Pesticide concentration in three selected fish species and human health risk in the Lake Tana sub-basin, Ethiopia.

Pesticide use has increased in the Lake Tana sub-basin due to increased agricultural activity, potentially endangering nontargeted organisms. To assess its potential impact on fish health and fish-consuming human populations, pesticide concentrations in the fillet and liver tissue of three fish species, namely Labeobarbus megastoma, Labeobarbus tsanensis, and Oreochromis niloticus, were investigated in Lake Tana. Fish samples were taken from the lake near the rivers of Ribb and Gumara, which flow through agricultural areas where considerable amounts of pesticides have been applied. A total of 96 fish samples were collected. Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) revealed the presence of ten pesticides. Pyrimethanil was frequently detected in 96% of liver and 65% of fillet samples at a median concentration of 33.9 µg kg-1 and 19.7 µg kg-1, respectively. The highest concentration of pyrimethanil was found in L. megastoma (1850.0 µg kg-1). Labeobarbus megastoma also had the highest concentration of oxamyl (507.0 µg kg-1) and flazasulfuron (60.1 µg kg-1) detected in the liver tissue. The highest concentration of carbaryl (56.5 µg kg-1) was found in the liver tissue of O. niloticus. Fish tissue samples from the two study sites contained pyrimethanil, oxamyl, carbaryl, and flazasulfuron. Only pyrimethanil showed a statistically significant difference between the two sites and the species L. megastoma and L. tsanensis. The amounts of pesticides found in the fish species pose no direct risk to the health of fish consumer human population. However, the results show that the lake ecosystem needs immediate attention and regular monitoring of the rising pesticide usage in the lake watershed.

Seasonal Dynamics in Bacteriological and Physicochemical Water Quality of the Southern Gulf of Lake Tana.

Freshwater lakes are important sources of water for domestic, agricultural, and industrial uses. Lake Tana offers a range of ecosystem services to the surrounding communities. However, this lake is facing deterioration in water quality due to pollution caused by anthropogenic influences. Therefore, regular monitoring of key water quality parameters is critical to understanding the water quality status of the lake. This study aimed to assess the seasonal fluctuation of water quality of the Southern Gulf of Lake Tana using indicator bacteria and some physicochemical parameters. A total of 48 water samples were collected in dry and wet seasons from eight sites in the study area. Total coliforms (TC), faecal coliforms (FC), and some physicochemical parameters (pH, temperature, turbidity, electrical conductivity, total dissolved solids, dissolved oxygen, biochemical oxygen demand, ammonium, nitrate, and phosphate) were determined following standard methods. The results revealed that coliform counts were above the permissible level set by Ethiopian Standards and varied significantly among sites (P < 0.05). FC counts ranged from 1 to 1600 MPN/100 ml (with the lowest and highest mean value of 1 at site 8 to 1076.5 ± 3.1 at site 4) and again TC counts ranged from 1 to 1600 MPN/100 ml (with a mean value of 4.8 ± 1.81 at site 6 to 1600 at site 4 and site 8). The findings also confirmed that the highest counts of coliforms were observed during the wet season. The high counts are attributed to the discharge of human excreta and animal wastes during the rainy season from the different anthropogenic activities near the Gulf. Significant variations in most of the physicochemical parameters were also observed between sites and seasons. FC and biochemical oxygen demand (BOD5) in most sites did not meet the EPA standard for surface water. Corrective measures are highly recommended for anthropogenic activities driving high pollution loads in the lake.

Campylobacter occurrence and antimicrobial resistance profile in under five-year-old diarrheal children, backyard farm animals, and companion pets.

Campylobacteriosis disproportionately affects children under five in low-income countries. However, epidemiological and antimicrobial resistance (AMR) information at the children-animal interface is lacking. We hypothesized that Campylobacter is a major cause of enteritis in children in Ethiopia, and contact with animals is a potential source of transmission. The objective of the study was to determine Campylobacter occurrence and its AMR in children under five with diarrhea, backyard farm animals, and companion pets. Stool from 303 children and feces from 711 animals were sampled. Campylobacter was isolated through membrane filtration on modified charcoal cefoperazone deoxycholate agar plates under microaerobic incubation, and the technique showed to be feasible for use in regions lacking organized laboratories. Typical isolates were characterized with MALDI-TOF MS and multiplex PCR. Of 303 children, 20% (n = 59) were infected, with a higher proportion in the 6 to 11-month age group. Campylobacter occurred in 64% (n = 14) of dogs and 44% (n = 112) of poultry. Campylobacter jejuni was present in both a child and animal species in 15% (n = 23) of 149 households positive for Campylobacter. MICs using the gradient strip diffusion test of 128 isolates displayed resistance rates of 20% to ciprofloxacin and 11% to doxycycline. MICs of ciprofloxacin and doxycycline varied between C. coli and C. jejuni, with higher resistance in C. coli and poultry isolates. Campylobacter infection in children and its prevalent excretion from backyard poultry and dogs is a understudied concern. The co-occurrence of C. jejuni in animals and children suggest household-level transmission As resistance to ciprofloxacin and doxycycline was observed, therapy of severe campylobacteriosis should consider susceptibility testing. Findings from this study can support evidence-based diagnosis, antimicrobial treatment, and further investigations on the spread of AMR mechanisms for informed One Health intervention.

Prevalence of enteric bacterial pathogens in diarrheic under-five children and their association with the nutritional status in Bahir Dar Zuria District, Northwest Ethiopia.

BACKGROUND: Diarrheal disease is one of the leading causes of child mortality in low and middle-income countries. Low nutritional status and bacterial infections contribute to growth deficiency and death in children. But there is a gap in identifying the bacterial etiology of diarrheal diseases and their association with the nutritional status of under-five children. This study aimed to determine the bacterial etiology of diarrheal diseases and their association with the nutritional status of diarrheic under-five children. METHODS: A cross-sectional study was carried out from February 2021 to March 2022 at seven Health Centers in Bahir Dar Zuria district, Ethiopia. A total of 196 diarrheic under-five children visiting the health centers were included in the study. Stool samples were collected from each child for the isolation of Salmonella, Shigella, and E.coli O157:H7. The demographic characteristics and symptoms of children were obtained from parents/guardians. The weight, height, and age of each child were recorded and anthropometric indices were determined by WHO Anthro version 3.2.2 software. The association between bacterial prevalence and the nutritional status of children was analyzed by SPSS version 26 software using Binary logistic regression. All analyses were conducted at a 95% confidence interval and significant association was determined using a p-value < 0.05. RESULTS: Of the total children included in the study, 13.1% had either E.coli O157:H7, Shigella, or Salmonella. Watery diarrhea and fever were the most clinical characteristics observed in children who are positive for enteric bacteria. The prevalence of stunted, underweight, and wasted was 56.6%, 24.4%, and 13.2% respectively. Children with wasting were significantly associated with Salmonella detection (OR = 7.2, CI, 1.38-38.1, P = 0.02) whereas stunted and underweight were not associated with bacterial prevalence. CONCLUSION: Overall, the prevalence of bacterial pathogens in the study area is high. Stunting, wasting, and being underweight are important nutritional deficits of diarrheic under-five children in the study site. Further studies targeting possible sources of bacteria and determinants of malnutrition in children are suggested. Health sectors found in the district should increase their effort to enhance good nutritional practice through health education and treatment of malnourished children by the provision of micronutrients.

Throat Swab Culture Positivity and Antibiotic Resistance Profiles in Children 2-5 Years of Age Suspected of Bacterial Tonsillitis at Hargeisa Group of Hospitals, Somaliland: A Cross-Sectional Study.

Introduction: Tonsillitis is the third most frequently diagnosed infection in the pediatric age and is associated with significant morbidity and loss of school attendance. Throat swab cultures are useful for the confirmation of children with a clinically suspected tonsillitis. However, Somaliland is one of the underdeveloped countries with a low standard of sanitation and poor health seeking culture. Treatment of tonsillitis with antibiotics is irrational and not empirical. This study determined the bacterial throat swab culture positivity and antibiotic resistance profiles of the bacterial isolates among children 2-5 years of age with suspicion of tonsillitis at Hargeisa Group of Hospital, Somaliland. Materials and Methods: A cross-sectional study was conducted from March to July 2020. A total of 374 children from 2 to 5 years of age suspicion of tonsillitis was included using a convenient sampling method. Throat swabs were collected, and bacterial isolation and identification were done using standard bacteriological procedures. Antimicrobial susceptibility testing was done using the disk diffusion method. Data on demographic variables and clinical profiles were collected using structured questionnaires. Logistic regression analysis was computed to identify factors associated with bacterial tonsillitis. Results: Overall, 120 (32.1%) (95% CI 27.4-36.8%) of children were positive for bacterial throat cultures. Of these, 23 (19.2%) were mixed bacterial isolates. The most frequent bacterial isolates were beta-hemolytic streptococci 78 (55%), Staphylococcus aureus 42 (29%), and Streptococcus pneumoniae 10 (7%). Isolates revealed 83.3-100% rate of resistance to ampicillin. Beta-hemolytic streptococci isolates were 94.9% resistant to ampicillin. S. aureus was resistant to clarithromycin (38%) while S. pneumoniae isolates were 100% resistant to ampicillin. History of tonsillitis (AOR = 0.12; 95% CI = 0.06-0.21), difficulty in swallowing (AOR = 6.99; 95% CI = 3.56-13.73), and attending schools (AOR = 2.98; 95% CI = 1.64-5.42) were found to be associated with positive throat culture. Conclusions: Resistance to ampicillin and MDR among beta-hemolytic streptococci and other isolates of throat colonizers in children with clinically suspected of bacterial tonsillitis are major concerns in Hargeisa, Somaliland. Therefore, treatments of cases are recommended to be guided by regular culture and antimicrobial susceptibility testing to prevent complications of tonsillitis and associated antibiotic resistance.

Knowledge, Attitudes and Practices of Patients on Antibiotic Resistance and Use in Public Hospitals of Amhara Regional State, Northwestern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Although inappropriate antibiotic use could contribute to the spread of antimicrobial resistance, data on the knowledge, attitude and  practice of antibiotic use and resistance among patients in north-western Ethiopia are scarce. This study assessed patients' knowledge, attitudes and practices regarding antibiotic use and resistance in selected public hospitals of Amhara regional state, Ethiopia. METHODS: A cross-sectional study was conducted in selected public hospitals of Amhara regional state from November to December 2020 to assess the knowledge, attitude, and practice of patients on antibiotic resistance and use. Data were collected from 233 participants using a structured questionnaire and analyzed using SPSS version 23. RESULTS: According to the findings, 60.3% of the participants obtained their antibiotics without a prescription from private pharmacies, and the most commonly used antibiotic to treat human diseases was ampicillin (70.7%). Even though 69.8% of the patients heard about antibiotics and antibiotic resistance from several sources, 68.1-87.9% of them were unaware on the factors that contribute to the transmission of resistant bacteria to humans and the impact of antibiotic resistance on human and animal health. Using the mean score of 3.15 ± 0.08 as the cut-off, 37.5% of patients know about antimicrobial resistance and use. With a mean score of 27.6 ± 0.3, 45.3% of patients had positive attitudes toward prudent antibiotic use and resistance. About 44% of participants had a good practice, with a mean practice score of 4.95 ± 0.17. A higher level of education was associated with better knowledge, positive attitudes, and better practices regarding antibiotic use and resistance. Although 57.3% of respondents viewed poor handwashing practices in hospitals as a major factor contributing to increased antibiotic resistance, 59.9% of respondents viewed implementing hygiene, infection prevention, and control practices as a major strategy contributing to reducing antibiotic use and resistance. CONCLUSION: According to the present study, there is a low level of awareness among patients about the proper antibiotics use and resistance. It is essential to raise awareness, develop, and implement interventions to reduce antimicrobial use and antibiotic resistance in the study area.

Antibiotic Resistance Profiles of Bacteria Isolated from Hotspot Environments in Bahir Dar City, Northwestern Ethiopia.

Background: Wastes generated from hotspot environments contain a wide range of antibiotics and pathogens that play a significant role in the dissemination of antibiotic-resistant bacteria in the environment. This study was carried out to isolate bacteria from hotspot environments and determine their resistance profiles to commonly used antibiotics in Bahir Dar city, Ethiopia. Methods: A cross-sectional study was conducted from October 2020 to June 2021 in Bahir Dar City. A total of 126 waste and wastewater samples were aseptically collected, transported, and processed for bacteriological isolation and susceptibility testing following standard procedures. Results: A total of 411 bacterial isolates were recovered and the highest value of 122 (29.7%) bacterial isolates were obtained from medical wastewater samples, and the most frequently isolated bacteria were assigned to the species Escherichia coli with 82 strains (19.5%). The results revealed that the highest resistance profile of 69 (95.8%) was obtained in Staphylococcus aureus against ampicillin and 46 (86.8%) Citrobacter spp. against tetracycline. Two hundred and sixteen (52.6%) of bacteria showed multi-drug resistance and the highest multi-drug resistance was observed in Pseudomonas spp. 47 (65.3%), followed by Escherichia coli 51 (62.2%). The highest resistance profile of 12 (85.7%) and 60 (74.1%) for tetracycline were obtained from beef waste and wastewater and medical wastewater samples. The highest multi-drug resistance was recorded in isolates isolated from beef waste and wastewater samples 11 (64.7%), followed by medical wastewater samples 84 (64.1%). Even though a higher (>0.2) multi-antibiotic resistance index was found in all hotspot environments, the highest multi-antibiotic resistance index (0.477) was recorded in bacteria isolated from medical wastewater. Conclusion: It was concluded that wastes generated from hotspot environments and released in the environment contain large numbers of antibiotic-resistant, multidrug, extensively, and pan-drug-resistant bacteria. Proper waste management strategies should be established.

Emergence of High Prevalence of Extended-Spectrum Beta-Lactamase and Carbapenemase-Producing Enterobacteriaceae Species among Patients in Northwestern Ethiopia Region.

BACKGROUND: World Health Organization identified some Enterobacteriaceae as superbugs because of their high production and spread of extended-spectrum beta-lactamases (ESBL) and carbapenemases. Moreover, their resistance against commonly prescribed antibiotics left few choices of drugs to treat infection. This study is aimed at determining the magnitude of ESBL and carbapenemase-producing Enterobacteriaceae pathogens and their antimicrobial resistance pattern. MATERIALS AND METHODS: A hospital-based cross-sectional study was carried out from February to April 2019 in the Northwestern Ethiopia region. A total of 384 patients presumptive for bacterial infections were conveniently enrolled in the study. Specimens were collected and processed following standard bacteriological procedures. Drug susceptibility tests were performed using disk diffusion technique. ESBL and carbapenemase enzymes were tested by double disk diffusion and modified carbapenem inhibition methods, respectively. The data obtained were analyzed using SPSS version 22 software, and descriptive statistics were summarized in tables and graphs. RESULTS: Out of 384 clinical specimens processed 100 (26%) were culture positive for Enterobacteriaceae. The proportion of Enterobacteriaceae infection was relatively higher among in-patients 86 (32.6%) than out-patients 14 (11.7%). Overall, Escherichia coli 35 (9.1%) was the leading isolate followed by Klebsiella pneumoniae 31 (8.1%). Klebsiella pneumoniae 15 (15.6%) was the most frequent isolate from bloodstream infection and is the leading isolate from intensive care unit patients 15 (38.3%). Overall, 44 (44%) of Enterobacteriaceae were extended-spectrum beta-lactamase producers. Among them, Citrobacter spp. was the leading one 4 (80%) followed by Enterobacter cloacae 6 (60%) and K. pneumoniae 18 (58.1%). Furthermore, 6 (6%) of Enterobacteriaceae were carbapenemase-producers, in which 5 (50%) of E. cloacae and 3 (9.7%) of K. pneumoniae had highest percentage. Conclusions. ESBL and carbapenemase-producing isolates of Enterobacteriaceae are alarmingly spreading in the study area. Thus, improving the infection prevention strategy and further screening at the national level is recommended to develop the optimal use of antibiotics.

Eichhornia crassipes (Mart.) Solms: A Comprehensive Review of Its Chemical Composition, Traditional Use, and Value-Added Products.

Eichhornia crassipes (Mart.) Solms, commonly known as water hyacinth, is one of the world's most invasive aquatic plants of the Pontederiaceae family occurring in tropical and subtropical regions of the world. Although, E. crassipes causes significant ecological and socioeconomic issues such as a high loss in water resources, it has multipurpose applications since it is famous for many industrial applications such as bioenergy, biofertilizer production, wastewater treatment (absorption of heavy metals), and animal feed. Furthermore, E. crassipes is rich in diverse bioactive secondary metabolites including sterols, alkaloids, phenolics, flavonoids, tannins, and saponins. These secondary metabolites are well known for a wide array of therapeutic properties. The findings of this review suggest that extracts and some isolated compounds from E. crassipes possess some pharmacological activities including anticancer, antioxidant, anti-inflammatory, antimicrobial, skin whitening, neuroprotective, and hepatoprotective activities, among other biological activities such as allelopathic, larvicidal, and insecticidal activities. The present review comprehensively summarizes the chemical composition of E. crassipes, reported to date, along with its traditional uses and pharmacological and biological activities.

Prevalence and antimicrobial susceptibility patterns of shigella species at Felege Hiwot Referral Hospital, Northwest Ethiopia.

BACKGROUND: Shigella species infections coupled with increased levels of antimicrobial resistances are major public health problems in developing countries particularly in children. OBJECTIVES: The present study was conducted to determine the prevalence and antimicrobial resistance pattern of Shigella species among patients with diarrhea at Felege Hiwot Referral Hospital. METHODS: A cross-sectional prospective study was undertaken among patients with diarrhea (n=215) from August to November 2009. A4 pre-tested structured questionnaire was used for collecting data. Stool samples were investigated for identification of Shigella species following standard procedures and antimicrobial susceptibility tests were performed using disc diffusion technique. RESULTS: The isolation rate of Shigella species was 32/215 [14.9% (95% CI.: 10.5-20.5)], with high prevalence in patents under five years of age. Educational level, latrine usage, source of drinking water, and hand washing habits showed a statistically significant association with the prevalence of Shigella species (p = 0.004). All isolates of Shigella species were susceptible to ciprofloxacin and high level of sensitivity was observed for norfloxacin (90.6%) and gentamicin (75%). Multiple drug resistance to as many as nine antibiotics was also detected CONCLUSION: High prevalence of Shigella with multiple antibiotic resistance isolates was observed in this study. Public health workers should emphasize, on primary preventive measures and periodic surveillance for antibiotic susceptibility pattern of Shigella isolates. When culturing and antibiotic susceptibility testing facilities are not available, prescription of ciprofloxacin as a choice of treatment is recommended.

Knowledge, attitudes and practices of animal farm owners/workers on antibiotic use and resistance in Amhara region, north western Ethiopia.

Inappropriate use of antibiotics in animal and human plays a role in the emergence and spread of bacteria resistant to antibiotics which threatens human health significantly. Although extensive use of these antibiotics could contribute to the development of drug resistance, information on the knowledge, attitude and practice of antimicrobial resistance and use among animal farm owners/workers in north western Ethiopia is rare. The objective of the present study was to assess knowledge, attitude and practice of animal farm owner/workers towards antibiotic resistance and use in Amhara regional state north western Ethiopia. A cross sectional study was conducted in selected cities of Amhara regional state from January to February, 2020. Data was collected from 91 participants using structured questionnaire and analyzed using SPSSS version 23. The results showed that 96.7% of respondents gave antibiotics to treat their livestock from different sources. Most of the respondents bought their antibiotics from private pharmacies without prescription and the most frequently mentioned antibiotics used to treat animal diseases was tetracycline (76.9%), followed by ampicillin (72.5%). Although, 90.1% of the animal farm owners heard about antibiotics and antibiotic resistance from different sources, they did not know the factors contributing to the transmission of resistant bacteria to humans and the impact of antibiotic resistance on human and animals' health. Using the mean score 4.44 ± 0.15 as the cut-off, half of the animal farm owners/workers had good knowledge about antimicrobial resistance and use. 52.5% of animal farm owners/workers had positive attitudes towards wise antibiotic use and resistance with a mean score of 28.4 ± 0.5. However, 52.75% participants had poor practice with the mean score of practice 4.95 ± 0.17. Better knowledge, positive attitudes and better practices on antibiotic use and resistance were associated with farm owners/workers who engaged in higher education. Although poor awareness on antimicrobial resistance was perceived by 76.9% of respondents as very important factors that contribute to increasing antibiotic resistance, increasing the use of complementary treatments was perceived by the majority of respondents as very important strategies that contribute to reduce antibiotic use and resistance. The current study disclosed that there is low level of awareness among animal farm owners about the correct use of antibiotics and resistance. It is necessary to raise awareness, develop and implement interventions to reduce antimicrobial use and antibiotic resistance in the study area.

Antibiogram Profiles of Bacteria Isolated from Different Body Site Infections Among Patients Admitted to GAMBY Teaching General Hospital, Northwest Ethiopia.

BACKGROUND: Infections with multi-drug resistant (MDR) bacteria are serious threats to many low-income countries associated with overuse and misuse of antibiotics. This study determined the antibiogram profiles of bacteria isolated from different body site infections among patients admitted to GAMBY Teaching General Hospital, Bahir Dar, Northwest Ethiopia. METHODS: A hospital-based cross-sectional study was done between November 2015 and May 2018. Various clinical specimens were sampled from patients and analyzed for aerobic bacterial isolation and Kirby-Bauer disk diffusion susceptibility testing. Chi-square test was calculated to see association among variables, and P-value <0.05 was taken as a cutoff value for statistical significance. RESULTS: From the 716 clinical specimens processed, 134 (18.7%) were culture-positive for aerobic bacterial pathogens. Culture-confirmed positivity was higher in ear discharge (27.3%) and urine (26.3%) samples. The prevalence of infection was significantly highest among females (P = 0.001). Escherichia coli 63 (47.4%) and 10 (7.4%) of Klebsiella spp. from Gram-negative bacteria were the predominant bacterial isolates, while Staphylococcus saprophyticus 17 (12.6%) and S. aureus 14 (10.4%) were from Gram-positive bacteria. Overall, 61.8% of the isolates were found to be MDR. The proportion of MDR among Klebsiella spp., S. aureus and E. coli isolates was 90.9%, 60.9% and 50%, respectively. Gram-positive bacteria demonstrated 20%, 48.6% and 100% of resistance against norfloxacin, ciprofloxacin and clindamycin, respectively. Gram-negative bacteria also revealed from 20% resistance for the antibiotic nitrofurantoin and 100% of resistance for ampicillin and penicillin. CONCLUSION: Infections with bacterial isolates resistant to the majority of antibiotics are a major issue in the study area. Most of the identified bacteria were resistant to the routinely used antibiotics, and MDR isolates are alarmingly high. Therefore, clinicians should practice rational choice of antibiotics and treatment should be guided by antimicrobial susceptibility testing.

Identifying Advanced Biotechnologies to Generate Biofertilizers and Biofuels From the World's Worst Aquatic Weed.

Water hyacinth (Eichhornia crassipes L.) was introduced as an invasive plant in freshwater bodies more particularly in Asia and Africa. This invasive plant grows rapidly and then occupies a huge layer of freshwater bodies. Hence, challenges are facing many countries for implementing suitable approaches for the valorization of the world's worst aquatic weed, and water hyacinth (WH). A critical and up-to-date review article has been conducted for more than 1 year, based on more than 100 scientific journal articles, case studies, and other scientific reports. Worldwide distribution of WH and the associated social, economic, and environmental impacts were described. In addition, an extensive evaluation of the most widely used and innovative valorization biotechnologies, leading to the production of biofertilizer and bioenergy from WH, and was dressed. Furthermore, an integrated search was used in order to examine the related advantages and drawbacks of each bioprocess, and future perspectives stated. Aerobic and anaerobic processes have their specific basic parameters, ensuring their standard performances. Composting was mostly used even at a large scale, for producing biofertilizers from WH. Nevertheless, this review explored some critical points to better optimize the conditions (presence of pollutants, inoculation, and duration) of composting. WH has a high potential for biofuel production, especially by implementing several pretreatment approaches. This review highlighted the combined pretreatment (physical-chemical-biological) as a promising approach to increase biofuel production. WH valorization must be in large quantities to tackle its fast proliferation and to ensure the generation of bio-based products with significant revenue. So, a road map for future researches and applications based on an advanced statistical study was conducted. Several recommendations were explored in terms of the choice of co-substrates, initial basic parameters, and pretreatment conditions and all crucial conditions for the production of biofuels from WH. These recommendations will be of a great interest to generate biofertilizers and bioenergy from WH, especially within the framework of a circular economy.

Aetiology of acute diarrhoea and antimicrobial usage among children aged under five years at health centres in Bahir Dar, Ethiopia.

The aetiology of diarrhoea with Cryptosporidium species and pathogenic bacteria has not been identified in the Ethiopian primary healthcare system. Thus, antibiotic consumption for unconfirmed pathogenic diarrhoea is not infrequent. A total of 344 children aged <5 years with diarrhoea were included in the present study to determine protozoal or bacterial aetiology and antibiotic use. Overall, 47.1% of children with diarrhoea had either protozoan or bacterial pathogens. The prevalence of Cryptosporidium species was 12.8% while bacterial pathogens were 13.1%. Based on direct microscopic stool examination, 77.6% (267/344) of children with diarrhoea were treated with antimicrobials. Of these, 16.7%-51.4% of prescribed antimicrobials were appropriate. None of the children with Cryptosporidium diarrhoea were treated with the appropriate antimicrobial. Enteric bacterial pathogens showed a resistance of 51.6% to cotrimoxazole. Empirical treatments are not appropriate for the majority of child cases of diarrhoea.

Physicochemical and bacteriological quality of bottled drinking water in three sites of Amhara Regional State, Ethiopia.

BACKGROUND: The consumption of bottled drinking water is becoming increasing in Ethiopia. As a result there has been a growing concern about the chemical, physical and bacteriological quality of this product. Studies on the chemical, physical and bacteriological quality of bottled water is quite scarce in Ethiopia. OBJECTIVE: This study was therefore aimed to assess the physicochemical and bacteriological qualities of three factories of bottled drinking water products produced in Amhara region. METHODS: A Laboratory based comparative study was conducted to evaluate the physicochemical and bacteriological quality of three factories of bottled drinking water produced in Amhara region. Analysis on the quality of bottled drinking water from the sources, wholesalers and retailers were made with World Health Organization and Quality and Standards Authority of Ethiopia recommendations. Triplicate samples from three types of bottled drinking water were randomly collected and analyzed from June, 2006 to December, 2006. RESULT: A total of 108 commercial bottled drinking water samples were analyzed. The result showed that except pH of factory A all the physicochemical parameters analyzed were with in the recommended limits. The pH value of factory A tested from sources is 5.3 and from wholesalers and retailers is 5.5 and 5.3, respectively, which is below the normal value set by World Health Organization (6.5-8.0) and Quality and Standards Authority of Ethiopia (6.0-8.5). Our analyses also demonstrated that 2 (16.7%) of the samples tested from sources and 1 (8.3%) from wholesalers of factory B were contaminated with total coliforms, where as 2 (16.7%) samples from retailers were also contaminated with total coliforms. On the other hand, 1 (8.3%) of the samples tested from wholesalers and 2 (16.7%) of the samples tested from retailers of factory A were also contaminated with total coliforms. Total coliforms were not detected from all samples of factory C, fecal coliforms were not also isolated from all samples. Percent of coefficient of variation showed that variations in total coliforms counts were significant with in the samples of both factory A and B (CV > 10%). CONCLUSIONS: Based on the recommended limit of World Health Organization and Quality and Standards Authority of Ethiopia, 7.4% of bottled drinking water sold commercially could be considered unfit for human consumption. Consumers of bottled water should be aware of this.

Pharyngeal colonization and drug resistance profiles of Morraxella catarrrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae among HIV infected children attending ART Clinic of Felegehiwot Referral Hospital, Ethiopia.

BACKGROUND: Asymptomatic pharyngeal colonization by potential bacteria is the primary reservoir for bacterial species within a population and is considered a prerequisite for development of major childhood diseases such as sinusitis, otitis media, pneumonia, bacteremia, and meningitis. However, there is dearth of data on the colonization and drug resistance pattern of the main bacterial pathogens in the pharynx of HIV infected children in Ethiopia. Therefore, this study determined the pharyngeal colonization and drug resistance profile of bacterial pathogens in HIV infected children attending ART clinic of Felegehiwot Referral Hospital (FHRH), Amhara Region, Ethiopia. METHODS: A hospital based cross-sectional study was conducted from May 2016 to June 2017 at the ART clinic of FHRH. A total of 300 HIV infected children were enrolled in the study. Data on socio-demographic characteristics of the study participants were collected with face-to-face interview and patient-card review using structured questionnaire. Bacterial species were identified using standard bacteriological techniques. Drug susceptibility testing was performed using disk diffusion technique. Chi-square test was done to determine associations among variables. RESULTS: The median age of the participants was 11 years. Overall, 153 (51%) of children were colonized by respiratory bacteria in their pharynx. Colonization rate was higher in children from mothers who had attained college and above levels of education than others (P = 0.04). It was also higher in children without the sign of malnutrition than others (P = 0.004). The colonization rate of S.aureus, M.catarrhalis, S.pneumoniae and H.influenzae were 88 (29%), 37 (12.3%), 31 (10.3%) and 6 (2%), respectively. S.aureus-M.catarrhalis concurrent colonization was found in 14 (4.7%) of children. Age (P = 0.03), schooling (P = 0.045) and history of running nose (P = 0.043) were significantly associated with S.aureus colonization. Living in urban setting (P = 0.042) and children from mothers with college and above levels of education (P = 0.002) were significantly associated with M.catarrhalis colonization. Majority of the isolates were resistant to penicillin (68.5%) and cotrimoxazole (52.5%).S.aureus isolates were resistant to penicillin (84.1%) and cotrimoxazole (51.1%).M.catarrhalis isolates were resistant to penicillin (94.6%), erythromycin (86.5%)and cotrimoxazole (78.4%). Overall, 99 (59.3%) of the isolates were multi-drug (MDR) resistant. The overall MDR rates among S.aureus, M.catarrhalis and S.pneumoniae isolates were 65.9%, 78.4% and 22.6%, respectively. CONCLUSIONS: Pharyngeal colonization of respiratory bacteria in HIV infected children is a major public health problem. Single and multiple antibiotic resistant is alarmingly high among respiratory colonizers. Therefore, regular screening of HIV infected children for culture and antimicrobial susceptibility testing is recommended to prevent the development of severe opportunistic infections.

The Bacteriological Quality, Safety, and Antibiogram of Salmonella Isolates from Fresh Meat in Retail Shops of Bahir Dar City, Ethiopia.

The habit of raw meat consumption in addition to the poor hygienic standards and lack of knowledge contribute to food-borne diseases outbreaks. The objective of this research was to assess the bacterial quality and safety of fresh meat from retail Bahir Dar City, Ethiopia. A total of 30 fresh meat samples were collected from butcher shops. Standard bacteriological methods were used to isolate and enumerate bacteria. Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing of Salmonella isolates. The mean counts of AMB, TC, and S. aureus were log104.53, 3.97, and 3.88 log10cfu/g, respectively. Salmonella was isolated from 21 (70%) of the samples. Salmonella isolates in this study were highly susceptible to ciprofloxacin, gentamycin, and norfloxacin while they were resistant to erythromycin and tetracycline. High rate of multiple drug resistance was also noticed in Salmonella isolates. The microbial loads of meat were above the recommended microbial safety limits. Besides this, the isolation rate of Salmonella was high and high levels of drug resistance were documented for Salmonella isolates. Measures on handling and appropriate personal hygiene practices of workers in the retail shops are recommended to reduce the change of forborne disease outbreaks.

Extended-Spectrum beta (ß)-Lactamases and Antibiogram in Enterobacteriaceae from Clinical and Drinking Water Sources from Bahir Dar City, Ethiopia.

BACKGROUND: The spread of Extended-Spectrum beta (ß)-Lactamases (ESBL)-producing Enterobacteriaceae has become a serious global problem. ESBL-producing Enterobacteriaceae vary based on differences in antibiotic use, nature of patients and hospital settings. This study was aimed at determining ESBL and antibiogram in Enterobacteriaceae isolates from clinical and drinking water sources in Bahir Dar City, Northwest Ethiopia. METHODS: Enterobacteriaceae species were isolated from clinical materials and tap water using standard culturing procedures from September 2013 to March 2015. ESBL-producing-Enterobacteriaceae were detected using double-disk method by E-test Cefotaxim/cefotaxim+ clavulanic acid and Ceftazidime/ceftazidime+ clavulanic acid (BioMerieux SA, France) on Mueller Hinton agar (Oxoid, UK). RESULTS: Overall, 274 Enterobacteriaceae were isolated. Of these, 210 (44%) were from patients and 64 (17.1%) were from drinking water. The median age of the patients was 28 years. Urinary tract infection and blood stream infection accounted for 60% and 21.9% of Enterobacteriaceae isolates, respectively. Klebsiella pneumoniae was isolated from 9 (75%) of neonatal sepsis. The overall prevalence of ESBL-producing Enterobacteriaceae in clinical and drinking water samples were 57.6% and 9.4%, respectively. The predominant ESBL-producers were K. pneumoniae 34 (69.4%) and Escherichia coli 71 (58.2%). Statistically significant associations were noted between ESBL-producing and non- producing Enterobacteriaceae with regard to age of patients, infected body sites and patient settings (P = 0.001). ESBL-producing Enterobacteriaceae showed higher levels of resistance against chloramphenicol, ciprofloxacin and cotrimoxazole than non-ESBL producers (P = 0.001). CONCLUSIONS: ESBL-producing Enterobacteriaceae coupled with high levels of other antimicrobials become a major concern for treatment of patients with invasive infections such as blood stream infections, neonatal sepsis and urinary tract infections. ESBL-producing Enterobacteriaceae were also detected in drinking water sources.

Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town.

BACKGROUND: Diarrheal disease and its complications remain a major cause of morbidity and mortality in children. The prevalence and antibiogram of E. coli as causative agents of diarrhea vary from region to region, and even within countries in the same geographical area. OBJECTIVES: To determine the serotype and antimicrobial susceptibility of E. coli in children under-five years of age. METHODS: A cross-sectional study was conducted among 422 children with diarrhea from December 2011 to February 2012. Identification of E. coli and antimicrobial susceptibility testing were done following standard procedures. RESULTS: The overall isolation rate of E. coli was 48.3%. Poly 2 sero-groups, poly 3 sero-groups, poly 4 sero-groups and E. coli O157:H7 accounted for 80 (39.2%), 40 (19.6%), 25 (12.3%), and 59 (28.9%) of the isolates, respectively. Poly 2 sero-groups, constituting isolates belonging to enteropathogenic E. coli were the most commonly isolated serotypes. E. coli exhibited high levels of antimicrobial resistance to ampicillin (86.8%), tetracycline (76%) and cotrimoxazole (76%). Low levels of resistance to ciprofloxacin (6.9%) and norfloxacin (9.3%) were documented. CONCLUSION: High prevalence of diarrheagenic E. coli compounded by alarming antimicrobial resistances is a serious public health problem. Regular determination of antibiogram and public education are recommended.

Reproductive health knowledge, attitude and practice among high school students in Bahir Dar, Ethiopia.

This study was carried out to investigate the reproductive health knowledge, attitude and practice of high school students in Bahir Dar, Ethiopia. Data were collected using self-administered questionnaire and focus group discussions. The study revealed that the students had high level knowledge of contraceptives and where to obtain contraceptive services; however, level of use was low. Some of the reasons given for not using contraceptives include lack of access to services, carelessness, unplanned sexual intercourse and pressure from sexual partner. The study indicates that young people engage in sexual relationships at an early age without protection or with unsafe non-conventional methods. There was no significant difference between the demographic variables and contraceptive use at first intercourse. Educational level of the respondents was the only demographic variable that had significant association with sexual experience (p < 0.05). We recommend improved access to family planning information and services and family life education programmes based on the needs and experience of these young people as a potential solution to alleviate their reproductive health problems.