Hygienic Practices of Vendors and Their Contribution to Coliform, Salmonella, and Shigella Bacteria of Raw Milk at Asella Town, Oromia, Ethiopia.

Background: Coliform, Salmonella, and Shigella are among the most encountered bacteria in raw milk. This study is aimed at determining the extent of coliform, Salmonella, and Shigella bacteria in raw milk and vendor hygiene practices at Asella town, Oromia Regional State, Ethiopia, from March 1 to 30, 2022. Methods: In this study, 210 milk vendors were included; each vendor provided a 50 ml sample of raw milk. Bacteria were isolated and identified using standard bacteriological techniques. Data were entered and analyzed using EPI info version 7 and SPSS version 22, respectively. A binary logistic regression model was applied to determine the factors associated with bacterial contamination of raw milk. Results: The total contamination percentage of raw milk was 50 (23.8%) (95% CI: 18.1-29.5%). The predominant bacteria identified were coliform 43 (20.5%) followed by Salmonella species 7 (3.3%). Among coliforms, the predominant bacteria were Citrobacter species 15 (34.9%) followed by Enterobacter species 11 (25.6%), Escherichia coli and Serratia species each 6 (14%), and Klebsiella species 5 (11.6%). However, no Shigella was isolated in this study. Not having the habit of washing cow teats (p < 0.0001), the habit of washing teats with tap water (p < 0.0001), not having separate cloth during milking (p < 0.0001), not having a practice of testing milk for bacterial contamination (p = 0.027), and not having separate vending environment (p = 0.039) were significantly associated with bacterial contamination of raw milk. Conclusions: The percentage of bacterial contamination of milk was found to be high. Participants without a habit of washing cow teats, a habit of washing milk utensils with only tap water, and not having separate vending environments were associated factors for bacterial contamination of raw milk. Milk vendors are advised to develop the habit of washing teats before milking, avoid washing teat/milk utensils only with tap water, and have a separate vending environment.

Prevalence of phenotypic multi-drug resistant Klebsiella species recovered from different human specimens in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Multidrug-resistant (MDR) Klebsiella species are among public health important bacteria that cause infections difficult to treat with available antimicrobial agents. Infections with Klebsiella lead to high morbidity and mortality in developing countries particularly in patients admitted to the intensive care unit. This systematic review and meta-analysis aimed to determine the pooled prevalence of MDR Klebsiella species from different human specimens using studies conducted in Ethiopia from 2018-2022. METHODS: We have systematically searched online databases such as PubMed/Medline, Google Scholar, Hinari, African journals online, Web of Science, Cochrane, and grey literature (Addis Ababa University and Hawassa University) to identify studies reporting the proportion of MDR Klebsiella species in Ethiopia. Published articles were selected based on the Preferred Reporting Item of Systematic Review and Meta-analysis (PRISMA). R-Studio version 4.2.3 was used to conduct pooled prevalence, heterogeneity test, and publication bias. A binary random effect model was used to determine the pooled prevalence. Heterogeneity was checked with the inconsistency index (I2). Publication bias was checked with a funnel plot and Egger test. Sensitivity analysis was conducted with leave-one-out analysis. Joanna Briggs Institute's critical appraisal tool for prevalence studies was used to check the quality of each article. RESULTS: In this systematic review and meta-analysis, 40 articles were included in which 12,239 human specimens were examined. Out of the total specimens examined, 721 Klebsiella species were isolated and 545 isolates were reported to be MDR Klebsiella species. The prevalence of MDR Klebsiella species ranged from 7.3%-100% whereas the pooled prevalence of MDR Klebsiella species was 72% (95% CI: 63 - 82%, I2 = 95%). Sub-group analysis based on region revealed the highest prevalence of MDR from Addis Ababa (97%) and the least from the Somali region (33%); whereas sub-group analysis based on the specimen type indicated the highest prevalence was from blood culture specimens 96% and the least was from other specimens (ear and vaginal discharge, and stool) (51%). CONCLUSION: Our finding indicated a high prevalence of MDR Klebsiella species found in different human specimens. The prevalence of MDR Klebsiella varies across regions in Ethiopia, age, the type of specimens, source and site of infection. Therefore, integrated action should be taken to reduce the prevalence of MDR Klebsiella species in regional states and focus on clinical features. Effective infection and prevention control should be applied to reduce the transmission within and outside health care settings.

High Gastrointestinal Colonization Rate of Vancomycin-Resistant Enterococci among Hospitalized Patients: Potential Source for Resistant Gene.

Background: Vancomycin-resistant Enterococci (VRE) is a global health problem and responsible for healthcare-associated infections (HAIs) in patients with prolonged hospital stay, severe underlying disease, and previous broad-spectrum antibiotic therapy. These bacteria can cross-resist and transfer drug-resistant genes to other potentially pathogenic bacteria. Therefore; this study was aimed to determine the gastrointestinal colonization rate of VRE, its antimicrobial susceptibility profile, and associated factors among hospitalized patients. Methods: Prospective cross-sectional study was conducted using stool samples from 223 patients admitted to different wards at Hawassa University Comprehensive Specialized Hospital, from April 1 to June 30, 2021. Patients admitted to the hospital for more than 48 hours for various medical conditions were included. Sociodemographic and clinical characteristics were collected using a structured questionnaire. Fecal specimens were cultured on Enterococci selective media. Enterococcus species were identified using their growth and mannitol fermentation properties. Vancomycin resistance was screened using both the Kirby-Bauer disk diffusion method and a vancomycin E-test strip. Data were entered and analyzed using SPSS version 25. Descriptive and logistic regressions were used to determine the frequency and association of factors with the VRE colonization rate. A p value of <0.05 was considered statistically significant. Results: A total of 223 fecal specimens were collected and processed, and 141 (63.2%) them were positive for Enterococci. The predominant species was E. faecalis 65 (46.1%) followed by E. faecium 76 (53.9%). In this study, the gastrointestinal colonization rate of VRE was 15 (6.7%) and all the species belong to E. faecium. Study participants who had no formal education (AOR = 4.26, 95% CI: 1.01, 18.06), hospitalized patients for >2 weeks (AOR = 4.10, 95% CI: 1.08, 15.57), and those who had a history of treatment with vancomycin (AOR = 4.77, 95% CI: 1.26, 18.09) were more likely to be colonized with vancomycin-resistant Enterococci. More than 95% of Enterococci isolates were susceptible to linezolid, whereas 70.2%, 63.1%, 56.7%, and 53.9% were resistant to tetracycline, erythromycin, penicillin, and ampicillin, respectively. Among the total Enterococci isolated, 141 (54.6%) were multidrug resistant. Conclusions: In our study, high proportion of vancomycin-resistant Enterococci was found. Previous exposure to antibiotics and hospital stay were significant factors for VRE gut colonization. The isolated Enterococci showed variable degrees of resistance to commonly prescribed antibiotics which leads to a worldwide problem multidrug resistance. Therefore, periodic surveillance on antimicrobial resistance pattern, adhering to rational use of antibiotics, and implementing infection prevention protocols may reduce colonization by VRE.

Magnitude of tuberculosis lymphadenitis, risk factors, and rifampicin resistance at Adama city, Ethiopia: a cross-sectional study.

Mycobacterium tuberculosis complex has an impact on public health and is responsible for over one million deaths per year. Substantial numbers of people infected with M. tuberculosis can develop tuberculosis lymphadenitis; however, there is a limited study in Adama, Ethiopia. The aim of this study was to determine the magnitude of Tuberculosis lymphadenitis, its predictors, and rifampicin-resistance gene-positive M. tuberculosis. A total of 291 patients with enlarged lymph nodes were recruited from May 2022 to August 30 at Adama Comprehensive Specialized Hospital Medical College (ACSHMC). GeneXpert, Ziehl-Neelsen staining, and cytology were used for the diagnosis of TB lymphadenitis from the Fine Needle Aspirate (FNA) specimen. Rifampicin-resistant gene was detected using GeneXpert. For data entry and analysis, Epi Data version 3.0 and SPSS version 25 were used respectively. A binary logistic regression model was used to identify predictors of TB lymphadenitis. A p < 0.05 with a 95% confidence interval (CI) was taken as a cut point to determine the significant association between dependent and independent variables. The prevalence of TB lymphadenitis using GeneXpert, Ziehl-Neelsen staining, and cytology were 138 (47.4%) (95% CI 41.70-53.10), 100 (34.4%) (95% CI 28.94-39.85), and 123 (42.3%) (95% CI 36.63-47.00) respectively. Nine (3.1%) participants were infected with rifampicin-resistant gene-positive M. tuberculosis. Out of the total M. tuberculosis detected by GeneXpert (n = 138), 9 (6.5%) were positive for rifampicin resistance-gene. Participants with a chronic cough had 2 times odds of developing TB lymphadenitis (AOR: 2.001, 95% CI 1.142-3.508). Close to half of patients with enlarged lymph nodes were positive for M. tuberculosis by the GeneXpert method in the study area. Chronic cough was significantly associated with TB lymphadenitis. Rifampicin-resistant gene-positive M. tuberculosis was relatively prevalent among patients with enlarged lymph node in the study area.

Determinants of Podoconiosis in Bensa District, Sidama Region, Ethiopia: A case control study.

BACKGROUND: Podoconiosis is one of the neglected tropical diseases (NTD) with the greatest potential for elimination. Despite its public health importance, podoconiosis is a poorly understood disease which led to a widespread misconception about its cause, prevention, and treatment. Even though the exact global burden is still to be measured, it is estimated that at least 4 million people are affected with podoconiosis worldwide, of which more than 1.5 million people are in Ethiopia. The objective of this study was to identify the determinants of podoconiosis in Bensa District, Sidama Regional State, Ethiopia. METHODOLOGY/PRINCIPAL FINDINGS: A community-based unmatched case-control study was used to identify the determinants of podoconiosis. The sample size was estimated using the double population proportion formula. An interviewer-administered structured questionnaire was used for data collection. Blood specimens collected from cases were tested by Filariasis Test Strip to exclude lymphatic filariasis. Data were checked for completeness, coded and entered into Epi-data Version 4.6, and exported to the SPSS version 22 software. Variables with a p<0.2 in the bivariate analysis were further analyzed using multivariable binary logistic regression. Multivariable logistic regression analysis was used to examine determinants that could be associated with podoconiosis with a 95% confidence interval. A total of 459 (153 cases and 306 controls) participants were included with a response rate of 100%. Factors such as the age of participant [AOR = 0.34, 95% CI (0.13-0.87)], being female [AOR = 2.90, 95% CI (1.40-6.10)], age at which shoe wearing started [AOR = 0.7, 95% CI (0.03-0.16)], not wearing shoe daily [AOR = 2.26, 95% CI (1.05-4.86)], wearing hard plastic shoe [AOR = 3.38, 95% CI (1.31-10.89)], and family history with a similar disease (leg swelling) [AOR = 10.2, 95% CI (3.97-26.37)] were significantly associated with the occurrence of podoconiosis. CONCLUSIONS/SIGNIFICANCE: The age of the participants, gender, the age at which shoe wearing started, type of shoe the participants' wear, frequency of shoe wearing, traveling barefoot, and family history with similar disease (leg swelling) were significantly associated with the occurrence of podoconiosis. Sidama regional health bureau along with non-governmental organizations working on the neglected tropical disease should plan modalities on awareness creation and comprehensive health education on shoe wearing and foot hygiene.

Sero-prevalence and associated factors of sexually transmitted infections among youth-friendly services Attendees.

BACKGROUND: Worldwide, more than one million peoples acquire sexually transmitted infections (STIs). The burden of STIs and the youth awareness level on the transmission of STIs is under investigated in Sidama Regional State. OBJECTIVE: To determine the seroprevalence of STIs such as hepatitis B surface antigen (HBsAg), Anti-hepatitis C virus (HCV) antibodies, Human Immunodeficiency virus (HIV) seroprevalence, and syphilis and to determine associated factors among youth-friendly services Attendees at selected health facilities in Hawassa city, Ethiopia. METHODS: A multicenter cross-sectional study was conducted among 416 randomly selected youth attending youth-friendly services at selected health facilities from May to August 2021. To collect the background characteristics of participants an interviewer-administered questionnaire was used. Blood samples were collected, processed, and tested using Advanced Quality One Step rapid colloidal gold immunochromatographic assay for detection of antibodies for syphilis and hepatitis C virus infection, and hepatitis B virus surface antigen. For the diagnosis of syphilis Rapid Plasma Reagin was also used. HIV1/2 STAT PAK, HIV1/2/O ABON and HIV1/2 SD Bioline were used for testing antibodies for HIV infection. Data entry and analysis were performed using Statistical Package for the Social Sciences (SPSS) version 20.0 software. A crude and adjusted odds ratio with a 95% confidence interval (CI) was computed to identify associated factors. RESULTS: The overall seroprevalence of STIs was 11.5% (48/422), with a 95% CI: (8.7-14.9). Out of the 48 positive results, the proportions of HBsAg, Anti-HCV, HIV, and syphilis were 56.3% (27/48), 27.1% (13/48), 10.4% (5/48), and 6.3% (3/48) respectively. Out of 416 participants, 17.1% responded that it is safe to have sex without using a condom. The Odds of developing STI among female participants, participants who did not identify alcohol intake as a risk factor for STIs, and those who engaged in transactional sex were (AOR = 2.989: 95% CI: 1.27, 7.02), and (AOR = 2.393, 95% CI: 1.18, 4.81) and practice of transactional sex (AOR = 5.527, 95% CI: 1.62, 18.75). CONCLUSIONS: STIs are common among youth-friendly services Attendee in Hawassa city The overall STI was significantly associated with sex (females), not able to identify alcohol intake as a risk factor, and practice of transactional sex. High number of (n = 289, 69.5%) participants think that the use of condoms is not effective in preventing STIs and they engage in sexual activity without using condoms.

Comparison of Fine Needle Aspiration Cytology and Histopathology in the diagnosis of lymph node pathologies at health facilities located in Hawassa: A 5-year retrospective study.

Objective: The aim of this study was to evaluate the performance of Fine Needle Aspiration Cytology in the diagnosis of lymph node pathologies in comparison with Histopathologic examination. Methods: A retrospective health facility-based cross-sectional study was carried out at health facilities located in Hawassa city among 101 patients who had both Fine Needle Aspiration Cytology and Histopathologic examination on the same site from 13 September 2016 to 30 August 2021. Background data were collected using a structured questionnaire and analyzed by SPSS version 20. Results: A total of 3892 patients had Fine Needle Aspiration Cytology for lymphadenopathies within a specified 5-year span, out of which 101 cases had both Fine Needle Aspiration Cytology and Histopathologic examination. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of fine needle aspiration cytology for the diagnosis of lymphoma were 88.2%, 92%, 91.8%, 88.5%, and 90.1%, respectively. Conclusions: Fine Needle Aspiration Cytology can be recommended for clinically significant lymphadenopathy as a first-line diagnostic test since it is fast, safe, cost-effective, reasonably sensitive, and specific with significant positive and negative predictive values and diagnostic accuracy.

Bacterial etiology and risk factors among newborns suspected of sepsis at Hawassa, Ethiopia.

Neonatal sepsis is a systemic infection that occurs at an early age. Its etiology varies from one region to the other. The contribution of sepsis to neonatal mortality and morbidity is significant in resource-limited countries; however, there is limited information about the etiology of sepsis in Sidama Regional State, Ethiopia. The aim of this study was to determine the prevalence of bacterial caused newborn sepsis, associated factors, and the antimicrobial susceptibility profile of bacteria. A hospital-based prospective cross-sectional study was conducted among 392 sepsis suspected newborns admitted to the neonatal intensive care unit of Hawassa University Comprehensive Specialized Hospital from March 2021 to November 2021. Blood specimens were collected and bacteria were isolated using the standard culture method. The drug resistance profile of bacteria was evaluated using the disk diffusion method. The socio-demographic and clinical parameters of participants were gathered using a questionnaire. Binary logistic regression was used to determine the determinants of sepsis. A variable with a p < 0.05 was considered a significant determinant of neonatal sepsis with a 95% confidence level. The prevalence of sepsis caused by bacteria among newborns was 143 (36.5%); 95% CI (31.3-41.4). The predominant bacteria was Klebsiella species (n = 61; 42.65%), followed by non-lactose fermenting Gram-negative bacteria (n = 27; 18.88%) and Enterococcus species (n = 26; 18.18%). The overall proportions of antimicrobial resistance of Gram-negative bacteria range from 10.2 to 99.1%. All Klebsiella species were resistant to ceftriaxone. Ppremature rupture of membrane [AOR = 12.7 (95% CI 6.430-25.106)], absence of respiratory support [AOR = 3.53 (95% CI 1.840-6.759)], sex of newborns [AOR = 2.10 (1.214-3.560)] and reason for admission [AOR = 3.17 (95% CI 1.278-7.859)] were significantly associated with culture-confirmed neonatal sepsis. This study indicated the contribution of bacteria in causing sepsis among newborns; the majority of them were Gram-negative bacteria. Most recovered bacteria were resistant to commonly used antibiotics. Pre-term, mode of delivery and types of respiratory support were significantly associated with the occurrence of sepsis caused by bacteria.

Prevalence and Multi-Drug Resistance of Streptococcus pneumoniae Infection Among Presumptive Tuberculosis Adult Cases at Dilla University Referral Hospital, Dilla, Ethiopia.

Introduction: Streptococcus pneumoniae is the leading cause of community-acquired pneumonia in Africa. The simultaneous occurrence of both infections leads to delayed diagnosis and inadequate treatment. The study aimed to determine the prevalence, antimicrobial susceptibility pattern and associated factors of Streptococcus pneumoniae infection among presumptive Tuberculosis adult cases at Dilla University Referral Hospital, Dilla, Ethiopia. Methods: An institution-based cross-sectional study was conducted on 422 presumptive TB cases visiting TB clinic at Dilla University Referral Hospital from April to June 2021. Following the Bartlett's criteria, the accepted sputum samples were cultured on Blood agar plate and chocolate agar plate. Streptococcus pneumoniae was identified and confirmed by typical colony morphology, alpha-hemolysis, gram staining, optochin susceptibility and bile solubility tests. Antimicrobial susceptibility test was done by using the Kirby-Bauer disc diffusion method. Semi-structured questionnaires were used to collect data. Bivariate and multivariate logistic regression analyses were done by using SPSS version 23.0, computer software. Results: The overall prevalence of S. pneumoniae in presumptive tuberculosis adult cases was 21.4% (95% CI: 17.7-25.5). S. pneumoniae has a high level of resistance to penicillin (74.1%), tetracycline (78.7%) and Trimethoprim-sulfamethoxazole (46%). Multidrug resistance was observed in 46.1% of bacterial isolates. Being primary education, more than five family size and one or two rooms in the house had more likely to cause S. pneumoniae infection. Conclusion: This study revealed a relatively high prevalence of multidrug resistance of Streptococcus pneumoniae infection. Primary educational status, living in a crowded family, below two rooms in the house, had a significant association with S. pneumoniae infection.

Methicillin-resistant Staphylococcus aureus antibiotic susceptibility profile and associated factors among hospitalized patients at Hawassa University Comprehensive Specialized Hospital, Ethiopia.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of hospital-acquired infection, which is difficult to treat because of antibiotic resistance. There is scant data on MRSA from southern parts of Ethiopia. Objective: The aim of this study was to determine the prevalence of MRSA nasal carriage, antibiotic susceptibility profiles, and associated factors among hospitalized patients attending Hawassa University Comprehensive Specialized Hospital (HUCSH), Hawassa, Ethiopia. Methods: A hospital-based cross-sectional study was conducted from December 11, 2019 to February 15, 2020. Background and clinical data were captured by an interviewer-administered questionnaire. Nasal swabs were collected aseptically and inoculated onto mannitol salt agar and sheep blood agar, which was incubated for 24 hours at 37°C. S. aureus was confirmed using standard bacteriological methods. MRSA was identified using the cefoxitin Kirby-Bauer disk diffusion method. Results: Of the 280 included hospitalized patients, 38 (13.6%) were colonized with S. aureus. The prevalence of MRSA carriage was 9.3% (95% CI 6.1‒12.2). Twenty-six (68.4%) of the S. aureus isolates were methicillin resistant. Participants with a monthly income > 4000 Ethiopian Birr were four times more likely to be colonized with MRSA (p = 0.022). A high proportion of patients with a history of admission to the surgical ward was colonized with MRSA. Over 10% of MRSA isolates were resistant to all antibiotics except clindamycin and erythromycin. Of the 26 MRSA isolates, 88.5% showed multidrug resistance. Conclusions: The prevalence of MRSA was relatively high among hospitalized patients at HUCSH. Factors such as weight and monthly income were significantly associated with the occurrence of MRSA.

Magnitude of HIV Infection and Associated Factors among Female Sex Workers at Hawassa, Ethiopia.

Background: HIV is among one of the most serious public health problems. Low-income countries are highly affected by Human Immuno-deficiency Virus (HIV). The burden of HIV varies across various segments of the population. The aim of this study was to determine the magnitude of HIV infection and associated factors among female sex workers (FSWs). Methods: A cross-sectional study was conducted among 381 FSWs at Integrated Service on Health and Development Organization (ISHDO) located in Hawassa city from July to November 2018. Socio-demographic and related data were collected using a structured questionnaire. About 5 ml of venous blood was collected from study participants; serum was prepared and tested for HIV using the 4th generation Microlisa HIV assay. Data were analyzed by using SPSS version 21; binary and multivariable logistic regressions were used to determine factors associated with HIV infection among FSWs. A p-value of less than 0.05 was considered statistically significant. Results: The prevalence of HIV among FSWs at ISHDO, Hawassa was 19.9% [95% CI: 16, 24.4]. Conclusion: The prevalence of HIV among FSWs at ISHDO, Hawassa was relatively high compared to national and regional reports. In this study, none of the factors assessed were significantly associated with HIV infection.

Determinants of pneumonia among children attending public health facilities in Worabe town.

Childhood pneumonia is common in developing countries, with significant morbidity and mortality. Taking the significance of the problem and variability of risk factors into account, a study was needed to identify the potential determinants of pneumonia in under-five children. A facility-based unmatched case-control study was conducted among 435 children (145 cases and 290 controls) aged 2-59 months at public health facilities in Worabe town from December 28, 2016, to January 30, 2017. Data were collected using interviewer-administered questionnaire and analysed using SPSS version 22. Bivariable and multivariable binary logistic regression were used to determine association between dependant and independent variables. Among the factors assessed, stunting [AOR = 3.6,95% CI: 1.9-6.9], carrying the child on the back during cooking [AOR = 2.0,95% CI: 1.2-3.2], absence of chimney in the cooking room [AOR = 2.2, 95% CI: 1.3-3.7], having a history of asthma [AOR = 5.0,95% CI: 2-12], and a previous acute upper respiratory tract infection [AOR = 3.7,95% CI:2.3-6.1] were significantly associated with pneumonia.

Dental caries and associated factors among patients visiting Shashamane Comprehensive Specialized Hospital.

INTRODUCTION: Dental caries is a major public health problem. In Ethiopia, prevention and treatment of oral health-related illness had given little attention and there is limited data on the extent and factors associated with oral health-related illnesses and oral care practices. OBJECTIVE: This study was aimed to investigate the prevalence of dental caries and associated factors among patients visiting Shashamane Comprehensive Specialized Hospital (SCSH). METHODS: A hospital-based cross-sectional study was conducted among 288 patients who visited SCSH dental clinic from March 1, 2021, to April 15, 2021. A questionnaire was employed to collect the background characteristics of the participants. Dental caries was confirmed as per World Health Organization guidelines. Data were analyzed using SPSS version 24. Bivariable and multivariable logistic regression were used to determine predictors of dental caries. A p-value less than 0.05 was taken as a cut point to determine a significant association. RESULTS: The overall prevalence of dental caries was 64.6% with 95% CI (58.8‒70.1). The mean of Decayed, Missing, and Filled Teeth was 1.33. Dental caries was significantly higher among respondents who did not brush their teeth (AOR = 3.589, 95% CI:1.756‒7.334), who consumed sugary food (AOR = 3.650, 95% CI: 1.747‒7.628), those with monthly a income of less than 5000.00 Ethiopian Birr (AOR = 2.452, 95% CI (1.193‒5.042), and those who had poor oral hygiene status (AOR = 1.826, 95% CI: 0.901‒3.700). CONCLUSIONS: This study revealed a high prevalence of dental caries among patients visiting the dental clinic. Tooth brushing habits, consumption of sugary food, and poor oral hygiene were significantly associated with dental caries.

Acid-Fast Bacilli Positivity Rate and Associated Factors among Leprosy Suspected Cases attending Selected Health Facilities located in West Arsi Zone, Oromia, Ethiopia.

INTRODUCTION: Leprosy is one of the neglected tropical diseases that affect skin and peripheral nervous system often results in severe, lifelong disabilities and deformities. Even though multidrug therapy was in place for more than 30 years to treat and prevent leprosy worldwide including Ethiopia, its epidemiology is not well studied in the West Arsi zone. OBJECTIVE: The aim of this study was to determine the prevalence of acid-fast bacilli (AFB) positivity rate and associated factors among leprosy suspected cases. METHODS: A health facility-based cross-sectional study was conducted among 422 leprosy suspected cases from August 2020 to December 2020. To detect AFB, skin slit specimens were collected and examined using the Ziehl-Neelsen staining technique. Socio-demographic and clinical data were collected using a structured questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 24. Logistic regression was employed to determine predictors of AFB positivity rate. RESULTS: Acid-fast bacilli were detected among 46 leprosy suspected cases which gives a prevalence of 10.9% with 95% CI (8.2‒15.6). Suspected leprosy cases with multibacillary type were 4 times more likely to be AFB positive (p=0.021) than their counterparts. Study participants who had contact with known leprosy cases were 2 times more likely to be AFB positive (p = 0.032) and those with no formal education were 2 times more likely to be AFB positive (p = 0.03). Participants who had close contact with leprosy patients for ≥3 years were 8 times more likely to be AFB positive (p = 0.02). CONCLUSION: This study revealed a high prevalence of AFB positivity rate in the era of multidrug therapy. Types of leprosy, close contact with known leprosy cases, educational status, and duration of closer contact with leprosy cases were significantly associated with AFB positivity rate.

Prevalence of Mycobacterium tuberculosis infection and rifampicin resistance among presumptive tuberculosis cases visiting tuberculosis clinic of Adare General Hospital, Southern Ethiopia.

OBJECTIVE: Multidrug-resistant Mycobacterium tuberculosis is a public health threat in resource-limited countries where it is easily disseminated and difficult to control. The aim of this study was to determine the prevalence of tuberculosis, rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis, and associated factors among presumptive tuberculosis cases attending the tuberculosis clinic of Adare General Hospital located in Hawassa city. METHODS: A hospital-based cross-sectional study was conducted among 321 tuberculosis suspected patients from April to July 2018. Socio-demographic, environmental, and behavioral data were collected using a structured questionnaire. Sputum specimens were analyzed using GeneXpert. Data entry was made using Epi info version 7 and analyzed by SPSS version 20. Logistic regression models were used to determine the risk factors. A p-value less than 0.05 was taken as a cut point. RESULTS: In this study, the prevalence of Mycobacterium tuberculosis was 98 (30.5%) with 95% confidence interval (25.5-35.8), and the prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis among the 98 Mycobacterium tuberculosis confirmed cases was 4 (4.1%). The prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis among the tuberculosis suspected patients was 1.24%. Participants who had a history of treatment with anti-tuberculosis drugs were more likely to develop rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis. CONCLUSIONS: This study identified relatively high rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis among tuberculosis suspected patients in the study area. Early detection of drug-resistant Mycobacterium tuberculosis should be given enough attention to strengthen the management of tuberculosis cases and improve direct observation therapy short-course and eventually minimize the spread of rifampicin-resistant tuberculosis strain in the community.

Distribution and antimicrobial resistance profile of bacteria recovered from sewage system of health institutions found in Hawassa, Sidama Regional State, Ethiopia: A descriptive study.

OBJECTIVES: The aim of the study was to determine the distribution and antimicrobial susceptibility profile of bacteria recovered from the sewage systems of health institutions found in Hawassa, Sidama Regional State, Ethiopia. METHODS: A cross-sectional study was conducted from 20 October 2020 to 1 December 2020. A total of 27 sewage samples were collected at two points, namely, before entering the septic tank and from the septic tank of seven health institutions. Samples were inoculated onto Mannitol salt agar, Blood agar, and MacConkey agar, and incubated for 24 h at 37°C. Bacteria were identified using colony morphology, Gram staining, and biochemical tests. An antimicrobial susceptibility test was performed using the Kirby-Bauer disk diffusion method. Data were analyzed by SPSS, version 25, and results were presented in text and tables. RESULTS: All sewage samples (n = 27) examined in the current study contained potential pathogenic bacteria. Overall, 129 different types of bacteria were identified. Of isolated bacteria, 14 (10.8%) were Gram positive, while 115 (89.2%) were Gram negative. The most prevalent bacteria were Escherichia coli (n = 27, 20.9%) followed by Shigella species (n = 26, 20.2%), Pseudomonas species (n = 25, 19.4%), Salmonella species (n = 25, 19.4%), Staphylococcus aureus (n = 14, 10.9%), and Klebsiella species (n = 12, 9.3%). All bacteria were susceptible to azithromycin. About 80% of bacteria were resistant to ampicillin, whereas greater than 80% of bacteria were susceptible to norfloxacin, ciprofloxacin, and gentamicin. CONCLUSION: All sewage systems of health institutions included in the current study contained different types of pathogenic bacteria, which are resistant to commonly prescribed antibiotics.

Potency of commonly retailed antibiotics in pharmacies found in Adama, Oromia regional state, Ethiopia.

INTRODUCTION: Antibiotics are commonly used for the treatment and prevention of bacterial infections. The potency of antibiotics can be affected by factors such as temperature, light, moisture, and storage conditions. Inappropriate storage and transportation of antibiotics may lead to loss of potency earlier than the expiry date. The aim of this study was to determine the potency and associated factors of commonly retailed antibiotics. METHOD: Institution-based cross-sectional study was conducted on commonly retailed antibiotics in pharmacies that are available in Adama, Ethiopia from March 2018 to June 2018. This study focused on commonly ordered antibiotics such as amoxicillin, azithromycin, ciprofloxacin, and ceftriaxone. Antibiotics to be tested were selected by using a simple random sampling technique. Socio-demographic and related data were collected using a semi-structured questionnaire. Antibiotic susceptibility testing was performed using the disc diffusion method as described in the Clinical Laboratory Standard Institute guideline. RESULTS: Mean inhibition zones of amoxicillin, ciprofloxacin, azithromycin, and ceftriaxone were 14.2 ± 4 mm, 30.9 ± 4.2 mm, 17.47 ± 3.83 mm, and 32.7±1.8 respectively. Out of 164 antibiotics tested, 61% passed the potency test. The potency of antibiotics varies across different countries in which 53.7% and 54.6 of antibiotics from India and Ethiopia passed the potency test. All ceftriaxone tested in this study passed the potency test. Factors such as air condition of pharmacy (X2 = 4.27; p = 0.039), source of all antibiotics (X2 = 5.41; p = 0.02), and source of amoxicillin (X2 = 4.73; p = 0.03) were significantly associated with potency of antibiotics. CONCLUSIONS: About 40% of antibiotics tested in the current study did not pass the potency test; this warrants further investigation to identify the magnitude of the problem and its causes at a large scale.

Asymptomatic Plasmodium infection and associated factors among pregnant women in the Merti district, Oromia, Ethiopia.

BACKGROUND: Asymptomatic Plasmodium infection (API) that occurs during pregnancy increases the risk of stillbirths, abortion, premature delivery, and low birth weight. API also hinders the control and prevention of malaria as infected hosts serve as silent reservoirs for transmission of Plasmodium species in the community. OBJECTIVE: The aim of this study was to determine the prevalence of API and associated factors among pregnant women. This community-based cross-sectional study was conducted at Merti district, Oromia, Ethiopia among 364 pregnant women from March to September 2018. METHODS: Sociodemographic and obstetrics features were collected using a structured questionnaire. About 2ml of blood was collected from participants to detect Plasmodium species, gametocyte carriage rate, parasite density, and anemia. RESULTS: The prevalence of API among pregnant women was 3.6%. The proportion of Plasmodium falciparum and Plasmodium vivax was 6(46.2%) and 7(53.8%) respectively. Out of 13 Plasmodium species identified, Gametocyte carriage rate was 4(30.7%). The geometric mean density of the asexual stage of the parasites was 994.7(interquartile [IQR], 320 to 2200) parasites/ul. The geometric mean gametocyte density was 303.3 (interquartile range [IQR], 160 to 600). The proportion of anemia among Plasmodium-infected participants was 12(92.3%). Previous infection by Plasmodium species (AOR = 5.42; 95% CI: 1.19-29.03, p = 0.047), lack of insecticide-treated bed net use (AOR = 6.52; 95% CI: 1.17-36.44, p = 0.032), and living close to stagnant water (AOR = 4.18; 95% CI (1.12-17.36, p = 0.049) were significantly associated with API. Anemia was significantly higher among Plasmodium-infected than non-infected pregnant women (x2 = 27.62, p <0.001). CONCLUSION: In the current study, a relatively high prevalence of API was detected among pregnant women. Identifying API in the community is important to prevent the unwanted outcomes of Plasmodium infection and its transmission.

Salmonella and Shigella and antimicrobial susceptibility profiles among adult patients with complaints of diarrhea at Hawassa comprehensive specialized hospital, Hawassa, Ethiopia.

INTRODUCTION: Diarrhea is one of the public health important diseases in developing countries. Among the causative agents of diarrhea, Salmonella serovars and Shigella species continue to play a major role in resource-limited countries. The aim of this study was to assess the prevalence of Salmonella and Shigella, risk factors, and antimicrobial susceptibility profiles among adult patients with complaints of diarrhea. METHODS: A hospital-based cross-sectional study was conducted among adult patients with complaints of diarrhea at Hawassa University Comprehensive Specialized Hospital from March 2019 to November 2019. A structured questionnaire was used to collect sociodemographic, behavioral, and environmental characteristics of participants. Fecal samples were inoculated onto Selenite F broth and Xylose Lysine Dextrose media to isolate Salmonella serovars and Shigella species. Antibiotic susceptibility testing was performed by the Kirby-Bauer method. Data were analyzed by SPSS computer software version 20. Bivariate and multivariable analysis was used to determine the association between dependent and independent variables. RESULTS: The overall prevalence of Salmonella serovars and Shigella species was 8.6% with 95% confidence interval (3.2-13.8). Participant those who do not wash their hands were three times more likely to be infected with Salmonella and Shigella (p < 0.001) than their counterparts. Participants who consume uncooked food had about two times the chance to be infected with Salmonella and Shigella (p < 0.001) than their counterparts. All serovars of Salmonella and serotypes of Shigella were resistant to ampicillin. CONCLUSION: In this study, relatively a high prevalence of Salmonella serovars and Shigella species was found among adult patients with complaints of diarrhea at Hawassa University Comprehensive Specialized Hospital. Consuming uncooked food and not washing hands were significantly associated with the prevalence of Salmonella and Shigella.