The prevalence of intestinal parasites, undernutrition and their associated risk factors among school-age children in Sekota Town, Northeast Ethiopia: A community-based cross-sectional study.

Background and Aims: In developing countries, intestinal parasitic infections and malnutrition are among the most serious health issues affecting school-aged children. They have synergetic consequences. This study aimed to determine the prevalence of intestinal parasites, undernutrition, and their associated risk factors among school-age children. Methods: A community-based cross-sectional study was conducted from April to June 2021 among school-age children in Sekota Town, Northeast Ethiopia. Households were selected using a systematic random sampling technique. Risk factor variables were collected using pretested questionnaires. Stool samples were collected from study participants and examined using a wet mount, formol-ether concentration, and modified acid-fast techniques. The height and weight of children were also measured using a meter and a standard calibrated balance, respectively. Data were analyzed using SPSS version 26.0 statistical software. Results: The overall prevalence of intestinal parasites among school-age children was 44.3% (178/402). About seven species of intestinal parasites were identified. The predominant parasite identified was E. histolytica/dispar (11.2%), followed by H. nana (9.2%) and G. lamblia (6.7%). The well as a source of drinking water (adjusted odds ratio [AOR] = 7.93; 95% confidence interval [CI]: 4.38-14.36), habit of open-field defecation (AOR = 7.02; 95% CI: 13.05-12.06), and being undernourished (AOR = 5.67; 95% CI: 2.98-10.79) were independent predictors of intestinal parasitic infections. On the other hand, the overall prevalence of undernutrition was 46.3%. Undernutrition was significantly more likely in children with a dietary diversity score (DDS) of 3 (AOR = 3.73, 95% CI: 2.37-5.88), meal frequency of no more than three times per day (AOR = 2.00, 95% CI: 1.71-2.98), intestinal parasite infection (AOR = 5.25, 95% CI: 3.24-8.52), and no access to school-based feeding (AOR = 3.52, 95% CI: 2.17-7.96). Conclusion: The prevalence of intestinal parasitic infections and undernutrition was high among school-age children in Sekota Town. The results imply the need for strengthening integrated strategies for the reduction of intestinal parasitic infections and undernutrition.

Therapeutic efficacy of Chloroquine for the treatment of uncomplicated Plasmodium vivax infection in Shewa Robit, Northeast Ethiopia.

BACKGROUND: The development of drug resistance to chloroquine is posing a challenge in the prevention and control efforts of malaria globally. Chloroquine is the first-line treatment for uncomplicated P.vivax in Ethiopia. Regular monitoring of anti-malarial drugs is recommended to help early detection of drug-resistant strains of malaria parasites before widely distributed. The emergence of P.vivax resistance to chloroquine in the country endangers the efficacy of P.vivax treatment. This study aimed to assess the therapeutic efficacy of chloroquine among uncomplicated P.vivax infections at Shewa Robit Health Center, northeast Ethiopia. METHODS: One-arm in vivo prospective chloroquine efficacy study was conducted from November 2020 to March 2021. Ninety participants aged between 16 months to 60 years confirmed with P.vivax mono-infection microscopically were selected and treated with a 25 mg/kg standard dose of chloroquine over three days. Thick and thin blood smears were prepared and examined. Clinical examination was performed over 28 follow-up days. Hemoglobin concentration level was measured on days 0, 14, and 28. RESULT: Of the 90 enrolled participants, 86 (96%) completed their 28 days follow-up period. The overall cure rate of the drug was 98.8% (95% CI: 95.3-100%). All asexual stages and gametocytes were cleared within 48 hours with rapid clearance of fever. Hemoglobin concentration had significantly recovered between days 0 and 14, 0 and 28, and 14 and 28 days (P = 0.032, P<0.001, and P = 0.005), respectively. Fast resolution of clinical signs and symptoms was also observed. Severe adverse events were not recorded. CONCLUSION: The present study revealed that chloroquine remains an efficacious and safe drug in the study setting for treating uncomplicated P.vivax in the study area. Large-scale continuous surveillance is needed to monitor the development of resistance in due time.

High Prevalence of Hookworm Species and Associated Factors among Soil-Transmitted Helminth-Infected Household Contacts in Burie Zuria District, Northwest Ethiopia: A Community-Based Cross-Sectional Study.

Background: Soil-transmitted helminths (STHs) are parasitic worms that are widely distributed in the tropical and subtropical regions. In Ethiopia, one of the tropical countries, STH infections are high and cause a huge burden. Several STH species show a pattern of household clustering with regard to prevalence and intensity. However, there is a scarcity of data on the status of STH infection among family contacts of STH-infected individuals in Ethiopia in general and in the study area in particular. Objective: This study is aimed at assessing the prevalence of soil-transmitted helminths and associated factors among STH-infected household contacts in Burie Zuria district, northwest Ethiopia. Method: A community-based cross-sectional study was conducted among 422 study participants from March to May 2021. Study participants were traced to their residences by following STH-infected patients. A convenient sampling technique was used to recruit the study participants. The stool samples were processed using duplicate Kato-Katz thick smears and a modified Ritchie's technique. The data were entered and analyzed using the Statistical Package for Social Sciences, version 26 of the software package. A P value <0.05 was considered a statistically significant association. Results: The overall prevalence of STHs was 36.5% (95% CI: 31.7%-41.5%). Two STHs, namely hookworm species (33.2%, 140/422) at (95% CI: 28.9%-37.8%) and Ascaris lumbricoides (4.3%, 18/422) at (95% CI: 2.7%-6.6%), were identified, with a double infection of 2.6% (4/154) at (95% CI: 1.0%-6.5%). Almost the majority (96.9%) of hookworm species and all Ascaris lumbricoides infections were categorized under a light intensity of infection. Family size >5 (AOR = 1.74; 95% CI: 1.15-2.60; P = 0.008) and lack of latrine facility (AOR = 1.86; 95% CI: 1.17-2.90; P = 0.02) were significantly associated with STH infections. Conclusion: A high prevalence of hookworms was found in the study area, where the majority of the study participants were adults. This finding may provide a basis for revising the school-based deworming programs that exclude the adult population. Public health interventions like accessing latrines, health education, and deworming programs should be regularly implemented for all age groups in the areas.

Soil Contamination and Infection of School Children by Soil-Transmitted Helminths and Associated Factors at Kola Diba Primary School, Northwest Ethiopia: An Institution-Based Cross-Sectional Study.

Background: Soil-transmitted helminths (STHs) are among the most prevalent parasitic worms infecting humans worldwide. They are still a major public health concern in the developing world, school-age children being the most affected segment of the population. Soil polluted with parasite ova and/or infective larvae is a source of human parasitic infections. There is a substantial shift in the notion of sanitation in many countries, and control of STHs contamination in the environment is becoming an emerging topic of research. However, data are scarce on the extent of soil contamination with STHs in Ethiopia in general and the study area in particular. Objective: This study aimed to determine the prevalence of STHs in soil, and school children and associated factors at Kola Diba primary school, Northwest Ethiopia. Methods: A school-based cross-sectional study was conducted in 2020 at Kola Diba primary school. A systematic random sampling technique was used to select 400 participants. About 150 soil samples were collected. A structured Amharic version questionnaire was used to collect data on sociodemographic variables and the factors associated with STH infection. Two grams of stool specimen was processed using the Kato-Katz technique. Data were entered and analyzed using STATA version 14.1. Binary and multiple logistic regressions were performed, and P < 0.05 was considered statistically significant. Result: The overall prevalence of soil-transmitted helminths was 50.0% with Ascaris lumbricoides (26.2%), hookworm species (16.5%), and Trichuris trichiura (3.5%). The overall soil contamination rate was 13.3% with A. lumbricoides (9.3%) and T. trichiura (4.0%). No habit of handwashing after toilet (AOR; 2.2, 95%CI: 1.3-3.6, P value = 0.002), no habit of regular shoe-wearing (AOR; 3.7, 95%CI: 2.1-6.2, P value <0.001), untrimmed fingernail status (AOR; 4.3, 95%CI: 2.6-7.1, P value <0.001), and playing with soil (AOR; 3.5, 95%CI: 2.2-5.7, P value <0.001) were significantly associated with STHs infection. Conclusion: The prevalence of STHs remains high among primary school children, with a considerable soil contamination rate. No habit of handwashing after defecation, untrimmed fingernail status, and no habit of regular shoe-wearing and playing with soil were significantly associated with the STHs infections.

Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia.

Background: Malaria is the leading vector-borne parasitic disease that is causing high morbidity and mortality worldwide. So far huge efforts to control and eliminate malaria are hindered by the occurrence of asymptomatic carriers that are a potential source of infection. Yet, there is a scarcity of data nationally and in the current study area as well. Therefore, this study was aimed to assess the prevalence of asymptomatic malaria in Northeast Ethiopia. Methods: A community-based cross-sectional study was conducted in 2019 involving a total of 270 study participants recruited via purposive non-probability sampling technique. A structured questionnaire was used to collect data on sociodemographic characteristics, individual and household factors related to asymptomatic malaria. Data were entered in Epi Data 3.1 version and analyzed by using SPSS version 20, and p< 0.05 was considered statistically significant. Results: The overall prevalence of asymptomatic malaria was 7.0%, with 3.0%, 5.2%, and 12.0%, respectively by Rapid diagnostic tests (RDT), Microscopy and Polymerase chain reaction (PCR). The majority of infections (73.7%) were identified from index households. Previous malaria history (AOR: 4.030, 95% CI: 1.021-15.903), living with index cases (AOR: 3.880, 95% CI: 1.275-11.806) and family size > 6 members (AOR: 4.820, 95% CI: 1.260-18.437) were significant predictors of asymptomatic malaria. Conclusion: Reactive case detection had identified considerably higher asymptomatic malaria cases in the community. Therefore, active case investigation should be established in the community by tracking the symptomatic cases at the health facilities.

Prevalence of malaria and associated factors among symptomatic pregnant women attending antenatal care at three health centers in north-west Ethiopia.

BACKGROUND: Malaria is the disease caused by Plasmodium species and primarily transmitted by the bite of female Anopheles mosquitoes. During pregnancy, malaria causes life threatening outcomes to the mother, the fetus and the new born. Even though, malaria symptomatic pregnant women highly attract mosquitoes and have higher potential of transmitting the disease in communities, most of the previous studies focused on pregnant women with asymptomatic Plasmodium infections. Therefore, the aim of this study was to assess the prevalence of malaria and associated factors among symptomatic pregnant women attending antenatal care at three health centers in northwest Ethiopia. METHODS: A health facility based cross-sectional study was conducted from February to April, 2021. A total of 312 malaria symptomatic pregnant women were involved from three health centers and enrolled by convenient sampling technique. A questionnaire was used to collect socio demographic and clinical data through face to face interview. Capillary blood samples were collected and used to prepare thin and thick blood smears, which were then stained using 10% Giemsa and examined under light microscope. Logistic regression was used to assess factors associated with malaria. Adjusted odds ratio with 95% confidence interval was calculated and P-value < 0.05 was considered statistically significant. RESULTS: The prevalence of malaria among symptomatic pregnant women was 20.8% (65/312) of which 12.2% (38/312), 4.8% (15/312) and 3.8% (12/312) were P. falciparum, P. vivax and mixed infections, respectively. Being illiterate (p< 0.001), first trimester (p = 0.036), primigravidae (p<0.001), living far from health center (p<0.001), not sleeping under long lasting insecticide treated nets (p<0.001) and living near irrigation areas (p = 0.006) were significantly associated with prevalence of malaria in malaria symptomatic pregnant women. CONCLUSIONS: Even though prevalence of malaria is decreasing in the country because of scale-up of intervention and prevention measures, this study showed that, malaria is still the major public health problem among pregnant women. Being illiterate, first trimester, primigravidae, living far from health centers, not sleeping under long lasting insecticide treated nets and living near irrigation areas were factors that increased the prevalence of malaria in malaria symptomatic pregnant women. Therefore, special attention should be given to pregnant women prone to these factors.

Determinants of Helminthic Infections and Anemia among Schoolchildren in Bahir Dar Zuria District, Northwest Ethiopia.

BACKGROUND: Soil-transmitted helminths and Schistosoma mansoni are the major helminthic parasites that cause major public health problems among schoolchildren in developing countries. Infection with the above parasites decreases the hemoglobin level of children. However, information regarding the current status of helminthic infections and anemia is limited. Hence, this study aimed to assess the prevalence and determinants of helminthic infections and anemia among children. METHODS: A cross-sectional study was conducted among 394 schoolchildren at Sekelet primary school in northwest Ethiopia, from February to March 2017. Study participants were selected by a systematic random sampling technique. Stool samples were collected and processed via the modified Ritchie's concentration technique to detect parasites in stool. A HemoCue Hb 201 analyzer was used to determine the hemoglobin level. Data were analyzed using SPSS version 23 statistical software. Association of helminthic infections and anemia with independent variables was determined using logistic regression analysis. Variables with P < 0.05 were considered statistically significant. RESULTS: From the total of 394 participants, 185 (46.9%), 164 (41.6%), and 112 (28.4%) were infected with intestinal parasites, helminths, and STHs, respectively. The prevalence of hookworm and Schistosoma mansoni were 106 (25.6%) and 54 (13.7%), respectively. The prevalence of anemia among the schoolchildren was 278 (70.6%). Anemia was prevalent among 55 (51.9%) hookworm-infected and 19 (35.2%) S. mansoni-infected children. Not wearing shoes and improper utilization of latrine were significantly associated (P < 0.05) with hookworm infection, and frequent swimming in the river was also significantly associated (P ≤ 0.001) with Schistosoma mansoni infection. Schistosoma mansoni and hookworm infections were also significantly associated (P ≤ 0.001) with low levels of hemoglobin. CONCLUSION: Hookworm and Schistosoma mansoni infections and anemia are highly prevalent among schoolchildren. Hookworm and Schistosoma mansoni infections are significantly associated with anemia. Therefore, helminthic detection and hemoglobin determination should be done simultaneously among schoolchildren.

Efficacy of Mebendazole and Praziquantel against Soil-Transmitted Helminths and Schistosoma mansoni Infections among Schoolchildren in Northwest Ethiopia.

BACKGROUND: Soil-transmitted helminths (STHs) and Schistosoma mansoni are the main causes of morbidity among schoolchildren in the tropics. A school-based deworming program was launched to control and eliminate the infection in endemic countries including Ethiopia. Although periodic deworming is conducted in endemic areas, the prevalence of the infection is high in the country. In addition, periodic evaluation of the efficacy of the anthelminthic drug is limited. OBJECTIVE: This study is aimed at checking the efficacy of mebendazole and praziquantel with the respective STHs and Schistosoma mansoni parasites. METHODS: A longitudinal study was conducted from February to March 2018 among 422 schoolchildren. Stool samples were collected at baseline and at 2 and 4 weeks posttreatment and were processed using the Kato-Katz technique. Schoolchildren positive for STHs were treated with mebendazole and those positive for Schistosoma mansoni with praziquantel. After two weeks, a second round of stool was collected and examined, and then, single-dose redosing was given to each positive child. Lastly, the third stool sample was collected two weeks after the initiation of the redosing and checked for STHs and S. mansoni parasites. A close follow-up of students who were treated was done. All the data were entered and analyzed using SPSS version 20 for analysis. Descriptive statistics was used to compute the cure rate and egg reduction rate of mebendazole and praziquantel. RESULTS: Among 422 participants, the prevalence of STHs, hookworm, Ascaris lumbricoides, and S. mansoni was 44.7%, 35.1%, 21.1%, and 13.9%, respectively. The cure rate of mebendazole against A. lumbricoides increased from 60% in the single dose to 100% in redosing after two weeks. The cure rate of mebendazole against hookworm also increased from 32.4% in the single dose to 91.0% in the redosing. The cure rate of praziquantel against S. mansoni-infected children was 91.5% in the first round and 100% in the redosing phase. There was a 98.6-100% egg reduction rate in the redosing regimen of both drugs. CONCLUSION: The cure and egg reduction rates of single-dose mebendazole in the treatment of hookworm and A. lumbricoides are lower at week two than at redosing, while cure and egg reduction rates of single-dose praziquantel are satisfactory to treat S. mansoni. Therefore, single-dose praziquantel to S. mansoni and redosing of single-dose mebendazole to A. lumbricoides and hookworm infections can be used for treatment purposes.

Prevalence of Opportunistic Intestinal Parasitic Infections Among HIV/AIDS Patients Before and After Commencement of Antiretroviral Treatment at Felege Hiwot Referral Hospital: A Follow-up Study.

BACKGROUND: Coccidian parasites are opportunistic intestinal parasites that cause diarrhea in immunocompromised individuals. Although the impacts of coccidian infection are significant among HIV/AIDS infected cases, proper diagnosis and management of coccidian infection is limited in sub-Saharan Africa including Ethiopia. OBJECTIVE: The aim of this study was to determine the prevalence of coccidian parasitic infections among HIV/AIDS cases before and after commencement of antiretroviral treatment. METHODS: An institution-based longitudinal study was conducted among 304 randomly selected HIV/AIDS cases from February to July 2018 before and after commencement of antiretroviral therapy. A structured questionnaire was used to collect sociodemographic and associated factors data. Stool and blood samples were collected before and three months after treatment. Coccidian detection and CD4+ count were conducted via modified acid fast stain technique and fluorescence-activated cell scanning, respectively. Data were entered and analyzed using SPSS version 20. Descriptive statistics were used to compute coccidian prevalence. Logistic regression was used to compute possible association between associated factors and coccidian parasitic infection. Variables with P<0.05 were considered to be statistically significant. RESULTS: Among 304 HIV/AIDS cases, prevalence of coccidian parasitic infection before and after antiretroviral treatment was 23.4% and 8.9%, respectively. Prevalence of Cryptosporidium spp. (19.7%) and Isospora belli (4.3%) before antiretroviral treatment were higher than Cryptosporidium spp. (7.9%) and Isospora belli (1.0%) after treatment. Drinking unprotected water (AOR: 7.41; 95%CI: 1.64-33.45), poor knowledge of HIV/AIDS and coccidian parasite (AOR: 4.19; 95%CI: 1.69-10.40), and CD4+ count below 200 cells/mm3 (AOR: 62.49; 95%CI: 25.32-154.21) were significantly associated with coccidian infection. CONCLUSION: Prevalence of coccidian parasites among HIV/AIDS cases decreases after antiretroviral treatment. Drinking unsafe water, limited knowledge of HIV/AIDS and coccidian parasite and low CD4+ cell count are factors associated with coccidian infection. Therefore, proper detection and treatment of coccidian parasites among HIV/AIDS cases should be prioritized.

Species Composition, Parous Rate, and Infection Rate of Anopheles Mosquitoes (Diptera: Culicidae) in Bahir Dar City Administration, Northwest Ethiopia.

Anopheles mosquitoes are the main vectors of malaria. There is little information on the current entomological aspects of Anopheles mosquitoes in Amhara region of northwestern Ethiopia. Therefore, the aim of this study was to assess the prevailing species composition, parous rate, and infection rate of Anopheles mosquitoes in the Bahir Dar city administration. A community-based cross-sectional study was conducted from January through July 2020. For this, six Centers for Disease Control and Prevention light traps (three traps indoor and three traps outdoor) were used to collect adult female Anopheles mosquitoes. The species were morphologically identified, and the parous and infection rates were determined via dissection of ovaries and salivary gland, respectively. A total of 378 adult female Anopheles mosquitoes comprised of three species (Anopheles d'thali, Anopheles rhodesiensis, and Anopheles gambiae complex) were collected and identified at the study sites. Anopheles rhodesiensis was the predominant species accounting for 90% of all collections at the Zenzelima site, followed by An. gambiae complex (6.5%). In contrast, An. gambiae complex was the predominant species at the Tis Abay site, comprising 94% of captures. The overall parous and infection rates were 35 (62.5%) and 1 (2.9%), respectively.

Performance Evaluation of Diagnostic Methods for Schistosoma mansoni Detection in Amhara Region, Northwest Ethiopia.

BACKGROUND: Schistosoma mansoni is a parasitic worm that infects humans throughout the world. It is more prevalent in sub-Saharan Africa including Ethiopia. Proper detection of Schistosoma mansoni using sensitive diagnostic methods is crucial in the prevention and control era. Since direct wet mount microscopy with its low sensitivity has been used as a diagnostic technique in Ethiopia, searching alternative diagnostic methods which have better sensitivity should be a priority agenda. OBJECTIVE: This study is aimed at evaluating the performance of diagnostic methods for Schistosoma mansoni in Amhara region. METHODS: A cross-sectional study was conducted among 520 school children from October to December 2019 in Amhara region. The study participants were selected by a systematic random sampling technique. Stool samples were collected from each participant and processed via formol-ether concentration, Kato-Katz, and spontaneous tube sedimentation techniques. The data was entered into EpiData version 3.1, and analysis was done using SPSS version 20. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated against the combined result as "Gold" standard. A kappa value was computed to measure the strength of agreement of the diagnostic methods. RESULTS: The overall prevalence of Schistosoma mansoni was 20.2% using a combination of three methods. The prevalence of 8.3%, 12.9%, and16.3%, respectively, was recorded by using formol-ether concentration, Kato-Katz, and spontaneous tube sedimentation. The spontaneous tube sedimentation method (81.0%) had better sensitivity compared to Kato-Katz (63.8%) and formol-ether concentration (41.0%) methods in Schistosoma mansoni detection. CONCLUSION: The spontaneous tube sedimentation technique is more sensitive and has better detection rate to Schistosoma mansoni infection followed by the Kato-Katz technique. Therefore, updating the current diagnostic methods for Schistosoma mansoni could be a priority agenda to take action in schistosomiasis prevention and control.

Evaluating the performance of diagnostic methods for soil transmitted helminths in the Amhara National Regional State, Northwest Ethiopia.

BACKGROUND: Soil-transmitted helminths are more prevalent in tropics and sub-tropics including Ethiopia. Despite their high prevalence, direct saline microscopy with its low sensitivity has been used as a diagnostic method in almost all health facilities in Ethiopia. Alternative diagnostic methods which have higher sensitivity are not yet implemented. Therefore, this study aimed to compare and evaluate the performance of diagnostic methods for soil transmitted helminths. METHODS: A cross-sectional study among 520 school children was conducted from October to December, 2019 in Amhara National Regional State. The study participants were selected using systematic random sampling technique. Stool samples were processed via formol ether concentration, Kato-Katz, spontaneous tube sedimentation and agar plate culture techniques. Data was entered into Epi-data version 3.1 and analysis was done using SPSS version 20.0. The sensitivity, specificity, and negative predictive value were calculated against the combined result. Strength of agreement of the diagnostic methods was determined by Kappa value. RESULTS: The Overall prevalence of soil transmitted helminths was 40.8% using combination of methods. The prevalence 24.4, 22.5, and 32.4%, respectively was recorded by using formol ether concentration, Kato-Katz and spontaneous tube sedimentation. The highest prevalence of hookworm (29.2%) was detected by the agar plate culture. The sensitivity and negative predictive value of formol ether concentration were 57.9 and 78.4%, for Kato-Katz thick smear 55.2 and 76.4%, for spontaneous tube sedimentation were 79.2 and 87.5% to soil transmitted helminths detection, respectively. The sensitivity and negative predictive value of agar plate culture to hookworm detection were 86.4 and 93.5%, respectively. CONCLUSION: Spontaneous tube sedimentation shows higher sensitivity in the detection of soil transmitted helminth infections. Agar plate culture method also indicated better performance for hookworm detection than other methods. Therefore, the employment of spontaneous tube sedimentation technique for routine laboratory and agar plate culture for research purposes will significantly aid in accurate diagnosis of parasitic infections.

Parasitic Contamination of Fruits and Vegetables Collected from Local Markets of Bahir Dar City, Northwest Ethiopia.

BACKGROUND: Fruits and vegetables, which are consumed raw, act as potential sources for the spread of various parasitic diseases. The rate of contamination and species of contaminant parasites varies based on climatic, ecological, and human factors. Therefore, local data about the contamination status and predisposing factors augments efforts for successful control of parasitic diseases. METHODS: A cross-sectional study was conducted on fruits and vegetables collected from local markets of Bahir Dar city from February to May 2019. A total of 384 samples were purchased from three randomly selected markets. Data on sociodemographic characteristics of vendors and factors associated with contamination of fruits and vegetables were collected using a structured questionnaire. About 200 g of fruit and vegetable samples were processed for parasites using direct wet mount and modified Zeihl-Neelson staining techniques following standard protocols. All data were analyzed using SPSS version 23. RESULTS: Among a total of 384 fruit and vegetable samples purchased from 112 vendors, 150 (39.1%) were contaminated with at least one species of parasite. Lettuce (56.4%) and mango (16.7%) were the most and the least commonly contaminated items respectively. Larva of Strongyloides species (13.5%) was the most frequently detected parasite followed by cysts of Entamoeba histolytica/E. dispar (12.8%). Contamination was more common in vegetables than fruits (AOR=2.968, p<0.001). Fruits and vegetables purchased from vendors with untrimmed fingernails (AOR=1.966, p=0.006), directly delivered from farmers (AOR=1.883, p=0.040), displayed in bucket with water (AOR=2.676, p=0.017) and those displayed without washing (AOR=5.511, p<0.001) were significantly associated with parasitic contamination. CONCLUSION: The level of parasitic contamination of fruits and vegetables in Bahir Dar city is of public health importance. Hence, the public health sector should create public awareness in order to reduce parasitic transmission via fruits and vegetables.

Correction to: Foodborne intestinal protozoan infection and associated factors among patients with watery diarrhea in Northern Ethiopia; a cross-sectional study.

In the publication of this article [1], the contributing author name Brhane Berhe contains an error.

Magnitude of Intestinal Parasitosis and Associated Factors in Rural School Children, Northwest Ethiopia.

BACKGROUND: Intestinal parasitoses are among the most commonly encountered infections among school children in poor regions of the world. Up to 600 million school children are living in areas where there is high transmission of parasitic worms. Intestinal parasitic infection has been found to have a great effect on nutritional and cognitive status, school absenteeism and dropouts among school age children. This study aimed at determining the prevalence of intestinal parasites infections and associated factors among children in a rural primary school, Northwest Ethiopia. METHODS: A cross-sectional study was conducted in May 2016 among Gob Gob Primary School children. The study participants were provided with labeled stool cups to give stool specimen. The stool samples were processed via direct wet mount and formal-ether concentration techniques. A structured questionnaire was used to collect demographic data and data on factors associated with intestinal parasitic infection through face-to-face interview. RESULTS: Out of the 273 school children, 84(30.8%) were infected with at least one parasite species. Higher proportion of intestinal parasitic infection was recorded for boys (38.9%), the age group 6-10 years (38.9%), children with untrimmed finger nails (36.4%) and among those whose drinking water was from a stream (56.1%). The predominant species identified were A. lumburicoides 28(33.3%), H. nana 12(14%), E. histolytica/dispar 11(13%), G. lamblia 9(11%), hookworms 7(8.3%), Taenia spp 6(7%), E. vermicularis 6(7%), T. trichuria 4(4.8%) and S. stericoralis 1(1.2%). CONCLUSION: This study showed that intestinal parasites were prevalent among the school children in focus. Ascaris lumbricoides was the predominant species.

Magnitude of intestinal parasitosis and associated factors in rural school children, Northwest Ethiopia

BACKGROUND: Intestinal parasitoses are among the most commonly encountered infections among school children in poor regions of the world. Up to 600 million school children are living in areas where there is high transmission of parasitic worms. Intestinal parasitic infection has been found to have a great effect on nutritional and cognitive status, school absenteeism and dropouts among school age children. This study aimed at determining the prevalence of intestinal parasites infections and associated factors among children in a rural primary school, Northwest Ethiopia. METHODS: A cross-sectional study was conducted in May 2016 among Gob Gob Primary School children. The study participants were provided with labeled stool cups to give stool specimen. The stool samples were processed via direct wet mount and formal-ether concentration techniques. A structured questionnaire was used to collect demographic data and data on factors associated with intestinal parasitic infection through face-to-face interview. RESULTS: Out of the 273 school children, 84(30.8%) were infected with at least one parasite species. Higher proportion of intestinal parasitic infection was recorded for boys (38.9%), the age group 6-10 years (38.9%), children with untrimmed finger nails (36.4%) and among those whose drinking water was from a stream (56.1%). The predominant species identified were A. lumburicoides 28(33.3%), H. nana 12(14%), E. histolytica/dispar 11(13%), G. lamblia 9(11%), hookworms 7(8.3%), Taenia spp 6(7%), E. vermicularis 6(7%), T.trichuria 4(4.8%) and S. stericoralis 1(1.2%). CONCLUSION: This study showed that intestinal parasites were prevalent among the school children in focus. Ascaris lumbricoides was the predominant species

Magnitude and associated factors of postpartum morbidity in public health institutions of Debre Markos town, North West Ethiopia.

BACKGROUND: Postpartum maternal morbidity is maternal illness that occurs after one hour of expulsion of placenta up to six weeks of childbirth. Though the true burden of this problem is not well known estimates of WHO, UNICEF and UNFPA showed that 1.4 million women experience acute obstetric morbidity annually. Knowledge of magnitude and predicting factors postpartum morbidity is central to understand the extent of the problem and will help as a cornerstone in designing and implementing better preventive strategies. OBJECTIVES: To assess the magnitude and factors associated with postpartum morbidity in public health institutions in Debre Markos town. METHOD: Institutional based cross sectional study was conducted in Debre Markos town public health institutions by reviewing delivery charts, delivery records and reporting log books. Total deliveries in each health institution in the previous year were identified and number of records to be included from each institution was determined by probability proportion to size. Systematic sampling technique was employed to select 308 charts for review. Data was collected by trained midwifes using structured checklist; entered by epi info and analyzed using SPSS 20. To present findings descriptive statistics using frequencies, charts and figures were used accordingly. Finally binary and multiple logistic regressions were performed to identify predicting factors. RESULTS: The magnitude of postpartum morbidity was found to be 101(32.8%). Divorced/widowed women [AOR = 10.920, 95% CI: (2.168, 54.998)], women who didn't have ANC follow up [AOR = 3.710, 95% CI: (1.749, 7.870)], abnormal labour [AOR =3.496, 95% CI: (1.69, 7.22)], women delivered by doctor [AOR =0.111, 95% CI: (0.027, 0.454)] and women who were not attended postpartum visit [AOR =0.088, 95% CI: (0.040, 0.194)] were the factors associated with postpartum maternal morbidity. CONCLUSION: Maternal morbidity in Debre Markos health institution was found to be major maternal health issue. Being divorced/widowed, absence of ANC visit, intrapartum abnormalities, delivery attended by skilled professionals and no post-partum visit were important predictors of maternal postpartum morbidity.

Incidence of Plasmodium infections and determinant factors among febrile children in a district of Northwest Ethiopia; a cross-sectional study.

BACKGROUND: According to the Ethiopian national malaria indicator survey of 2015, the highest burden of Plasmodia infection resided among the school-age children. Even though several studies revealed various determinant factors of childhood malaria, consistent findings are not reported across the nation and elsewhere. This in turn creates obstacles in implementing exactprevention and control measures in the study area in particular and the country at large. OBJECTIVES: The aim of this study is to determine the incidence of Plasmodium and determinant factors among febrile children in Northwest Ethiopia. METHODS: This cross-sectional study was conducted from April-August 2016. Blood samples were collected from febrile children selected by systematic random sampling. Thin and thick blood films were prepared and stained with Giemsa. Statistical analysis was done via SPSS version 20 statistical software and data were summarized with percentages and frequencies. The bi-variate and multi-variate logistic regressions were used to measure strength of association between Plasmodium infection and determinant factors, and to rule out confounders, respectively. RESULT: Among a total of 333 febrile children, 146 (43.8%) were positive for the Plasmodia. The prevalence of plasmodium infection was 47%, 50%, and 40%, among the age groups of 6-8, 9-10 and 11-14 years, respectively. Prevalence of plasmodium among male and female children was 44.2% and 43.5%, respectively. Shorter distance from stagnant water (AOR (adjusted odds ratio) =43, 95% CI (confidence interval):2.8-680.7; P < 0.01), family size (AOR =14.7, 95% CI:(1.4-151.2; P = 0.02), outdoor sleeping (AOR =36.6, 95% CI:2.4-554.2; P < 0.01, irregular bed net use (AOR =21.1, 95% CI:2.9-154.7; P < 0.01), and late bed time (AOR =31.9, 95% CI:2.8-371.3; P < 0.01) showed statistically significant association with plasmodium infection. CONCLUSION: The incidence of Plasmodium infection is high among febrile children in the study area. Shorter distance from stagnant water, larger family size, outdoor sleeping, irregular bed net use, and late night sleeping are the major determinant factors for the high incidence of malaria. Therefore, community mobilization and health education should focus on the specific determinant factors of plasmodium infection to alleviate incidence of malaria among the school children.

Efficacy of single dose albendazole and praziquantel drugs among helminth-infected school children at Rural Bahir Dar, northwest Ethiopia.

The resistance of anthelminthic drugs makes helminth control difficult. The aim of our study was to assess the efficacy of single dose albendazole and praziquantel drugs among helminth-infected children. A cross-sectional study was conducted from April to June, 2017. Stool examination was done by the Formol-Ether concentration technique. Students infected with geohelminths and s chistosoma mansoni were treated with a single dose of albendazole and praziquantel, respectively. Post-treatment stool examination was performed after two weeks. The magnitude of parasite infection, percentage of egg count reduction and cure rate following treatment were calculated using descriptive statistics. A total of 409 Sebatamet primary school students were included. The total prevalence of intestinal parasitosis was 58%. The cure rate of albendazole against hookworm was only 76.8%. Praziquantel had a 91.4% cure rate against Schistosoma mansoni. Therefore, periodic evaluation of the efficacy of anthelminthic drugs is required.

Multivariate analysis of factors associated with Schistosoma mansoni and hookworm infection among primary school children in rural Bahir Dar, Northwest Ethiopia.

BACKGROUND: Soil-transmitted helminths and Schistosoma mansoni infections are the major causes of morbidity and mortality in Sub-Saharan countries. The highest burden of the disease resides in school-age children. Poor water sanitation and hygiene are believed to be the major contributing factors for the high prevalence. Therefore, the goal of this study was to determine the prevalence of intestinal parasite infections in rural Bahir Dar, Northwest Ethiopia. METHODS: A cross-sectional study was conducted from April 2017-June 2017 among 409 randomly selected primary school children. A structured questionnaire was used to obtain socio-demographic information and determinant factors through interviewing the students. Stool examination was done by Ritchie's concentration method. The data were entered and analyzed using SPSS version 22. Prevalence of helminthic infections was calculated using descriptive statistics. The association between helminthic infection and determinant factors was determined by Bavarian regression. The confounding effect was checked by multivariate regression at 95% confidence interval. Any association was significant when the p-value was < 0.05. RESULT: The overall prevalence of intestinal parasite infection was 47.2%.(193/409).. The prevalence of Hookworm species and Schistosoma mansoni was 31.1 and 8.0%, respectively. Co-infection of Hookworm species with Schistosoma mansoni was 5.1% (21/409). The highest prevalence of Schistosoma mansoni was recorded for boys (21%), older children (21.4%) and rural children (17.6%) (P < 0.05). Schistosoma mansoni infection was also higher among children whose household drinking water was sourced from streams/rivers (P < 0.05). The multivariate analysis showed lower odds of Schistosoma mansoni infection for those with no history of bathing (AOR = 3.7, 95% CI: 1.1-12.2; P = 0.034), washing clothes/utensils (AOR = 3.4; 95% CI: 1.2-9.7; P = 0.022), swimming (AOR = 2.8, 95% CI: 1.2-6.9; P = 0.023), and irrigation (AOR = 2.8, 95% CI: 1.3-6.0; P = 0.01). Significantly, higher odds of Hookworm infection was recorded for older children (AOR = 2.3, 95% CI: 1.08-4.89; P = 0.029), boys (AOR = 1.9, 95% CI: 1.12-3.24; P = 0.018), and rural children (AOR = 1.8, 95% CI: 1.04-3.0; P = 0.037). Regular shoe wearing (AOR = 0.29, 95% CI: 0.16-0.50; P = 0.00) is protective for hookworm infection. Higher odds of hookworm infection was also recorded for schoolchildren who had the habit of eating raw vegetables (AOR = 1.2 95% CI: 1.1-1.7 P = 0.011). CONCLUSION: Hookworm infection and schistosomiasis are prevalent in the school children in rural Bahir Dar in Northwest Ethiopia. Various activities and behaviors of the children were strongly associated with helminthic infection. Hence health education should be delivered regularly to minimize/avoid the risky behaviors and water-based activities. Deworming programs should also be implemented on a regular basis.