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Background: Bacterial bloodstream infections (BSIs) are the leading cause of sepsis-related morbidity and mortality worldwide. The emergence and spread of antimicrobial resistance (AMR) in bacteria is also a growing global concern. As a result, data on bacterial profile and their antibiogram are essential for strategies to contain drug resistance, improve the quality of patient care, and strengthen health systems. Methods: Retrospective data from bacteriological results of blood samples of BSI-suspected patients from 2018 to 2021 were collected using a data collection sheet. Standard bacteriological techniques were followed during sample collection, culture preparation, bacterial identification, and antibiotic susceptibility testing (AST). We used Epi Info version 7 to enter and clean the data and then exported it to SPSS version 26 for analysis. Logistic regression models were used to measure the association between variables. A p value <0.05 with a 95% confidence interval was considered as statistically significant. Result: Of the total 2,795 blood culture records, 455 (16.3%) were culture positive for bacteria, with Klebsiella pneumoniae (26%) and Staphylococcus aureus (24.6%) being the leading isolates. The isolates were highly resistant to common antibiotics, with more than 80% of them being resistant to ceftriaxone and penicillin. Moreover, about 43% of isolates were multidrug resistant (MDR), with Klebsiella pneumoniae (65.5%), Acinetobacter species (56.7%), and Citrobacter species (53.8%) being the most common MDR isolates. Age and diagnosis year were significantly associated with the presence of bacterial BSIs (p value <0.05). Conclusion: Bacterial BSI and AMR were growing concerns in the study area. Bacteremia was more common in children under the age of five, and it decreased as the patient's age increased. The alarming rate of AMR, such as MDR blood isolates, calls for periodic and continuous monitoring of antibiotic usage in the study area.
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BACKGROUND: Because of the multidrug resistance features of Acinetobacter baumannii, endurance to diverse conditions, and causing health fatalities in healthcare settings, the global health system is looking for the development of new antimicrobials for such bacteria. As the new antimicrobial drugs pipeline is running dry, it is imperative to look for eco-friendly bio-control strategies. In this regard, phages are one to combat the biofilm producer and MDR A. baumannii. Thus, the study aimed to isolate and examine the role of phages against biofilm producers and MDR A. baumannii from inanimate objects at Jimma Medical Center (JMC), Ethiopia. METHOD: Institution-based cross-sectional study was conducted from June to November 2019. A total of 309 swab samples were collected from inanimate objects and the environment in JMC. Isolation of A. baumannii, antimicrobial susceptibility testing, and biofilm detection were carried out according to standard protocol. Kirby Bauer disk diffusion and microliter plate were methods for AST and biofilm detection, respectively. Specific phage was isolated and characterized from sewage at JMC compound. The data were analyzed by SPSS version 25.0, and chi-square (X2) cross-tabulation was used to determine the correlation of variables. A P-value of < 0.05 was considered a statistically significant association. RESULT: A. baumannii from inanimate objects and surfaces of different environments at JMC was detected in 6.5% of the samples. From 20 of the isolates, 85% were biofilm producers, and 60% were MDR. The lytic phage isolated specifically against A. baumannii was found host specific, and thermally stable ranging from 10-50°C. The phage was active against 42% of MDR A. baumannii, 40% of both biofilm-producing and MDR A. baumannii (MDRAB), and 35.3% of the biofilm-producing isolates. CONCLUSION: The good activity of phages towards MDRAB isolates, its biofilm degradation capability, thermal stability, and host specificity in our study encourages viewing the potential use of phages as a bio-control agent besides the routine cleansing agents. Therefore, we recommend isolation of specific phages in the eradication of MDRAB from health facilities with additional efforts to characterize in detail and assess their efficacy in animal models.
Subject(s)
Acinetobacter baumannii , Bacteriophages , Ethiopia , Cross-Sectional Studies , Anti-Bacterial Agents/therapeutic use , Drug Resistance, Multiple, BacterialABSTRACT
BACKGROUND: Ethiopia is among the highly HIV-affected countries, with reported 12,000 and 12,000 AIDS-related deaths and incidents as per reports from 2021. Although the country has made a promising progress in antiretroviral therapy, recent studies have indicated that pretreatment drug resistance (PDR) is alarmingly increasing, which has become a challenge for the effectiveness of HIV treatment. Epidemiologic data on PDR is necessary to help establish ART regimens with good efficacy. Thus, this systematic review aimed to determine the trend analysis of PDR among ART-naïve individuals along with HIV variant dynamics in Ethiopia. METHOD: HIV-1 pol sequences from studies conducted between 2003 and 2018 among ART-naïve Ethiopian individuals were retrieved from GenBank and analyzed for the presence of PDR mutations (PDRM) along with the analysis of HIV-1 variant dynamics. The Calibrated Population Resistance (CPR) tool Version 8.1 and the REGA HIV-1 Subtyping Tool Version 3 were used to determine the PDRM and HIV-1 genetic diversity, respectively. RESULT: We identified nine studies and analyzed 1070 retrieved HIV-1 pol sequences in this systematic review. The pooled prevalence of PDR was 4.8% (51/1070), including 1.4% (15/1070), 2.8% (30/1070), and 0.8% (9/1070) for nucleoside reverse transcriptase inhibitor (NRTI), non-NRTI (NNRTI), and protease inhibitor (PI) resistance, respectively. NRTI and NNRTI concurrent PDRM were observed among 0.2% (2/799) of the analyzed sequences. The overall PDR prevalence has been increasing over the years. Though the prevalence of the NNRTI, NRTI, and PI PDR also increased over the years, the NNRTI increment was more pronounced than the others, reaching 7.84% in 2018 from 2.19% in 2003. The majority (97%; 1038/1070) of the genetic diversity was HIV-1 subtype C virus, followed by subtype C' (2%; 20/1038) and other subtypes (1%; 10/1038). CONCLUSIONS: According to this systematic review, the overall pooled prevalence of PDR is low. Despite the low prevalence, there has been an increasing trend of PDR over the years, which implies the need for routine surveillance of PDRMs along with preventive measures. Hence, this supports the recently endorsed transition of ART regimens from NNRTI to integrase strand transfer inhibitor-based regimens recommended by the WHO. In addition, this finding underscores the need for routine baseline genotypic drug resistance testing for all newly diagnosed HIV-infected patients before initiating treatment to halt the upward trend of PDR.
Subject(s)
Anti-HIV Agents , HIV Infections , HIV Seropositivity , HIV-1 , Humans , HIV-1/genetics , Anti-HIV Agents/pharmacology , Anti-HIV Agents/therapeutic use , HIV Infections/drug therapy , HIV Infections/epidemiology , Reverse Transcriptase Inhibitors/therapeutic use , HIV Seropositivity/drug therapy , Mutation , Genotype , Drug Resistance, Viral/genetics , Prevalence , Sequence AnalysisABSTRACT
Introduction: It is well established that starting antiretroviral therapy (ART) increases a patient's life expectancy among HIV-positive individuals. Considering the HIV pandemic, the major concern is initiation of ARTs to the large segment of HIV infected population, not adverse events from immune restoration. The prevalence of HIV-associated immune reconstitution inflammatory syndrome (IRIS) is poorly estimated due to Africa's underdeveloped infrastructure, particularly in Eastern Africa. Therefore, this study compiled data regarding the magnitude and associated factors of IRIS in the context of Eastern Africa. Methods: The electronic databases such as Google Scholar, PubMed, Web of Science, and free Google access were searched till 5 June 2021, and the search was lastly updated on 30 June 2022 for studies of interest. The pooled prevalence, and associated factors with a 95% confidence interval were estimated using the random effects model. The I2 and Egger's tests were used for heterogeneity and publication bias assessment, respectively. Results: The development of HIV-associated IRIS in Eastern Africa was estimated to be 18.18% (95% CI 13.30-23.06) in the current review. The two most common predictors of IRIS associated with Eastern Africa were the lower pre-ART CD4 T-cell count of 50 cells/µl and the low baseline body mass index level. Therefore, attention should be focused on the early detection and care of HIV-associated IRIS to reduce the morbidity and death caused by IRIS.
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Background: The emergence and spread of extended-spectrum ß-lactamases (ESßLs) and carbapenemase (CP) producing gram negative non-fermenters are becoming a serious public health threat globally. Infections caused by these pathogens limit treatment options and contribute to the significant morbidity and mortality. Thus, to reduce their spread, early detection of these superbugs is very crucial. This study therefore aimed to assess the prevalence of ESßLs and CP producing gram negative non-fermenters at selected hospitals of North East Ethiopia. Methods: A cross-sectional study was conducted from January to June 2021. Acinetobacter baumannii (A. baumannii) and Pseudomonas aeruginosa (P. aeruginosa) were identified using standard bacteriological techniques. ESßL and CP production were detected by combined disk diffusion and modified carbapenem inhibitory methods, respectively. Data were collected via face-to-face interview and patient card review. Chi-squared and Fisher's exact tests were calculated and p-value < 0.05 was considered statistically significant. Results: A total of 384 patients participated in this study. Overall, 30 (7.8%) patients had positive culture for A. baumannii and P. aeruginosa. The prevalence of A. baumannii was 20 (5.2%) and that of P. aeruginosa was 10 (2.6%). From the overall isolates, 16 (53.3%) were ESßL and the proportion of carbapenemase production was 4 (13.3%). ESßL production was 8 (40%) in A. baumannii and 8 (80%) in P. aeruginosa isolates. ESßL production infections were significantly associated with hospitalization (p=0.004). Intravenous catheterization, hospitalization, and surgery had significant association with ESßL production (p<0.005). All isolates of A. baumannii and P. aeruginosa were MDR. Conclusion: ESßL and carbapenemase production among A. baumannii and P. aeruginosa were high in the selected hospitals. The treatment of such resistant infectious agents should be guided by antimicrobial susceptibility test in a study setting. Thus, restricted and wise use of antibiotics is highly recommended to contain the spread of these superbugs. Hospitals should develop infection prevention guidelines to prevent the spread of resistant pathogens in hospitalized patients.
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With the widespread use of Integrase strand transfer inhibitors (INSTIs), surveillance of HIV-1 pretreatment drug resistance is critical in optimizing antiretroviral treatment efficacy. However, despite the introduction of these drugs, data concerning their resistance mutations (RMs) is still limited in Ethiopia. Thus, this study aimed to assess INSTI RMs and polymorphisms at the gene locus coding for Integrase (IN) among viral isolates from ART-naive HIV-1 infected Ethiopian population. This was a cross-sectional study involving isolation of HIV-1 from plasma of 49 newly diagnosed drug-naive HIV-1 infected individuals in Addis-Ababa during the period between June to December 2018. The IN region covering the first 263 codons of blood samples was amplified and sequenced using an in-house assay. INSTIs RMs were examined using calibrated population resistance tool version 8.0 from Stanford HIV drug resistance database while both REGA version 3 online HIV-1 subtyping tool and the jumping profile Hidden Markov Model from GOBICS were used to examine HIV-1 genetic diversity. Among the 49 study participants, 1 (1/49; 2%) harbored a major INSTIs RM (R263K). In addition, blood specimens from 14 (14/49; 28.5%) patients had accessory mutations. Among these, the M50I accessory mutation was observed in a highest frequency (13/49; 28.3%) followed by L74I (1/49; 2%), S119R (1/49; 2%), and S230N (1/49; 2%). Concerning HIV-1 subtype distribution, all the entire study subjects were detected to harbor HIV-1C strain as per the IN gene analysis. This study showed that the level of primary HIV-1 drug resistance to INSTIs is still low in Ethiopia reflecting the cumulative natural occurrence of these mutations in the absence of selective drug pressure and supports the use of INSTIs in the country. However, continues monitoring of drug resistance should be enhanced since the virus potentially develop resistance to this drug classes as time goes by.
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Drug Resistance, Neoplasm , Drug Resistance, Viral , HIV Infections , HIV Integrase Inhibitors , HIV Integrase , HIV-1 , Humans , Cross-Sectional Studies , Drug Resistance, Viral/drug effects , Drug Resistance, Viral/genetics , Genotype , HIV Infections/drug therapy , HIV Infections/genetics , HIV Infections/virology , HIV Integrase/drug effects , HIV Integrase/genetics , HIV Integrase/isolation & purification , HIV Integrase Inhibitors/pharmacology , HIV Integrase Inhibitors/therapeutic use , HIV Seropositivity/drug therapy , HIV-1/drug effects , HIV-1/genetics , HIV-1/isolation & purification , Mutation , Drug Resistance, Neoplasm/drug effects , Drug Resistance, Neoplasm/geneticsABSTRACT
Typhoid fever continued to be the key cause of morbidity and mortality in developing countries with poor hygienic practices and limited access to safe drinking water. The Widal card agglutination test is the main diagnostic tool in Ethiopia, which is limited in differentiating the overlapping symptoms with other acute febrile illnesses such as malaria and viral enteritis. This eventually leds to unnecessary antibiotic use and eventual drug resistance. Therefore this study wants to assess the burden and associated potential risk factors of typhoid fever among suspected cases using the typhoid rapid stool antigen test in Northeast Ethiopia. A hospital-based cross-sectional study was conducted at Gaint and Meket Shediho primary hospitals from May to July 2021. A total of 255 patients clinically suspected of typhoid fever, and willing to grant informed consent were included systematically. The demographic and hygiene-related variables were collected using a pre-tested structured questionnaire. The rapid stool antigenic test and xylose-lysine-deoxycholate agar (XLD) stool culture were evaluated for the level of agreement. The present study indicated that the prevalence of typhoid fever was 15.3%. This displayed that the human-restricted infectious disease, typhoid fever remained a challenge to Ethiopians. Washing hands with soap, history of typhoid fever, having previous history of hospitalization, and chronic underlying disease was the significant potential factor for typhoid fever. The higher agreement of the rapid stool antigenic test with the stool culture can indicate the factual burden of typhoid fever in the suspected population. This could minimize empiric treatment and the possible emergence of drug resistance. Thus, resource-poor settings may need to look for a rapid and reliable stool antigenic test.
Subject(s)
Typhoid Fever , Humans , Cross-Sectional Studies , Ethiopia/epidemiology , Immunologic Tests , Salmonella typhi , Typhoid Fever/diagnosis , Typhoid Fever/epidemiology , Feces/enzymology , Feces/microbiologyABSTRACT
Natural killer (NK) cells are crucial effector cells of the innate immune response to viral infections, including HIV, through cytolytic activity and the production of cytokines with anti-HIV activities. We recruited 15 treatment naïve HIV patients and 16 healthy controls (HC) to assess NK cell subsets or expression of multiple markers by flow cytometry. The frequency of circulating CD56brightCD16-ve and CD56dimCD16bright NK cell subsets was significantly lower among the HIV group than in HC. The CD56-veCD16bright subset was higher in HIV patients, but this was only apparent when gated among total NK cells, not total lymphocytes. NK cells among HIV participants also showed a lower and higher frequency of CD8 and HLA-DR expressing cells, respectively. In addition, CD7 median fluorescent intensity and CD2+CD7- frequencies were significantly lower in HIV patients. A distinct population of KIR3DL1/S1 cells was unexpectedly higher among CD56brightCD16-ve NK cells in HIV patients. In conclusion, this study in the Ethiopian setting confirms many previous findings, but the down-regulation of CD7 and enhanced KIR3DL1/S1 within the CD56bright subsets have not been widely reported among HIV patients and merit further research.
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HIV Infections , CD56 Antigen/metabolism , Ethiopia , Flow Cytometry , Humans , Killer Cells, Natural , Lymphocyte Subsets , Receptors, IgG/metabolismABSTRACT
Background: Despite ongoing intensive public health intervention efforts, intestinal parasitic infections (IPIs) remain a major public health problem in developing countries, including Ethiopia. Having updated epidemiological data focusing on the top common IPIs that cause emergency visits is crucial for implementing area-specific and evidence-based intervention strategies. Hence, this study aimed to determine the prevalence of IPIs in Woldia Comprehensive Specialized Hospital's (WCSH) emergency laboratory over a six-year period. Methods: An institutional-based retrospective study was conducted to assess the prevalence of IPIs over a six-year period (2014-2019) using a recorded saline wet-mount stool sample examination result in the laboratory logbook at WCSH's emergency department. Results: In this study, of the total of 11,281 clinically suspected individuals who were requested for stool sample examination, 3908 (34.6%) individuals were diagnosed with IPs. The majority of confirmed cases were caused by protozoan parasites (32.9%), followed by helminth infections (1.7%). A slight fluctuating trend in the prevalence of IPs was observed in the six-year study period, with the highest prevalence documented in the year of 2014 (41.3%) and the lowest in 2017 (28.0%). Entamoeba histolytica/dispar and Giardia lamblia accounts for 95% of the IPs. The prevalence of protozoan infection was significantly higher in females (p-value = 0.0101), while H. nana (p-value =0.0138) and E. vermicularis (p-value = 0.0201) infections were higher in males. The highest and the lowest IP prevalence were reported in the age groups of 45-54 years (40%) and under five years (25.6%), respectively. Conclusion and Recommendations: In the study area, nearly one-third of patients with emergency visits due to gastrointestinal symptoms were infected with IPs. This underlines the severity of the problem in the study area, which requires a collaborative effort of concerned bodies to minimize the burden of IP to the level where it is no longer a public health threat.
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The burden of human listeriosis, an emerging food-borne illness would be higher in Africa due to poor food processing practices. The severity of the disease and the high case fatality rate make human listeriosis an important public health problem. Besides, pregnant women and their fetuses are at higher risk of gaining human listeriosis. Thus, we planned to estimate the pooled prevalence of pregnancy-associated human listeriosis in Africa. Primary studies were exhaustively searched using PubMed, Cochrane, Web of Science, Google Scholar, and University of Gondar online research repository. Observational studies (cross-sectional) revealing the pregnancy-associated human listeriosis were incorporated. Eligible studies were selected and critically appraised for quality using the Joanna Briggs Institute (JBI) quality appraisal checklist. The required data were extracted and exported to Stata version 14 for meta-analysis. The pooled prevalence of pregnancy-associated human listeriosis in Africa was estimated using a weighted inverse random effect model. Sensitivity and sub-group analysis were conducted for evidence of heterogeneity. Among 639 reviewed articles, 5 articles were eligible with total study participants of 621. The pooled prevalence of pregnancy-associated listeriosis was found to be 5.17% (95% CI, 1.51, 8.82). The pooled level resistance of isolates was high. Cotrimoxazole and erythromycin were the relative choices of antibiotics for pregnancy-associated listeriosis in Africa. The burden of pregnancy-associated listeriosis in Africa was higher with an increased level of antibiotic resistance. Therefore, we recommend due attention to the deadly emerging disease in terms of health educations and the role of food hygiene particularly for risk groups, pregnant women. The antibiotics of choice should be after performing drug susceptibility test.
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BACKGROUND: Because of limited infrastructure and skilled human capital, the etiology of meningitis is rarely identified in developing countries like Ethiopia. This results in unnecessary antibiotics use, economic crisis, hospitalization, and related nosocomial infections. Thus, we aimed to assess the epidemiology of human enteroviruses (HEVs) among clinically suspected meningitis cases in Addis Ababa, Ethiopia. METHOD: A cross-sectional study was conducted from January to August 2020 at selected Hospitals in Addis Ababa, Ethiopia. Reverse transcriptase-polymerase chain reaction (RT-PCR) was conducted on cerebrospinal fluid (CSF) collected from 146 clinically suspected meningitis and bacterial culture-negative patients. SPSS v 21.0 was used for data analysis and bivariate correlation was done for the association between variables of interest. RESULTS: HEVs were detected in 39 (26.7%) of the 146 clinically suspected meningitis cases. Most of the HEVs cases 28 (71.9%) were detected in younger-aged infants less than 1 year. The most commonly observed clinical manifestations were vomiting (75.5%) followed by fever (56.8%) and impaired consciousness or irritability (50.7%). The mean length of hospital stay for patients with enteroviral meningitis was 9 days. Many patients with HEVs were recovered with sequelae (46.2%), and HEVs has contributed for one out of the nine meningeal deaths (11.1%). CONCLUSIONS: HEVs were found to be the commonest cause of morbidity and mortality in all age groups. Many of the patients were mistreated with antibiotics and hospitalized. The detection of HEVs in 26.7% of clinically suspected meningitis cases indicated the need for molecular tests in investigating the etiology of meningitis. Therefore, we suggest the introduction of molecular tests as a routine practice in referral hospitals and the need to further characterize circulating HEVs strains.
Subject(s)
Enterovirus Infections/epidemiology , Enterovirus Infections/virology , Hospitals , Meningitis, Viral/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Ethiopia/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young AdultABSTRACT
BACKGROUND: The poor socio-economic status, underdeveloped health care system, and the high HIV/AIDS burden have potentially increased the incidence of cervical cancer in sub-Saharan Africa (SSA) including Ethiopia. Studies on the magnitude of pre-cancerous cervical lesion and human papillomavirus (HPV) among HIV-infected women are still limited, particularly in the current study setting. Thus, we determined the prevalence of pre-cancerous cervical lesion and HPV among HIV-infected women in comparison with HIV-uninfected women at Debre Tabor Comprehensive Specialized Hospital (DTCSH), North-West Ethiopia. METHODS: Hospital-based comparative retrospective cross-sectional study was conducted among 546 women from July 2018 to January 2020 at DTCSH. All records during the study period were collected using a structured checklist. Epi data version 4.02 and SPSS version 25.0 were used for data entry and analysis, respectively. RESULTS: The overall prevalence of pre-cancerous cervical lesion among 546 women was 8.8%. The prevalence of pre-cancerous cervical lesion was comparable between HIV-infected (9.3%) and HIV-uninfected women (8.6%) (p = 0.859). Age >45 years old, widowed marital status, multiparous (women ≥ 5 childbirths), and educational status were independent contributing factors of a pre-cancerous cervical lesion. Regarding HPV prevalence, among 109 screened women, 7 (6.4%) were positive for both HPV 16 and 18 strains. CONCLUSION: HIV infection was not statistically correlated with the magnitude of pre-cancerous cervical lesion (p = 0.859). Women in the study setting developed pre-cancerous cervical lesions irrespective of their HIV status. Hence, we recommend routine screening of women for pre-cancerous cervical lesion and HPV infection regardless of their HIV status for early management and prevention of associated morbidity and/or mortality.
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BACKGROUND: Listeria monocytogenes (LM) has come to be a major public health issue of at-risk groups, causing high morbidity and mortality. Despite this data, studies are very limited in developing countries like Ethiopia. Thus, we aimed to isolate and characterize LM in terms of antibiogram and biofilm formation among pregnant women with fever, women with a history of spontaneous abortion, women with a history of fetal loss, and women with preterm delivery at Jimma University Medical Center (JUMC), southwest Ethiopia. METHODS: A cross-sectional study was done among 144 women from June to August 2019. Isolates were tested for antibiotic susceptibility and biofilm formation using disc diffusion and microtiter plate method, respectively. Data were collected using a structured questionnaire, entered into Epidata 3.1 and logistic regression was done by SPSS v25.0. RESULTS: LM was isolated in 8 (5.56%) of 144 screened women. The isolation rate of LM was relatively higher among women with a history of fetal loss (9.7%), followed by women with preterm delivery (6.25%). One of the six cord blood was positive for LM, indicating that the transplacental transmission rate at JUMC was 16.7%. More than 2% of women with an ongoing pregnancy were found to have LM septicemia, which could hurt their fetus. All of the isolates tested were susceptible to Ampicillin. However, all of the isolates were resistant to Penicillin and Meropenem and were biofilm producers. CONCLUSIONS: The high magnitude of pregnancy-related listeriosis in the current study setting appears that implementation of educational programs targeting risk reduction and more studies to identify sources of LM are warranted. The choice of antibiotics should be after susceptibility testing.
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Anti-Bacterial Agents/pharmacology , Listeria monocytogenes , Listeriosis/microbiology , Pregnancy Complications, Infectious/microbiology , Academic Medical Centers , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Humans , Listeria monocytogenes/drug effects , Listeria monocytogenes/isolation & purification , Listeriosis/prevention & control , Microbial Sensitivity Tests , Pregnancy , Pregnancy Complications, Infectious/prevention & controlABSTRACT
INTRODUCTION: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the causative agent of coronavirus disease 2019 (COVID-19), pandemics has remained to be a public health emergency of international concern. This ongoing pandemic has resulted in the death of millions of people globally. About one and a half thousand people have died due to this illness in Ethiopia. The clinical presentations of the disease vary with geography and populations. We therefore aimed at investigating the clinical characteristics of patients infected with SARS-CoV-2 in North-East Ethiopia. METHODS: real time polymerase chain reaction (PCR) was conducted for 18,112 individuals suspected of SARS-CoV-2 infection during June 27 to October 20, 2020, at Woldia university COVID-19 testing center. Recorded data of 372 Ethiopians who tested positive for SARS-CoV-2 infection at Woldia university COVID-19 testing center were retrospectively extracted and analyzed using SPSS v25.0. A P-value of < 0.05 was considered statistically significant. RESULTS: nearly 2.1% of the screened participants were found positive for SARS-CoV-2 infection. Among them, three fourth of SARS-CoV-2 infected patients were male, with an overall median age of 30 years. About 85% of the patients were asymptomatic. The most common clinical manifestations were cough (14.2%), followed by fever (11.0%) and headache (8.6%), whereas hypertension (1.6%), human immunodeficiency virus (HIV) (1.6%) diabetes mellitus (1.1%), and chronic respiratory diseases (1.1%) were relatively the most common comorbidities noted. The case-fatality ratio was found at 1.6%. Age and underlying comorbidities had a statistically significant association with severity and poor outcome of patients (P < 0.001). CONCLUSION: the finding from this study indicated that older age and people with underlying comorbidities are at high risk of having the severe disease and poor outcomes. Hence, appropriate care and priority should be given to these people to decrease the morbidity and mortality caused by this illness. The presence of higher asymptomatic infection is the possible indicator of potential asymptomatic transmissions within the community. This highlights the need for widespread testing, and contact tracing to flatten the transmission curve.
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Asymptomatic Infections/epidemiology , COVID-19 Testing , COVID-19/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/physiopathology , Child , Child, Preschool , Contact Tracing , Ethiopia/epidemiology , Female , Humans , Male , Middle Aged , Real-Time Polymerase Chain Reaction , Retrospective Studies , Risk Factors , SARS-CoV-2/isolation & purification , Severity of Illness Index , Young AdultABSTRACT
INTRODUCTION: Viral meningitis is common in most resource-limited settings, posing a challenge for the management and prognosis of suspected patients. No study has been done on the detection of either viral or viral-bacterial co-infection among presumed pyogenic meningitis cases in Ethiopia. We, therefore, aimed to determine the distribution of cytomegalovirus (CMV) and human enteroviruses (HEVs) among patients with presumptive pyogenic meningitis at University hospitals in Ethiopia. METHODS: Viral nucleic acid was extracted from 86 repository CSF samples, which were collected from patients presumptively diagnosed with pyogenic meningitis between 2012 and 2013. PCR was done consecutively to investigate the possible viral etiologic agents of meningitis. RESULTS: HEVs were detected in 11 (12.8%) of the analyzed samples while none of the 86 samples were tested positive for CMV. Viral-bacterial co-infections were found among 4/11 (36.4%) confirmed cases. The majority of the patients (10/11) with HEVs were younger aged ≤ 19 years old. CONCLUSIONS: In this study, the magnitude of HEVs was shown to have a significant role in presumed pyogenic meningitis cases. Therefore, we recommend presumed pyogenic meningitis cases to be inspected for viral etiologies and improve meningeal symptoms interpretations.
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Subclinical human cytomegalovirus (HCMV) replication is associated with immune dysfunction in immuno-suppressed antiretroviral therapy (ART) naive HIV infected individuals. No data is documented in Ethiopia so far concerning HCMV co-infection among HIV infected individuals. Hence, this study was aimed at generating data regarding the prevalence of active HCMV infection among treatment-naive HIV-infected individuals from Ethiopia. For this purpose, we enrolled 97 treatment-naive HIV infected study subjects in Addis Ababa from June to December 2018. ELISA and conventional PCR were performed consecutively to detect HCMV specific IgM antibody and HCMV DNA respectively. Of the 97 study subjects, 12 (12.4%) were positive for anti-CMV IgM antibodies but were not confirmed by PCR. With regard to the PCR positivity, 4/97 (4.1%) samples were positive for HCMV DNA. No statically significant associations were found between the dependent and independent variables. The presence of HCMV DNA in the current study highlights the need for a routine laboratory diagnosis for preventing HCMV disease among HIV-infected individuals early. Besides, the use of anti-CMV therapy for these CMV viremic individuals is also recommended as this can reduce the burden of CMV complications and consecutively prolonging the life of HIV infected individuals.
Subject(s)
Antibodies, Viral/metabolism , Cytomegalovirus Infections/epidemiology , Cytomegalovirus/physiology , DNA, Viral/genetics , HIV Infections/epidemiology , Adult , Cross-Sectional Studies , Cytomegalovirus/genetics , Cytomegalovirus/immunology , Cytomegalovirus Infections/virology , Ethiopia/epidemiology , Female , HIV Infections/immunology , HIV Infections/virology , HIV-1/physiology , Humans , Immunoglobulin M/metabolism , Male , Middle Aged , Prevalence , Viral Load , Young AdultABSTRACT
Meningitis is one of the top ten causes of death among Ethiopian infants. Group B streptococcus (GBS) has emerged as a leading cause of meningitis in neonates and young infants, resulting in high mortality. Despite this, there is no report on GBS associated meningitis in Ethiopia where infant meningitis is common. Hence, the aim of this study was to determine the proportion of GBS associated meningitis among Ethiopian infants. PCR was prospectively used to detect GBS in culture-negative cerebrospinal fluid (CSF) samples, which were collected from infants suspected for meningitis, at Tikur Anbessa specialized hospital, Ethiopia, over a one-year period. GBS was detected by PCR in 63.9% of culture-negative CSF samples. Out of the 46 GBS positive infants, 10.9% (n = 5) of them died. The late onset of GBS (LOGBS) disease was noted to have a poor outcome with 3 LOGBS out of 5 GBS positive samples collected from patients with the final outcome of death. PCR was advantageous in the identification of GBS in culture-negative CSF samples. GBS was detected in 64% of the CSF samples from infants with meningitis compared with zero-detection rate by culture.
Subject(s)
Meningitis, Bacterial , Polymerase Chain Reaction , Streptococcal Infections , Streptococcus agalactiae/genetics , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Bacterial/epidemiology , Meningitis, Bacterial/genetics , Streptococcal Infections/cerebrospinal fluid , Streptococcal Infections/epidemiology , Streptococcal Infections/geneticsABSTRACT
On 11 March 2020, the World Health Organization (WHO) announced Corona Virus Disease (COVID-19), a disease caused by a pathogen called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a pandemic. This ongoing pandemic has now been reported in 215 countries with more than 23 million confirmed cases and more than 803 thousand deaths worldwide as of August 22, 2020. Although efforts are undergoing, there is no approved vaccine or any specific antiretroviral drug to treat COVID-19 so far. It is now known that SARS-CoV-2 can affect not only humans but also pets and other domestic and wild animals, making it a one health global problem. Several published scientific evidence has shown that bats are the initial reservoir hosts of SARS-CoV-2, and pangolins are suggested as an intermediate hosts. So far, little is known concerning the role of pets and other animals in the transmission of COVID-19. Therefore, updated knowledge about the potential role of pets in the current outbreak will be of paramount importance for effective prevention and control of the disease. This review summarized the current evidence about the role of pets and other animals in the transmission of COVID-19.