Assessment of knowledge, practice, and status of food handlers toward Salmonella, Shigella, and intestinal parasites: A cross-sectional study in Tigrai prison centers, Ethiopia.

BACKGROUND: Unsafe food becomes a global public health and economic threat to humans. The health status, personal hygiene, knowledge, and practice of food handlers have crucial impact on food contamination. Hence, this study is aimed at assessing the knowledge, practice, and prevalence of Salmonella, Shigella, and intestinal parasites among food handlers in Eastern Tigrai prison centers, Northern Ethiopia. METHODS: An institutional-based cross-sectional study was carried out from April to September 2019 among food handlers in Eastern Tigrai prison centers, Northern Ethiopia. A structured questionnaire was used to collect the demographic characteristics, the knowledge, and the practice of the study participants. Direct wet mount and formol-ether concentration techniques were applied to identify intestinal parasites. Culture and biochemical tests were used to isolate the Salmonella and the Shigella species. Additionally, antimicrobial susceptibility tests to selected antibiotics were performed using Kirby-Baur disk diffusion method. We used SPSS version 23 software for statistical analysis. RESULTS: Thirty-seven (62.7%, 37/59) of the participants had harbored one or more intestinal parasites. The protozoan Entamoeba histolytica/dispar was detected among 23.7% (14/59) of the study participants who provided stool specimen. Besides, 6.8% (4/59) of the samples were positive for either Salmonella or Shigella species. The Salmonella isolates (n = 2) were sensitive to Gentamicin, Ciprofloxacin, Ceftriaxone, and Clarithromycin but resistant to Amoxicillin, Ampicillin, and Amoxicillin/clavulanic acid. Similarly, the two Shigella isolates were susceptible to Gentamicin, Ciprofloxacin, and Ceftriaxone but showed resistance to Amoxicillin, Tetracycline, and Chloramphenicol. Further, 60.6% (40/66) of the participants had good level of knowledge, and 51.5% (34/66) had good level of practice on foodborne diseases and on food safety. CONCLUSIONS: We conclude that foodborne pathogens are significant health problems in the study areas. Regular health education and training programs among the food handlers are demanded to tackle foodborne diseases at the prison centers.

Community based hematological reference intervals among apparently healthy adolescents aged 12-17 years in Mekelle city, Tigrai, northern Ethiopia: A cross sectional study.

BACKGROUND: Hematological reference intervals are important in clinical and diagnostic management for the assessment of health and disease conditions. Hematological reference intervals are better to be established based on gender and age differences as these are among the main affecting factors. OBJECTIVE: The aim of this study was to establish hematological reference intervals among apparently healthy adolescents aged 12-17 years in Mekelle City, Tigrai, Northern Ethiopia, 2019. METHOD: A community-based cross-sectional study was conducted in 249 adolescents aged 12-17 years from December 2018 to May 2019. About 4ml of blood sample was collected from each study participant using vacutainer tube containing K2EDTA. Hematological parameters were analyzed using Sysmex KX-21N hematology analyzer (Sysmex Corporation Kobe, Japan). Data were entered and analyzed using SPSS version 23. Both parametric and non-parametric analyses were used to calculate the median and 95% of reference intervals. The 97.5th and 2.5th percentiles were calculated using descriptive statistics for the upper and lower reference limits of the study participants. Differences in reference intervals between male and female participants were evaluated using the Mann-Whitney U test. RESULT: Among the 249 participants 122 (49%) were males and 127 (51%) were females with the median age of 14.5 (range 12 to 17) years were recruited in this study. The median and the 95% reference intervals of hematological parameters were determined. The 95% RIs were: Red blood cells (1012/Liter) 4.6-5.9 (Males) and 4.3-5.6 (Females), White blood cells (109/Liter) 2.9-9.6 (Males) and 3.4-10.2 (Females), Hemoglobin (g/dl) 12.6-17.1 (Males) and 12-15.4 (Females), Platelets (109/Liter) 138-364 (Males) and 151-462 (Females). Almost all of the hematological parameters showed significant differences (p<0.05) across gender. CONCLUSION: The hematological reference intervals established in this study showed a difference based on gender. We suggest preparing and using distinct local reference intervals for males and females separately.

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.

Alteration of Clinical Chemistry Parameters Among Visceral Leishmaniasis Patients in Western Tigrai, Ethiopia, 2018/2019: A Comparative Cross-Sectional Study.

BACKGROUND: Visceral leishmaniasis causes alterations of lipid metabolism and it is associated with hypocholesterolemia and severe hypertriglyceridemia. Hepatic dysfunction and life-threatening hepatitis are associated with visceral leishmaniasis. Kidney damage is frequently associated with increased morbidity and mortality in visceral leishmaniasis patients. METHODS: A cross-sectional study was carried out to assess the alterations of clinical chemistry parameters among visceral leishmaniasis patients attending Kahsay Abera and Mearg hospitals, Northwest Ethiopia. A total of 100 visceral leishmaniasis patients and 100 healthy controls without visceral leishmaniasis were selected by using convenient sampling techniques. Data were entered and analyzed using statistical package for social sciences (SPSS) version 23. RESULTS: Results were showed that the mean value of serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, and triglyceride was significantly higher in visceral leishmaniasis patients than in apparently healthy controls, but the mean value of serum urea and total cholesterol was significantly lower in visceral leishmaniasis patients than healthy controls. CONCLUSION: The finding of this study concluded that visceral leishmaniasis causes significant alterations of clinical chemistry tests like liver and lipid profile tests compared to healthy controls.

Community based reference interval of selected clinical chemistry parameters among apparently healthy Adolescents in Mekelle City, Tigrai, Northern Ethiopia.

BACKGROUND: Locally established clinical laboratory reference intervals (RIs) are required to interpret laboratory test results for screening, diagnosis and prognosis. The objective of this study was establishing reference interval of clinical chemistry parameters among apparently healthy adolescents aged between 12 and 17 years in Mekelle, Tigrai, northern part of Ethiopia. METHODS: Community based cross sectional study was employed from December 2018 to March 2019 in Mekelle city among 172 males and 172 females based on Multi stage sampling technique. Blood samples were tested for Fasting blood sugar (FBS), alanine aminino transferase (ALT), aspartate amino transferase (AST), alkaline phosphatase (ALP), Creatinine, urea, total protein, albumin (ALB), direct and indirect bilirubin (BIL.D and BIL.T) using 25 Bio system clinical chemistry analyzer. Results were analyzed using SPSS version 23 software and based on the Clinical Laboratory Standard Institute (CLSI)/ International Federation of Clinical Chemistry (IFCC) C 28-A3 Guideline which defines the reference interval as the 95% central range of 2.5th and 97.5th percentiles. Mann Whitney U test, descriptive statistics and box and whisker were statistical tools used for analysis. RESULTS: This study observed statistically significant differences between males and females in ALP, ALT, AST, Urea and Creatinine Reference intervals. The established reference intervals for males and females, respectively, were: ALP (U/L) 79.48-492.12 versus 63.56-253.34, ALT (U/L) 4.54-23.69 versus 5.1-20.03, AST 15.7-39.1 versus 13.3-28.5, Urea (mg/dL) 9.33-24.99 versus 7.43-23.11, and Creatinine (mg/dL) 0.393-0.957 versus 0.301-0.846. The combined RIs for Total Protein (g/dL) was 6.08-7.85, ALB (g/dL) 4.42-5.46, FBS(mg/dL) 65-110, BIL.D (mg/dL) 0.033-0.532, and BIL.T (mg/dL) 0.106-0.812. CONCLUSIONS: The result showed marked difference among sex and with the company derived values for selected clinical chemistry parameters. Thus, use of age and sex specific locally established reference intervals for clinical chemistry parameters is recommended.

More Than Half Prevalence of Protozoan Parasitic Infections Among Diarrheic Outpatients in Eastern Tigrai, Ethiopia, 2019; A Cross-Sectional Study.

BACKGROUND: Protozoan infections remain a major public health concern in Ethiopia, which causes malnutrition, protein and iron deficiencies, increment of health costs, hospitalization and long-term deleterious effects. In Tigrai, particularly, in the study area, there are limited literatures on the prevalence of protozoa and associated factors among diarrheic outpatients. Thus, aimed to determine the prevalence and associated factors of protozoan infections among diarrheic outpatients in Eastern Tigrai. METHODS: Health facility-based cross-sectional study was conducted in Eastern Tigrai, Ethiopia from April to October 2019 among diarrheic outpatient in health facilities of Adigrat. Four hundred one eighteen study participants were included consecutively. The stool samples were examined via direct wet mount following formal-ether concentration technique. Both interviewer based and self-administrated questionnaires were used to collect demographic data and factors associated with protozoan infections. Data were analyzed and computed using BM SPSS statistics version 22.0. P-value=0.05 at 95% confidence interval declared statistically significant. RESULTS: Out of 418 diarrheic outpatients, the overall prevalence of protozoan infection was 59.3% (248/418). A higher percentage of intestinal protozoan infection was recorded for females 130 (31.1%). Using well water as a source of drinking, poor hand washing habits before eating, not home latrine, dirty and untrimmed fingernails were the most important risk factors identified. E. histolytica complex and Giardia duodenalis were the most predominant protozoan infections detected among diarrheic outpatients. CONCLUSION: The present study showed that diarrheic outpatients in the study area were heavily infected with protozoan parasitic infection. E. histolytica complex and Giardia duodenalis were the most predominant protozoans detected among diarrheic outpatients. Using well water as a source of drinking, poor handwashing habit before eating, not having home latrine, dirty and untrimmed fingernails were most important risk factors identified. So, cooperative action and health education on preventive measure are needed to reduce protozoan infections in Tigrai, particularly in the study area. The present study showed that diarrheic outpatients in the study area were heavily infected with protozoan parasitic infection.