidemic continues to spread in developing nations. The information on the prevalence and risk factors of Hepatitis C virus and human immunodeficiency virus infections among voluntary counseling and testing clients in Ethiopia is limited. Hence, the study aimed to assess the prevalence and associated factors of Hepatitis C virus and human immunodeficiency virus infections among voluntary counseling and testing clients attending private health facilities in Bahir Dar city. RESULT: A total of 382 study participants with the mean age of 25.43 years (SD = ± 6.87) were enrolled. Overall, 14 (3.7%) and 8 (2.1%) voluntary counseling and testing clients were positive for human immunodeficiency virus and Hepatitis C virus respectively. All Hepatitis C virus antibody positive individuals were males (3.8%). The sero-prevalence of Hepatitis C virus was significantly associated with the age group 41-50 years old (AOR = 65.65; 95% CI 4.57-943). Married study participants were also significantly associated with HIV infection (AOR = 7.92, 95% CI 1.32-47.31).

Type of bacterial isolates and antimicrobial resistance profile from different clinical samples at a Referral Hospital, Northwest Ethiopia: five years data analysis.

OBJECTIVE: Antimicrobial resistance (AMR) is one of the most serious global public health threats that exert a significant burden in terms of patient morbidity and mortality and financial crises in many developing countries including Ethiopia. Knowledge on the type of predominantly circulating pathogens with their respective AMR profile in a given area is essential for optimal patient care. This study was aimed at assessing the types of bacterial isolates and their AMR profile identified from a range of clinical samples at Debre Markos Referral Hospital, Northwest Ethiopia, over a period of 5 years (2013 to 2017). RESULTS: From the total of 514 different clinical samples processed in the stated time frame, about 240 (46.7%) yield bacterial growth. Majority of the identified bacteria were isolated from stool culture 68 (28.3%) followed by urine 56 (23.3%), ear discharge 54 (22.5%) and wound swabs at 26 (10.8%). Most of the clinical isolates were Gram-negative at 171 (71.25%). The predominant isolate was S. aureus at 41 (17.1%) followed by Salmonella species, 40 (16.7%), Escherichia coli 36 (15%) and Pseudomonas aeruginosa at 26 (11.7%). Generally, the isolates were found resistant at (60-100%) against ampicillin, co-trimoxazole, doxycycline, gentamicin, norfloxacin and tetracycline. Gram-positive isolates were found relatively sensitive to ceftriaxone, erythromycin and vancomycin at (71-84%).

Correction to: Prevalence, antimicrobial susceptibility profile and predictors of asymptomatic bacteriuria among pregnant women in Adigrat General Hospital, Northern Ethiopia.

Following publication of the original article [1], the authors reported that one of the authors' names was spelled incorrectly. In this Correction the incorrect and correct author name are shown. The original publication of this article has been corrected.

Prevalence, antimicrobial susceptibility profile and predictors of asymptomatic bacteriuria among pregnant women in Adigrat General Hospital, Northern Ethiopia.

OBJECTIVE: Approach to asymptomatic bacteriuria among pregnant women in Ethiopia is mainly based on clinical grounds and urine strip and microscopy tests. On top of this, the treatment is also on an empirical basis which may leads to an increased antimicrobial resistance. The aim of this study was to assess the prevalence, antimicrobial susceptibility profile and associated factors of asymptomatic bacteriuria among pregnant women attending antenatal clinic in Adigrat Hospital, Northern Ethiopia. RESULTS: Out of 259 pregnant women included in the study, the prevalence of asymptomatic bacteriuria was at 55 (21.2%). Gram negative bacteria, specifically Escherichia coli were the predominant isolates followed by Klebsiella species and Proteus mirabilis. Of the Gram positive identified bacteria, Staphylococcus aureus was main isolate. Age of the mother (18-25 years old) with [AOR = 8.5, 95% CI (2.2, 32.9)], family income (< 1000 ETB) with [AOR = 7.5, 95% CI = (2.4, 23.1)] and gestational period at 1st trimester [AOR = 11.9, 95% CI (4.4, 32.4)] and 2nd trimester [AOR; 5.6, 95% CI (2.0, 15.5%)] were predictors significantly associated with asymptomatic bacteriuria. All Gram negative isolates were found 100% resistance to Ampicllin. Moreover, all Gram positive isolates were found sensitive to Vancomycin at 100%.