Efficacy of 400 mg albendazole against soil-transmitted helminthes among Salgy Primary School Children, Dembia district, Northwest Ethiopia, 2020. "Uncontrolled experimental study".

Background and Aims: Soil-transmitted helminths are one of the most prevalent causes of both intellectual and physical disability in the world. Albendazole (ALB) is a drug recommended for mass treatment of the high burden of soil-transmitted helminths in schoolchildren, particularly in developing countries. However, some researchers have reported that the efficacy of albedazole against soil-transmitted helminths is inconsistent. Monitoring the programs is crucial to evaluating the effectiveness of 400 mg of ALB against soil-transmitted helminths, as well as any changes in its therapeutic efficacy. Thus, the purpose of this study was to evaluate ALB effectiveness in treating soil-transmitted helminthes in Salgy Primary School Children. Methods: An uncontrolled experimental study was conducted at Salgy Primary School Children, Northwest Ethiopia, from March to May 2020. A total of 439 schoolchildren were enrolled and screened for soil-transmitted helminths by stratified proportionate systematic random sampling to get 228 positive schoolchildren. Students in grades one through eight were grouped based on their educational attainment. Using the Kato-Katz thick smear technique, the selected stool sample collected from school children was examined using the Kato-Katz thick smear technique to determine the cure and egg reduction rates. The statistical package for social science software, version 20, was used to analyze the data. To determine the relationship between CR (cure rate) and ERR (egg reduction rate) by age, a chi-square test (X 2) was employed and significance was considered at A 95% confidence interval and p Value (p < 0.05). Results: A 400 mg single dosage of ALB showed a 99.35% CR and a 97.30% egg reduction rate against Ascaris lumibricoides. Additionally, a 400 mg dose of ALB showed a 95.75% CR and an 82.07% egg reduction rate, suggesting questionable effectiveness against hookworm infections. Trichuris trichiura showed a decreased efficacy, with a 43.53% CR and a 23.12% egg reduction rate. Conclusion: A single dose of 400 mg ALB is effective (satisfactory), doubtful, and unsatisfactory against Ascaris lumbricoides, hookworm, and T. trichiura infections, respectively. Further studies using different brands, doses, and routes will be needed to treat hookworm and T. trichiura infections successfully by using a larger sample size.

The Unmet Need: Low Performance of Laboratory Professionals in Malaria Microscopy, Oromia Regional State, Ethiopia.

Ethiopia aims to diagnose and treat all clinical malaria within 24 hours of fever onset in its stride to eliminate the disease by 2030. Microscopy remains to be the mainstay for diagnosis at the health center and hospital level. Continuous evaluation and performance upgrading of malaria microscopists is one of the cornerstones in this effort. We assessed the performance of malaria microscopists compared with reference readers in diagnosing, identifying the species, and quantifying parasitemia. A total of 174 microscopists were enrolled from health facilities located in 86 districts in Oromia region (Ethiopia) from January 2017 to June 2018. Panel slides with known Plasmodium species, diagnostic blood stage, and parasite density were prepared by the reference readers. Sociodemographics, education, in-service training, and routine practice of participants were captured. Sensitivity, specificity, percent agreement, and kappa score were calculated. An overall low performance was observed that could threaten the malaria diagnostic service. Of all the slides distributed (1,218), only 17.0% of the positive and 30.0% of the negative slides were correctly identified and 22.4% were correctly quantified. Compared with the reference readers, participants had lower competence in diagnosing (74.3% agreement and kappa 0.45) and identifying the species (71.2% agreement and kappa 0.40). Two-fifths of the participants were graded as "in training" with respect to identifying the species (41.0%) and the diagnostic stages (40.0%). An in-service training/retraining and supportive supervision are needed to raise and maintain the competence of microscopists in settings with a recent decline in malaria transmission and aiming for ultimate elimination of the disease.

HIV and Malaria Infections and Associated Risk Factors Among Febrile Illness Patients in Northwest Ethiopia.

OBJECTIVE: Malaria and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) are the major medical challenges of priority faced by the sub-Saharan African countries in general and Ethiopia in particular. Thus, the aim of this study was to determine the prevalence and associated risk factors of HIV and malaria infections among febrile illness patients. METHODS: A cross-sectional study was conducted from November 1, 2014 to May 30, 2015 at Kolla-Diba Health Center, Northwest Ethiopia. After obtaining informed consent, blood samples were collected from each febrile patient for the laboratory determination of HIV and malaria infections. Sociodemographic data and other associated factors for HIV and malaria infections were collected using a structured questionnaire. RESULTS: Of the total of 384 febrile illness patients, 23.7% (91/384) were positive for Plasmodium species. Of these, the most prevalent was P. falciparum, 56.0% (51/91), followed by Plasmodium vivax infection, 38.5% (35/91). In this study, 13.8% (53/384) of the participants were positive for HIV. Furthermore, 3.13% (12/91) of the participants were coinfected with HIV and malaria. According to the findings of the present study, genital ulcer patients and those who do not use bed net were significantly associated with HIV and malaria infections, respectively. CONCLUSION: Malaria and HIV are still common challenges independently occurring in the study area. The coexistence of the two diseases cannot be underestimated. Hence, health professionals should strengthen the provider initiative counseling and testing (PICT) program as a means of HIV/AIDS prevention and control strategy. Furthermore, approaching the febrile illness patients for both malaria and HIV diagnoses may help in having a joint HIV and malaria prevention and control strategy.

A serologic study of dengue in northwest Ethiopia: Suggesting preventive and control measures.

BACKGROUND: Dengue is one of the most serious and rapidly spreading arboviral diseases in the world. Despite many acute febrile illnesses in Ethiopia, the burden of illness due to dengue in the country is largely unknown. Thus, the present study aimed to provide the first baseline data on seroprevalence and associated risk factors of dengue virus (DENV) infection in the country. METHODS: A cross-sectional study of febrile patients who were visiting Metema and Humera hospitals in Northwest Ethiopia from March 2016 to May 2017 was conducted. Blood samples were collected from each participant and serum samples were separated and tested for IgM and IgG antibodies against DENV infection by enzyme-linked immunosorbent assay (ELISA). Risk factors associated with the prevalence of anti-DENV antibodies were tested using logistic regression analysis. RESULTS: Of the 600 samples tested, the overall seroprevalence against DENV infection was 33.3%, while the seroprevalence by the study area was 40% in Metema and 27.5% in Humera. The overall prevalence of IgM and IgG antibodies against DENV infection was 19% and 21% respectively. Of these, 6.7% were positive for both IgM and IgG antibodies. Residence and occupational status were significantly associated with the prevalence of anti-DENV IgM seropositivity and anti-DENV IgM-/G+serostatus. The seasonal variation was significantly associated with the prevalence of anti-DENV IgM but not with anti-DENV IgM-/G+serostatus. The prevalence of anti-DENV IgM-/G+serostatus was significantly higher in Metema than Humera. High prevalence of anti-DENV IgM seropositivity was found in the summer and spring, with a peak in the month of August. The presence of uncovered water either indoor or outdoor and lack of mosquito net use was identified as risk factors for DENV infection. CONCLUSIONS: These findings provide the preliminary data on seroprevalence and associated risk factors of DENV infection in the country. The presence of antibodies against DENV infection indicates dengue as one of the causes of undifferentiated febrile illnesses in the study areas. This suggests that prevention and control measures should be designed considering the risk factors identified by this study. Furthermore, we recommend a large-scale study to include DENV infection in the differential diagnosis of all febrile illnesses in Ethiopia.

Distribution and larval breeding habitats of Aedes mosquito species in residential areas of northwest Ethiopia.

OBJECTIVES: The Aedes mosquito is a vector for transmitting many arboviruses. Knowledge of the breeding habitat of this vector is vital for implementing appropriate interventions. Thus, this study was conducted to determine the breeding habitats and presence of Aedes mosquito species in the study areas. METHODS: A house-to-house cross-sectional survey of Aedes mosquito breeding habitats was carried out in Metema and Humera, Ethiopia, in August 2017. All available water-holding containers present in and around houses were inspected for the presence of immature stages of Aedes mosquitoes, and they were collected and reared to the adult stage for species identification. In the larval survey, the house index, container index, and Breteau index were computed as risk indices. RESULTS: Of the 384 houses surveyed for the presence of Aedes mosquito larval breeding, 98 were found to be positive for larvae. During the survey, a total of 566 containers were inspected, of which 186 were found to be infested with Aedes mosquito larvae, with a container index of 32.9, a house index of 25.5, and a Breteau index of 48.4. The most common Aedes mosquito breeding habitats were discarded tires (57.5%), followed by mud pots (30.0%). Of the 1,077 larvae and pupae collected and reared, Aedesaegypti (49.3%), Ae. vittatus (6.5%), and Culex species (44.2%) were identified. CONCLUSIONS: Discarded tires were the most preferred breeding habitats for Aedes mosquitoes. Moreover, Ae. aegypti, the main vector of dengue and other arboviruses, was identified for the first time in this region, suggesting a high potential for arbovirus transmission in the study areas.

Urinary tract infection among obstetric fistula patients at Gondar University Hospital, northwest Ethiopia.

BACKGROUND: Many women die from complications related to pregnancy and childbirth. In developing countries particularly in sub-Saharan Africa and Asia, where access to emergency obstetrical care is often limited, obstetric fistula usually occurs as a result of prolonged obstructed labour. Obstetric fistula patients have many social and health related problems like urinary tract infections (UTIs). Despite this reality there was limited data on prevalence UTIs on those patients in Ethiopia. Therefore, the aim of this study was to determine the prevalence, drug susceptibility pattern and associated risk factors of UTI among obstetric fistula patients at Gondar University Hospital, Northwest Ethiopia. METHODS: A cross sectional study was conducted from January to May, 2013 at Gondar University Hospital. From each post repair obstetric fistula patients, socio-demographic and UTIs associated risk factors were collected by using a structured questionnaire. After the removal of their catheters, the mid-stream urine was collected and cultured on CLED. After overnight incubation, significant bacteriuria was sub-cultured on Blood Agar Plate (BAP) and MacConkey (MAC). The bacterial species were identified by series of biochemical tests. Antibiotic susceptibility test was done by disc diffusion method. Data was entered and analyzed by using SPSS version 20. RESULTS: A total of 53 post repair obstetric fistula patients were included for the determination of bacterial isolate and 28 (52.8%) of them had significant bacteriuria. Majority of the bacterial isolates, 26 (92.9%), were gram negative bacteria and the predominant ones were Citrobacter 13 (24.5%) and E. coli 6 (11.3%). Enterobacter, E.coli and Proteus mirabilis were 100% resistant to tetracycline. Enterobacter, Proteus mirabilis, Klebsella pneumonia, Klebsella ozenae and Staphylococcus aureus were also 100% resistant to ceftriaxone. CONCLUSION: The prevalence of bacterial isolates in obstetric fistula patients was high and majority of the isolates were gram negative bacteria. Even thought the predominant bacterial isolates were Citrobacter and E. coli, all of the bacterial isolates had multiple antibiotic resistance patterns which alert health profession to look better treatment for these patients.

Asymptomatic Malaria and Associated Risk Factors among School Children in Sanja Town, Northwest Ethiopia.

Introduction. Asymptomatic malaria is prevalent in highly endemic areas of Africa and is new challenge for malaria prevention and control strategies. Objective. To determine the prevalence of asymptomatic malaria and associated risk factors among school children in Sanja Town, northwest Ethiopia. Methods. A cross-sectional study was conducted from February to March 2013, on 385 school children selected using stratified proportionate systematic sampling technique. Pretested questionnaire was used to collect sociodemographic data and associated risk factors. Giemsa-stained thin and thick blood films were examined for detection, identification, and quantification of malaria parasites. Data were entered and analyzed using SPSS 20.0 statistical software. Multivariate logistic regression was done for assessing associated risk factors and proportions for categorical variables were compared using chi-square test. P values less than 0.05 were taken as statistically significant. Results. The prevalence of asymptomatic malaria was 6.8% (n = 26). The majority of parasitemic study participants had low parasite density 65.5% (17/26). Level of grade, age, bed net usage, and frequent exposure to malaria infection were associated with risk of asymptomatic malaria. Conclusion. Asymptomatic malaria was low in this study area and is associated with level of grade, age, bed net usage, and frequent exposure to malaria infection.