Evaluation of urine sample for diagnosis of visceral leishmaniasis using rK-39 immunochromatographic test in Northwest Ethiopia.

BACKGROUND: Visceral leishmaniasis is the most severe form of leishmaniasis which ranks second in mortality and fourth in morbidity. Parasitological diagnostic techniques with splenic aspirate remain the gold standard. However, sample collection is risky, painful, and difficult. Alternatively, serological techniques provide good diagnostic accuracy using serum sample that is difficult for applying on small children and in the field. So, finding alternative non-invasive and self-collected samples like urine is very important. Thus, the study aimed to evaluate the diagnostic performance of the rK-39 strip test using urine for diagnosis of visceral leishmaniasis. METHODS: A multicenter institutional-based cross-sectional study was conducted from November 2019 to March 2021 at Northwest Ethiopia. Sociodemographic information was collected using a structured questionnaire. Blood sample and midstream urine sample were collected for rK-39 test. Data were entered into Epi-data version 4.2 and analyzed using SPSS version 24.0. Diagnostic performance parameters of urine-based rK-39 rapid test, i.e. sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios (LR+/-), and diagnostic accuracy were determined on contingency table by using serum-based rK-39 test result as a reference. An agreement between urine and serum-based rK-39 test was statistically determined by kappa value. RESULT: In total, 300 subjects, age ranged between 7 and 60 years, were included in the study. The overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of urine-based rK-39 test were found to be 98.0% (95% CI: 93.0% - 99.8%), 95.5% (95% CI: 91.6% - 97.9%), 91.6% (95% CI: 85.2%- 95.4%), 98.9 (95% CI: 96.0%- 99.7%), and 96.33% (95% CI: 93.53-98.16%), respectively. Additionally, there was a strong agreement between the results obtained on rK-39 ICT using urine and serum samples (kappa = 0.92; P < 0.001). CONCLUSION: Urine-based rK-39 ICT had an excellent high sensitivity, specificity and strong agreement with serum-based rK-39 ICT results. This indicates that urine sample would be a promising noninvasive and easy to collect sample for diagnosis of VL in field and rural settings.

Evaluation of Intestinal Parasite Infection in Low and High Coverage of Graduated Households, Northwest Ethiopia: A Comparative-Based Crosssectional Study.

Intestinal parasite infections are widely distributed and affect various segments of the population in Ethiopia as in many developing countries. The government launched an innovative program called Health Extension Program to increase the coverage of primary health care services, mainly by producing model households using model-family training. The aim of this study was to evaluate the intestinal parasite infection in low and high coverage of graduated households. Method. A community-based crosssectional study was conducted from February to June, 2019. A total of 478 participants were enrolled in this study by using a multistage sampling technique. Data were collected by using pretested and semistructured questionnaire. Five grams of stool specimen was collected, and samples were processed using a direct wet mount and Kato Katz technique. Data were coded, entered, and cleaned using statistical package for social science (SPSS) version 20. A Chi-square test was employed to compare the two groups. P value < 0.05 were taken as statistically significant. Result. The prevalence rate of IPIs was 39% and 20.5% in LCGHH and HCGHH, respectively. A. lumbricoides was the predominant parasite, detected in 14.6% and 8.8% followed by S. mansoni 6.3% and 2.1% in LCGHH and HCGHH districts, respectively. LCGHH had significantly higher prevalence of A. lumbricoides, S. mansoni, and hookworm infections than the HCGHH district (P < 0.05). Thirteen (18.8%) study participants in LCGHH and four (11.7%) in HCGHH showed heavy infection with the four common soil-transmitted helminths (A. lumbricoides, S. mansoni, hookworm, and T. trichiura). Among study participants who were positive for S. mansoni, 53.3% in LCGHH and 20% in HCGHH had heavy infection for the Kato thick smear used. Conclusion. The prevalence of IPIs is significantly higher in LCGHH than in the HCGHH district. Producing more model households by giving model family training to nonmodel households and strengthening the information, education, and communication package are crucial in the implementation of the HEP to decrease the prevalence of IPIs especially in LCGHH districts.

A 5-year trend of Helicobacter pylori seroprevalence among dyspeptic patients at Bahir Dar Felege Hiwot Referral Hospital, Northwest Ethiopia.

BACKGROUND: Helicobacter pylori infection is a major public health problem affecting half of the world's population. The prevalence of H. pylori varies in different societies and geographical locations. Thus, timely information on H. pylori epidemiology is critical to combat this infection. This study aimed to determine the seroprevalence and trend of H. pylori infection over a period of 5 years among dyspeptic patients at Bahir Dar Felege Hiwot Referral Hospital, Northwest Ethiopia. METHODS: A retrospective analysis of consecutive dyspeptic patients' records covering the period between January 2009 and December 2013 was conducted. The hospital laboratory generated the data by a serological method of detecting the antibodies for H. pylori from serum by a one-step rapid test device. Chi-square analysis was used to identify significant predictors. A P-value of <0.05 was considered as statistically significant. RESULTS: Among all the study subjects, 2,733 (41.6%) were found to be seropositive. The seroprevalence was significantly higher in males (43.2%) than in females (39.9%) (χ2=9; P=0.002). In terms of age groups of the patients, high rates of H. pylori were found among the participants older than 60 years (57%) (χ2=36.6; P≤0.00001). The trend analysis of H. pylori prevalence revealed a fluctuating prevalence; it was 44.5% in the year 2009 and decreased to 34% and 40% in the years 2010 and 2011, respectively. However, there was an increment to 52.5% in the year 2012, and then it decreased to 30.2% in the year 2013. CONCLUSION: This study showed high seroprevalence of H. pylori among the dyspeptic patients in Bahir Dar Felege Hiwot Referral Hospital. The trend of the seroprevalence varied from year to year in the 5 consecutive years. Considering this, designing appropriate prevention and control strategies is mandatory.