Efficacy and safety of chloroquine plus primaquine for the treatment of Plasmodium vivax malaria in Hamusit site, Northwestern Ethiopia.

BACKGROUND: Plasmodium vivax malaria is still an important public health problem in Ethiopia. Unlike Plasmodium falciparum, P. vivax has a dormant liver stage (hypnozoite) that can be a risk of recurrent vivax malaria unless treated by radical cure with primaquine. Drug resistance to chloroquine is threatening malaria control and elimination efforts. This study assessed the therapeutic efficacy and safety of chloroquine plus 14 days of primaquine on P. vivax infection based on parasitological, clinical, and haematological parameters. METHODS: A single-arm in vivo prospective therapeutic efficacy study was conducted to assess the clinical and parasitological response to the first-line treatment of P. vivax in Ethiopia, chloroquine plus 14 days low dose of (0.25 mg/kg/day) primaquine between December 2022 and March 2023 at Hamusit Health Centre using the standard World Health Organization (WHO) protocol. A total of 100 study participants with P. vivax mono-infection who were over 6 months old were enrolled and monitored for adequate clinical and parasitological responses for 42 days. The WHO double-entry Excel sheet and SPSS v.25 software were used for Kaplan-Meier survival analysis, and a paired t-test was used for analysis of haemoglobin improvements between follow up days. RESULTS: A total of 100 patients were enrolled among those, 96% cases were rural residents, 93% had previous malaria exposure, and predominant age group was 5-15 years (61%). 92.6% (95% CI 85.1-96.4%) of enrolled patients were adequate clinical and parasitological response, and 7.4% (95% CI 3.6-14.9%) recurrences were observed among treated patients. The fever and parasite clearance rate on day 3 were 98% and 94%, respectively. The baseline haemoglobin levels improved significantly compared to those days 14 and 42 (p < 0.001). No serious adverse event was observed during the study period. CONCLUSIONS: In this study, co-administration of chloroquine with primaquine was efficacious and well-tolerated with fast resolution of fever and high parasites clearance rate. However, the 7.4% failure is reported is alarming that warrant further monitoring of the therapeutic efficacy study of P. vivax.

Comparison of malaria diagnostic methods for detection of asymptomatic Plasmodium infections among pregnant women in northwest Ethiopia.

BACKGROUND: Malaria in pregnancy remains a major public health problem in the globe, especially in sub-Saharan Africa. In malaria endemic areas, most pregnant women remain asymptomatic, but malaria could still cause complications on the mother and her offspring; as well as serve as reservoirs to transmit infection. Despite these effects, no attention is given to the diagnosis of asymptomatic Plasmodium infections (APIs) using highly sensitive and specific laboratory diagnostic tools in Ethiopia. Therefore, the goal of this study was to compare the performance of Rapid Diagnostic Test (RDT), microscopy and real-time polymerase chain reaction (RT-PCR) to detect APIs among pregnant women. METHODS: A health facility based cross -sectional study was conducted among pregnant women attending antenatal care at Fendeka town health facilities Jawi district, northwest Ethiopia from February to March, 2019. A total of 166 participants were enrolled by using convenient sampling technique. Socio-demographic features were collected using a semi structured questionnaire. Dried blood spot (DBS) samples were collected for molecular analysis. Asymptomatic Plasmodium infection on pregnant women was diagnosed using RDT, microscopy and RT-PCR. Descriptive statistics were used to determine the prevalence of APIs. Method comparison was performed, and Cohen's kappa coefficient (k) was used to determine the degree of agreement among the diagnostic methods. Parasite densities were also calculated. RESULTS: The prevalence of API was 9.6%, 11.4% and 18.7% using RDT, microscopy and RT-PCR, respectively. The overall proportion of API was 19.3%. Sensitivity of the RDT was 83.3% as compared with microscopy. Rapid Diagnostic Test and microscopy also showed sensitivity of 50% and 60%, respectively, as compared with RT-PCR. The mean parasite density was 3213 parasites/µl for P falciparum and 1140 parasites/µl of blood for P. vivax. CONCLUSION: Prevalence of API in the study area was high. Both RDT and microscopy had lower sensitivity when compared with RT-PCR. Therefore, routine laboratory diagnosis of API among pregnant women should be given attention and done with better sensitive and specific laboratory diagnostic tools.

Community seroprevalence of hepatitis B, C and human immunodeficiency virus in adult population in gojjam zones, northwest Ethiopia.

BACKGROUND: In Ethiopia, there is lack of data on the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immune deficiency virus (HIV) infections in adult population at community level. This study aimed at determining the HBV, HCV and HIV seroprevalence in adult population at community level in East and West Gojjam zones in Amhara region, Ethiopia. METHODS: A cross-sectional study was conducted between October 01 and November 30, 2015. The Hepatitis B surface antigen (HBsAg) and anti-HCV were detected using the standard serological tests. The antibody to HIV infection was tested using the national HIV rapid tests algorithms. RESULTS: A total of 481 adults comprised of 51% females with median age of 25 years took part in the study. Overall, 7.5% (95% CI: 5.5-10.2%) of adult population were infected either with HBV, HCV and HIV. The prevalence of HBV was 15 (3.1%) and for HIV was 16 (3.3%). The seroprevalence of HCV was five (1.0%). HIV-HCV co-infection was found to be two (0.4%). HIV prevalence was higher in non-educated population than their counter parts (P = 0.001). HIV prevalence was high in housewives (6.0%) and merchants (4.7%). CONCLUSIONS: This study revealed an intermediate HBV prevalence and low prevalence of HCV in adult population at community level. HIV prevalence is still a major public health problem in the area. To have the national data, we recommend further study on genotypes of HBV and HCV including local risk factors for transmissions. Moreover, health education on HBV, HCV and HIV transmission should be an intervention measure in the community.

Prevalence of human immunodeficiency virus and hepatitis B virus infections in young women seeking abortion care in Ethiopia: a cross - sectional study.

BACKGROUND: Young women aged 15-24 years are members of key populations at higher risk for Human Immunodeficiency Virus (HIV) acquisition through sexual intercourse. In areas where unprotected sex is a common practice, Hepatitis B virus (HBV) commonly transmitted via sexual and parenteral routes. The study aimed at determining HIV and HBV infections prevalence in young women attending health institutions for abortion care in Bahir Dar city, Ethiopia. METHODS: A cross - sectional study was conducted from January 2015 to June 2015. Convenient sampling technique was used. Demographic and explanatory variables were collected using a structured questionnaire via face to face interview. The presence of antibody to HIV infection was detected using national HIV diagnostic test algorithm. Hepatitis B surface antigen (HBsAg) was detected using ELISA. Data were analyzed using descriptive, fisher's exact and independent sample T test as appropriate. RESULTS: A total of 360 young women aged 15-24 years participated in the study. The median age of the women was 22 years. Overall, 16 (4.4 %) (95 % CI: 2.7-7.1 %) women were positive for either HBV or HIV infections. The prevalence of HIV and HBV infections were 9 (2.5 %) (95 % CI: 1.3-4.7 %) and 7 (1.94 %) (95 % CI: 0.95-4.0 %), respectively. The mean age of first sexual intercourse was 17.6 and 19.3 in HIV and HBV infected women, respectively. The prevalence of HIV infection was significantly associated with lower educational status (P < 0.001), divorced marital status (P = 0.009) and ever had symptom of other sexually transmitted infections (P = 0.001). The proportion of HBV was higher in women aged 15-17 years (P = 0.02). CONCLUSION: Though there were no co-infections, HIV and HBV infections are major health problems in young women seeking abortion care. Therefore, appropriate prevention, treatment and care services must be reached to these higher risk populations.

Challenges in visceral leishmaniasis control and elimination in the developing countries: A review.

Leishmaniasis is a disease caused by an obligate intracellular protozoan that affects animals and human. Transmission is zoonotic and/or anthroponotic through the bite of an infected female sandfly. Control and elimination of visceral leishmaniasis (VL) require proper case detection, identification of reservoir hosts, and launching of effective vector control strategies in endemic areas. The aim of this review was to highlight the challenges in VL control in developing countries. Literatures pertaining to VL burden, diagnosis, prevention and control from the year 1969 to 2014 were systematically reviewed from PubMed, Scopus, Medline and Google scholar sources during July 2015. Poor vector control strategies, limited diagnostic services, drugs, treatments and lack of community awareness are the most important challenges in VL control and elimination especially in endemic areas. Absence of highly sensitive and specific tests, lack of trained man power, and community awareness are the major challenges in VL control. Therefore, proper case diagnosis, community mobilization and launching of effective vector control strategies in endemic areas are vital.

Common causes of vaginal infections and antibiotic susceptibility of aerobic bacterial isolates in women of reproductive age attending at Felegehiwot Referral Hospital, Ethiopia: a cross sectional study.

BACKGROUND: Bacterial vaginosis, candidal, trichomonal and Gonococcal vaginal infections are a major health problems associated with gynecologic complications and increase in replication, shedding and transmission of HIV and other STIs in women of reproductive age. The study aimed at determining the prevalence of common vaginal infections and antimicrobial susceptibility profiles of aerobic bacterial isolates in women of reproductive age, attending Felegehiwot referral Hospital. METHODS: A hospital based cross sectional study was conducted from May to November, 2013. Simple random sampling technique was used. Demographic variables were collected using a structured questionnaire. Clinical data were collected by physicians. Two vaginal swab specimens were collected from each participant. Wet mount and Gram staining were carried out to identify motile T.vaginalis, budding yeast and clue cells. All vaginal specimens were cultured for aerobic bacterial isolates using standard microbiology methods. Antimicrobial susceptibility was performed using disc diffusion technique as per the standard by Kirby-Bauer method. The results were analyzed using descriptive, chi-square and fisher's exact test as appropriate. RESULTS: A total of 409 women in reproductive age (15 - 49 years) participated in the study. The median age of the women was 28 years. Overall, 63 (15.4 %) of women had vaginal infections. The proportion of vaginal infection was higher in non-pregnant (17.3 %) than pregnant women (13.3 %) (P = 0.002). The most common identified vaginal infections were candidiasis (8.3 %) and bacterial vaginosis (2.8 %) followed by trichomoniasis (2.1 %). The isolation rate of N. gonorrhoeae and group B Streptococcus colonization was 4 (1 %) and 6 (1.2 %), respectively. Bacterial vaginosis was higher in non-pregnant (5.6 %) than pregnant women (0.5 %) (P = 0.002). Religion, age, living in rural area and having lower abdominal pain were significantly associated with bacterial vaginosis and candidiasis (P < 0.05). E.coli, Pseudomonas spp. and S.aureus were frequently isolated. Norfloxacin (75.6 %), ciprofloxacin (79.6 %) and gentamicin (77.6 %) revealed high level of sensitivity whereas high resistance rates were observed for amoxicillin (82.2 %), tetracycline (63.3 %) and cotrimoxazole (62.2 %). CONCLUSIONS: Bacterial vaginosis, candidiasis and trichomoniasis are a common problem in women of reproductive age. Therefore, screening of vaginal infections in women of reproductive age should be implemented. Moreover, ciprofloxacin, norfloxacin and gentamicin are the recommended drugs for empiric therapy and prophylaxis as needed.

Epidemiology of elephantiasis with special emphasis on podoconiosis in Ethiopia: A literature review.

Elephantiasis is a symptom of a variety of diseases that is characterized by the thickening of the skin and underlying tissues, especially in the legs, male genitals and female breasts. Some conditions having this symptom include: Elephantiasis nostras, due to longstanding chronic lymphangitis; Elephantiasis tropica or lymphatic filariasis, caused by a number of parasitic worms, particularly Wuchereria bancrofti; non-filarial elephantiasis or podoconiosis, an immune disease caused by heavy metals affecting the lymph vessels; proteus syndrome, the genetic disorder of the so-called Elephant Man, etc. Podoconiosis is a type of lower limb tropical elephantiasis distinct from lymphatic filariasis. Lymphatic filariasis affects all population at risk, whereas podoconiosis predominantly affects barefoot subsistence farmers in areas with red volcanic soil. Ethiopia is one of the countries with the highest number of podoconiosis patients since many people are at risk to red-clay soil exposure in many parts of the country. The aim of this review was to know the current status and impact of podoconiosis and its relevance to elephantiasis in Ethiopia. To know the epidemiology and disease burden, the literatures published by different scholars were systematically reviewed. The distribution of the disease and knowledge about filarial elephantiasis and podoconiosis are not well known in Ethiopia. It is relatively well studied in southern Ethiopia but data from other parts of the country are limited. Moreover, programmes that focus on diagnosis, treatment, prevention and control of filarial elephantiasis and podoconiosis are also non-existent even in endemic areas. Furthermore, the disease mapping has not been carried out country-wide. Therefore, in order to address these gaps, Ethiopian Ministry of Health needs to take initiative for undertaking concrete research and mapping of the disease in collaboration with stakeholders.

Sero-prevalence and risk factors of hepatitis B virus and human immunodeficiency virus infection among pregnant women in Bahir Dar city, Northwest Ethiopia: a cross sectional study.

BACKGROUND: Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) are the two most important agents of infectious diseases. Both HBV and HIV share common modes of transmission and have serious effects on both pregnant women and infants. In Bahir Dar city administration, there is a scarcity of information on sero-prevalence of HIV and HBV infection among pregnant women. The main objective of this study was to assess sero-prevalence and risk factors of HIV and HBV infection among pregnant women attending antenatal care in Bahir Dar city, Northwest Ethiopia. METHODS: A cross-sectional study was conducted from March 2013 to April 2013. Socio-demographic and explanatory variables were collected using a structured questionnaire by face to face interview. Hepatitis B surface antigen (HBsAg) was detected using an enzyme linked immunosorbent assay (ELISA). HIV infection was also detected using the national HIV test algorithms. The results were analyzed with descriptive statistics and binary logistic regression. The odds ratio and 95% Confidence intervals were calculated. RESULTS: A total of 318 pregnant women with the mean age of 25.72 (SD. ±5.14) years old were enrolled. Overall, 21/318 (6.6%) and 12 /318 (3.8%) of the pregnant women were positive for HIV and HBsAg, respectively. Of these, HIV/HBV co-infection rate was 4 (19.0%). Previous history of blood transfusion (AOR = 3.7, 95% CI, 9.02-14.84), body tattooing (AOR = 5.7, 95% CI, 1.24-26.50), history of surgery (AOR = 11.1, 95% CI, 2.64-46.88) and unsafe injection (AOR = 5.6, 95% CI, 1.44-22.19) were significantly associated with HBV infection. Previous history of piercing with sharp materials (AOR = 3.0, 95% CI 1.17-7.80) and history of abortion (AOR = 6.6, 95% CI 2.50-17.71) were also statistically significant for HIV infection. CONCLUSIONS: This study indicates that HIV and HBV infections are important public health issues in our region that need to be addressed. All pregnant women need to be screened for both HIV and HBV infections during antenatal care. Furthermore, health education about modes of transmission of HIV and HBV has to be given.

Sexual behaviours and associated factors among students at Bahir Dar University: a cross sectional study.

BACKGROUND: Sexual behaviour is the core of sexuality matters in adolescents and youths. Their modest or dynamic behaviour vulnerable them to risky sexual behaviours. In Ethiopia, there is scarcity of multicentered representative data on sexual behaviours in students to have a national picture at higher education. This study therefore conducted to assess sexual behaviours and associated factors at Bahir Dar University, Ethiopia. METHODS: A cross sectional study was conducted among Bahir Dar University students from December to February 2013. Multistage sampling and self administered questionnaires were employed. Descriptive statistics such as frequency and mean were used to describe the study participants in relation to relevant variables. Multivariate analysis was carried for those variables that had a p-value of ≤ 0.2 in the bivariate analysis to identify the predictor variables. RESULTS: Of the 817 study participants, 297 (36.4%) students had ever had sex. The mean age at first sexual practice was 18.6 years. Unprotected sex, having multiple sex partners, sex with commercial sex workers and sex for the exchange of money was practiced by 184 (62%), 126 (42.7%), 22 (7.4%) and 12 (4%) of sexually active students, respectively. The proportion of attending night clubs and watching porn videos was 130 (15.8%) and 534 (65.4%), respectively. Male respondents had significant positive association with watching porn videos (AOR = 4.8, CI = 3.49 - 6.54) and attending night clubs (AOR = 3.9, CI = 2.3 - 6.7). Watching porn videos, attending night clubs, khat chewing and taking alcohol frequently were significantly associated for ever had sex and having multiple sexual partners. Khat chewing practice (AOR = 8.5, CI =1.31 - 55.5) and attending night clubs (AOR = 4.6, CI = 1.8 - 11.77) had statistical significant association with the purpose of sexual intercourse for the sake of money and for having sex with commercial sex workers, respectively. CONCLUSIONS: Significant number of students had different risky sexual behaviours. Substance use, attending night clubs and watching porno video were predictor factors for practicing different sexual behaviours. Therefore, preventive intervention programmes should be strengthened, effectively implemented and monitored both in the earlier school and in the universities.

Species composition, infection rate and feeding preference of Anopheles mosquito species (Diptera: Culicidae) in the west Amhara Region, northwest Ethiopia.

BACKGROUND: Reports showed that Amhara Region is accounting for 31% of Ethiopia`s malaria burden. Reports also depicted that despite the existing malaria vector control tools implemented by the regional government, currently there is an increment in malaria prevalence in the region. This might be due to lack of entomological monitoring and comprehensive information on the prevailing species composition, infection rate and feeding presences of An. mosquito species in the study areas. Therefore, this study aimed to address this information. METHODS: A community-based cross-sectional study was conducted from 18 February to 30 March 2023 at three districts of the west Amhara Region. For this, six CDC light traps (three indoor and three outdoor) were used to collect adult female An. mosquito species. In this study, 261 An. mosquito species comprising seven species were collected. Their morphological identification and abdominal status determination were carried out using standard morphological identification keys under a dissection microscope. While their infection rates and blood meal sources were determined, using circumsporozoite protein-ELISA and blood meal-ELISA based on the standard protocol. Data were entered to SPSS versions 20 for analysis and p- value < 0.05 was considered as statistically significant. RESULTS: In our study, total of 261 An. mosquito species were identified. An. demeilloni was the most abundant species accounted for 112(42.9%) of all captures. It was also the most predominant species at Ayehu-Guagusa followed by Jabitehnan districts. An. demeilloni and An. cinereus altogether accounting for infection rate of 3(1.1%) for P. vivax parasite. Furthermore, our study showed that more than 50% of An. mosquito species collected fed on cattle blood showing shifting of feeding behaviors. CONCLUSIONS: Our study depicted that An. demeilloni and An. cinereus were the most abundant species and infected with P. vivax parasite. Therefore, further comprehensive study should be done in the future.

Demographic characteristics and clinical features of patients presenting with different forms of cutaneous leishmaniasis, in Lay Gayint, Northern Ethiopia.

Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by Leishmania parasites, that can cause long-term chronic disabilities. The clinical presentation of CL varies in both type and severity. CL presents as three main clinical forms: localised lesions (localised cutaneous leishmaniasis, LCL); mucocutaneous leishmaniasis (MCL) that affects the mucosa of the nose or the mouth; or as disseminated not ulcerating nodules (diffuse cutaneous leishmaniasis, DCL). Here we recruited a cohort of CL patients in a newly established leishmaniasis treatment centre (LTC) in Lay Gayint, Northwest Ethiopia, and collected detailed demographic and clinical data. The results of our study show that more males than females present to the LTC to seek diagnosis and treatment. 70.2% of CL patients presented with LCL and 20.8% with MCL. A small number of patients presented with DCL, recidivans CL (a rare form of CL where new lesions appear on the edges of CL scars) or with a combination of different clinical presentations. The duration of illness varied from 1 month to 180 months. Over a third of CL patients had additional suspected CL cases in their household. Despite the majority of CL patients having heard about CL, only a minority knew about its transmission or that it could be treated. Most CL patients lived in areas where environmental factors known to be associated with the transmission of CL were present. This work highlights that CL is an important public health problem in Lay Gayint and emphasises the urgent need for more CL awareness campaigns, better health education and better disease management practices.

Demographic characteristics and prevalence of asymptomatic Leishmania donovani infection in migrant workers working in an endemic area in Northwest Ethiopia.

Introduction: Visceral leishmaniasis (VL), a neglected tropical disease that causes substantial morbidity and mortality, is a serious health problem in Ethiopia. Infections are caused by Leishmania (L.) donovani parasites. Most individuals remain asymptomatic, but some develop VL, which is generally fatal if not treated. We identified the area of Metema-Humera in Northwest Ethiopia as a setting in which we could follow migrant workers when they arrived in an endemic area. The demographic characteristics of this population and factors associated with their risk of asymptomatic infection are poorly characterised. Methods: We divided our cohort into individuals who visited this area for the first time (first comers, FC) and those who had already been in this area (repeat comers, RC). We followed them from the beginning (Time 1, T1) to the end of the agricultural season (Time 2, T2), performing tests for sand fly bite exposure (anti-sand fly saliva antibody ELISA) and serology for Leishmania infection (rK39 rapid diagnostic test and the direct agglutination test) at each time point and collecting information on risk factors for infection. Results: Our results show that most migrant workers come from non-endemic areas, are male, young (median age of 20 years) and are farmers or students. At T1, >80% of them had been already exposed to sand fly bites, as shown by the presence of anti-saliva antibodies. However, due to seasonality of sand flies there was no difference in exposure between FC and RC, or between T1 and T2. The serology data showed that at T1, but not at T2, a significantly higher proportion of RC were asymptomatic. Furthermore, 28.6% of FC became asymptomatic between T1 and T2. Over the duration of this study, one FC and one RC developed VL. In multivariable logistic regression of asymptomatic infection at T1, only age and the number of visits to Metema/Humera were significantly associated with asymptomatic infection. Conclusion: A better understanding of the dynamics of parasite transmission and the risk factors associated with the development of asymptomatic infections and potentially VL will be essential for the development of new strategies to prevent leishmaniasis.

First record of Phlebotomus (Synphlebotomus) vansomerenae (Diptera: Psychodidae) in Ethiopia.

Male Phlebotomus (Synphlebotomus) vansomerenae, specimens were collected together with two other members of the same subgenus between August 2010 and December 2011 in Melka Guba village near Dawa River in Liben district, southeastern Ethiopia. This is the first record of the species in Ethiopia and the first time it has been found outside of Kenya where it was originally described, extending the known distribution of this species in East Africa.

Asymptomatic Leishmania donovani infection and associated factors among blood donors attending at Metema district Blood Bank, Northwest Ethiopia: a cross- sectional study.

BACKGROUND: Ethiopia is one of the top 10 countries in the world where 90% visceral leishmaniasis cases are reported. Metema-Humera lowlands are the most important foci in Ethiopia. Blood transfusion in visceral leishmaniasis endemic foci in Ethiopia does not consider screening of visceral leishmaniasis during blood donation. The aim of this study is therefore, was to assess asymptomatic Leishmania donovani infection and associated factors among blood donors attending at Metema district Blood Bank, Northwest Ethiopia. METHODS: A Health facility based cross-sectional study was conducted at Metema Blood Bank from February to March 2020. A total of 205 blood donors were eligible and participated in this study. Structured questionnaire were used to collect data on socio-demographic characteristics and perceived risk factors associated with asymptomatic visceral leishmaniasis among blood donors. Blood donors were screened using both rK39 and direct agglutination tests based on the manufactures' instructions. Data were analyzed using SPSS version 20.0. Chi-square test was used to assess associations of Leishmania donovani infection with predisposing factors. Associations were considered statstically significant on P-value < 0.05 at 95% confidence level. RESULTS: Of the total 205 participants, 32(15.6%) were positive for asymptomatic Leishmania donovani infection at least by one of the diagnostic tests used. Eight (3.9%) and 30(14.6%) of the participants` were positive by the rK39 and direct agglutination tests, respectively. Six (2.9%) donors were tested positive by both diagnostic tests. Family history of visceral leishmaniasis (X²=11.334, P = 0.003) and having neighbors with history of visceral leishmaniasis (X²=5.923, P = 0.015) were significantly associated with asymptomatic Leishmania donovani infection among blood donors. CONCLUSIONS: The prevalence of asymptomatic Leishmania donovani infection was 15.6%. Asymptomatic visceral leishmaniasis was significantly associated with donors' family and neighbors' history of infection. Therefore, laboratory screening of blood donors for visceral leishmaniasis in endemic areas will be mandatory. Moreover, this study will give base line information for future study in the country.

Updates on Prevalence and Trend Status of Visceral Leishmaniasis at Two Health Facilities in Amhara Regional State, Northwest Ethiopia: A Retrospective Study.

Ethiopia is one of the countries accounted for over 90% of annual visceral leishmaniasis incidence. Despite this, yet there are no active and passive surveillance activities in the Amhara Region that will give up-to-date information about the disease status at the health facility levels. Therefore, this study aimed to report up-to-date information about visceral leishmaniasis and its trend status at two health facilities and the surrounding areas. A retrospective study from October 2017 to May 2021 was conducted by reviewing patient records at Metema and Addis Zemen Hospitals. Data on Sex, age, occupation, residence, month, year, and rK39 test results were collected using a questionnaire and were analyzed using Statistical Package for Social Sciences (SPSS) version 20. The chi-square test was used to see the association between variables. p < 0.05 was considered as statistically significant. Of the 2,703 visceral leishmaniasis suspected cases diagnosed with the rK39 test, 877 (32.4%) were confirmed (positive) cases. Monthly and yearly trends depicted that the largest number of suspected cases was reported in October and 2018, respectively. Daily laborers were the most affected individuals in Metema areas.

Prevalence of malaria and associated factors among symptomatic pregnant women attending antenatal care at three health centers in north-west Ethiopia.

BACKGROUND: Malaria is the disease caused by Plasmodium species and primarily transmitted by the bite of female Anopheles mosquitoes. During pregnancy, malaria causes life threatening outcomes to the mother, the fetus and the new born. Even though, malaria symptomatic pregnant women highly attract mosquitoes and have higher potential of transmitting the disease in communities, most of the previous studies focused on pregnant women with asymptomatic Plasmodium infections. Therefore, the aim of this study was to assess the prevalence of malaria and associated factors among symptomatic pregnant women attending antenatal care at three health centers in northwest Ethiopia. METHODS: A health facility based cross-sectional study was conducted from February to April, 2021. A total of 312 malaria symptomatic pregnant women were involved from three health centers and enrolled by convenient sampling technique. A questionnaire was used to collect socio demographic and clinical data through face to face interview. Capillary blood samples were collected and used to prepare thin and thick blood smears, which were then stained using 10% Giemsa and examined under light microscope. Logistic regression was used to assess factors associated with malaria. Adjusted odds ratio with 95% confidence interval was calculated and P-value < 0.05 was considered statistically significant. RESULTS: The prevalence of malaria among symptomatic pregnant women was 20.8% (65/312) of which 12.2% (38/312), 4.8% (15/312) and 3.8% (12/312) were P. falciparum, P. vivax and mixed infections, respectively. Being illiterate (p< 0.001), first trimester (p = 0.036), primigravidae (p<0.001), living far from health center (p<0.001), not sleeping under long lasting insecticide treated nets (p<0.001) and living near irrigation areas (p = 0.006) were significantly associated with prevalence of malaria in malaria symptomatic pregnant women. CONCLUSIONS: Even though prevalence of malaria is decreasing in the country because of scale-up of intervention and prevention measures, this study showed that, malaria is still the major public health problem among pregnant women. Being illiterate, first trimester, primigravidae, living far from health centers, not sleeping under long lasting insecticide treated nets and living near irrigation areas were factors that increased the prevalence of malaria in malaria symptomatic pregnant women. Therefore, special attention should be given to pregnant women prone to these factors.

Eight-Year Trend Analysis of Cutaneous Leishmaniasis Cases in West Amhara Region Referred to Amhara Public Health Institute Northwest, Ethiopia: A Retrospective Study.

Cutaneous leishmaniasis is a continually spreading health problem in Amhara Region, Ethiopia. Despite this, up- to-date information on referral laboratory facility has been not yet reported. Therefore, this study was aimed at reporting up-to-date information about eight year's cutaneous leishmaniasis trend status. Data on referred cases from 2013 to 2020 were collected at Amhara Public Health Institute Parasitology department by reviewing log book. Of the 243 suspected cases, 114 (46.9%) were positive (confirmed) with microscope and cultured results showed that most of them were negatives. Most of the suspected cases were from 16 to 30 years and males by age and sex, respectively. Trend status by year depicted that largest numbers of suspected and confirmed cases were reported in 2013, 2015, and 2019 years. Finally, the trend status by zone showed that most cases were reported from South Gondar and Awi zones, respectively.

Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia.

Background: Malaria is the leading vector-borne parasitic disease that is causing high morbidity and mortality worldwide. So far huge efforts to control and eliminate malaria are hindered by the occurrence of asymptomatic carriers that are a potential source of infection. Yet, there is a scarcity of data nationally and in the current study area as well. Therefore, this study was aimed to assess the prevalence of asymptomatic malaria in Northeast Ethiopia. Methods: A community-based cross-sectional study was conducted in 2019 involving a total of 270 study participants recruited via purposive non-probability sampling technique. A structured questionnaire was used to collect data on sociodemographic characteristics, individual and household factors related to asymptomatic malaria. Data were entered in Epi Data 3.1 version and analyzed by using SPSS version 20, and p< 0.05 was considered statistically significant. Results: The overall prevalence of asymptomatic malaria was 7.0%, with 3.0%, 5.2%, and 12.0%, respectively by Rapid diagnostic tests (RDT), Microscopy and Polymerase chain reaction (PCR). The majority of infections (73.7%) were identified from index households. Previous malaria history (AOR: 4.030, 95% CI: 1.021-15.903), living with index cases (AOR: 3.880, 95% CI: 1.275-11.806) and family size > 6 members (AOR: 4.820, 95% CI: 1.260-18.437) were significant predictors of asymptomatic malaria. Conclusion: Reactive case detection had identified considerably higher asymptomatic malaria cases in the community. Therefore, active case investigation should be established in the community by tracking the symptomatic cases at the health facilities.

Short reports on cutaneous leishmaniasis outbreak investigation in Ankesha-Guagsa district, Amhara region, Northwest Ethiopia.

Cutaneous leishmaniasis is spreading in Ethiopia and outbreaks have been recorded at new foci. In the Ankesha-Guagsa district, from September 24 to 28, 2020, 39 suspected cases were screened, and amastigote stages were identified in lesion samples of 34 (87.2%) cases.

Determinants of Helminthic Infections and Anemia among Schoolchildren in Bahir Dar Zuria District, Northwest Ethiopia.

BACKGROUND: Soil-transmitted helminths and Schistosoma mansoni are the major helminthic parasites that cause major public health problems among schoolchildren in developing countries. Infection with the above parasites decreases the hemoglobin level of children. However, information regarding the current status of helminthic infections and anemia is limited. Hence, this study aimed to assess the prevalence and determinants of helminthic infections and anemia among children. METHODS: A cross-sectional study was conducted among 394 schoolchildren at Sekelet primary school in northwest Ethiopia, from February to March 2017. Study participants were selected by a systematic random sampling technique. Stool samples were collected and processed via the modified Ritchie's concentration technique to detect parasites in stool. A HemoCue Hb 201 analyzer was used to determine the hemoglobin level. Data were analyzed using SPSS version 23 statistical software. Association of helminthic infections and anemia with independent variables was determined using logistic regression analysis. Variables with P < 0.05 were considered statistically significant. RESULTS: From the total of 394 participants, 185 (46.9%), 164 (41.6%), and 112 (28.4%) were infected with intestinal parasites, helminths, and STHs, respectively. The prevalence of hookworm and Schistosoma mansoni were 106 (25.6%) and 54 (13.7%), respectively. The prevalence of anemia among the schoolchildren was 278 (70.6%). Anemia was prevalent among 55 (51.9%) hookworm-infected and 19 (35.2%) S. mansoni-infected children. Not wearing shoes and improper utilization of latrine were significantly associated (P < 0.05) with hookworm infection, and frequent swimming in the river was also significantly associated (P ≤ 0.001) with Schistosoma mansoni infection. Schistosoma mansoni and hookworm infections were also significantly associated (P ≤ 0.001) with low levels of hemoglobin. CONCLUSION: Hookworm and Schistosoma mansoni infections and anemia are highly prevalent among schoolchildren. Hookworm and Schistosoma mansoni infections are significantly associated with anemia. Therefore, helminthic detection and hemoglobin determination should be done simultaneously among schoolchildren.