Determining the rate and reasons for specimen rejection among specimens referred for HIV viral load determination through referral linkage to Debre Tabor Comprehensive Specialized Hospital, north-central, Ethiopia,2023: Retrospective study.

Background: The preanalytical phase encompasses the time between the clinician's test order to the sample being ready for analysis. Of all errors during the laboratory diagnostic process,70 % appeared in the pre-analytical phase. In clinical laboratories, it is crucial to ensure proper specimen collection and handling, which is essential to guarantee quality assessment, monitoring process standardization, improving performance, and ensuring patient safety. Despite this importance, no study has been conducted in the study area to investigate the rate and reasons for human immunodeficiency virus viral load sample rejection. Objective: To determine the rate of human immunodeficiency virus viral load sample rejection (number of preanalytical errors) documented during the preanalytical phase and articulate possible causes for specimen rejection. Material and methods: A retrospective study was conducted at Debre Tabor Comprehensive Specialized Hospital from January 1st to January 31, 2023. During the study period, 5950 samples were extracted from the human immunodeficiency virus viral load laboratory sample tracking log books, which were sent to the hospital for viral load testing between August 2021 to November 2022. The collected data were cleaned and entered into EPI data version 4.6 before transferred it to STATA version 14.0 for analysis. Descriptive statistics such as frequencies, percentages, and cross-tabulations were used to summarize the findings. Results: The study found that improper sample handling was common during the preanalytical phase. According to the current study, 3.6 % of the sample was rejected at pre analytical stage. The most common reasons for specimen rejection were using inappropriate containers (64.0 %) uncentrifuged specimens (20.4 %); hemolyzed specimens (7.0 %); insufficient specimen volume (6.2 %); clotted specimens (1.9 %); and specimen labeling problems (0.5 %). Conclusion: This study found that the most common preanalytical error was using an inappropriate sample collection container, followed by uncentrifuged samples, Therefore, it is recommended that mentorship programs be developed to educate staff on the preanalytical phase of laboratory testing, specifically on sample collection, storage, and transportation for HIV viral load testing. Additionally, the quality management system of laboratory processes should be strengthened to ensure accuracy and minimize errors.

Long non-coding RNA as potential diagnostic markers for acute myeloid leukemia: A systematic review and meta-analysis.

BACKGROUND: Acute myeloid leukemia (AML) is aggressive type of hematological malignancy. Its poses challenges in early diagnosis, necessitating the identification of an effective biomarker. This study aims to assess the diagnostic accuracy of long noncoding RNAs (lncRNA) in the diagnosis of AML through a meta-analysis. The study is registered on the PROSPERO website with the number 493518. METHOD: A literature search was conducted in the PubMed, Embase, Hinari, and the Scopus databases to identify relevant studies. We pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristics (ROC) using Stata 14.1 software. Heterogeneity between studies was determined through the I2 statistic and Cochran-Q test. A random effect model was chosen due to significant heterogeneity among included studies. Meta-regression and subgroup analysis were performed to assess the potential source of heterogeneity. Furthermore, potential publication bias was estimated using Deek's funnel plot asymmetry test. RESULTS: A total of 14 articles covering 19 studies were included in this meta-analysis comprising 1588 AML patients and 529 healthy participants. The overall pooled sensitivity, specificity, PLR, NLR, DOR, and the area under the summary ROC curve were 0.85 (95% CI = 0.78-0.91), 0.82 (95% CI = 0.72-0.89), 4.7 (95% CI = 2.9-7.4), 0.18 (95% CI = 0.12-0.28), 26 (95% CI = 12-53), and 0.90 (95% CI = 0.87-0.93), respectively. Moreover, lncRNAs from non-bone marrow mononuclear cells (BMMC) had superior diagnostic value with pooled sensitivity, specificity, and AUC were 0.93, 0.82, and 0.95, respectively. CONCLUSION: This meta-analysis demonstrated that circulating lncRNAs can serve as potential diagnostic markers for AML. High accuracy of diagnosis was observed in non-BMMC lncRNAs, given cutoff value, and the GADPH internal reference gene used. However, further studies with large sample size are required to confirm our results.

The Role of Extracorporeal Photopheresis in the Management of Graft Versus Host Disease: Narrative Review.

Hematopoietic stem cell donation is a method used to treat both blood-related and non-blood-related malignancies. Graft-versus-host disease is a potentially life-threatening complication that can occur following a stem cell transplant from a donor. This happens after the transplanted grafts attack the recipient's body as foreign cells, causing significant morbidity and mortality. Clinically, this condition can be classified as acute or chronic based on onset and pathophysiology. This review aims to provide an overview of recent studies on extracorporeal photopheresis as a treatment strategy option for graft-versus-host-diseased patients. It will explain how it treats graft-versus-host disease, summarize its promising effects, and provide future recommendations for its use in treating this illness. Extracorporeal photopheresis is used to treat graft-versus-host disease by collecting and separating white blood cells from the patient. This blood is fractionated into different parts, and white blood cells undergo treatment with 8-methoxy psoralen, a photoactivable drug, before exposure to ultraviolet light A. Lastly, the cells that have been treated are reinfused into the recipient's body. It prompts the programmed cell death of lymphocytes and the engulfment of cellular debris by host antigen-presenting, leading to a subsequent rise in T regulatory cells. However, more experimental and randomized controlled studies are required to identify the best patient selection requirements, environments, and treatment regimens for graft-versus-host disease.

Efficacy of 400 mg albendazole against soil-transmitted helminthes among Salgy Primary School Children, Dembia district, Northwest Ethiopia, 2020. "Uncontrolled experimental study".

Background and Aims: Soil-transmitted helminths are one of the most prevalent causes of both intellectual and physical disability in the world. Albendazole (ALB) is a drug recommended for mass treatment of the high burden of soil-transmitted helminths in schoolchildren, particularly in developing countries. However, some researchers have reported that the efficacy of albedazole against soil-transmitted helminths is inconsistent. Monitoring the programs is crucial to evaluating the effectiveness of 400 mg of ALB against soil-transmitted helminths, as well as any changes in its therapeutic efficacy. Thus, the purpose of this study was to evaluate ALB effectiveness in treating soil-transmitted helminthes in Salgy Primary School Children. Methods: An uncontrolled experimental study was conducted at Salgy Primary School Children, Northwest Ethiopia, from March to May 2020. A total of 439 schoolchildren were enrolled and screened for soil-transmitted helminths by stratified proportionate systematic random sampling to get 228 positive schoolchildren. Students in grades one through eight were grouped based on their educational attainment. Using the Kato-Katz thick smear technique, the selected stool sample collected from school children was examined using the Kato-Katz thick smear technique to determine the cure and egg reduction rates. The statistical package for social science software, version 20, was used to analyze the data. To determine the relationship between CR (cure rate) and ERR (egg reduction rate) by age, a chi-square test (X 2) was employed and significance was considered at A 95% confidence interval and p Value (p < 0.05). Results: A 400 mg single dosage of ALB showed a 99.35% CR and a 97.30% egg reduction rate against Ascaris lumibricoides. Additionally, a 400 mg dose of ALB showed a 95.75% CR and an 82.07% egg reduction rate, suggesting questionable effectiveness against hookworm infections. Trichuris trichiura showed a decreased efficacy, with a 43.53% CR and a 23.12% egg reduction rate. Conclusion: A single dose of 400 mg ALB is effective (satisfactory), doubtful, and unsatisfactory against Ascaris lumbricoides, hookworm, and T. trichiura infections, respectively. Further studies using different brands, doses, and routes will be needed to treat hookworm and T. trichiura infections successfully by using a larger sample size.

The frequency of ABO and Rhesus(D) blood group antigens among blood transfused patients in Northern Ethiopia, 2023: Retrospective study.

Background: Data about the distribution of ABO and RhD blood groups is important for effective blood utilization, which is maintained by identifying the most clinically required blood type. However, there is a scarcity of data in Ethiopia about the distribution of ABO and RhD blood groups among blood-transfused patients, particularly in the study area. Objective: To determine the frequency of ABO and RhD blood groups among blood transfused patients at Dessie Comprehensive Specialized Hospital, Northern Ethiopia, 2023. Method: A hospital-based retrospective study was conducted from September 1 to September 30, 2022, to determine the frequency of ABO and RhD blood groups among blood-transfused patients at Dessie Comprehensive Specialized Hospital. The study was conducted on data from blood-transfused patients from October 2019 to June 2022. A total of 3762 blood transfused patients' data was collected from the blood transfusion log book records. The data were coded, entered, and cleaned using Epi-data version 4.6 and analyzed for descriptive statistics using Stata version 14.0. Result: A total of 3762 blood-transfused patients were included in the study. Of those, females made up 57.3 % (2156/3762). Of 3762 blood transfused patients, the majority (33.9 %, 1277/3762) had ABO blood group B, and 81.3 % (3060/3762) of the blood transfused patients were RhD-positive. Eight thousand three hundred fifteen units of whole blood were transfused to 3762 patients, with a mean of 2.2 units of blood transfused per patient. Furthermore, the majority of the study participants 42.82 %, (1611/3762) were given two units of blood, and 8.77 % (330/3762) were given four units of blood. Conclusion: Most of the study participants had B and RhD-positive blood groups. The majority of the blood transfused patients were females. Most of the blood was transfused in the medical ward, and whole blood was transfused for all patients.

Multi-drug-resistant tuberculosis and its associated factors among pulmonary tuberculosis patients linked to first-line anti-tuberculosis drugs in north-west Ethiopia.

Introduction. Multi-drug-resistant tuberculosis (MDR-TB) is an emerging global challenge. Ethiopia is one of the 20 top countries with the highest estimated numbers of incidents of MDR-TB. Recently, the World Health Organization warned that drug-resistant TB is escalating and called for concerted action to reduce the spread of drug resistance.Hypothesis. The current study investigated MDR-TB in patients receiving first-line anti-TB drug treatment and associated factors.Aim. The study aimed to determine the prevalence of MDR-TB and its associated factors among smear-positive pulmonary TB patients receiving first-line anti-TB drug treatment.Methodology. An institution-based cross-sectional study was employed. All data were collected from laboratory result log books and information via a questionnaire. Samples from 205 smear-positive pulmonary TB patients were selected among first-line drug treatment by a systematic sampling method. Specimens were transported to Felege Hiwot referral hospital laboratory for GeneXpert testing. Factors associated with an outcome variable in binary multi-variable logistic regression analysis at P<0.05 were considered statistically significant variables. An ethical approval letter was taken to the respective health facility and written consent was obtained from each participant.Results. The overall prevalence of MDR-TB was 9.3 % (95 % CI, 5.4 13.7 %). Sign and symptom experience of anti-TB drug side effects [adjusted odds ratio (AOR)=0.18, 95 % CI=0.03-0.99, P=0.049] and co-morbidity (AOR=0.03, 95 % CI=0.01-0.55, P=0.02) were statistically associated with the development of MDR-TB infectionConclusion. The prevalence of MDR-TB was high (9.3 %) and contributed highly to new cases (8.3 %). Factors associated with MDR-TB were previous treatment, co-morbidity and laboratory diagnosis method prior to TB treatment. Therefore, this finding aims to maximize early detection and treatment, strengthening TB infection control, and proper implementation of directly observed therapy short course recommendations to reduce the burden of MDR-TB.

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.

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.

Maximizing the detection rate of hypoglycemia among preterm neonates admitted in Neonatal intensive care unit in Ethiopia, 2021.

The burden of hypoglycemia is high in resource limited countries, such as Ethiopia. However, there are no sufficient studies conducted in Ethiopia in general and in the study setting in particular in the previous era. Hence, this study aims to assess the proportion of hypoglycemia and associated factors among preterm neonates admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital, Ethiopia, in 2021. A hospital-based cross-sectional study was conducted from October 1 to December 30, 2021, at Debre Tabor Comprehensive Specialized Hospital in the neonatal intensive care unit ward. The data was entered in Epi-info 7 and exported to STATA version 14. A binary and multivariable logistic regression was computed at 95% confidence interval (CI). During bivariable analysis, variables having a p-value of less than 0.25 were chosen for multivariable logistic regression analysis, and variables having a p-value of less than 0.05 in multivariable analysis, were significant associations with the dependent variable. The study included 267 preterm neonates, and 23.59% (95% CI 18.9-29.1) were develop hypoglycemia. Moreover, 49 (18.35%) preterm neonates died during the study period. In this study, preterm neonates with hypothermia [Adjusted Odds Ratio (AOR = 4.5; 95 CI 3.4, 7.2)], birth asphyxia (AOR = 5.1; 95 CI 3.9, 27.1), seizure (AOR = 4.7; 95 CI 2.8, 17.8), and also preterm neonates born from diabetic mothers (AOR = 6.7; 95 CI 3.3, 27.2) were significantly associated with the occurrence of hypoglycemia in the neonatal intensive care. The proportion of hypoglycemia and associated factors among preterm neonates admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital was found to be high. The associated factors for the occurrence of hypoglycemia were discovered to be neonates with hypothermia, birth asphyxia, seizure, and neonates born with a diabetes mother. Thus, recognizing and treating the above associated factors is essential to preventing, and controlling hypoglycemia.

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.

HIV/AIDS Associated Lymphoma: Review.

Lymphoma is one of the hematologic malignancies that occur at a higher rate in human immunodeficiency virus-infected individuals. It is one of the most frequent neoplastic causes of death in those individuals. Non-Hodgkin's lymphoma and Hodgkin's lymphomas are acquired immunodeficiency syndrome defining lymphoma and non-acquired immunodeficiency syndrome defining lymphoma, respectively. Non-Hodgkin's lymphoma is the most common type of lymphoma in human immunodeficiency virus-positive people. The lymphoma that develops in patients infected with the human immunodeficiency virus/acquired immunodeficiency syndrome is heterogeneous in terms of morphology, pathogenesis pathways, and cellular derivation. A narrative review was conducted on the basis of relevant literature on the current topic to summarize the current epidemiology, pathogenesis, laboratory diagnosis, and treatment of lymphoma in human immunodeficiency virus-infected patients. The finding showed that although the incidence of non-Hodgkin's lymphoma has decreased after the advent of highly active antiretroviral therapy, it has remained higher in human immunodeficiency virus-infected people than in the general population. On the other hand, the incidence of Hodgkin's lymphoma has increased after the introduction of highly active antiretroviral therapy. Therefore, it is recommended that people living with human immunodeficiency virus/ acquired immunodeficiency syndrome be screened for the development of lymphoma to increase their survival time and quality of life, and further research is required regarding the pathogenesis, treatment, and laboratory diagnosis of human immunodeficiency virus/ acquired immunodeficiency syndrome-associated lymphoma.

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.