Knowledge, attitude, and practice of cervical cancer screening and its associated risk factors among family planning service users at Debre Tabor town health facilities, North Central Ethiopia: A cross-sectional study.

Background: The fourth most common cancer in women worldwide is cervical cancer. Over 87% of deaths from cervical cancer occur in developing nations. One of the risks of developing cervical cancer is the use of oral contraceptives. However, there is limited evidence on the knowledge, attitude, and practice of cervical cancer screening among family planning service users in Ethiopia. Objective: To assess the knowledge, attitude, and practice toward cervical cancer screening and its associated factors among family planning service users. Methods: A facility-based cross-sectional study was conducted from January 1 to February 28, 2023. A total of 816 participants were selected using a systematic sampling technique. Data were collected using a pretested, structured, and interviewer-administered questionnaire. The collected data were entered into EPI Data 3.1 and exported to SPSS version 24 (IBM, Armonk, NY, USA) for analysis. Logistic regression was used to identify risk factors. An odds ratio with a 95% confidence interval and a p-value < 0.05 were used to declare statistical significance. Results: Overall, 42.5%, 36.6%, and 20.1% of the participants had good knowledge, a positive attitude, and practiced cervical cancer screening, respectively. Being single (adjusted odds ratio (AOR) = 3.39, 95% confidence intervals: 1.15-6.26), having college or university level of education (AOR = 8.03, 95% confidence intervals: 3.45-19.23), having a family history of cervical cancer (AOR = 3.14, 95% confidence intervals: 1.82-8.84), and having a source of information from the media (AOR = 1.74, 95% confidence intervals: 1.09-2.54) were significantly associated with good knowledge of cervical cancer screening. Women who were aged 15-23 years (AOR = 5.62, 95% confidence intervals: 2.76-14.56), had college- or university-level education (AOR = 3.69, 95% confidence intervals: 1.65-8.22), and had good knowledge of cervical cancer (AOR = 4.71, 95% confidence intervals: 3.08-7.55) were significantly associated with a positive attitude toward cervical cancer screening. An earlier age of first sexual intercourse (AOR = 5.0, 95% confidence intervals: 3.80-9.20) and good knowledge of cervical cancer (AOR = 1.52, 1.21-5.82) were positively associated with good practice of cervical cancer screening. Women who attended high school were negatively associated with good practice in cervical cancer screening (AOR = 0.46, 0.23-0.73). Conclusion: Knowledge, attitude, and practice toward cervical cancer screening were low. As a result, during patient visits for care delivery, healthcare providers should inform and educate patients about cervical cancer screening.

Carriage of ß-lactamase and carbapenemase-producing Enterobacteriaceae in hospitalized patients at debre tabor comprehensive specialized hospital.

Background: Antimicrobial resistance has remained global public health threat. Carriage with drug-resistant bacterial pathogens, particularly beta-lactamase and carbapenemase-producing Enterobacteriaceae is among the most concerning. The purpose of this study was to look into the magnitude, antimicrobial resistance patterns, and associated risk factors among hospitalized patients. Methods: A facility-based cross-sectional study was conducted on 383 hospitalized patients at Debre Tabor Comprehensive Specialized Hospital between September 2022 and May 2023. A pre-tested structured questionnaire was used to collect sociodemographic and clinical data. The data on the etiologic agent was collected using standard bacteriological techniques. Briefly, stool specimens were collected aseptically into sterile, leak-proof stool cups. The stool sample was inoculated onto MacConkey agar and incubated aerobically at 37 °C for 24 h. The species isolation and antimicrobial resistance patterns were then performed adhering to bacteriological procedures. In the analysis, a p-value of <0.05 was considered statistically significant. Results: There were 383 study participants, and men made up the majority (55.6%). The study participants' mean age was 33 ± 18 years. Three hundred and seventy-seven (88%) of the study's participants had no previous history of antibiotic use. There were 102 (26.6%) and 21 (5.5%) cases of gastrointestinal carriage caused by Enterobacteriaceae that produce beta-lactamase and carbapenemase, respectively. In total, 175 isolates of Enterobacteriaceae were detected. E. coli (n = 89) and K. pneumoniae (n = 51) were the most frequently recovered. In this study, 46 (79.3%) and 8 (13.8%) isolates of E. coli that produce beta-lactamase were resistant to ampicillin and amoxicillin/clavulanic acid, respectively. Furthermore, participants who had previously used antibiotics experienced a two-fold increase in exposure to gastrointestinal tract carriage by carbapenemase-producing Enterobacteriaceae [AOR, 95% CI (2.01, 1.06-2.98), p = 0.001]. Conclusions: The emergence of drug-resistant pathogens is a growing concern. An increase in the prevalence of drug-resistant infections in hospitalized patients is warranting further investigation.

Burden of lower respiratory infections and associated risk factors across regions in Ethiopia: a subnational analysis of the Global Burden of Diseases 2019 study.

OBJECTIVE: This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019. DESIGN: This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI). STUDY SETTING: The study includes nine region states and two chartered cities of Ethiopia. OUTCOME MEASURES: We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates. RESULTS: In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6-8918), 59.4 (95% UI 49.8-71.4) and 2404.5 (95% UI 2059.4-2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions-Benishangul-Gumuz 101.8 (95% UI 84.0-121.7) and Afar 103.7 (95% UI 86.6-122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country. CONCLUSION: In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.

Bacterial Etiology of Urinary Tract Infection and Antibiogram Profile in Children Attending Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.

Background: Bacterial urinary tract infections are important public health problems in children. This study was conducted to identify the bacterial agents of urinary tract infections and antibiogram patterns in children. Methods: A hospital-based cross-sectional study including 220 children was carried out between November 15, 2021, and March 10, 2022. Simple random sampling was used to enroll participants. The sociodemographic and clinically pertinent information was gathered using a semi-structured questionnaire. Every participant in the study who was ≤15 years old gave clean-catch midstream urine. Urine samples were inoculated onto a cystine lactose electrolyte-deficient agar using a calibrated inoculating loop with a 0.001 ml capacity and then incubated aerobically for 24 hours at 37°C. Subculturing for significant bacteriuria was done on MacConkey and blood agar. Gram staining, biochemical assays, and colony characteristics were used for bacterial identification. The disc diffusion method developed by Kirby and Bauer was used for antimicrobial susceptibility testing. SPSS software version 25 was used for data entry and analysis. To find the risk factors, bivariate and multivariate logistic regression analyses were performed. An association was deemed statistically significant if the p value at the 95 percent confidence interval was less than 0.05. Results: In this study, the majority (50.5%) of the study participants were males. The mean age of the study participants was 6 ± 0.91 years. It was found that 31.8% of children had urinary tract infections. The most prevalent urinary pathogens among the isolates were E. coli (27.1%) and S. aureus (18.6%). Approximately 56% of the participants were infected with multidrug-resistant pathogens. Additionally, compared to children who have never had a urinary tract infection, children with a history of infection had 1.04 (95 percent confidence interval (CI): 0.39, 2.75) times higher risk of infection. Conclusion: This study has shown an alarming increase in the prevalence of pediatric urinary tract infections which warrants further investigation into multidrug-resistant bacterial infection.

The magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town, northcentral Ethiopia: A community-based cross-sectional study.

Background: Diabetes mellitus (DM) is a worldwide public health problem. The burden of diabetes has been continuously increasing from day to day, especially in developing countries like Ethiopia. Globally, half of all cases of diabetes mellitus are undiagnosed. Diabetes mellitus can be easily handled if it is detected early. There is limited evidence on the magnitude of undiagnosed diabetics and prediabetes at the community level in Ethiopia, particularly in the study area. Objective: To assess the magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town. Methods: A community-based cross-sectional study was conducted in Debre Tabor town from October to December 2021. A total of 407 participants were selected using a multistage sampling technique. A pretested structural questionnaire was used to collect demographic, behavioral, and clinical data. Anthropometric measurements were taken with standardized and calibrated equipment. A fasting venous blood sample was collected for blood glucose level determination. Logistic regression was used to identify risk factors. A P-value ≤0.05 was considered statistically significant. Result: The magnitude of undiagnosed diabetes mellitus and prediabetes was found to be 4.5% (95% CI: 2.9-7.4) and 14.5% (95% CI: 11.1-18.1), respectively. Older age (AOR: 6.50, 95% CI: 1.82-23.21), abnormal body mass index (AOR: 6.84, 95% CI: 1.91-24.54), systolic hypertension (AOR: 8.74, 95% CI: 2.53-30.19), and family history of diabetes mellitus (FHDM) (AOR: 12.45, 95% CI: 3.63-42.65) were significantly associated with undiagnosed diabetes mellitus. Using saturated oil (AOR: 1.97, 95% CI: 1.09-3.55), having a high waist circumference (AOR: 2.16, 95% CI: 1.20-3.87), and being hypertensive (AOR: 2.26, 95% CI: 1.04-4.96) were all significantly associated with Prediabetes. Conclusion: Adults in Debre Tabor town have a high prevalence of undiagnosed diabetes and prediabetes. A variety of modifiable risk factors were also identified. As a result, focusing the prevention strategy on such modifiable risk factors may help to minimize the prevalence of undiagnosed diabetes mellitus and prediabetes as well as future disease complications.

Tuberculosis Treatment Outcome and Associated Factors Among Tuberculosis Patients Linked to Tuberculosis Treatment Clinics in Ethiopia, 2023: A Multi-Center Retrospective Study.

Background: Tuberculosis is a communicable disease, mainly caused by the bacillus Mycobacterium tuberculosis. Globally, TB is the ninth leading cause of death, with developing countries bearing most of the burden. The discovery of chemotherapy lead to significant improvements in patient survival. Therefore, this study aimed to assess Tuberculosis treatment outcomes and associated factors in South Gondar Administrative Zone Governmental Hospitals, Northwest Ethiopia, 2023. Method and Materials: A hospital-based retrospective study was conducted from July 1 to August 30, 2022, at South Gondar zone public hospitals. The data was entered into Epi-data version 4 and exported to STATA version 14. A binary and multivariable logistic regression was computed at a 95% confidence interval. Variables with a p-value less than 0.25 in the bivariable analysis were chosen for multivariable logistic regression analysis, and variables having a p-value of less than 0.05 in the multivariable analysis, were considered to have significant associations with the dependent variable. Results: The study included 400 tuberculosis patients, and the overall successful treatment outcome was 89.0% (95% Confidence Interval: 85.5-91.7). In this study, study participants who tested positive for HIV were approximately three times more likely to have unsuccessful treatment outcomes (Adjusted odds ratio = 3.07; 95% Confidence Interval = 1.49-6.16.5; P = 0.002) relative to HIV-negative patients. On the other hand, patients with sputum-positive were more likely to have a successful treatment rate (Adjusted odds ratio = 0.08; 95% Confidence Interval = 0.011-0.638, P = 0.002) relative to sputum-negative TB patients. Conclusion: The overall treatment success rate was 89.0%, which was lower than the global milestone target of > 90% set for 2025, and the prevalence of TB-HIV coinfection was 16.5%. In this study, HIV-positive was negatively associated with successful treatment outcomes, and sputum positive was independently associated with successful tuberculosis treatment outcomes.

Peripheral blood eosinophilia in adult asthmatic patients and its association with the severity of asthma.

BACKGROUND: Asthma is a diverse disease with various etiologic bases. Severe asthma can be associated with increased mortality, hospitalization, and decreased quality of life for asthma patients. High blood eosinophil counts were associated with severe asthma, but recent studies have failed to confirm this as a marker of severe asthma among adult asthma patients. As a result, the purpose of this study was to determine the association between the severity of asthma and high blood eosinophil count. METHODOLOGY: A simple random sampling technique was used to select 291 asthmatic patients for an institution-based cross-sectional study. Socio-demographic, behavioral, and clinical characteristics were collected by using a pre-tested structured questionnaire. Four milliliters of venous blood were collected from asthmatic patients for complete blood count and peripheral morphology assessment. The eosinophil count was analyzed by the Unicel DxH 800 (Beckman Coulter, Ireland) analyzer. A statistical package for social science version 20 (SPSS) software was used to analyze the data. The non-parametric (Mann-Whitney U) test was used to compare the eosinophil count with different background variables. A binary logistic regression analysis was used to assess the factors associated with eosinophilia. A p-value less than 0.05 in multivariable logistic regression analysis was considered statistically significant. RESULT: In this study, the overall magnitude of eosinophilia was 19.6% (95% CI = 14.8-24.1). Being admitted to the emergency department (AOR = 0.25; 95% CI: 0.09-0.69, p = 0.007) and being female (AOR = 0.49; 95% CI: 0.26-0.9, p = 0.025) were shown to have a statistically significant association with eosinophilia. Moreover, the absolute eosinophil count was significantly higher among asthmatic patients infected with intestinal parasitic infection (p < 0.045). CONCLUSION: Being female and admission to the emergency department were negatively associated with eosinophilia. Lack of eosinophilia can be related to the low-T2 asthma phenotype. The absolute eosinophil counts were higher among intestinal parasite-infected patients. Therefore, different biomarkers will be considered for the proper diagnosis and management of adult asthma patients.

Escalating the limit of median survival time and predictors of mortality among preterm neonates in Northwest Ethiopia, 2021: a 1-year prospective follow-up study.

OBJECTIVES: To examine the survival rate and predictors of mortality among preterm neonates in the neonatal intensive care unit at South Gondar public hospitals, 2021. DESIGN: Prospective follow-up study. SETTING: South Gondar public hospitals, Northwest, Ethiopia. PARTICIPANTS: We recruited 283 preterm neonates who were admitted at neonatal intensive care unit at selected hospitals from 15 February 2020 to 22 January 2021. OUTCOME MEASURES: The primary outcome measure of this study was the survival rate of preterm neonates in the neonatal intensive care unit. Moreover, the study assessed the predictors for the occurrence of mortality by the Cox-proportional hazard model. Data were entered into Epi data V.4.2 and exported to Stata V.14 statistical software for analysis. The log-rank test determines the survival difference between predictor variables. RESULTS: A total of 283 preterm neonates, 61 died during the follow-up. Born from antepartum haemorrhage mother (adjusted HR (AHR)=2.2 (95% CI 1.10 to 4.37)), being small weight for gestational age (AHR=4.6 (95% CI 2.22 to 9.53)), not having kangaroo mother care practice initiated (AHR=2.7 (95% CI 1.39 to 7.74)), hypothermia (AHR=4.0 (95% CI 1.96 to 8.30)) and perinatal asphyxia (AHR=3.9 (95% CI 1.97 to 7.94)) were significant predictors of preterm neonate mortality. CONCLUSION: In this study, the preterm neonates survival rate (78.4%) and the median survival time (21 days) were found to be low. Preventing and managing the predictors, including an antepartum haemorrhagic mother, small weight for gestational age, hypothermia and prenatal asphyxia, is crucial. In addition, more emphasis should be placed on initiating universal kangaroo mother care practice soon after birth to increase the survival of preterm neonates.

Association of ABO and Rhesus Blood Types with Transfusion-Transmitted Infections (TTIs) Among Apparently Healthy Blood Donors at Bahir Dar Blood Bank, Bahir Dar, North West, Ethiopia: A Retrospective Cross-Sectional Study.

Background: Besides their clinical significance in blood transfusion medicine, ABO and Rh blood group antigens were found to be associated with many non-infectious and infectious diseases. This investigation aimed to assess the association of ABO and Rh blood group antigens with transfusion transmissible infections (TTIs). Methods and Materials: A cross-sectional retrospective investigation was conducted on 27,027 blood donors at Bahir Dar blood bank, from March 24/2019 to October 21/2021. The blood sample was collected from each blood donor and tested for TTI markers (HBV, HCV, HIV, and syphilis), with ELISA, and ABO and Rh blood grouping was performed. Descriptive analysis was done for sociodemographic data, and a chi-square test was used to show the association between the ABO and Rh blood groups with TTI markers, and a P-value <0.05 was considered statistically significant. Results: From 27,027 study participants, 18,911 (70%) were males, with a mean age of 25.2 years, and 49.4% of the blood donors were students. The overall TTI prevalence was 5.43%, of which 2.8% was HBV, 1.5% was syphilis, 0.8% was HIV, and 0.3% was HCV. Blood group O (41.4%) was the most common blood group followed by, A (29.6%), B (23.6%), and AB (5.4%). Ninety-one point seven percent of the blood donors were Rh (D) positive. All TTI markers (HBV: p = 0.62, HIV: p = 0.77, HCV: p = 0.52, and syphilis: p = 0. 0.94) showed no significant association with ABO blood group. Rh blood type also showed no association with all TTI markers. Conclusion: The prevalence of TTI markers was not significantly associated with ABO and Rh blood groups.

The effect of maternal anaemia on low birth weight among newborns in Northwest Ethiopia.

Low birth weight is an indicator of maternal-related multifactorial problems such as malnutrition, illness, and work overload. As a result, low birth weight is associated with maternal anaemia, and both of them were significant public health issues in developing nations. Low birth weight and anaemia are caused by insufficient nutrient intake, which is especially severe during pregnancy. So, this study aimed to assess the effect of maternal anaemia during the late trimester on low birth weight among newborns in Northwest Ethiopia. A systematic random sampling technique was used to select 211 participants for the primary data collection. Face-to-face interviews were used to collect data, while blood samples were collected using standard operating procedures. For further analysis, the data file was imported into Stata version 16 (MP) software. The binary logistic regression model was used to investigate significant factors related to low birth weight. Finally, the statistical significance of the variables was determined using a p value of ≤ 0.05. The prevalence of anaemia among pregnant women in the late trimester and newborns was 34 (16.11%, 95% CI: 11.42, 21.78) and 64 (30.33%, 95% CI: 24.20, 37.01), respectively. The mean ± standard deviation of the newborn babies' weight was 3.19 ± 0.49 kg. The proportion of low birth weight among newborns was 26 (12.32%, 95% CI: 8.20, 17.53%). The independent effect of anaemia on low birth weight was 4.19 times while all other factors were constant (COR = 4.19, 95% CI: 1.70, 10.30). Maternal educational status [unable to read and write (AOR = 10.94, 95% CI: 1.74, 68.58) and attained secondary education (AOR = 8.06, 95% CI: 1.53, 42.36)], and maternal anaemia (AOR = 3.51, 95% CI: 1.29, 9.55) were associated with low birth weight after adjusting with all other variables. In this study, the proportion of low birth weight was high. Here, maternal anaemia alone had a significant independent role in the development of low birth weight. Maternal education status and anaemic conditions were associated with low birth weight among newborns. Early detection and treatment of maternal anaemia during pregnancy is crucial with the usual nutritional-related care.

Immuno-virological status and its associated factors among HIV-positive patients receiving highly active antiretroviral therapy at delgi primary hospital, northwest Ethiopia, 2020/2021: A cross-sectional study.

Background: Highly active antiretroviral therapy (HAART) improves clinical outcomes by suppressing viral replication and allowing immune reconstitution. It also reduces HIV-related complications including morbidity, mortality, and extended hospitalizations for HIV-positive individuals. Regular assessment for antiretroviral treatment response is fundamentally important to address the factors associated with the poor clinical outcome including immunologic failures among HIV-positive patients on HAART. Therefore, this study aimed to investigate the immuno-virological status and describe its determinants among HIV-positive patients receiving HAART at Delgi primary hospital, Northwest Ethiopia. Methods: A hospital-based cross-sectional study was conducted at Delgi primary hospital from October 25th through June 19th 2021 among a total of 442 study participants. A systematic random sampling technique was employed to enrol participants in the study. Socio-demographic and clinically related data were collected using a semi-structured questionnaire. About 3-5 ml of venous blood was collected aseptically for CD4+ T cell count and viral load test. SPSS version 20 software was used for statistical analysis. Bivariate and multivariate logistic regression analyses were conducted to determine the factors associated with immuno-virologic status among HIV-positive patients on HAART. The odds ratio with 95% CI was computed to determine the strength of association. Then, a p-value < 0.05 was considered a statistically significant association. For this study, the results were presented by using frequency summary tables, and texts. Results: Among the total study participants, 283 (64%) were males and the mean age of the study participants was 37 ± 11.5. The overall immunological and virological failure among highly active antiretroviral therapy (HAART) receiving participants was found to be 9.5% (42/442, 95%CI:3.23-15.09) and 12.2% (54/442, 95% CI: 2.81-23.04) respectively. In the multivariate analysis, study participants with age ≥50 years old [AOR = 1.97, p = 0.01, 95%CI (0.02-4.03)], participants having current viral load count greater ≥1000 copies/ml [AOR = 3.97, p = 0.03, 95%CI (1.09-5.01)] and having TB-co-infection [AOR = 2.51, p = 0.05, 95%CI (1.02-7.51)] were statistically associated with increased risk of immunological failure. Similarly, TB-coinfected participants were 1.88 (95%CI = 0.89-10.02) times at greater risk for virological failure. Conclusion: In this study, the magnitude of immuno-virological failure is alarming. This may be shown the need for integrated and substantial commitment to enhancing patient antiretroviral treatment adherence in the study area. Also, regular assessment for antiretroviral treatment response is fundamentally important to address the determinants associated with virological and immunologic failures among HIV-positive patients taking HAART. Furthermore, early initiation of HAART may be imperative to achieve favourable virological suppression and immunological reconstitution.

Prevalence, intensity of infection and associated risk factors of soil-transmitted helminth infections among school children at Tachgayint woreda, Northcentral Ethiopia.

BACKGROUND: Soil-transmitted helminths (STH) are one of the most common infections affecting underprivileged populations in low- and middle-income countries. Ascaris lumbricoides, Trichuris trichiura, and hookworm are the three main species that infect people. School children are the most vulnerable groups for STH infections due to their practice of walking and playing barefoot, poor personal hygiene, and environmental sanitation. However, evidence is limited in the study area. So, this study aimed to assess the current prevalence, infection intensity, and associated risk factors of STHs among school children in Tachgayint woreda, Northcentral Ethiopia. METHODS: A cross-sectional study was conducted among school children of Tachgayint woreda from February to May 2021. The study participants were chosen via systematic random sampling. Stool samples were collected from 325 children and examined using the Kato-Katz technique. The data was analyzed using SPSS version 23. Binary and multivariable logistic regression analyses were used to identify the potential associated factors for STHs. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the magnitude of the association. A P-value <0.05 was considered statistically significant. RESULTS: The overall prevalence of STHs in this study was 36.0% (95% CI: 30.5-41.2%). Ascaris lumbricoides are the most prevalent species 89 (27.4%) followed by hookworm 14 (4.3%) and Trichuris trichiura 10 (3.1%). All of the infected school children had light-intensity of infections with the mean of eggs per gram (EPG) being 464.53. Lack of shoe wearing habit (AOR = 4.08, 95% CI: 1.29-12.88) and having untrimmed fingernail (AOR = 1.85, 95% CI: 1.06-3.22) were identified as risk factors for STH infections. CONCLUSIONS: More than one-third of the school children were infected with at least one STH species and this indicates that STHs are still a health problem among school children in the study area. Therefore, periodic deworming, implementation of different prevention strategies, and health education programs should be regularly applied in the area.

Balantidium coli; Rare and Accidental Finding in the Urine of Pregnant Woman: Case Report.

Background: Balantidium coli is a ciliated protozoan parasite, which causes intestinal and extraintestinal infections in humans. It is transmitted feco-orally by ingesting infective cysts with food and water. Urinary balantidiasis may occur through contamination (direct spread from the anal area), secondarily to rectovaginal fistula and following immune suppression. Data about cases of urinary balantidiasis are rare in the world. Currently, there are no documented reports of urinary balantidiasis in Ethiopia. As our understanding, there are only eleven documented reports of urinary balantidiasis globally. However, cases of urinary balantidiasis among pregnant women have not been documented yet. The aim of this report is to alarm health professionals for considering the occurrence of such rare cases and conduct diagnosis. Case Presentation: A 24-year old pregnant woman was admitted due to severe preeclampsia and preterm delivery at Debre Tabor Comprehensive Specialized Hospital, gynecology ward. Her urine was presented to inpatient laboratory for routine urinalysis. We detected unusual and ciliated parasite from her urine sediment characterized by its active and rotary motility through its cilia and possessing macro- and micro-nuclei, several food vacuoles and ingested red blood cells inside the cytoplasm. Hematuria, many white blood cells and epithelial cells were also detected from the urine sediment, which suggests genito-urinary tract infection due to this parasite. This rare parasite finding was confirmed to be B. coli. Conclusion: The route of transmission and extraintestinal existence from this woman's urine was unclear. It might be due to feco-oral transmission and spread to the genitourinary tract through direct anal contact. Moreover, it might be associated with immune suppression as she is pregnant woman.

Trend Analysis of Intestinal Parasitic Infections at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia from 2017 to 2021: A Five-Year Retrospective Study.

Introduction: In Ethiopia, intestinal parasites are common due to poverty, poor personal hygiene, poor environmental sanitation, overcrowding, a lack of safe drinking water, and a lack of knowledge. As a result, evaluating the intestinal parasite morbidity pattern in low-income countries such as Ethiopia is important for designing intestinal parasite intervention programs that minimize the illness burden. Despite the high prevalence of the disease in the Debre Tabor catchment areas, there is a lack of data on the trend of intestinal parasites. As a result, the study's goal was to close the gap on the patterns of intestinal parasite infection for better control and intervention programs. Methods: A retrospective study was conducted from 2017 to 2021 at Debre Tabor comprehensive specialized hospital to determine the trend of intestinal parasite infection. The findings of 7965 saline wet mount stool examinations were collected from the laboratory registration book by trained data collectors over the last five years. The study excluded any data that lacked sociodemographic characteristics and the year of the stool examination. Finally, the data were analyzed by SPSS version 25. Results: The overall prevalence of intestinal parasites during the study period (2017-2021) was 2171 (27.3%) out of 7965 patients. Entamoeba histolytica/dispar (18.6%) was the predominant parasite, followed by Giardia lamblia (5.7%) and Ascaris lumbricoides (1%). Males (28.6%) were infected at a higher rate than females (26.2%) (P = 0.02). The intestinal parasite was reported in all age groups in the area, but the highest and the lowest prevalence were reported in the age groups of above 14 years (27.7%) and under five years (23.4%), respectively (P = 0.03). Conclusion: The finding showed cyclic patterns of fluctuations in the prevalence of intestinal parasitic infections. Therefore, it is important to develop effective prevention and control strategies to prevent the distribution of intestinal parasites.

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

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

The effect of timely initiation of complementary feeding and vitamin A supplementation on acute malnutrition among children aged 6-59 months attending Hamusit Health Centre, Northwest Ethiopia, 2021: A cross-sectional study.

INTRODUCTION: Acute malnutrition is a nutritional deficiency that results either from inadequate energy or protein intake. It is more prevalent in low- and middle-income countries. Even though efforts have been carried out at the global and national level, the burden is still intolerable and it attracts the attention of the government and researchers. Hence, this study aims to assess the magnitude of acute malnutrition and its associated factors among under-five children who attended Hamusit Health Centre from 1st September to 30th January 2021. MATERIALS AND METHODS: This institution-based cross-sectional study was conducted from 1st September to 30th January on 404 randomly selected under-five children who visited the health centre. Samples were selected using a simple random sampling technique, and the data were obtained using a pre-tested standardized questionnaire. For data entry and analysis, Epi-info 7 and SPSS 21 applications were used, respectively. Bivariable and multivariable binary logistic regression were used to identify associated factors at a 95% confidence interval. Significance was considered at p-value<0.05. RESULTS: The present research involved a total of 404 children aged 6-59 months. The magnitude of acute malnutrition in this study was 14.4%. Children aged 6-23 months [AOR: 2.92; 95%CI (1.46, 5.85)], vitamin A supplementation [AOR: 0.49; 95%CI (0.25, 0.95)], not timely initiation of complementary feeding [AOR: 2.02; 95%CI (1.06, 3.82)] and children with diarrhea prior to two weeks of the survey [AOR: 2.47; 95% CI (1.28, 4.87)] were significantly associated with acute malnutrition. CONCLUSION: A significant number of children aged 6-59 months were affected by acute malnutrition. Younger children, vitamin A supplementation, not timely initiation of complementary feeding, and children with diarrhoea were other factors associated with acute malnutrition.

A Retrospective Study of Malaria Trend in Libokemkem District Over the Last Five Years: North West Ethiopia.

BACKGROUND: Malaria is a vector-borne disease caused by public health important Plasmodium species. Despite the fact that Ethiopia has implemented several malaria prevention and control techniques aimed at reducing its morbidity and death, it continues as major cause of morbidity and mortality in Ethiopia. Transmission dynamics are really critical for guiding the selection of the appropriate intervention in a given area. As a result, the goal of this study was to analyze the trend of malaria prevalence over the last five years in the Addis Zemen health center. METHODS: An institutional-based retrospective analysis on malaria data from 2015/16 to 2019/20 was undertaken in Addis Zemen health center of Libokemkem district. The data collectors thoroughly and systematically collected the results of 15,452 blood films performed over a five-year period from the malaria registration book in the health center. Any data missing species and stage of the parasite, as well as sociodemographic characteristics, date, month, and year of blood film performed, were omitted from the study. Finally, data were entered and analyzed using SPSS version 25, with P-values of less than or equal to 0.05 deemed statistically significant variables. RESULTS: The overall malaria slide positivity rate over the last five years in the study area was 10.9%. From 2015/16 to 2018/19, the positive rate fell, then it spiked in 2019/20. Plasmodium falciparum was the most common parasite found, accounting for 72.6% of the total. The months of October, November, May, June, August, and September showed the largest number of malaria cases. Males, rural residents, and adult population groups were more affected by malaria, according to multivariate logistic regression (P ≤0.05). CONCLUSION: There was high malaria morbidity case in 2019/20 as compared to the remaining years. Therefore, malaria control, prevention, and intervention programs in the district should be strengthened.

Prevalence of Intestinal Parasitosis and Its Associated Factors Among Children Aged 6 to 59 months Attending Mekane Eyesus Primary Hospital, Northcentral Ethiopia.

Background. Intestinal parasites are still a serious public health problem and important cause of morbidity and mortality all over the world, particularly in developing countries. Unfortunately, pre-school children are more susceptible to infection. However, information is scarce in the study area. Thus, this study aimed to assess the prevalence of intestinal parasitosis and associated factors among children aged 6 to 59 months in Northcentral Ethiopia. Methods. An institutional-based cross-sectional study was carried out at Mekane Eyesus primary hospital from June 10 to November 30, 2020. Stool samples were collected from 322 children and examined by using direct wet mount and formal ether concentration techniques. The data were entered and analyzed using EPI Info v7 and SPSS v23 statistical software, respectively. Both bivariable and multivariable logistic analysis was carried out and potential associated factors were identified based on adjusted odds ratio with 95% confidence interval and P-value <.05. Results. The prevalence of intestinal parasitosis was 18.0% (95% CI: 14.0%-22.0%). A total of 4 parasites were examined and the dominant parasite was E. histolytica/dispar (8.1%) followed by A. limbricoide (4.7%). Children with irregular trimming of fingernails (AOR = 3.14, 95% CI: 1.59-6.21), and child who have habit of eating unwashed fruits/vegetables (AOR = 3.80, 95% CI: 1.14-12.82) were strongly associated with IPIs. Conclusions. Protozoa parasites are most common cause of diseases in children. The study identified some preventable and modifiable factors to address the prevalence of IPIs. Additionally, improving mothers/guardians awareness about source of infection and mode of transmission is necessary.

Bacterial Pathogens and Their Antimicrobial Resistance Patterns of Inanimate Surfaces and Equipment in Ethiopia: A Systematic Review and Meta-analysis.

BACKGROUND: Hospital-acquired infections have remained a serious cause of mortality, morbidity, and extended hospitalization. Bacterial contamination of inanimate surfaces of the hospital environment and equipment is considered a major contributing factor to the development of several nosocomial infections worldwide. The hospital environment and many devices are an important reservoir of many clinically important bacterial agents including multidrug-resistant pathogens. Therefore, this systematic review and meta-analysis are aimed at investigating bacterial pathogens and their antimicrobial resistance patterns of inanimate surfaces and equipment in Ethiopia. METHODS: An exhaustive literature search was carried out using the major electronic databases including PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, Google Scholar, Cochrane Library, Scopus, and Wiley online library to identify potentially relevant studies without date restriction. Original articles which address the research question were identified, screened, and included using the PRISMA flow diagram. Data extraction was prepared in Microsoft Excel, and data quality was assessed by using 9-point Joanna Briggs Institute critical appraisal tools. Then, data were exported to STATA 16.0 software for analyses of pooled estimation of outcome measures. Estimation of outcome measures at a 95% confidence interval was performed using DerSimonian-Laird's random-effects model. Finally, results were presented via text, figures, and tables. RESULTS: A total of 18 studies with 3058 bacterial isolates recovered from 3423 swab specimens were included for systematic review and meta-analysis. The pooled prevalence of bacterial contamination of inanimate surfaces and equipment was found 70% (95% CI: 59, 82). Among the Gram-negative bacterial species, the prevalence of ampicillin-resistant K. pneumoniae was the highest 80% (95% CI: 78, 92) followed by Citrobacter species 78% (95% CI: 57, 83). CONCLUSION: This study has shown a high prevalence of bacterial contamination of inanimate surfaces and equipment in Ethiopia.

Hematological Abnormalities of Adult HIV-Infected Patients Before and After Initiation of Highly Active Antiretroviral Treatment at Debre Tabor Comprehensive Specialized Hospital, Northcentral Ethiopia: A Cross-Sectional Study.

BACKGROUND: Hematological abnormalities have been associated with an increased risk of disease progression and death in people living with human immunodeficiency virus (HIV). The use of antiretroviral medications can have a positive or negative effect on the hematological disorder. However, little is known about its impact on hematological parameters in antiretroviral-treated patients in Ethiopia, especially in the study area. METHODS: A cross-sectional study was conducted at Debre Tabor Comprehensive Specialized Hospital from September to November 2020. A total of 334 HIV-infected patients taking highly active antiretroviral treatment (HAART) at least for 6 months were selected using a simple random sampling technique. Socio-demographic and clinical characteristics of the study subjects were collected using a semi-structured questionnaire. Hematological and immunological parameters were determined using Sysmex kx-21 hematology analyzer and BD FACS count CD4 analyzer, respectively. Statistical analysis was done using SPSS version 20 statistical software. A P-value <0.05 was considered statistically significant. RESULTS: A total of 334 HIV patients were included in this study. The prevalence of anemia, leucopenia, neutropenia, lymphopenia and thrombocytopenia were 37.1%, 22.8%, 8.4%, 10.5% and 17.1% before initiation of HAART and 17.4%, 34.2%, 18.8%, 13.1% and 8.3% after initiation of HAART, respectively. There was a significant difference in total white blood cell (WBC) count, absolute neutrophil count (ANC), red blood cell (RBC) count, hemoglobin value, mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), red cell distribution width (RDW), platelet and CD4+ T cell counts in HIV patients before and after initiation of HAART (P<0.05). CONCLUSION: The most common hematological abnormalities observed in this study before and after HAART initiation were anemia, leucopenia, neutropenia, lymphopenia, and thrombocytopenia. However, after beginning HAART, the prevalence of anemia and thrombocytopenia decreased dramatically.