Multidrug-resistance and extended-spectrum beta-lactamase-producing lactose-fermenting enterobacteriaceae in the human-dairy interface in northwest Ethiopia.

BACKGROUND: Antimicrobial resistance (AMR) is among the top public health concerns in the globe. Estimating the prevalence of multidrug resistance (MDR), MDR index (MDR-I) and extended-spectrum beta-lactamase (ESBL)-producing lactose fermenting Enterobacteriaceae (LFE) is important in designing strategies to combat AMR. Thus, this study was designed to determine the status of MDR, MDR-I and ESBL-producing LFE isolated from the human-dairy interface in the northwestern part of Ethiopia, where such information is lacking. METHODOLOGY: A cross-sectional study was conducted from June 2022 to August 2023 by analyzing 362 samples consisting of raw pooled milk (58), milk container swabs (58), milker's hand swabs (58), farm sewage (57), milker's stool (47), and cow's feces (84). The samples were analyzed using standard bacteriological methods. The antimicrobial susceptibility patterns and ESBL production ability of the LFE isolates were screened using the Kirby-Bauer disk diffusion method, and candidate isolates passing the screening criteria were phenotypically confirmed by using cefotaxime (30 µg) and cefotaxime /clavulanic acid (30 µg/10 µg) combined-disk diffusion test. The isolates were further characterized genotypically using multiplex polymerase chain reaction targeting the three ESBL-encoding- genes namely blaTEM, blaSHV, and blaCTX-M. RESULTS: A total of 375 bacterial isolates were identified and the proportion of MDR and ESBL-producing bacterial isolates were 70.7 and 21.3%, respectively. The MDR-I varied from 0.0 to 0.81 with an average of 0.30. The ESBL production was detected in all sample types. Genotypically, the majority of the isolates (97.5%), which were positive on the phenotypic test, were carrying one or more of the three genes. CONCLUSION: A high proportion of the bacterial isolates were MDR; had high MDR-I and were positive for ESBL production. The findings provide evidence that the human-dairy interface is one of the important reservoirs of AMR traits. Therefore, the implementation of AMR mitigation strategies is highly needed in the area.

Detection and antibiogram profile of diarrheagenic Escherichia coli isolated from two abattoir settings in northwest Ethiopia: a one health perspective.

BACKGROUND: Diarrheagenic Escherichia coli (E. coli) is a zoonotic pathogen that contaminates abattoir workers, slaughter environments, slaughter equipment, and carcasses during abattoir processing. Infection with E. coli is associated with the consumption of contaminated food and water, and it is a potential threat to the health and welfare of both humans and animals. Hence, this study aimed to detect diarrheagenic E. coli and assess its antibiogram profile in two abattoir settings, in one health lens. METHODS: A cross-sectional study in one health approach was conducted from December 2020 to June 2021. A total of 384 samples from abattoir workers' hands, carcasses, knives, cattle feces, abattoir water and effluents were collected. Bacterial culture and biochemical tests were conducted to isolate E. coli, while conventional polymerase chain reaction was performed to identify virulence genes. The antibiogram of diarrheagenic E. coli was tested against nine antimicrobials using the Kirby Bauer disk diffusion method. RESULTS: A total of 115 (29.95%) E. coli were isolated from the 384 samples, and from these isolates, about 17 (14.8%) were confirmed to be diarrheagenic E. coli (DEC). Among the DEC pathotypes, nine (52.94%), five (29.4%), and three (17.65%) were Shiga toxin-producing, enterohemorrhagic, and enterotoxigenic E. coli, respectively. While 14 (82.35%) DEC isolates harbored the stx2 gene, five (29.41%) the eae gene, five (29.41%) the hlyA gene and three (17.65%) harbored the st gene. All the DEC isolates were resistant to erythromycin and vancomycin; whereas, they were susceptible to ampicillin, nalidixic acid and norfloxacin. Furthermore, 64.7% of DEC isolates showed resistance to both ceftazidime and kanamycin and 88.24% of the isolates showed multidrug resistance. CONCLUSION: This study detected DEC isolates having different virulence genes, which showed single and multiple antimicrobial resistance. Given the existing poor hygienic and sanitary practices along the abattoir-to-table food chain, coupled with the habit of raw meat consumption, this result indicates a potential public and animal health risk from the pathogen and antimicrobial resistance.

Risk factors associated with contagious caprine pleuropneumonia in goats of Amhara region, Ethiopia.

Contagious caprine pleuropneumonia (CCPP) is a serious contagious disease of goats, sheep and wild ruminants caused by Mycoplasma capricolum subspecies capripneumoniae. The disease is known for its high mortality, morbidity and economic losses. A cross-sectional study using multistage cluster sampling technique was conducted in Amhara region from January 2019 to July 2019 to estimate seroprevalence and identify risk factors of CCPP occurrence in the region. A total of 2080 goats from 61 villages and 12 districts of the region were tested for CCPP serostatus using Competitive Enzyme-Linked Immunosorbent Assay (C-ELISA). A multilevel mixed-effect logistic regression model was used to identify risk factors of CCPP seropositivity at animal and flock-level. The serum sample results revealed an overall animal level seroprevalence of 5.1% (95% CI: 3.8-6.6) and flock-level prevalence of 26.0% (95% CI: 19.7-33.4). At individual animal level, presence of other health problems (OR = 45.9 (95% CI: 25.3-83.4)), age (adult age (OR = 6.2 (95% CI:3.4-11.4)) and old age (OR = 13.1 (95% CI: 6.2-27.8))), and breed type (Afar (OR= 32.3 (95% CI: 2.9-366.1)), Central highland (OR=13.7 (95% CI: 1.3-140.6)), and western highland (OR=16.2 (95% CI: 1.4-185.7))) were identified as risk factors for CCPP seropositivity. In contrast, contact with other flocks (OR = 59.9 (95% CI: 6.1-585.6)), presence of trade route (OR = 3.1 (95% CI: 1.0-9.1)) and presence of sheep (OR = 2.6 (95% CI: 1.2-5.7)) were flock-level risk factors for CCPP seropositivity. Generally, CCPP appears to be common among goats of Amhara region. Goat flocks dominated with older age animals; breeds of Afar, central highland, and western highland; raise with sheep; have contact with other flocks; and kept along trade routes are more at risk for CCPP. Hence, awareness creation to the producers, movement control, and regular prophylactic vaccination should be considered to control CCPP in Amhara region.

Health and economic burden of foodborne zoonotic diseases in Amhara region, Ethiopia.

Diseases from food of animal origin are common health problems in Ethiopia. A cross-sectional study was carried out to estimate health and economic burden, and to identify demographic factors associated with community awareness of foodborne zoonotic diseases in Amhara region, Ethiopia. Data was collected from 435 households in three towns: Gondar, Lalibela and Debark. A retrospective data was also collected from health records in each town. The health burden due to zoonotic diseases was estimated at 0.2, 0.1 and 1.3 DALYs per household per year and at 73.2, 146.6 and 1,689.5 DALYs out of 100,000 populations per year in Gondar, Lalibela and Debark, respectively. The overall health burden due to foodborne zoonotic diseases (aggregated over the 435 households in the three towns) was estimated to be 89.9 DALYs per 100,000 populations per year. The economic impact of foodborne zoonotic diseases in the three towns of Amhara regional state was 278.98 Ethiopian Birr (ETB) (1ETB = 0.025 US Dollar) per household per year and 121,355.68 ETB per year. Costs of preventive measures followed by costs of patients' time made the highest contribution while costs of diagnosis made the lowest contribution to the total economic burden of foodborne zoonotic diseases. From a total of 435 respondents, 305 (70.1%) had known the presence of zoonotic diseases. Level of education, number of families in the house and income were highly associated with awareness of zoonosis. Although majority of respondents had known zoonotic diseases exists (70.1%) and disease can be acquired from animal source food (63.2%), the health and economic burden associated to foodborne zoonotic diseases are still high. Therefore, changing mindset and practical training aiming in controlling foodborne zoonotic diseases may be suggested to the community in the health improvement extension service.

Smear-Positive Tuberculosis Prevalence and Associated Factors among Pregnant Women Attending Antinatal Care in North Gondar Zone Hospitals, Ethiopia.

Tuberculosis is an ancient infectious disease that remains a threat to public health around the world. It is a contagious airborne disease caused by Mycobacterium tuberculosis complex. In high tuberculosis burden countries, the prevalence of tuberculosis was 10-fold higher in the HIV-infected mothers than that in those not infected with HIV. However, little is known about the burden of tuberculosis (TB) and associated factors in women of reproductive age in most resource poor countries. Therefore, this study aims to investigate prevalence of smear-positive TB and factors associated in pregnant women attending antenatal care in North West, Ethiopia. An institution-based cross-sectional study was conducted in three governmental hospitals of the North Gondar Zone, and a total of 1272 pregnant women attending antenatal care were included. Data were collected by trained personnel's using a pretested and structured symptom screening questionnaire; then, spot-morning-spot sputum samples were collected from those pregnant women who had two or more weeks of cough, and sputum smear was done by using a light-emitted diode fluorescent microscope. 99% of the pregnant women visited the hospitals for antenatal care. The prevalence of smear-positive tuberculosis was 864/100,000 population, and HIV positivity (AOR = 7.24; 95% CI: (2.01-26.03)), urban residence (AOR = 2.28; 95% CI: (1.419-3.158)), and family history of TB (AOR = 2.12; 95% CI: (1.371-3.451)) were significantly associated with smear-positive tuberculosis. In this study, the prevalence of smear-positive tuberculosis was found to be higher than that in other community-based studies in the country. Therefore, health education, targeted screening of pregnant women for TB, and collaboration of TB-HIV clinic with antenatal care clinic should be implemented in the area. Further research should also be conducted for better understanding of the magnitude of tuberculosis in females of reproductive age.