Prevalence of Orthohantavirus-Reactive Antibodies in Humans and Peri-Domestic Rodents in Northern Ethiopia.

In 2012, Tigray orthohantavirus was discovered in Ethiopia, but its seasonal infection in small mammals, and whether it poses a risk to humans was unknown. The occurrence of small mammals, rodents and shrews, in human inhabitations in northern Ethiopia is affected by season and presence of stone bunds. We sampled small mammals in two seasons from low- and high-density stone bund fields adjacent to houses and community-protected semi-natural habitats in Atsbi and Hagere Selam, where Tigray orthohantavirus was first discovered. We collected blood samples from both small mammals and residents using filter paper. The presence of orthohantavirus-reactive antibodies in blood was then analyzed using immunofluorescence assay (human samples) and enzyme linked immunosorbent assays (small mammal samples) with Puumala orthohantavirus as antigen. Viral RNA was detected by RT-PCR using small mammal blood samples. Total orthohantavirus prevalence (antibodies or virus RNA) in the small mammals was 3.37%. The positive animals were three Stenocephalemys albipes rats (prevalence in this species = 13.04%). The low prevalence made it impossible to determine whether season and stone bunds were associated with orthohantavirus prevalence in the small mammals. In humans, we report the first detection of orthohantavirus-reactive IgG antibodies in Ethiopia (seroprevalence = 5.26%). S. albipes lives in close proximity to humans, likely increasing the risk of zoonotic transmission.

Incidence and Trends of Leishmaniasis and Its Risk Factors in Humera, Western Tigray.

INTRODUCTION: Leishmaniasis is a neglected vector borne disease, which constitutes a major public health concern in several tropical and subtropical countries. An estimated 4500 to 4000 new cases of visceral leishmaniasis (VL) occur per year and over 3.2 million people are at risk of infection in the country. In Humera, VL epidemics are associated with migration of workers from nonendemic highlands into the visceral leishmaniasis endemic extensive farmlands. Therefore, the objective of this study is to estimate the incidence and the risk factors of leishmaniasis in Humera, Western Tigray. METHODS: A retrospective study was conducted using the hospital admission database on all patients admitted who have been suspected of having leishmaniasis infection and tested for rK39-based immune chromatographic test (ICT) at Kahsay Abera Hospital in Humera town from January 2012 to December 2017. Potential risk factors for leishmaniasis infection in human were collected from the hospital, which included categorical variables: age, sex, origin of place, clinical forms of leishmaniasis, mortality rates, and the occurrence of infections according to format of hospital. RESULTS: A total of 26511 hospital discharged patients with diagnosis of leishmaniasis were identified, out of which 2232 (8.42%) human leishmaniasis cases were registered and of them 71 were dead from January 2012 to December 2017. Mortality rates of leishmaniasis were 18 (3.3%) in 2012, 16 (3.1%) in 2013, 15 (2.4%) in 2014, 8 (3.3%) in 2015, 9 (4.1%) in 2016, and 5 (5.4%) in 2017. Univariate analysis of the infection rate of leishmaniasis was based on the potential risk factors and found higher male infection rates than female (P <0.05) in all the study years. Origin of place was also significantly associated (P< 0.05) where labor migrants from highland to agricultural fields had higher infection rates than those who permanently lived in and around Humera. Trends in season of occurrence revealed that weeding and harvesting time (July-December) had higher incidence of leishmaniasis than dry time (January-June). CONCLUSION: Male labor migrants from the highlands older than 15 years of age were at the highest risks of leishmaniasis during weeding and harvest season. Therefore, awareness creation on the risks of sleeping outdoors and the impact of using of bed nets is imperative especially for labor migrants during weeding and harvesting season.

TOWARDS A 'GLOBAL' STRATEGY FOR TACKLING THE GLOBAL BURDEN OF COMMUNICABLE AND NON-COMMUNICABLE DISEASES IN RESOURSE LIMITED SETTINGS.

The global burden of communicable diseases (CD) and non-communicable diseases (NCD) in low and middle-income countries (LMICs) likely stems from a common substratum of societal and system inadequacies. In order to appropriately control these conditions and to manage the determinants and deterrents of both CDs and NCDs related deaths and disabilities, joint strategies aimed at both systemic and population levels are warranted. Although deficiencies exist within the health systems of LMICs, assets which could be leveraged efficiently to produce desirable outcomes also abound. Significant changes are already taking place through health initiatives within LMICs, opening up opportunities for further success through the involvement of international agencies. The role of these agencies, including donor countries and LMICs' Diaspora, is to strengthen and support the opportunities offered by on-going changes at the country level. There is a need to better understand and support the drivers and processes of positive change within LMICs in order to harness them for more widespread benefit through scale-up efforts. Strategies for addressing CDs and NCDs should be devised and implemented as complementary rather than competing 'sides of the same coin'.