Prevalence of intestinal parasitic infections and associated risk factors among patients attending Debarq Primary Hospital, northwest Ethiopia.

Intestinal parasitic infections (IPIs) are major public health problems in developing countries. This study was conducted to determine the prevalence and associated risk factors of IPIs at Debarq Primary Hospital in northwest Ethiopia. A health facility-based cross-sectional study was conducted from March 2022 to June 2022. The study participants were recruited from patients who visited Debarq Primary Hospital during the study period. Stool samples were collected from each participant and examined for intestinal parasites using direct wet-mount and formal-ether concentration techniques. Socio-demographic data were collected using a structured questionnaire. Out of 422 individuals examined, 33.64% were infected with at least one intestinal parasite species. Entamoeba histolytica/dispar, Giardia intestinalis, Ascaris lumbricoides, and hookworm were found in 12.79%, 8.53%, 7.10%, and 1.65% of the participants, respectively. Double and triple parasite infections were found in 2.37% and 0.23% of the participants, respectively. A habit of eating unwashed vegetables (Adjusted odds ratio (AOR) = 9.98, 95% confidence interval (CI) = 2.68-37.14) and low income (AOR = 6.66, 95% CI = 1.87-23.70) were associated with increased odds of IPIs. Participants with a habit of hand washing after using the toilet had 0.05 (95% CI = 0.13-0.22) lower odds of IPIs than those who did not. In conclusion, IPIs are common among Debarq Primary Hospital patients and are associated with factors such as low income, not washing hands after using the toilet, and eating unwashed vegetation, necessitating control and prevention efforts in the study area that include health education and the provision and use of sanitary facilities.

Cancer signs and risk factors awareness in Addis Ababa, Ethiopia: a population-based survey.

BACKGROUND: There is a paucity of data on public awareness of cancer in Ethiopia. This study assessed cancer signs, symptoms, and risk factors awareness among individuals aged 18 and older in Addis Ababa, Ethiopia. METHOD: A population-based face-to-face interview was conducted applying a validated cancer awareness measure (CAM) tool. A total of 600 adults (315 males and 285 females) were recruited using a multistage sampling technique. One open-ended and ten closed-ended questions were used to assess awareness of cancer signs and symptoms. To assess awareness of cancer risk factors, one open-ended and twelve closed-ended questions were used. Logistic regression analysis was used to test the association between sociodemographic status and awareness of cancer signs, symptoms, and risk factors. RESULTS: Based on the responses for the open-ended questions, unexplained bleeding (23.16%) and smoking (24.17%) were the most frequently recalled cancer sign and risk factor, respectively. Based on the responses for the closed questions, the majority of respondents identified tiredness all the time (80.7%) as a cancer symptom and alcohol use (82.5%) as a cancer risk factor.  The odds of cancer signs and symptoms awareness was higher in those with primary (AOR = 4.50, 95% CI, 1.72-11.79, p = 0.02), secondary (AOR = 4.62; 95% CI 1.86-11.43; p = 0.001), and tertiary (AOR = 7.51; 95% CI 3.04-18.56; p < 0.001) education than those who were illiterate. The odds of awareness about cancer signs and risk factors was 0.28 (95% CI 0.12-0.65; p = 0.003) and 0.22 (95% CI 0.83-0.58; p = 0.002) times lower, respectively, among individuals aged 60 and older than those aged 18 to 29. CONCLUSIONS: Young adults who attended formal education of primary or higher level may have a better cancer signs and symptoms awareness. Future education interventions to increase awareness of the society in Addis Ababa may target illiterate and the elderly.

Prevalence of malaria in Woreta town, Amhara region, Northwest Ethiopia over eight years.

BACKGROUND: Data on trends in malaria prevalence is significant to assist efforts in the control and prevention of the disease. This retrospective study was, therefore, aimed to determine the prevalence of malaria in Woreta town, northwestern Ethiopia over 8 years. METHODS: A retrospective study was conducted in Woreta town, northwestern Ethiopia, from November to January 2013. Eight years (2005 to 2012) health center record of malaria cases was reviewed. Odds ratio (OR) was used to determine trend in malaria prevalence with respect to age, sex and Plasmodium species. P-values less than 0.05 were considered to be statistically significant. RESULTS: From 2005 to 2012, a total of 102,520 suspected cases of malaria were reported at Woreta health center. Of these, 33,431 (32.6%) were microscopically confirmed to be positive for the disease. Among these positive cases, 17,700 (52.9%) and 15,731 (47.1%) were males and females, respectively. Children less than 5 years old were 1.3 times more likely to be infected by malaria than those with 5-15 years ([OR]; 1.3, 95% confidence interval [CI]; 1.26-1.34, p < 0.001). There was higher percentage (69.7%) of Plasmodium falciparum infection than Plasmodium vivax (26.5%); and the difference was statistically significant (p < 0.05). There was fluctuation in yearly malaria prevalence with a minimum of 7% in 2008 and maximum of 47% in 2005. CONCLUSIONS: The present study revealed that malaria continued to be one of the major public health problems in Woreta town, northwest Ethiopia. Moreover, there was no successive yearly reduction in its prevalence. Therefore, efforts are required to reduce the disease burden through continuous monitoring and evaluation of control measures in the study area.

Risky HIV sexual behavior and utilization of voluntary counseling and HIV testing and associated factors among undergraduate students in Addis Ababa, Ethiopia.

BACKGROUND: HIV/AIDS is a major public health problem in Ethiopia. University students are often a young and sexually active group that is at risk of acquiring and transmitting HIV. We assessed risky HIV sexual behaviors and utilization of voluntary counseling and testing services among undergraduate students at Addis Ababa Science and Technology University, Ethiopia. METHODS: A cross-sectional study was conducted between May and June, 2013. Standardized semi-structured self-administered questionnaire was used to collect data. Simple random sampling technique was use to select departments from each school. All students in the selected departments were the study participants. Data were entered into EPI-Info and analyzed using SPPS statistical packages. P-value < 0.05 was considered as statistically significant. RESULTS: Of the total 602 students selected, an overall response rate of 557 (92.6%) were registered. Among the participants 361 (60%) were males. The student ages' were ranged from 17 up to 25 years with mean age of 20.3 ± 1.6. Around 385 (64%) of them were in the age group of 17 up to 20 years. Among the study participants, 161 (26.8%) had sexual contact and the mean age of first sexual encounter was 17.4 (SD =2.3) years. About 443 (76%) of students knew that condoms can prevent Sexually Transmitted Infections (STIs). Among sexually active students, 74 (46%) had not used condom during first time sex. Among those responded, 488 (83.4%) had heard information about VCT; however, 52% had not ever used VCT service. The overall mean score of knowledge and attitude of students towards risk perception on HIV was around 66% and 57%, respectively. Students who enrolled in health science departments had almost three time more knowledge [AOR(95%CI) = 2.83 (1.67, 4.80)] and two and half times more favorable [AOR (95% CI) = 2.55 (1.60, 4.06)] attitudes towards HIV risk reduction strategies than students in non-health related departments. CONCLUSIONS: Some students were engaged in risky sexual behaviour even though they had heard about HIV/AIDS. The perception of risk for acquisition of HIV infection and utilization of VCT were low. HIV prevention and control strategies including education in the areas of HIV/AIDS as part of university programs curriculum, specially non-health students, and strengthening health institutions to provide youth-friendly VCT services for HIV with "know your HIV status" campaigns are strongly recommended.

Determination of trace elements in Ethiopian, Vietnamese, and Japanese women using high-resolution IC-PMS.

OBJECTIVES: Humans and other living organisms require small quantities of trace elements throughout life. Both insufficient and excessive intakes of trace elements can have negative consequences. However, there is little information on serum level of trace elements in different populations. This study examines serum levels of trace elements in Ethiopian, Japanese, and Vietnamese women. METHODS: Random samples of healthy women who were referred for routine hospital laboratory examinations in the cities of Hanoi, Sapporo, and Gondar were invited to participate in the study. Serum levels of magnesium, zinc, copper, iron, selenium, and calcium were determined using an inductively coupled plasma mass spectrometer. Furthermore, body mass index of each study participant was determined. RESULTS: The mean ± SD serum concentrations of zinc (µg/dL), copper (µg/dL), iron (µg/dL), selenium (µg/dL) and calcium (mg/dL), respectively, were 76.51 ± 39.16, 152.20 ± 55.37, 385.68 ± 217.95, 9.15 ± 4.21, and 14.18 ± 3.91 in Ethiopian women; 111.49 ± 52.92, 105.86 ± 26.02, 155.09 ± 94.83, 14.11 ± 3.41, and 11.66 ± 2.51 in Vietnamese women; and 60.69 ± 9.76, 107 ± 156, 268 ± 128, 8.33 ± 3.65, and 11.18 ± 0.68 in Japanese participants. Ethiopian women had significantly higher level of serum calcium than Vietnamese and Japanese women (both P < 0.05). Although the mean calcium concentration in Vietnamese women was higher than in women from Japan, the difference was not statistically significant (P > 0.05). Furthermore, compared with Japanese women, Ethiopian women had significantly high iron and copper concentrations (P < 0.05). Serum selenium and zinc levels were higher in Vietnamese than Ethiopian women. CONCLUSION: The study revealed a remarkable difference in serum concentrations of trace elements in women from different countries, implying differences in trace elements in the food or soil.

Seroprevalence and Associated Risk Factors of Toxoplasma gondii in Pregnant Women Attending in Northwest Ethiopia.

BACKGROUND: Toxoplasmosis is a major public health problem among immuno-compromised individuals. This study aimed to determine the seroprevalence and associated risk factors of Toxoplasma gondii infection among pregnant women with and out HIV infections. METHODS: This cross sectional study was conducted among consecutive 385 pregnant women attended Antenatal Clinic from May 2010 to October 2011 at the Gondar University Teaching Hospital, Northwest Ethiopia. Venous blood was collected from each pregnant woman for testing HIV-1/2 and anti- Toxoplasma antibodies using rapid test kits. Data were entered and analyzed using SPSS version 20 statistical package. RESULTS: The overall magnitude of T. gondii and HIV was 88.6% (341/385) and 11.2% (43/385), respectively. The seroprevalence of T. gondii was not different among HIV infected and non-infected pregnant women (88.4%, 38/ 43 vs 88.6%, 303/342). Keeping cats in house showed statistically significant association with seropositivity of toxoplasmosis (P<0.05). CONCLUSION: Irrespective of HIV infection, high rate of T. gondii was detected among pregnant women. These high prevalences indicate the need for an intensified public health awareness to reduce both infections.

Urinary schistosomiasis and malaria associated anemia in Ethiopia.

OBJECTIVE: To assess the prevalence of anemia in children with urinary schistosomiasis, malaria and concurrent infections by the two diseases. METHODS: Urine and blood samples were collected from 387 children (216 males and 171 females) to examine urinary schistosomiasis and malaria and to determine hemoglobin concentration at Hassoba and Hassoba Buri village in Amibara woreda, Afar region, Ethiopia. RESULTS: The overall prevalence of urinary schistosomiasis and Plasmodium falciparum malaria was 24.54% and 6.20% respectively. Only 2.84% of children carried concurrent infections of both parasites. There was high percentage of anemic patients (81.81%) in the coinfected cases than in either malaria (33.3%) or schistosomiasis (38.94%) cases. There was significantly low mean hemoglobin concentration in concurrently infected children than non-infected and single infected (P<0.05). The mean hemoglobin concentration between Plasmodium falciparum and S. haematobium infected children showed no significant difference (P>0.05). The level of hemoglobin was negatively correlated with the number of S. haematobium eggs/10 mL urine (r=-0.6) and malaria parasitemia (r=-0.53). CONCLUSIONS: The study showed that anemia is higher in concurrently infected children than non-infected and single infected. Furthermore, level of hemoglobin was negatively correlated with the number of S. haematobium eggs and malaria parsitemia. Therefore, examination of hemoglobin status in patients co-infected with malaria and schistosomiasis is important to reduce the risk of anemia and to improve health of the community.

Determining the severity of Plasmodium falciparum malaria in Ethiopia.

BACKGROUND: In the majority of health centers in Ethiopia, the severity of falciparum malaria has been determined by parasitemia alone. However, it has been suggested that the use of peripheral infected RBC counts as an indicator of disease severity by itself is insufficient. Therefore, this study was performed to assess the severity of falciparum malaria infection in three Ethiopian localities with epidemic malaria and to compare the usual severe malaria determination technique (parasitemia) used in Ethiopia with other malaria severity determination parameters: circulatory collapse, cerebral malaria and severe anemia. METHODS: Blood samples were collected from 400 individuals to examine the presence of falciparum malaria in the Awash, Metehara and Ziway areas of Ethiopia. Data on cerebral malaria, circulatory collapse and severe anemia were collected from 210 falciparum malaria patients. RESULTS: Of the 400 individuals examined, 210 were positive for falciparum malaria, and 190 were negative and served as healthy controls (HC). Severe anemia (18 patients, 8.57%) and circulatory collapse (25 patients, 11.90%) were the common features associated with severe falciparum malaria. Additionally, the detection of severe malaria was comparable using parasitemia, circulatory collapse or anemia. CONCLUSION: The findings of this study demonstrated comparable capacity for detecting severe falciparum malaria using circulatory collapse, severe anemia or parasitemia. Therefore, in addition to parasitemia, assessing severity of falciparum malaria using circulatory collapse and severe anemia will facilitate the diagnosis and management of malaria in Ethiopia.

Comparison of the Kato-Katz, Wet Mount, and Formol-Ether Concentration Diagnostic Techniques for Intestinal Helminth Infections in Ethiopia.

Objective. The aim of this study was to evaluate the operational characteristics (sensitivity and negative predictive value (NPV)) of wet mount, formol-ether concentration (FEC), and Kato-Katz techniques for the determination of intestinal parasitic infections. Method. A total of 354 faecal specimens were collected from students in Northwest Ethiopia and screened with Kato-Katz, wet mount, and FEC for the presence of intestinal parasitic infection. Since a gold standard test is not available for detection of intestinal parasites, the combined results from the three methods were used as diagnostic gold standard. Result. The prevalences of intestinal parasites using the single wet mount, FEC, and Kato-Katz thick smear techniques were 38.4%, 57.1%, and 59%, respectively. Taking the combined results of three techniques as a standard test for intestinal parasitic infection, the sensitivity and negative predictive value of Kato-Katz is 81.0% (confidence interval (CI) = 0.793-0.810) and 66.2% (CI = 0.63-0.622), respectively. The FEC detected 56 negative samples that were positive by the gold standard, indicating 78.3% (CI = 0.766-0.783) and 63.2% (CI = 0.603-63) sensitivity and NPV, respectively. Furthermore, Kato-Katz detects 113 cases that were negative by a single wet mount. The κ agreement between the wet mount and Kato-Katz methods for the diagnosis of Ascaris lumbricoides and hookworm was substantial (κ = 0.61 for Ascaris lumbricoides, κ = 0.65 for hookworm).

Cross-Sectional Study on the Prevalence of Intestinal Parasites and Associated Risk Factors in Teda Health Centre, Northwest Ethiopia.

Objective. To assess the magnitude of intestinal parasitic infection and associated risk factors in Teda Health Centre, Northwest Ethiopia. Method. A cross-sectional study was conducted in Teda Health Centre from February to April, 2011. Stool samples were collected from 410 study participants and analysed by direct wet mount and formal ether concentration techniques. Furthermore, sociodemographic data were collected by using standardized questionnaire. Result. The overall prevalence of intestinal parasitic infection in this study was 62.3%. Ascaris lumbricoides was the most predominant parasite (23.2%) followed by Giardia intestinalis (12.4%), Entamoeba histolytica/dispar (4.6%), Schistosoma mansoni (8.9%), hookworm (6.6%), Hymenolepis nana (1.5%), Enterobius vermicularis (0.4%), and Strongyloides stercoralis (0.2%). Absence of toilet and hand washing after toilet was shown to be associated with intestinal parasitic infection (P < 0.05 for both). Furthermore, swimming and less shoe wearing habits showed a significant prevalence of S. mansoni and hookworm infections, respectively. Conclusion. The present study showed high prevalence of intestinal parasitic infection in the study area. Absence of toilet and hand washing after toilet was found to be associated with intestinal parasitic infection. Therefore, there is a need for integrated control programme to have a lasting impact on transmission of intestinal parasitic infection.

Survey of nasal carriage of Staphylococcus aureus and intestinal parasites among food handlers working at Gondar University, Northwest Ethiopia.

BACKGROUND: Food borne disease are major health problems in developing countries like Ethiopia. Food handlers with poor personal hygiene working in food establishments could be potential sources of disease due to pathogenic organisms. However; information on disease prevalence among food handlers working in University of Gondar cafeterias are very scarce. The aim of this study is to assess the prevalence of nasal carriage of Staphylococcus aureus, their drug resistance pattern and prevalence of intestinal parasites among food handlers working in University of Gondar student's cafeterias. METHOD: A cross sectional study was conducted among food handlers working in University of Gondar student's cafeterias. A pretested structured questionnaire was used for collecting data. Nasal swab and stool were investigated for S. aureus and intestinal parasites; respectively as per the standard of the laboratory methods. RESULTS: Among 200 food handlers, females comprised 171(85.5%). The majority (67.5%) of the food-handlers were young adults aged 18-39 years. One hundred ninety four (97%) of the food handlers were not certified as a food handler. Forty one (20.5%) food handlers were positive for nasal carriage of S. aureus, of these 4(9.8%) was resistant for methicilin. Giardia lamblia was the most prevalent parasites 22 (11%), followed by Ascaris lumbricoides 13(6.5%), Entamoeba histolytica 12 (6%), Strongyloides stercolaris (0.5), Taenia species 1(0.5%) and Schistosoma mansoni 1(0.5%). CONCLUSION: The finding stressed that food handlers with different pathogenic micro organisms may pose significant risk on the consumers. Higher officials should implement food handler's training on food safety, periodic medical checkup and continuous monitoring of personal hygiene of food handlers.

Comparison of CareStart™ HRP2/pLDH COMBO rapid malaria test with light microscopy in north-west Ethiopia.

BACKGROUND: In Ethiopia, light microscopy is the gold standard for malaria diagnosis although it is not available in most peripheral health facilities. It is time consuming, requires trained personnel and needs careful preparation and application of reagents to ensure quality results. This study was aimed at testing the diagnostic performance of CareStart™ malaria rapid diagnostic test (RDT) with reference to light microscopy for the diagnosis of falciparum and vivax malaria in Ethiopia. METHODS: Blood samples were collected from 254 patients suspected to have malaria at Kola Diba Health Center in the late malaria transmission peak season from November 2011 to December 2011. The samples were examined immediately by light microscopy and the RDT (CareStart™ Malaria HRP2/pLDH COMBO Test kit). Statistical analysis was performed using SPSS version 16 and the JavaStat two-way contingency table analysis. RESULTS: The overall sensitivity and specificity of CareStartTM RDT was found to be 95% (90-97.9%, 95% CI) and 94.2% (90.9-96%, 95% CI), respectively. The sensitivity of the CareStartTM RDT for Plasmodium falciparum or mixed infection was calculated to be 92.9% (82.5-98%, 95%CI) while a sensitivity of 90.9% (74.1-98.4%, 95%CI) was found for non-falciparum species. The specificity for P. falciparum or mixed infections was found to be 95.4% (92.5-96.8%, 95%CI) while it was 97.3% (94.8-98.4%, 95%CI) for non-falciparum species. There was an excellent agreement between the two tests with a kappa value of 0.918. CONCLUSION: The CareStartTM RDT test showed good sensitivity and specificity with an excellent agreement to the reference light microscopy. The RDT could therefore be used in place of light microscopy, which in poor set-ups cannot be used routinely.

The ABO blood group and Plasmodium falciparum malaria in Awash, Metehara and Ziway areas, Ethiopia.

BACKGROUND: The virulence of Plasmodium falciparum is associated with the capacity of the infected red blood cell (iRBC) to adhere to uninfected RBCs, a process known as rosetting, which has been linked to the occurrence of severe malaria. The present study was carried out in three Ethiopian malaria endemic localities to investigate the relationship between blood group type and severe disease in falciparum malaria. METHODS: A total of 210 cases of malaria (70 severe and 140 uncomplicated) and 190 healthy controls participated in the study. Patients with at least one of the severe malaria syndromes (cerebral malaria, severe anaemia and circulatory collapse) were considered as severe malaria cases. RESULTS: In the severe malaria category, there were 25 (35.7%), 15 (21.4%), 14 (20%) and 16 (22.9%) blood group A, B, AB and O patients, respectively. Blood group O was the dominant blood type in both uncomplicated malaria (45.7%) and healthy controls (41.6%). A case of severe malaria was almost twice as likely to be of type A as to be of type O (odds ratio (OR) 0.42, 95% confidence interval (CI) 0.20-0.88, P = 0.019), and more than twice as likely to be of type B as to be of type O (OR 0.38, 95% CI 0.16-0.89, P = 0.02). Furthermore, individuals with severe malaria were about six fold less likely to be of O as to be of type AB (OR 0.19, 95% CI 0.07-0.51, P = 0.0005). CONCLUSION: The study revealed that on the basis of the three criteria (cerebral malaria, severe anaemia and circulatory collapse) used to determine severity in P. falciparum malaria, patients with blood group O, which is less prone to rosetting have a reduced chance of developing severe falciparum malaria as compared to patients with other blood groups.