The prevalence of symptomatic and asymptomatic malaria and its associated factors in Debre Elias district communities, Northwest Ethiopia.

BACKGROUND: Malaria is a major cause of morbidity and mortality worldwide. According to the World Health Organization 2021 malaria report, it is considered to be endemic in 85 countries and territories. Malaria elimination programmes have also faced many challenges, such as widespread asymptomatic carriers in endemic regions, and they should be considered in malaria-control programmes in endemic areas for successful transmission interruption. This study aimed to assess the prevalence of symptomatic and asymptomatic malaria infections, and associated factors in Debre Elias district communities, Northwest Ethiopia from May to Jun 2018. METHODS: A community-based cross-sectional study was conducted among selected kebeles in Debre Elias district, Amhara region, North-western Ethiopia. Multi-stage sampling technique was carried out to select representative households. A total of 440 randomly selected households were included, of which one individual per household was sampled for laboratory examination. Malaria prevalence was determined by light microscopy of stained blood films and using CareStart™ Malaria HRP2/pLDH (Pf/Pv) Combo rapid diagnostic test (RDT). A structured questionnaire was employed to collect socio-demographic data and associated risk factors. Data entry and analysis were carried out using Epi data 3.1 and SPSS version 23 software, respectively. The association between dependent and independent variables was explored by using bivariate and multivariate logistic regression analyses. Statistically significant association was declared at P-value of < 0.05. RESULTS: A total of 440 (333 asymptomatic and 107 symptomatic) individuals were included in this study. The overall prevalence of malaria was 5% with the majority (59.1%) of infections caused by Plasmodium falciparum. Among asymptomatic participants, 4.8% (n = 16, 95% CI = 2.6-7.3) and 4.2% (n = 14, 95% CI = 2.1-6.5) were diagnosed and confirmed by RDT and light microscopy respectively. Similarly, the prevalence of malaria among 107 symptomatic individuals was 7.5% (n = 8, 95% CI = 2.8-12.6) by either RDT or light microscopy. Utilization of insecticide-treated net (ITN), availability of ITN, house with eave, previous history of malaria infection, and family history of malaria infection were significantly associated with malaria infection (P < 0.05). CONCLUSION: In this study, the prevalence of asymptomatic and symptomatic malaria was moderate. Screening of both symptomatic and asymptomatic malaria in the community is very important to scale up intervention programmes.

Anopheles gambiae s.l (Diptera: Culicidae) seasonal abundance, abdominal status and parity rates in Metema-Armachiho lowland, Northwest Ethiopia.

BACKGROUND: Malaria is a life threating vector borne disease caused by different Plasmodium parasites. Metema and Armachiho are two of the top five malaria endemic areas among the districts of Amhara region in Ethiopia. Transmission pattern is seasonal and migrant laborers who visit these areas for employment in mechanized agriculture are highly affected. The aim of this study was to investigate seasonal abundance, abdominal status and parity rate of An.gambiae s.l in Metema-Armachiho lowlands, Northwest Ethiopia. METHOD: A 1 year longitudinal entomological study was conducted in Metema-Armachiho lowlands from June 2016-May 2017. Mosquitoes were collected using CDC-light traps in indoor and outdoor sites for four consecutive days in each month. A total of eight standard battery operated CDC-light traps were used to collect mosquitoes. Female mosquitoes were classed as unfed, fed or gravid under a dissecting microscope. The ovaries of all unfed An.gambiae s.l mosquitoes were examined for evidence of parity. Data were entered and analyzed using SPSS-20 software. Chi-square test was applied to show significant difference between variables. P-value< 0.05 was taken as statistically significant. RESULTS: Of the total 1253 mosquitoes collected, 713 (552 female, 161 male) were culex and 540 (501 female, 39 male) were An.gambiae s.l. About 50.9% were collected in June-August 2016, 21.7% in September-November 2016, 12.0% in December 2016-February 2017 and 15.4% in March to May 2017. Of the total, 57.2 and 42.8% of the An.gambiae s.l were collected from indoor and outdoor sites respectively. Of the total females collected, 76.8% were unfed; of which 69.4% were parous. Significantly higher number of female An.gambiae s.l were collected in indoor and there was significant difference in abdominal status of An.gambiae s.l mosquitoes collected in different season (P < 0.05). CONCLUSIONS: Highest number of An.gambiae s.l was observed from June-August followed by September-November. The parity rate of An.gambiae s.l was high and there was significant difference in abdominal status of An.gambiae s.l collected in different season.

Malaria-visceral leishmaniasis co-infection and associated factors among migrant laborers in West Armachiho district, North West Ethiopia: community based cross-sectional study.

BACKGROUND: Malaria and leishmaniasis are the two largest parasitic killers in the world. Due togeographical overlap of these diseases, malaria-visceral leishmaniasis co-infections occur in large populations and exist in different areas even if they have been poorly investigated. The aim of this study was to determine malaria-visceral leishmaniasis co-infection and their associated factors among migrant laborers. METHODS: Community based cross-sectional study was conducted from October-December 2016 on migrant laborers who are residents of rural agricultural camp in West Armachiho district and involved in sesame and sorghum harvesting. Standardized questionnaire was used to collect socio-demographic data and risk factors. Capillary blood was collected for giemsa stained blood film examination to detect and identify Plasmodium parasites. Recombinant kinensin (rk39) antigen test was performed to detect anti-leishmania donovani antibody. Data was coded, entered, checked for completeness and analyzed using SPSS version-20 statistical software. Chi-square test was applied to show a significant association between variables. P-value < 0.05 was considered as statistically significant. RESULTS: A total of 178 migrant laborers were included in this study. Of these, 74.2% belong to the age group 15-29; 61.2% come from lowland areas and 51.6% visit the area more than four times. Seroprevalence of visceral leishmaniasis was 9.6% (17/178); and 22.4% (40/178) of tested migrant laborers were found malaria infected. The overall prevalence of malaria-visceral leishmaniasis co-infection was 2.8%. Of the total migrant laborer, 47.8% used bed nets, of them 1.2% were malaria-visceral leishmaniasis co-infected; 72.5% used outdoor sites as usual sleeping site, among them 3.1% were malaria-visceral leishmaniasis co-infected; 60.1% were migrants, of which 2.8% were malaria-visceral leishmaniasis co-infected. All variables were not significantly associated with malaria-visceral leishmaniasis co-infection (P > 0.05). CONCLUSIONS: Prevalence of malaria-visceral leishmaniasis co-infection was low and it is not significantly associated with residence, number of visits, bed net utilization and outdoor sleeping habit even if both diseases are prevalent in the study area.

Bacterial and Parasitic Assessment from Fingernails in Debre Markos, Northwest Ethiopia.

BACKGROUND: Food handlers with untrimmed finger nails could contribute or serve as a vehicle for the transmission of food poisoning pathogens. OBJECTIVES: This study was conducted to determine the prevalence of bacteria and intestinal parasites among food handlers and antibiotic susceptibility profile of the isolated bacteria in Debre Markos University, Ethiopia. MATERIALS AND METHODS: This laboratory-based cross-sectional study involved 220 food handlers working in food service establishments in Debre Markos University between 1st January 2015 to 31th June 2016. Subjects' finger nail specimens of both hands were examined microscopically for intestinal parasites. For bacterial isolation, samples were cultured and bacterial species were identified following standard laboratory procedures. Antimicrobial susceptibility test was performed for all bacterial isolates by using Kirby-Bauer disk diffusion method. RESULTS: Of the total 220 subjects examined, 29.5% showed positive culture for different bacterial species from their fingernail contents. Coagulase-negative Staphylococcus was the predominant bacteria species (12.3%) followed by Staphylococcus aureus (5%), E. coli (2.7%), Klebsiella species (2.7%), Enterococcus species (1.8%), Pseudomonas aeruginosa (1.8%), Proteus species (1.4%), Citrobacter species (1.4%), and Serratia species (0.9%). None of the food handlers showed positive culture for Shigella and salmonella and parasites in respect of their finger nail specimens. Isolation of bacteria in finger nail has significant association with finger nail status (P=0.044) and inverse relation with service years (P=0.048). All Staphylococcus aureus and coagulase-negative Staphylococcus species isolates were uniformly susceptible to vancomycin. Only one (9.1%) of Staphylococcus aureus isolates was resistant for methicillin. CONCLUSION: To prevent the food poisoning pathogens, implementation and adherence to infection are the key practices, specially food handlers with long finger nail harbor food debris, microbial contaminations, and allergens.

Validation of Blood Glucose and Lipid-Lowering Effect of Solvent Fractions of the Crinum Abyssinicum Shoot Tips in Streptozotocin-Induced Diabetic Mice.

Background: Diabetes mellitus prevalence has reached epidemic levels despite the existence of contemporary treatments. People thus started looking at the possible therapeutic value of natural therapies. Crushed shoot tips of Crinum abyssinicum (Amaryllidaceae) are mixed with water in Ethiopia to treat diabetes, yet this practice is not well supported by science. Objective: In this experiment, mice models were used to verify the blood sugar and lipid-lowering benefits of solvent fractions of C. abyssinicum shoot tips. Materials and Methods: In a single-dose treated Streptozotocin (STZ)-induced diabetic model, mice were randomly grouped into eleven categories which include diabetic negative control, diabetic positive control, and 9 diabetic treatment groups. In repeated daily doses treated STZ-induced model, Mice were divided into 6 groups which included normal and diabetic negative control (TW80), diabetic positive control (5 mg/kg glibenclamide), and three diabetic treatment groups 100, 200, and 400 mg/kg). Finally, blood glucose, lipid level, and body weight were examined. Results: In the single-dose treated diabetic model, there was a significant blood glucose reduction at 200 and 400 mg/kg doses of aqueous fraction and glibenclamide starting from the sixth-hour post-administration unlike ethyl acetate and chloroform fraction compared to baseline and negative control. In repeated daily dose-treated diabetic mice, all three doses (100, 200, and 400 mg/kg of aqueous fraction) resulted in a substantial reduction (P < .001) in blood glucose compared to baseline and negative control on the seventh day and 14th day. Besides the AQF shows improvement in lipid levels and body weight parameters. Conclusion: The results of the study demonstrated that C. abyssinicum shoot tip fractions have the greatest potential to lower blood sugar and lipid levels, supporting conventional claims for the treatment of diabetes.

Mechanism of antibacterial resistance, strategies and next-generation antimicrobials to contain antimicrobial resistance: a review.

Antibacterial drug resistance poses a significant challenge to modern healthcare systems, threatening our ability to effectively treat bacterial infections. This review aims to provide a comprehensive overview of the types and mechanisms of antibacterial drug resistance. To achieve this aim, a thorough literature search was conducted to identify key studies and reviews on antibacterial resistance mechanisms, strategies and next-generation antimicrobials to contain antimicrobial resistance. In this review, types of resistance and major mechanisms of antibacterial resistance with examples including target site modifications, decreased influx, increased efflux pumps, and enzymatic inactivation of antibacterials has been discussed. Moreover, biofilm formation, and horizontal gene transfer methods has also been included. Furthermore, measures (interventions) taken to control antimicrobial resistance and next-generation antimicrobials have been discussed in detail. Overall, this review provides valuable insights into the diverse mechanisms employed by bacteria to resist the effects of antibacterial drugs, with the aim of informing future research and guiding antimicrobial stewardship efforts.

Recent Advances in Messenger Ribonucleic Acid (mRNA) Vaccines and Their Delivery Systems: A Review.

Messenger ribonucleic acid (mRNA) was found as the intermediary that transfers genetic information from DNA to ribosomes for protein synthesis in 1961. The emergency use authorization of the two covid-19 mRNA vaccines, BNT162b2 and mRNA-1273, is a significant achievement in the history of vaccine development. Because they are generated in a cell-free environment using the in vitro transcription (IVT) process, mRNA vaccines are risk-free. Moreover, chemical modifications to the mRNA molecule, such as cap structures and changed nucleosides, have proved critical in overcoming immunogenicity concerns, achieving sustained stability, and achieving effective, accurate protein production in vivo. Several vaccine delivery strategies (including protamine, lipid nanoparticles (LNPs), polymers, nanoemulsions, and cell-based administration) were also optimized to load and transport RNA into the cytosol. LNPs, which are composed of a cationic or a pH-dependent ionizable lipid layer, a polyethylene glycol (PEG) component, phospholipids, and cholesterol, are the most advanced systems for delivering mRNA vaccines. Moreover, modifications of the four components that make up the LNPs showed to increase vaccine effectiveness and reduce side effects. Furthermore, the introduction of biodegradable lipids improved LNP biocompatibility. Furthermore, mRNA-based therapies are expected to be effective treatments for a variety of refractory conditions, including infectious diseases, metabolic genetic diseases, cancer, cardiovascular and cerebrovascular diseases. Therefore, the present review aims to provide the scientific community with up-to-date information on mRNA vaccines and their delivery systems.

Medicinal Plants Used for the Management of Hepatitis Over the Past 15 Years in Ethiopia: A Systematic Review.

Background: Treatment of human and animal ailments using botanical sources has obtained significant attention in Ethiopia. The compounds available in plants comprise a plentiful source of bioactive ingredients able to treat many complications. The review aimed to present an updated list of plants used for managing hepatitis over the past 15 years in Ethiopia. Methods: Systematic, comprehensive search was undertaken from electronic databases (PubMed, Google Scholar, Science Direct, and Scopus) between September 01 and October 15, 2022, using standard search terms. Original researches carried out in Ethiopia, written and published in English between January 01/2007 and December 31/2021, and reported hepatitis as a disease treated by medicinal plants were included in the review. Plants beyond the list of Ethiopian and Eritrean floral were excluded. Data were extracted from texts and tables of original papers on a Microsoft Excel. Quality was assessed by applying the Joanna Briggs Institute Critical Appraisal Checklist. Results: A total of 317 papers were obtained from the database search. After removing duplicates and screening, 15 articles fit the inclusion criteria and selected for final review. Of the 24 plants identified, 35.7% were herbs. Leaf and root (35.7% each) were the predominant plant parts used for remedy preparation. Combined use of leaf and root comprised 10.7%. The families Apocynaceae, Asteraceae, Euphorbiaceae, Cucurbitaceae, and Fabaceae comprise the highest number of plant species. About 89.3% of remedies were administered orally. Conclusion: The majority of plants belong to herbs and the frequently used plant parts are leaf and roots. Evidence generated from the present review indicated that lots of plants have been used to manage hepatitis. Moreover, the findings could serve as preliminary information to formulate new drugs acting against hepatitis. Therefore, it is desirable for scholars to recognize, document, and keep plants and the associated knowledge appropriately.

A 10-Year Trend Analysis of Intestinal Parasitic Infections at Grarigy Health Center, Northwest Ethiopia: Implication for Epidemic Preparedness.

Background: Intestinal parasitic infections (IPI) are one of the most significant health issues around the world. Their burden is significant in Ethiopia with an estimated five million cases reported annually. This study aimed to evaluate the 10-year trend of IPIs at the Grarigy Health Center in northwest Ethiopia. Methods: A retrospective analysis was done at Grarigy Health Center to determine the 10-year (2011-2020) trend of IPIs by reviewing stool examination reports from a laboratory logbook. The data was collected by laboratory personnel using data extraction sheets. Then, entered into EpiData, cleaned and analyzed using SPSS-20 software. The chi-square test was used to test for significant differences between variables. Results: A total of 9541 stool samples were examined over a 10-year period, of which, 5599 (58.7%) were from male participants and 3942 (41.3%) were from female participants. Participants in the study had an average age of 26.11 years. Infection with intestinal parasites was seen in 58.8% of people (n = 5612) (CI: 57.8-59.8). A significant fluctuating pattern of IPIs was observed from 2011 to 2020 (P < 0.05). The highest peak of IPIs was recorded in 2020 (61.9%; 767 cases) and the lowest peak was observed in 2011 (49%; 99 cases). A total of 10 different genera of intestinal parasites were reported, of which, A. lumbricoides was the predominant (23.5%) followed by E. histolytica/dispar (16.6%). The highest cases of all intestinal parasites were reported between the ages of 5 and 14 years except H. nana (highest case reported in < 5 years). Conclusion: Prevalence of IPIs is substantial at the Grarigy Health Centre. A fluctuating trend was noticed in the past 10 years. A surveillance system should be in place to bring the burden of IPI down to a level where it has no public health effect.

Systematic review of sporozoite infection rate of Anopheles mosquitoes in Ethiopia, 2001-2021.

BACKGROUND: Adult mosquitoes of the genus Anopheles are important vectors of Plasmodium parasites, causative agents of malaria. The aim of this review was to synthesize the overall and species-specific proportion of Anopheles species infected with sporozoites and their geographical distribution in the last 2 decades (2001-2021). METHODS: A comprehensive search was conducted using databases (PubMed, Google Scholar, Science Direct, Scopus, African Journals OnLine) and manual Google search between January 1 and February 15, 2022. Original articles describing work conducted in Ethiopia, published in English and reporting infection status, were included in the review. All the required data were extracted using a standardized data extraction form, imported to SPSS-24, and analyzed accordingly. The quality of each original study was assessed using a quality assessment tool adapted from the Joanna Briggs Institute critical appraisal checklist. This study was registered on PROSPERO (International Prospective Register of Systematic Reviews; registration no. CRD42022299078). RESULTS: A search for published articles produced a total of 3086 articles, of which 34 met the inclusion criteria. Data on mosquito surveillance revealed that a total of 129,410 anophelines comprising 25 species were captured, of which 48,365 comprising 21 species were tested for sporozoites. Anopheles arabiensis was the dominant species followed by An. pharoensis and An. coustani complex. The overall proportion infected with sporozoites over 21 years was 0.87%. Individual proportions included Anopheles arabiensis (1.09), An. pharoensis (0.79), An. coustani complex (0.13), An. funestus (2.71), An. demeilloni (0.31), An. stephensi (0.70), and An. cinereus (0.73). Plasmodium falciparum sporozoites accounted 79.2% of Plasmodium species. Mixed infection of Plasmodium vivax and P. falciparum was only reported from one An. arabiensis sample. CONCLUSIONS: Anopheles arebiensis was the dominant malaria vector over the years, with the highest sporozoite infection proportion of 2.85% and an average of 0.90% over the years. Other species contributing to malaria transmission in the area were An. pharoensis, An. coustani complex, An. funestus, An. stephensi, and An. coustani. The emergence of new vector species, in particular An. stephensi, is particularly concerning and should be investigated further.

Systematic Review of Safety of RTS,S with AS01 and AS02 Adjuvant Systems Using Data from Randomized Controlled Trials in Infants, Children, and Adults.

Background: Emergence of antimalarial drugs and insecticides resistance alarms scientists to develop a safe and effective malaria vaccine. A pre-erythrocytic malaria vaccine called RTS,S has made great strides. Aim: The review was aimed to assess the safety of the candidate malaria vaccine RTS,S with AS01 and AS02 adjuvants using data from Phase I-III randomized controlled clinical trials (RCTs). Methods: This systematic review was conducted based on PRISMA 2020. Regardless of time of publication year, all articles related with safety of RTS,S, RCTs published in the English language were included in the study. The last search of databases, and registry was conducted on 30 May, 2022. Pubmed, Google Scholar, Cochrane Library, Wiley Online Library, and Clinical trials.gov were thoroughly searched for accessible RCTs on the safety of RTS,S malaria vaccine. The studies were screened in three steps: duplicate removal, title and abstract screening, and full-text review. The included studies' bias risk was assessed using the Cochrane risk of bias tool for RCTs. This systematic review is registered at Prospero (registration number: CRD42021285888). The qualitative descriptive findings from the included published studies were reported stratified by clinical trial phases. Findings: A total of thirty-five eligible safety studies were identified. Injection site pain and swelling, febrile convulsion, fever, headache, meningitis, fatigue, gastroenteritis, myalgia, pneumonia, reactogenicity, and anemia were the most commonly reported adverse events. Despite few clinical trials reported serious adverse events, none of them were related to vaccination. Conclusion: Most of the adverse events observed from RTS,S/AS01 and RTS,S/AS02 malaria vaccines were reported in the control group and shared by other vaccines. Hence, the authors concluded that both RTS,S/AS01 and RTS,S/AS02 malaria vaccines are safe.

Prevalence of Intestinal Parasite Infections and Associated Factors among Pregnant Women in Northwest Ethiopia.

Background: Intestinal parasite infections are among the most common infections worldwide. They pose a high burden in pregnant women in developing countries causing maternal anemia, low birth weight, and prenatal mortality. This study is aimed at assessing intestinal parasite infection prevalence, species diversity, and associated factors among pregnant women. Methods: A community-based cross-sectional study was conducted among pregnant women in Debre Elias district from March 2021 to July 2021. Three hundred sixty-three study participants meeting the inclusion criteria were enrolled for the study, and all submitted the required amount and quality of stool specimen. Immediately after collection, macroscopic (gross) and microscopic (saline wet mount) examination of stool sample was performed to detect and identify intestinal parasites. The generated data were checked for completeness, coded, entered, and analyzed using SPSS version 20.0 (SPSS Inc., Chicago, 2011) software. Binary logistic regression was applied to show significant association between dependent and independent variables. Statistically significant association was declared at a P value of < 0.05. Result: Of the study participants screened for intestinal parasite, 43.5% (158/363) were infected with at least one intestinal parasite. From the total positives, 40.5% (147/363) were mono and 3.0% (11/363) were double infections. Five intestinal parasite species were recorded, of which hookworm was the predominant, (65.2%, 103/158) followed by E. histolytica/dispar (12.7%, 20/158) and G. lamblia (11.4%, 18/158). Ascaris lumbricoides and Taenia species comprised the least percentage (1.9%, 3/158 each). Source of drinking water and occupation were identified as significant factors associated with intestinal parasite infection. Farmer pregnant women were 6.41 times (AOR = 6.41, 95% CI: 1.05-39.16; P = 0.034) more likely to be infected by intestinal parasites than their counterparts. Pregnant women who drank tape water were 0.52 times less (AOR = 0.52, 95% CI: 0.30-0.88; P = 0.017) likely to be infected by intestinal parasites. Conclusion: Intestinal parasite infections remained a serious health burden to pregnant women in the study area with the dominance of a hematophagous worm (hookworm). Community-based intestinal parasite screening and treatment are essential to alleviate the burden caused by intestinal parasite infections.

Medicinal Plants Utilized for the Treatment of Gastrointestinal Parasitosis in Ethiopia.

Background: Nonhygienic living conditions give rise to parasitic infections. Intestinal parasitosis is a serious public health problem in Ethiopia. It is more common in the poor part of the population with low-income, poor personal, and environmental sanitation and limited clean water supply. This review is aimed at providing an overview of the medicinal plants used for the treatment of gastrointestinal parasitosis in Ethiopia. Methods: International databases (PubMed, Google Scholar, Scopus, and Web of Science) were systematically searched to access published original articles on medicinal plants used to treat gastrointestinal parasitosis without restriction on the year of publication and methodology. The validity of articles was checked before inclusion in the review by undertaking critical appraisal using tools adapted from JBI Critical Appraisal Checklist. The details of medicinal plants were extracted from the included studies using a standardized data extraction format in excel spreadsheet and analyzed using descriptive statistics to calculate frequency and percentage. Results: A search for published articles produced a total of 205 papers, of which 23 met the inclusion criteria. Of the 85 medicinal plants identified, the majority (40.2%) were shrubs, and the common plant part used was leaf (28.2%). Family Asteraceae has the highest number of plant species. The majority of the plant remedies were given orally (96.9%). Taeniasis comprises the highest percentage of intestinal parasitosis treated followed by ascariasis. Conclusion: Numerous plants have been utilized to treat gastrointestinal parasitosis. Information obtained from this review could serve as a guide to discover novel antiparasitic agents. Therefore, it is advisable for researchers to properly identify, document, conserve, and conduct safety and efficacy studies on such claimed medicinal plants.

Assessment of prevalence and associated factors of intestinal parasite infections among school children at Amber Primary School, Northwest Ethiopia.

Objective: This study is aimed to assess the prevalence and associated factors of intestinal parasitic infections among school children at Amber Primary School, Northwest Ethiopia. Methods: A school-based cross-sectional study was conducted at Amber Primary School from December 2019 to January 2020. Semi-structured questionnaire was used to collect socio-demographic data and clinical characteristics. Direct wet mount technique was applied for detection and identification of intestinal parasites. Result: A total of 384 participants were included in this study of which 50.3% were males and 65.4% were in the age group 9-12 years. The prevalence of at least one intestinal parasite was 26.8% (n = 103), of which 13.6% (n = 14) were mixed infections. Hymenolepis nana was the most prevalent intestinal parasite (5.2%) followed by Entamoeba histolytica/dispar (4.9%) and hookworm (4.7%). Male children (adjusted odds ratio = 0.624; 95% confidence interval: 0.392-0.993) and those whose mother completed elementary school (adjusted odds ratio = 2.171; 95% confidence interval: 1.012-4.658) were significantly associated with intestinal parasite infections (p < 0.05). Conclusion: Intestinal parasitic infections remained an important health problem among school children in the study area. Appropriate intervention measures should be taken to reduce the burden and related morbidities.

Hookworm re-infection rate and efficacy of single-dose albendazole among pregnant women in Debre Elias District, Northwest Ethiopia: A single-arm trial.

Hookworm is one of the soil-transmitted nematodes causing anaemia and low birth weight in pregnant women. This study aimed to assess albendazole efficacy and re-infection rate among pregnant women. A community-based cross-sectional study was conducted from February to September 2021 in Debre Elias District. Albendazole (400mg) was administered to assess efficacy and hookworm re-infection rate. Though the cure rate of single-dose albendazole was 81.7%, with an overall egg reduction rate of 92.5%, the re-infection rate of hookworm 18-24 weeks post-treatment was substantial at 21.4%. More effective intervention measures are thus needed.

National burden of intestinal parasitic infections and its determinants among people living with HIV/AIDS on anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis.

Objectives: The aim of this systematic review and meta-analysis is designed to assess the pooled prevalence and determine risk factors of intestinal parasitic infections among people living with HIV/AIDS on anti-retroviral therapy in Ethiopia. Methods: International databases: PubMed, Web of Science, Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were systematically searched. Publication bias was determined using the funnel plot and Egger's regression tests. Heterogeneity between the studies included in this review was checked by I 2 statistic. The DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. Sub-group, meta-regression, and sensitivity analysis were conducted. Overall, meta-analysis was done using Stata version 14 statistical software. Results: Twenty-seven studies with 8946 individuals were included, the estimated pooled prevalence of intestinal parasitic infections among people living with HIV/AIDS on anti-retroviral therapy was 40.24% (95% confidence interval = 33.8-46.6). Based on sub-group analysis, the highest prevalence was observed in the Tigray region 45.7% (95% confidence interval = 7.9-83.5), followed by Oromia region 42.2% (95% confidence interval = 28.8-55.6). Availability of latrine (odds ratio = 26.6, 95% confidence interval = 2.8-15.8), presence of animals at home (odds ratio = 2.7, 95% confidence interval = 1.2-5.8), and source of drinking water (odds ratio = 3.2, 95% confidence interval = 1.3-7.5) were significantly associated with intestinal parasitic infections. Conclusion: These findings indicated that the prevalence of intestinal parasites among people living with HIV/AIDS was high in Ethiopia.

Analysis of Five-Year Trend of Malaria at Bichena Primary Hospital, Amhara Region, Ethiopia.

BACKGROUND: Malaria is a life-threating infectious diseases caused by protozoan parasite of the genus Plasmodium. The WHO African region bears the largest burden of malaria morbidity and mortality every year. Prevention and control activity of malaria in Ethiopia is implemented as guided by a national strategic plan to decrease malaria burden. This study is aimed at assessing the five-year trend of malaria at Bichena Primary Hospital. METHOD: A retrospective study was conducted at Bichena Primary Hospital to assess the five-year (2015-2019) trend of malaria by reviewing blood film reports from a laboratory logbook. RESULT: In a five-year period, 9182 blood films were requested for malaria diagnosis of whom 53.8% were males and 41% were in the age group 15-29. The overall prevalence of malaria was 9.28% (n = 852), P. falciparum being the dominant malaria species. The highest peaks of total malaria cases were observed in 2016 and in December, and the lowest peaks were observed in 2018 and March (mean annual case 170.4; mean monthly case 14.2), and there was a statistically significant year and monthly variation of malaria cases (P < 0.001). Malaria was reported in both sexes and all age groups; of which, males and the age group 15-29 years old consist the highest number of malaria cases (P < 0.001). CONCLUSION: Malaria remains an important public health problem in the study area, and a significant fluctuation was noticed in a five-year period, P. falciparum being slightly the dominant malaria species. Successive efforts are still required to reduce malaria burden to a level that has no longer public health effect.

Extraintestinal Amoebiasis in Women after 6th Day of Delivery.

BACKGROUND: Extraintestinal amoebiasis is more common in countries with lower socioeconomic status. Complication related to amoebiasis is common in pregnant patients with malnutrition and others. Severe cases can be associated with high fatality rates. We would like to report a patient with a presumptive diagnosis of extraintestinal amoebiasis who was on the 6th postpartum day after intrauterine fetal death (IUFD). Case Presentation. The patient was a 31 year-old female who was on 6th postpartum day after IUFD after the 9th month of amenorrhea. She presented with severe epigastric pain, hiccups, and bloody vomiting of ingested matter for 5 days. She also had right upper quadrat pain and fatigue. In addition, she had generalized body weakness and yellowish discoloration of the eyes for one week. Moreover, she had pruritus, fever, and a history of watery diarrhea 6 days ago which got subsided during the presentation. Laboratory investigation indicated leukocytosis and increased level of alkaline phosphatase and direct and total bilirubin. Trophozoite of E. histolytica was seen on stool microscope, negative for viral marker and Helicobacter pylori. Abdominal ultrasonography showed normal liver parenchyma and biliary system. She was treated onsite with 500 mg metronidazole and 500 mg ceftriaxone for five days and discharged with metronidazole 500 mg PO three times a day and cloxacillin 500 mg PO four times a day for 7 days. CONCLUSIONS: Extraintesinal amoebiasis can be resolved if it is diagnosed early and treated with metronidazole. Clinicians should not neglect amoebiasis in patients presenting with jaundice and right upper quadrant pain.

Comparison of direct wet mount, Kato-Katz and formol ether sedimentation technique for the diagnosis of hookworm infection in Debre Elias Woreda, Northwest Ethiopia.

Hookworm infection is a neglected parasitic disease. Direct wet mount is the usual method for the diagnosis of hookworm in Ethiopia, but its sensitivity is unsatisfactory. A cross-sectional study was therefore conducted from January to February 2018 among 192 study participants in Debre Elias district. Stool samples were processed by three methods: the prevalence of hookworm was 77.6%, 68.2% and 49.0% by Kato-Katz, formol ether sedimentation technique and direct wet mount, respectively. Direct wet mount had relatively low sensitivity (61.4%) compared to formol ether sedimentation technique (85.6%) and Kato-Katz (97.4%). The latter two compared well with the gold standard method with kappa values of κ = 0.94, κ = 0.71 and κ = 0.39, respectively, and are therefore recommended over against the direct wet mount technique in detecting hookworm.

The Prevalence, Antibiotic Resistance Pattern, and Associated Factors of Bacterial Vaginosis Among Women of the Reproductive Age Group from Felege Hiwot Referral Hospital, Ethiopia.

BACKGROUND: Bacterial vaginosis is an infection of the vagina, which results due to change in the normal balance of vaginal bacteria. The aim of this study was to assess the magnitude and determinants of bacterial vaginosis among women of reproductive age group from Felege Hiwot Referral Hospital. MATERIALS AND METHODS: A cross-sectional study was conducted among women during the reproductive period at Felege Hiwot Referral Hospital from September 1, 2019 to October 2020. About 413 vaginal swab samples were collected and examined using the Nugent scoring system and culture. Data were analyzed by SPSS version 25. The odds ratio (OR) was used as a measure of the strength of association and reported with 95% confidence intervals. P-value ≤ 0.05 was considered to be statistically significant. Bivariate and multivariate logistic regression models were used to identify possible associated factors with bacteria causing bacterial vaginosis. RESULTS: The overall prevalence of bacteria causing bacterial vaginosis was 39.5%. The predominant bacteria were S. aureus (25.4%), G. vaginalis (22.7%), S. agalactiae (14.1%), and E. coli (13.5%). S. aureus was resistant to erythromycin (69.8%) and trimethoprim/sulfamethoxazole (53.5%); despite this, it was susceptible to ciprofloxacillin (93%), gentamycin (93%), and cefoxitin (90.7%). On the other hand, E. coli was resistant to trimethoprim/sulfamethoxazole (91.3%) and ceftriaxone (63.6%), but was susceptible to ciprofloxacillin (95.5%) and gentamycin (93%). CONCLUSION: The high prevalence of bacterial vaginosis was significantly associated with the pH level of the vagina (≥4.5), participant age ≤20, pregnancy, and history of HIV infection. Therefore, early identification of factors leading to bacterial overgrowth on the vagina is very important to protect maternal and child morbidity and mortality.