Prevalence, Antimicrobial Resistance, and Associated Factors of Streptococcus pneumoniae Colonization Rate among Old-Age Patients with Respiratory Tract Infection Attending Sheik Hassan Yebere Referral and Karamara General Hospitals, Jigjiga, Ethiopia.

Background: Streptococcus pneumoniae is part of the normal flora of the upper respiratory tract of humans. Colonization of the upper respiratory tract (carriage of pneumococcus) by S. pneumoniae is considered a prerequisite for pneumococcal infection. It is the major cause of respiratory tract infection and frequent cause of physician visits, hospitalization, and death among old-aged patients because of their low immunity status. However, data on S. pneumoniae among old-aged patients in eastern Ethiopia are limited. This study was undertaken to determine the prevalence, antimicrobial resistance, and associated factor of S. pneumoniae colonization among old-aged patients. Method: A health facility-based cross-sectional study was conducted from 1 March to 15 April 2020, at Sheik Hassan Yebere Referral and Karamara General Hospitals, Jigjiga, eastern Ethiopia. A total of 188 individuals greater than or equal to 60 years suspected of both upper and lower respiratory tract infections were included. Sociodemographic, behavioral, living conditions, and clinical data were collected by trained data collectors. Sputum samples were collected and examined for S. pneumoniae using the culture and biochemical tests as per the standard procedures. The Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing. The data were entered on Epi-data version 3.1, and frequencies, crude odds ratio, and adjusted odds ratio were analyzed using SPSS version 20. Results: The prevalence of S. pneumoniae colonization rate among old-aged patients was 13.8% (26/188) (95% CI: 9.6-19.1). Smoking (AOR = 3.3; 95% CI: 1.3-8.3), upper airway problems (AOR = 4.1; 95% CI: 1.1-15), and asthma disease (AOR = 3.1; 95% CI: 1.1-8.9) were the factors associated with S. pneumoniae colonization. The isolated organisms showed high antimicrobial resistance to trimethoprim-sulphamethoxazole (n = 12, 46.2%), tetracycline (n = 11, 42.3%), and ampicillin (n = 9, 34.6%). Conclusion: This study showed that high prevalence of S. pneumoniae and antimicrobial resistance for trimethoprim-sulphamethoxazole, tetracycline, and ampicillin when compared to similar studies. Cigarette smoking, having upper airway problem, and asthma disease were factors associated with S. pneumoniae colonization. The provision of pneumococci conjugate vaccination and avoiding smoking are highly recommended for old aged in the community.

High rate of non-vaccine targeted high-risk HPV genotypes circulate among women in Eastern Ethiopia.

The World Health Organization [WHO] recommends a genotype-specific human papillomavirus [HPV] vaccination as a primary prevention strategy to control the burden of cervical cancer globally. In Ethiopia, where the non-vaccine-targeted HPV genotypes have not been adequately studied, a vaccination initiative was launched in 2018 targeting HPV-6,-11, -16, and -18 for girls aged 14-18 years. The co-existence of both vaccine-targeted and non-targeted genotypes is a serious concern, as it can accelerate cancer progression. Therefore, this study was conducted to determine the prevalence of non-vaccine-targeted HPV genotypes and assess the level of multiple infections with other genotypes in eastern Ethiopia. A health facility-based cross-sectional study including 110 women with positive HPV DNA results was conducted from April to August 2021. A structured questionnaire to collect demographic and clinical data was used. Cervical swabs were collected using L-shaped FLOQSwabs. Women's cytological profile was determined based on Pap smear test results. An automated nucleic acid extraction system using STARMag 96 ProPrep Universal Extraction Kit was utilized following the manufacturer's protocol. An amplification assay in real-time was employed to amplify and identify the HPV Late 1 [L1] gene, which is utilized for genotyping purposes. Following this, the collected data was entered into Epi data version 3.1 software, and the analysis was performed using STATA version 14. A total of 110 women [age range 30-60 years, mean age = 36.5 years and SD ± 6.9] had positive HPV DNA results and were included in the study. Among these, 108 women had valid co-testing [Pap test and HPV DNA test] results for further analysis, and the results of the remaining 2 women were rejected. Overall, the prevalence of non-vaccine-targeted HPV was 56 (51.8%, 95%CI [0.42, 0.61]), of which 28 women (25.4%, 95%CI [0.18, 0.34]) had a single non-vaccine HPV genotype infection. The remaining 29 women (26.4%, 95% CI: 0.190-0.355) experienced multiple infections. The non-vaccine-targeted genotypes of HPV-35 accounted for 11 cases (10%, 95%CI [0.06, 0.17]), HPV-68 was detected in 9 women (8.2%, 95%CI [0.04, 0.15]), HPV-56 and HPV-66 were both found in 8 cases each (7.3%, 95%CI [0.04, 0.14]) of the total. In addition, out of these 108 women, 93 (86.1%, 95%CI [0.78, 0.91]) had low-grade squamous intraepithelial lesions, 13 (12%, 95%CI [0.07, 0.20]) no intraepithelial lesion or malignancy, and two (1.9%, 95%CI [0.01, 0.07]) high-grade squamous intraepithelial lesions. Furthermore, there was no statistical difference [p = 0.755] between vaccine-targeted and non-vaccine-targeted genotypes as the primary cause of cervical lesions. In conclusion, the findings of the present study highlight the existence of a notable prevalence of multiple infections caused by non-vaccine-targeted HPV genotypes. Therefore, it is recommended that both the Federal and regional health bureaus to evaluate the range of hr HPV genotypes protected by the current HPV vaccine and explore the option of transitioning from the quadrivalent HPV vaccine to a novavalent vaccine that includes seven high-risk HPV genotypes.

Knowledge of tuberculosis (TB) and human immunodeficiency virus (HIV) and perception about provider initiated HIV testing and counselling among TB patients attending health facilities in Harar town, Eastern Ethiopia.

BACKGROUND: Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) co-infection is one of the major health problems in Ethiopia. The national TB and HIV control guideline in Ethiopia recommends provider initiated HIV testing and counselling (PITC) as a routine care for TB patients. However, the impact of this approach on the treatment seeking of TB patients has not been well studied. In this study, we assessed knowledge of TB and HIV, and perception about PITC among TB patients attending health facilities in Harar town, Eastern Ethiopia. METHODS: In a health facilities based cross-sectional study, a total of 415 study participants were interviewed about knowledge of TB and HIV as well as the impact of HIV testing on their treatment seeking behavior using a semi-structured questionnaires. RESULTS: Multivariable logistic regression analysis showed the association of distance > 10 km from health facility [adjusted odds ratio (AOR)=0.48, 95% CI: 0.24 - 0.97, P=0.042] with low knowledge of TB. Distance > 10 km from health facility (AOR= 0.12, 95% CI: 0.06 -0.23, P < 0.001) was also associated with low knowledge of HIV testing. Delay in treatment seeking was associated with female participants (AOR = 0.11, 95% CI: 0.05-0.25, <0.001), single marital status (AOR =0.001, 95% CI: 0.00 - 0.01, P< 0.001) and distance > 10 km from health facility (AOR =0.46, 95% CI: 0.28 - 0.75, P=0.002). Most of the study participants (70%) believed that there is no association between TB and HIV/AIDS. On the other hand, two thirds (66.5%) of the participants thought that HIV testing has importance for TB patients. However, the majority (81.6%) of the study participants in the age category less than 21 years believed that fear of PITC could cause delay in treatment seeking. CONCLUSION: The study showed the association of low knowledge of the study participants about TB and HIV testing with distance > 10 km from health facility. Study participants in the age category less than 21 years thought that fear of PITC could cause treatment delay of TB patients. Hence, emphasis should be given to improve knowledge of TB and HIV among residents far away from health facility, and attention also needs to be given to improve the perception of individuals in the age group less than 21 years about PITC in the present study area.

Genotype heterogeneity of high-risk human papillomavirus infection in Ethiopia.

Cervical cancer is a vaccine-preventable sexually transmitted disease. In the year 2020, there were an estimated 604,000 new cases and 342,000 deaths worldwide. Although its incidence is global, it is much higher in sub-Saharan African countries. In Ethiopia, there is a scarcity of data about the prevalence of high-risk HPV infection and its association with cytological profiles. Therefore, this study was conducted to fill this information gap. A hospital-based cross-sectional study was conducted from April 26 to August 28, 2021, and enrolled 901 sexually active women. Socio-demographic and other relevant bio-behavioral and clinical data were collected using a standardized questionnaire. Visual inspection with acetic acid [VIA] was done as an initial screening method for cervical cancer. The cervical swab was then collected using L-Shaped FLOQSwabs in eNAT nucleic acid preservation and transportation medium. A Pap test was done to determine the cytological profile. Nucleic acid was extracted using STARMag 96 ProPrep Kit on SEEPREP32. A Real-time multiplex assay was performed to amplify and detect the HPV L1 gene used for genotyping. The data were entered into Epi data version 3.1 software and exported to STATA version 14 for analysis. A total of 901 (age range from 30 to 60 years, mean age = 34.8 years, and SD± 5.8) women were screened for cervical cancer using VIA and 832 women had a valid co-testing (Pap test and HPV DNA testing) results for further process. The overall prevalence of hr HPV infection was 13.1%. Out of 832 women, 88% of them had normal and 12% had abnormal Pap test results. The proportion of high risk HPV was significantly higher among women with abnormal cytology (X 2 = 688.446, p < 0.001) and younger age (X 2 = 15.3408, p = 0.018). Among 110 women with hr HPV, 14 genotypes (HPV-16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58, -59, -66, and -68) were identified while HPV-16, -31, -52, -58, and -35 genotypes were highly prevalent. The high risk HPV infection continues to be a significant public health problem among women 30-35 years old. The presence of high-risk HPV irrespective of genotypes is highly correlated with cervical cell abnormalities. Genotype heterogeneity is observed suggesting the importance of periodic geospatial genotyping surveillance for vaccine effectiveness.

Corrigendum: Genotype heterogeneity of high-risk human papillomavirus infection in Ethiopia.

[This corrects the article DOI: 10.3389/fmicb.2023.1116685.].

Bacteriological Quality and Antimicrobial Susceptibility Patterns Among Raw Milk Producers and Vendors in Gomole District, Borena Zone, Southern Ethiopia.

Background and Aim: Milk consumption plays a great role in the nutrition of consumers and the income of producers as well as vendors, but their bacteriological quality causes loss of those benefits. Hence, the aim of this study was to determine the bacteriological quality, associated factors and antimicrobial susceptibility pattern among raw milk of producers and vendors in Gomole district, Borena zone, South Ethiopia, from March 1 to April 30, 2019. Methods: A cross-sectional study was conducted on 130 purposively selected study participants. Pretested structured questionnaires and observation checklists were used to collect data. Then, 15 to 20 mL of milk samples were collected from producers and vendors for laboratory analysis. Standard plate count agar and eosin methylene blue agar were used for total bacterial count and total coliform count, respectively. Bacterial isolation from poor-quality milk was performed with biochemical tests and antimicrobial susceptibility tests using Kirby Bauer's disk diffusion method. After completeness checking, the data were analyzed by Statistical Package for the Social Sciences version 21. Chi-square (χ 2) was used to analyze association factors, and a p value <0.05 was considered statistically significant. Results: The overall means ± standard deviation of the total bacterial count (TBC) and total coliform count (TCC) were 7.75 ± 0.882 and 6.69 ± 1.545 log10 CFU/mL, respectively. The mean TBC was significantly different between producers' and vendors' milks t = 2.1 (P < 0.001). The proportions of raw milk TBC and TCC of poor quality were 90% and 80%, respectively. Poor hand washing practices before milking, water source and cleanliness of milk containers were associated with poor milk quality. The isolated bacteria were E. coli (30.8%), S. aureus (17.9%) and Salmonella spp. Out of the bacterial isolates, 80.4% were extensive drug resistant, 14.3% were multidrug resistant, and 5.4% were resistant against all antimicrobials used in this study. Conclusion: Ensuring proper hygienic practices during milking, storage and transportation to reduce milk contamination.

Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection Among Sub-Saharan African Women: A Systematic Review and Meta-Analysis.

Background: Among sub-Saharan African women, cervical cancer is steadily increasing with more than 75,000 new cases and 50,000 deaths annually. Due to the vast ethno geography variation, Africa harbors heterogeneous genotypes of HPV. High-risk HPV [hr HPV] genotypes such as hr HPV-16,-18,-35, and-52 are abundantly reported in sub-Saharan Africa. The purpose of this systematic review and meta-analysis is to generate an evidence on the prevalence and the genotype distribution of hr HPV among sub-Saharan African countries. Methods: The review was conducted by following the preferred reporting items for systematic reviews and Meta-analysis. PubMed/Medline, Embase, Scopus, Google Scholar, Heath Technology assessment and Cochrane Library databases were used to retrieve published original studies between 2001 and 2021. It included studies that used PCR-based or hybrid testing to assess the presence of HPV DNA in a cervical biopsy, cervical swelling, and vaginal swelling. Statistical software for data science (STATA V16) software using a random-effects model was used to determine the pooled prevalence and type-specific distribution of HPV with 95% confidence intervals (CI). The I-squared statistic was used to describe the level of heterogeneity. The study protocol is registered on PROSPERO with reference number CRD42022311157. Results: The review included 27 studies conducted in 19 sub-Saharan countries. A total of 16,506 study participants from 27 studies were included in a systematic review and 5,303 of them were infected with the hr HPV infection. Out these, only 3,075 of them were eligible for meta-analysis. The incidence proportion of estimatesof hr HPV infection among study participants with different health conditions ranges from 10.7 to 97.2% while the pooled incidence proportion of estimates is 34% (95%CI: 29-39). Among 3,075 women, 424 (13.8%), 305 (9.9%) and 279 (9%) were infected with HPV-16,-52 and-18, respectively. HPV-16 and-52 are the main genotypes causing the hr HPV infection in the Eastern and Southern African sub-contents, whereas HPV-16 and-35 are the main genotypes in the Western African countries. Conclusions: Depending on several factors, especially women's health conditions, the high rate of hr HPV infection with inconsistent genotype distribution shows that it is a growing public health challenge in sub-Saharan African countries. Therefore, to implement a vaccination-based prevention strategy and be effective, considering factors associated with hr HPV infection is crucial.

Knowledge, attitude, and practice regarding voluntary blood donation among adult residents of Harar town, Eastern Ethiopia: a community-based study.

BACKGROUND: The availability of safe blood and blood products is a critical factor in improving health care. In Ethiopia, lack of voluntary blood donors is a major challenge. This could be due to low community knowledge, unfavorable attitude, and poor donation practice regarding voluntary blood donation. Thus, the aim of this study was to assess community knowledge, attitude, and practice regarding voluntary blood donation among adults in Harar town, Ethiopia. MATERIALS AND METHODS: A community-based cross-sectional study was conducted from July 1 to July 31, 2015. A total of 845 adults were randomly selected and interviewed using a pretested, structured questionnaire. Six trained data collectors conducted a face-to-face interview. Data were entered into EpiData Version 3 and analyzed using STATA Version 11. RESULTS: Comprehensive knowledge of the study participants toward voluntary blood donation was 43.5%. Multivariable logistic regression demonstrated that male sex (adjusted odds ratio [AOR] = 1.69, 95% confidence interval [CI]: 1.19-2.39), age (31-45 years; AOR = 0.50, 95% CI: 0.34-0.74) and >45 years (AOR = 0.60, 95% CI: 0.38-0.95), and higher education (AOR = 15.34, 95% CI: 5.01-46.91) were significantly associated with comprehensive knowledge about voluntary blood donation. A total of 278 (32.9%) study participants had positive attitude toward voluntary blood donation. College graduates (AOR = 13.05, 95% CI: 4.12-41.29) were significantly associated with positive attitude toward voluntary blood donation. Only 191 (22.6%) subjects had ever donated blood. However, the proportion of study participants who donated blood voluntarily with good knowledge about voluntary blood donation was significantly lower than the study participants who donated blood voluntarily with low knowledge (X2 = 6.1746, P = 0.013). CONCLUSION: This study showed an inauspicious attitude toward blood donation and poor blood donation practices. Subjects with good comprehensive knowledge about voluntary blood donation were less likely to donate blood voluntarily compared to those with lower comprehensive knowledge about voluntary blood donation.

Community knowledge and the role of health extension workers on integrated diseases among households in East Hararghe Zone, Ethiopia.

BACKGROUND: Ethiopia constitutes approximately 1% of the world's population but it contributes to 7% of the world's HIV/AIDS cases. Malaria is the most important disease of humans in terms of mortality, morbidity, and long-term effects upon quality of life, especially in Ethiopia. Despite the ongoing efforts and progress in fighting HIV/AIDS and malaria, these diseases remain the leading cause of morbidity and mortality in the country. In this study, we assessed community knowledge and the role of health extension workers on integrated diseases among households in East Hararghe Zone, Ethiopia. METHODS: A community-based multistage stratified cross-sectional study was conducted from February to March 2014 among six woredas of the East Hararghe Zone, Ethiopia. The data were collected from 2,319 households using structured questionnaires. A total of 12 well trained data collectors conducted a face-to-face interview with the head female of each household. The data entered on Epi-Data version 3 were then exported for analysis on STATA version 11. RESULTS: Multivariable logistic regression showed that among the 1,967 (92.7%) study participants who scored above the mean value in regard to the overall knowledge of HIV/AIDS, study participants who could read/write (adjusted odd ratios [AOR] =2.54, 95% confidence interval [CI]: 1.15-5.61, P=0.021) and worked as a daily laborer (AOR =0.40, 95% CI: 0.17-0.91, P=0.029) were significantly associated with comprehensive knowledge about HIV/AIDS. Meanwhile, out of the 2,172 eligible study participants for the malaria interview, 934 (43%) scored above the mean in regard to the overall knowledge about malaria. Rural residents (AOR =0.27, 95% CI: 0.17-0.44, P<0.005), >45 years of age (AOR =1.44, 95% CI: 1.04-1.99, P=0.030), and single marital status (AOR =3.81, 95% CI: 1.97-7.37, P<0.005) were significantly associated with comprehensive knowledge about malaria. CONCLUSION: Based on the findings of this study, health extension workers' number of monthly regular visits of each household was high, with the overall knowledge of study participants regarding malaria was unsatisfactory, unlike the overall knowledge of study participants regarding HIV/AIDS, which is very high.