Prevalence of asymptomatic malaria and associated factors among pregnant women in Ethiopia: systematic review and meta-analysis.

The proactive identification of asymptomatic patients and the mitigation of associated problems are essential to the elimination of malaria. For asymptomatic malaria and related variables among pregnant women in Ethiopia, there are no national pooled estimates. As a result, the goal of this study is to compile thorough and compelling data from several Ethiopian investigations. Google Scholar, PubMed, Scopes, the Web of Science, the Cochrane Library, and African Journals Online were a few of the electronic resources that were accessed. The investigation included all observational studies. STATA version 15 was used to extract the data from the Microsoft Excel file and conduct the analysis. The estimated pooled prevalence of asymptomatic malaria among pregnant women was calculated using a random-effects model. An inverse variance index (I2) analysis was utilized to find heterogeneity. To assess the publication bias, funnel plots, and Egger's statistical tests were used. The study determined that the combined prevalence of asymptomatic malaria among pregnant women was 7.20 (95% confidence interval = 4.22, 10.18) and 4.69 (95% confidence interval = 2.77, 6.62) by microscopy and rapid diagnostic test, respectively. The presence of stagnant water near their home (odds ratio = 4.31; 95% confidence interval = 1.66, 11.20); not using insecticide-treated nets (odds ratio = 6.93; 95% confidence interval = 3.27, 14.71); the lack of indoor residual spray service (odds ratio = 2.68; 95% confidence interval = 1.63, 4.40); and the presence of pregnant women in their neighborhood (odds ratio = 3.14; 95% confidence interval = 1.4). This study showed that pregnant women have a high pooled prevalence of asymptomatic malaria. Women living in rural areas near stagnant water and those who never used insecticide-treated nets had a two-, four-, or six-fold higher prevalence of asymptomatic malaria, respectively. The use of advanced diagnostic techniques could produce a higher magnitude of the disease. For effective intervention toward elimination, active case detection at the community level is also advised. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023411385; identifier, CRD42023411385.

A Five-Year Retrospective Investigation of the Prevalence of Intestinal Parasites at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.

Background: Intestinal parasites are responsible for a significant amount of disease and mortality around the world. In developing nations, intestinal parasites are a severe public health issue. Intestinal parasite infections are one of the most common illnesses in the world. They're frequently linked to poor personal and environmental cleanliness, as well as low-quality drinking water. The aim of this study is to investigate the prevalence of intestinal parasites and their shifting trends during a five-year period at Mizan-Tepi University of Teaching Hospital (MTUTH). Methods: A cross-sectional retrospective survey using the past five years' (2017 to 2021) clinical records obtained from MTUTH Mizan-Aman town Southern west Ethiopia. Patients with complete age, sex, and stool parasite examination (direct wet mount or concentration techniques) records on the parasitology registration book were included. Data were entered and analysed using a Microsoft Excel sheet. The parasite prevalence was calculated using frequency and percentages. Results: Overall, 17,030 patient records of the past five years were reviewed from the registration books of parasitology laboratory departments at MTUTH and only 546 records were taken for this study. Of these 336 (61.50%) were female and the rest 210 (38.50%) were males. One hundred eighty-two (182) 33.33% of patients had one or more intestinal parasites over five years from 2017 to 2021. From total of 546 patients' records 17.77% in 2017, 18.89% in 2018, 23.44% in 2019, 19.96% in 2020 and 19.96% in 2021 had complete information. Conclusion: Intestinal parasite prevalence was high among patients who visited the Mizan-Tepi University of Teaching Hospital during the five-year period. Helminthes and protozoan parasites prevalence was higher in the 15-45 years age category. In order to avoid intestinal parasite-related disease, strategies other than mass drug administration are required.

Asymptomatic Plasmodium Infection and Associated Factors in Selected Districts of the Kaffa Zone, Southwest Ethiopia: A Cross-Sectional Study.

Background: Malaria remains a serious public health problem, particularly in resource scarce areas of the world. The number of malaria cases has dropped remarkably in Ethiopia over the last decade, and efforts to eliminate the disease are underway. Asymptomatic infections may pose significant challenges to the elimination program. The essence of this study was to assess the prevalence of asymptomatic Plasmodium infection and the associated factors among communities of the selected districts in the Kaffa zone. Materials and Methods: April to May and September to October 2021, were the two seasons in which the community-based cross-sectional survey was conducted. Capillary blood from a finger prick was examined by light microscopy (LM) and screened using rapid diagnostic tests (RDTs). The participants' sociodemographic characteristics and malaria prevention measures were collected using a pretested semistructured questionnaire. Data entry and analyses were carried out using EpiData and SPSS version 25.0. Logistic regression (bivariate and multivariable) analyses were carried out to assess the possible associations between the dependent variable and the associated factors. Results: 566 study participants were involved in the two cross-sectional surveys, including 234 male and 332 female subjects with a mean age of 18.486 (SD ± 15.167). Thirty-eight blood samples (6.7%) were found to be positive for Plasmodium species tested by both LM and RDT. Last night's use of long-lasting insecticidal net (LLIN) (AOR = 2.448, 95% CI: 1.009 5.938, p=0.048), presence of eave (AOR = 4.144, 95% CI: 1.049-16.363, p=0.043), and house sprayed in the last year (AOR = 5.206, 95% CI: 2.176-12.455, p < 0.001) were among factors that showed significant association with asymptomatic Plasmodium infection. Conclusion: The asymptomatic Plasmodium infection prevalence recorded in the study area was low. Last night's LLIN usage, the presence of an eave, a house sprayed in the last year, and the presence of stagnant water near the home of the study participants were among the factors associated with an increased risk of catching the disease.

SARS-CoV-2 Infections, Clinical Characteristics, and Related Risk Factors: The First 8 Months Surveillance Study Conducted in Southwest Ethiopia.

Coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome coronavirus (SARS-CoV-2) and became pandemic after emerging in Wuhan, China, in December 2019. We aimed to investigate the prevalence, clinical characteristics, and risk factors for SARS-CoV-2 infections in districts of southwest Ethiopia. A study was conducted on COVID-19 surveillance data in the diagnostic center of the southwest district of Ethiopia from July 1, 2020, to February 30, 2021. A total of 10 618 nasopharyngeal specimens were tested for SARS-COV-2 using the detection of unique sequences of virus RNA by reverse transcriptase PCR. Data were entered into Epidata version 3.1 and analyzed using SPSS version 25. Logistic regression was used to determine the relationship between COVID-19 and risk factors, with a significance level of P = 0.05. A total of 10 618 individuals were tested for SARS-CoV-2. Of these, 419 (3.9%) patients tested positive for SARS-CoV-2. Among a total of 419 patients who tested positive for SARS-CoV-2, 80.2% were asymptomatic, 264 (63.0%) were males, and 233 (55.6%) were aged 19 to 35 years. Comorbidity was present in 37 (8.8%). The risk of getting SARS-CoV-2 infections was increased with male sex (AOR = 1.248; 95% CI: 1.007, 1.547), health workers (AOR = 3.187; 95% CI: 1.960, 5.182), prisoners (AOR = 2.118; 95% CI: 1.104, 4.062), and comorbid conditions (AOR = 2.972; 95% CI: 1.649, 5.358), such as diabetes (AOR = 4.765; 95% CI: 1.977-11.485) and other respiratory problems (AOR = 3.267; 95% CI: 1.146-9.317). Despite the fact that overall laboratories confirmed prevalence of SARS-CoV-2 infections in the study area was low and dynamic, it was spread to all zones of the study area. This highlights the importance of implementing the most effective public health strategies to prevent the further spread and reduce the burden of SARS-CoV-2 infections.

Medication Adherence and Contributing Factors Among Type 2 Diabetes Patients at Adama Hospital Medical College in Eastern Ethiopia.

Introduction: Good glycemic control and preventing early complications are the ultimate targets of diabetes management, which depends on patients' adherence to regimens. Even though highly potent and effective medications have been developed and manufactured with astonishing advancement over the past few decades, excellent glycemic control has remained elusive. Objective: This study aimed to assess the magnitude and factors associated with medication adherence among type 2 diabetes (T2D) patients on follow-up at Adama Hospital Medical College (AHMC) in East Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 245 T2D patients on follow-up at AHMC from March 1 to March 30, 2020. Medication adherence reporting scale-5 (MARS-5) was utilized to collect information regarding patients' medication adherence. The data were entered and analyzed using SPSS (Statistical Package for Social Sciences) version 21. The level of significance was declared at a p-value of < .05. Results: Of the 245 respondents, the proportion of respondents who adhere to diabetes medication was 29.4%, 95% CI [confidence interval] (23.7%-35.1%). After adjusting for khat chewing and adherence to blood glucose testing as confounding factors, being married (AOR [adjusted odds ratio] = 3.43, 95%CI [1.27-4.86]), government employee (AOR = 3.75, 95%CI [2.12-7.37]), no alcohol drinking (AOR = 2.25, 95%CI [1.32-3.45]), absence of comorbidity (AOR = 1.49, 95%CI [1.16-4.32]), and having diabetes health education at health institution (AOR = 3.43, 95%CI [1.27-4.86]) were the factors associated with good medication adherence. Conclusion: The proportion of T2D patients who adhere to medication in the study area was remarkably low. The study also found that being married, government employee, no alcohol drinking, absence of comorbidity, and having diabetes health education at a health institution were the factors associated with good medication adherence. Therefore, imparting health education on the importance of diabetes medication adherence by health professionals at each follow-up visit should be considered. Besides, awareness creation programs regarding diabetes medication adherence should be considered using mass media (radio and television).

Suppressive, Curative, and Prophylactic Effects of Maesa lanceolata Forssk. against Rodent Malaria Parasite Plasmodium berghei.

The artemisinin partial resistance is believed to be spread to artemisinin-based combination therapy partner drugs. As a result, new antiplasmodial compounds are required to treat resistant malaria infections. In the invention of antimalarial substances, claimed medical plants are precious resources. So, the current study was designed to assess the antiplasmodial effects of Maesa lanceolata in mice. In this study, preliminary phytoconstituent and in vivo acute oral toxicity tests were done. Early infection, established infection, and residual infection tests were employed to determine the antimalarial effects of the test drugs. Three doses (200, 400, and 600 mg/kg) of the extracts were provided orally to the test mice. Analysis of variance (one-way) followed by post hoc Tukey's test was used to analyze the difference between and within groups. Terpenoids, tannins, saponins, flavonoids, and alkaloids were detected in the phytochemical constituent analysis. Both 80% methanolic crude extract and solvent fractions had no toxic result at the 2000 mg/kg dose. All test drug doses suppressed parasite levels in a significant manner at all tests. The activity of chloroform fraction (maximum percentage suppression, 81.28%) overwhelms the crude extract activity. The curative effects of 80% methanolic crude extract, with a maximum of 80.22% parasitemia suppression, were greater than its suppressive and prophylactic effects. The 400 mg/kg dose of chloroform fraction resulted in a maximum survival period (18 days) than other doses of tested materials. The results of this investigation provide support for the activity of M. lanceolata leaf extract against malaria.

Trends of Malaria Prevalence in Selected Districts of Kaffa Zone, Southwest Ethiopia.

Background: Malaria remains one of the world's major public health issues, particularly in low- and middle-income countries. In Ethiopia, cases have declined over the last decade, and attempts to eradicate the illness are underway. The purpose of this study was to determine trends in malaria prevalence in selected areas of the Kaffa zone during the last five years (Decha and Gimbo districts). Methods: All malaria cases registered from 2017 to 2021 were reviewed to assess the trends of malaria prevalence. A checklist was used to collect the secondary data from registers and entered it into an Excel spreadsheet, which was then exported to the Statistical Package for the Social Sciences (SPSS) version 25.0 for analysis. The malaria incidence rate was calculated with the total number of person-years as the denominator and the number of new cases as the numerator. Seasons, years, gender, age, and malaria parasite species were all used to show trends in malaria transmission in the areas. Tables and figures were used to present the data. Results: Out of 20,045 individuals screened for malaria, 13.6% (2,732/20,045) of them were recorded to have Plasmodium species tested using microscopy and rapid diagnostic test (RDT). Plasmodium falciparum, Plasmodium vivax, and mixed infections (Plasmodium falciparum + Plasmodium vivax) accounted for 1200 (5.9%), 1114 (5.56%), and 418 (2.09%) of the confirmed malaria cases, respectively. Overall, malaria incidence decreased with an interannual variation, from 4.08 cases per 1000 person-years in 2017 to 3.62 cases per 1000 person-years in 2018, then increased to 4.94 cases per 1000 person-years in 2021. Conclusion: The malaria trend over the last five years has revealed a nonconsistent pattern of cases in different years. The number of malaria cases has shown an increase over the period of 2017 to 2021. Interannual and intra-annual variations have been observed in the transmission of the disease.

Malaria prevalence and risk factors among patients visiting Mizan Tepi University Teaching Hospital, Southwest Ethiopia.

BACKGROUND: Ethiopia is among sub-Saharan African countries with a high number of malaria cases each year, with most of the landmass favoring the breeding of the vectors. There have been extensive efforts to control and prevent the transmission of malaria, which is part of the country's prevention-based health policy. OBJECTIVE: This study aimed to determine malaria prevalence and associated risk factors among patients visiting Mizan-Tepi University Teaching Hospital (MTUTH). MATERIALS AND METHODS: A cross-sectional study was conducted from September to December 2021 among patients visiting MTUTH, Southwest Ethiopia. A pretested structured questionnaire was used to collect sociodemographic data, and a capillary blood sample was collected after obtaining written informed consent from the study participants. The data were entered into Epi-data manager (v4.0.2.101) and analyzed with SPSS version 25.0, with a P-value of < 0.05 set as a significance. RESULTS: A total of 439 patients participated, of which 20.7% (91) were positive for malaria parasites, with a higher prevalence observed among the age group interval of 25-34 years (5.5%). Inadequate access to insecticide-treated bed net (ITN) 23.9% (105) and a low level of ITN usage 20.5% (90) were recorded. Patients living in areas of stagnant water were more likely to get infected with the malaria parasite (AOR = 16.191, 95% CI: 9.137, 28.692) compared to those who live away from stagnant water, and individuals living in houses not sprayed with insecticides were more susceptible to malaria infection (AOR = 0.215, 95% CI: 0.128, 0.360). CONCLUSION: The overall malaria prevalence in this study was 20.7% (91), which proves that malaria remains a major threat to the communities in the study area, with Plasmodium falciparum contributing to most of the cases. Improving the habits of ITN usage and indoor residual spray through health education may help to reduce the impact of malaria in the study area.

Nutritional Status of Postpartum Mothers and Associated Risk Factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia: A Community Based Cross-Sectional Study.

Background: Malnutrition affects millions of people in developing countries and contributes to poor health outcomes and nutritional status among women in the postpartum period. Lactation increases high nutritional demands and marks a significant life transition that can impact diet quality and subsequently predispose woman to high risk of overweight and undernutrition. Although, studies have been conducted on the nutritional status of lactating women, there is a gap especially on women's nutritional status during the postpartum period. Therefore, this study aimed to assess the nutritional status of postpartum women and associated factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia, 2020. Method: A community-based cross-sectional study was conducted in Shey-Bench District from March 1 to 30/2020 among 359 postpartum mothers. Bivariate analysis was employed to select candidate variables at P-value <.25 as a cut-off point. Multiple multinomial logistic regression analysis was used to identify variables significantly associated with nutritional status of the mother at P < .05 with 95% CI. Results: The study revealed that 10.3% of women were underweight and 16.7% were overweight. Employed mothers (AOR = 4.467, 95% CI [1.05-19.04]), employed husband (AOR = 0.087, 95% CI [0.021-0.370]), farmer husband (AOR = 0.084, 95% CI [0.024-0.293]), trader husband (AOR = 0.19, 95% CI [0.0614-0.616]), married mother (AOR = 0.222, 95% CI [0.088-0.560]), dietary diversity (AOR = 0.181, 95% CI [0.075-0.436]) were significantly associated with underweight and while being overweight was associated with dietary diversity, maternal age of between 15 to 24 and 25 to 34, exclusive breastfeeding, and frequency of breastfeeding. Conclusion: This study found a lower prevalence of underweight compared with overweight in the study area. Occupational status, marital status, age of the mother, dietary diversity, exclusive and frequency of breastfeeding were significantly associated factors with nutritional status of postpartum mother. We recommend strengthening the provision of nutrition education on modifiable factors with collaboration of other sectors.

Poor Sleep in Community-Dwelling Polysubstance Users: Association With Khat Dependence, Metacognition, and Socio-Demographic Factors.

Purpose: Poor sleep and cognitive deficits are often associated with increased drug use. However, no study has addressed the relationship between poor sleep, substance dependence, and metacognitive deficit in polysubstance users. Methods: This was a cross-sectional study with a simple random sampling involving community-dwelling polysubstance users (n = 326, age = 18-43 years) in Mizan, Ethiopia. Participants completed a brief sleep questionnaire, severity of dependence on khat (SDS-Khat), a brief meta-cognition questionnaire, and a socio-demographic survey. Results: Majority (56.4%) of the polysubstance users had sleep disturbance. Chronic health conditions [adjusted odds ratio (AOR) = 2.52, 95% confidence interval (CI) 1.31-4.85], chronic conditions in the family (AOR = 2.69, 95% CI 1.40-5.20), illiterate-primary level of educational status (AOR = 2.40, 95% CI 1.30-4.04), higher SDS-Khat score (AOR = 1.39, 95% CI 1.13-1.72), and lower meta-cognition score (AOR = 0.90, 95% CI 0.84-0.97) predicted poor sleep in the polysubstance users. Moreover, low metacognition score and high SDS score also predicted additional sleep disturbances like chronic sleep insufficiency, lethargy and restlessness after nighttime sleep, socio-occupational dysfunctions, and daytime disturbances in polysubstance users. Conclusion: Poor sleep, severe khat dependence, and metacognitive deficits are common in community polysubstance users. Moreover, poor sleep is associated with higher khat dependence, lower metacognitive ability, lower educational status, and the presence of chronic conditions in polysubstance users or their families.

In vivo antiplasmodial activity of hydromethanolic leaf extract and solvent fractions of Maytenus gracilipes (Celastraceae) against Plasmodium berghei in mice.

BACKGROUND: The incidence of resistance among currently available antimalarial drugs, as well as the high economic cost of malaria, has prompted researchers to look for novel antimalarial molecules. As a result, the current study was proposed to evaluate the antiplasmodial activity (in vivo) of Maytenus gracilipes based on the plant's traditional claims. METHODS: A cold maceration procedure using 80% methanol as a solvent was employed to obtain a crude extract from M. gracilipes leaves. Chloroform, n-butanol, and pure water were used to fractionate the hydromethanolic extract. Standard procedures were followed for an acute oral toxicity test. The antimalarial effects of the plant at 200, 400, and 600 mg/kg doses were investigated using three rodent malaria models (4-day suppressive, rane's, and repository tests). Thirty mice were utilized in each experiment (3 treatment and 2 control groups, each with six mice). Parasitemia, survival time, body weight, temperature, and packed cell volume were all used to assess the extracts' antiplasmodial activity. To compare results between groups, a one-way ANOVA with Post Hoc Tukey's HSD was used. RESULTS: In a 4-day suppressive investigation, all doses of the crude extract and fractions suppressed parasitemia significantly (P < 0.001) as compared to the negative control. The crude extract had the greatest chemosuppressive effect (74.15%) at 600 mg/kg dose. Chloroform had the greatest parasitemia suppression among the fractions; however it was less than the crude extract. In Rane's test, all doses of the crude extract produced substantial (P < 0.001) curative effects as compared to the negative control. CONCLUSION: According to this study, the crude extract and solvent fractions of M. gracilipes leaves contain antimalarial activity with a substantial suppressive effect. The antiplasmodial effects were more active in the chloroform and n-butanol fractions, indicating that the plant's non-polar and medium polar constituents are responsible. Nonetheless, further analysis is required to isolate and characterize the active compounds responsible for the study plant's antimalarial activity.

Antiplasmodial Activity of the Crude Extract and Solvent Fractions of Stem Barks of Gardenia ternifolia in Plasmodium berghei-Infected Mice.

BACKGROUND: The evolution of resistance to currently used malaria medicines together with the severe economic burden of malaria initiates the search for novel antimalarial drugs. Thus, the present experiment was intended to assess the in vivo antiplasmodial effect of Gardenia ternifolia based on the traditional claims and in vitro antimalarial effect of the plant. METHODS: For the crude extraction of stem barks of G. ternifolia, a cold maceration method using hydromethanol as a solvent was employed. The hydroalcoholic extract was then fractionated by three solvents (chloroform, n-butanol, and aqueous solvent) with different polarity indexes. Swiss albino mice infected with the chloroquine-sensitive malaria parasite (Plasmodium berghei) were used in this study. Acute oral toxicity study was done according to standard protocols. Four-day suppressive (hydromethanolic crude extract and solvent fractions), Rane's (crude extract), and repository (crude extract) tests were used to examine the antiplasmodial effects of the study plant. RESULTS: The chemosuppressive study revealed that all doses of the crude extract and its fractions displayed a significant (P < 0.001) inhibition of parasitemia compared with the vehicle (negative control). The crude extract's highest dose (600 mg/kg) showed the maximum (57.84%) parasitemia suppression during the chemosuppressive test. The crude extract also produced significant (P < 0.001) curative and prophylactic effects at all doses in Rane's and repository tests compared with the negative control. In the 4-day test, the n-butanol fraction produced parasitemia suppression higher than the chloroform fraction but lower than the crude extract. Of these, water fractions demonstrated the lowest chemosuppressive effect. Anthraquinone, alkaloids, flavonoids, saponins, steroids, tannins, and terpenoids were qualitatively detected in the plant material. CONCLUSION: The current results showed that the hydromethanolic extract and fractions of G. ternifolia stem barks have antiplasmodial action with a high curative effect. Chloroform and n-butanol fractions were more active among the fractions, indicating that the nonpolar and semipolar constituents of the plant are responsible for the antimalarial effects.

Evaluation of Antiplasmodial Activity of Hydroalcoholic Crude Extract and Solvent Fractions of Zehneria scabra Roots Against Plasmodium berghei in Swiss Albino Mice.

BACKGROUND: Since drug resistance makes controlling malaria parasites a major challenge, these pioneering researchers explore and discover new novel drugs from a variety of sources. As a result, this study aimed to assess the anti-plasmodial activity of hydroalcoholic crude extract and solvent fractions of Zehneria scabra roots in mice infected with Plasmodium berghei. METHODS: The antimalarial activity and safety profile of Zehneria scabra extracts were tested in a mouse model using four-day suppressive, prophylactic, and rane's tests against chloroquine-sensitive Plasmodium berghei. Mice were divided into five groups at random: group I received distilled water (10 mL/kg), group II, III, and IV received 200, 400, and 600 mg/kg of the extract, respectively, and group V received chloroquine (25 mg/kg). The antimalarial activity of the extract was determined using parasitemia levels, survival time, rectal temperature, and weight variation. RESULTS: At all dose levels, the crude extract and solvent fractions of Zehneria scabra showed significant (p<0.05 to p<0.001) chemosuppression, with the crude extract and butanol fraction showing the highest chemosuppression (73.09% and 74.09%, respectively). Apart from suppressing parasitemia, the extract also increased survival time and secured packed cell volume reduction substantially (p<0.05 to p<0.001), while the crude extract had no significant impact on body weight or rectal temperature reduction in four-day suppressive and prophylactic models. CONCLUSION: The result designated that Zehneria scabra is endowed with significant antimalarial activity. These results thus support the traditional use of Zehneria scabra, for the treatment of malaria.

Poor Glycemic Control and Its Contributing Factors Among Type 2 Diabetes Patients at Adama Hospital Medical College in East Ethiopia.

BACKGROUND: Poor glycemic control is a major public health issue among patients with type 2 diabetes mellitus and a significant risk factor for the progression of diabetic complications. This study aimed to assess the magnitude and contributing factors of poor glycemic control among type 2 diabetes patients on follow-up at Adama Hospital Medical College (AHMC) in East Ethiopia. METHODS: A cross-sectional study was conducted among 245 type 2 diabetes patients on follow-up at AHMC from March 1 to 30, 2020. All type 2 diabetes patients on follow-up at AHMC and fulfilling the inclusion criteria were included in the study. The data were collected through face-to-face interviews using structured questionnaires and reviewing the patient chart. The data were entered and analyzed using SPSS version 21. The level of significance was declared at a p-value of <0.05. RESULTS: Of the 245 type 2 diabetes patients included in the study, 157 (64.1%) had poor glycemic control. The factors associated with poor glycemic control were being male (AOR = 2.28, 95% CI [1.24-4.21]), not attending formal education (AOR = 3.12, 95% CI [1.53-6.35]), monthly income of <136 USD (AOR = 2.14, 95% CI [1.17-3.91]), overweight (AOR = 2.60, 95% CI [1.32-5.10]) and obesity (AOR = 3.44, 95% CI [1.44-8.21]), and chewing khat (AOR = 2.77, 95% CI [1.04-7.33]). CONCLUSION: The proportion of poor glycemic control among type 2 diabetes patients at AHMC was remarkably high. Therefore, more effort should be taken to strengthening and disseminating health education programs for diabetes patients at each follow-up visit on the importance of achieving optimal body weight, avoiding khat chewing, and maintaining regular physical exercise to prevent and mitigate the complications resulting from poor glycemic control.

Drug- and Multidrug-Resistance Pattern of Enterobacteriaceae Isolated from Droppings of Healthy Chickens on a Poultry Farm in Southwest Ethiopia.

BACKGROUND: In Ethiopia, the precise attribution of animals and their food products as the sources of resistant strains and the consequences of it on human health have not yet been seriously evaluated. Therefore, the aim of this study was to assess the drug- and multidrug-resistance pattern of Enterobacteriaceae isolated from chicken droppings at Jimma University poultry farm, College of Agriculture and Veterinary Medicine, southwest of Ethiopia. METHODS: A cross-sectional descriptive study was conducted from April, 2018 to June, 2018. A total of 140 fresh chicken dropping samples were collected and transported to Jimma University Medical Microbiology Laboratory for analysis. All samples were inoculated on MacConkey agar and xylose lysine deoxycholate agar. Gram stain and relevant biochemical tests were done for identification of isolates. Antimicrobial susceptibilities were tested by the Kirby-Bauer disk diffusion method. RESULTS: Out of 140 chicken dropping samples, 61 (43.6%) showed bacterial growth. Of these, E. coli accounts for 39.0% followed by K. pneumoniae (22.0%), P. mirabilis (19.3%), and Salmonella species (17.7%). With regard to antibiotic resistance pattern, E. coli demonstrated a high rate of resistance against ampicillin (91.7%), tetracycline (75.0%), and trimethoprim-sulfamethoxazole (70.8%). K. pneumoniae showed a high resistance rate against ampicillin, trimethoprim-sulfamethoxazole, and tetracycline, with a resistance rate ranging from 76.9% to 85.6%. P. mirabilis and Salmonella spp. also showed high resistance against ampicillin, tetracycline, and trimethoprim-sulfamethoxazole with a resistance rate ranging from 72.7% to 83.3%. All isolates relatively showed lower resistance rates with a range of 20.8% to 41.7% against third-generation cephalosporins (ceftazidime and ceftriaxone), ciprofloxacin, and gentamicin. Totally, 32 (52.5%) of the isolates showed MDR against three or more antibiotics. CONCLUSION: Antibiotic resistant isolates against commonly prescribed single and multiple drugs were common. This highlights that chickens in the farm may serve as the reservoirs of antibacterial resistant bacteria that might infect humans through the food chain. Therefore, emphasis on the usage of antibiotics in chicken farms has to be considered.

Identification of transmission foci of Schistosoma mansoni: narrowing the intervention target from district to transmission focus in Ethiopia.

BACKGROUND: Schistosoma mansoni (S. mansoni) infection is a significant public health problem in Ethiopia, and has wide distribution in the country. The impact of the disease is particularly high on school-age children. Nationwide 385 endemic districts were identified, whereby control and elimination interventions are underway using school-based annual mass drug administration (MDA) with praziquantel. The national elimination program targets endemic districts as a whole. The aim of this study was to identify the transmission foci of Schistosoma mansoni and determine prevalence of soil-transmitted helminths (STHs) in Abeshge district. METHODS: The study was conducted from April to May, 2019 among school-age children randomly selected from public elementary schools in Abeshge district, South-central Ethiopia. Demographic information and data on risk factors of S. mansoni infection were gathered using pre-tested questionnaire. Moreover, a stool sample was collected from each child and examined using Kato-Katz thick smear technique. The data were analyzed using STATA_MP version 12. RESULTS: A total of 389 school-age children from five public elementary schools were included in the study. The overall prevalence of S. mansoni and STHs was 19.3% (75/389) and 35% (136/389), respectively. The prevalence of S. mansoni was 60.6% in Kulit Elementary school, while it was zero in Geraba. The prevalence of S. mansoni was significantly higher among males (AOR = 2.6, 95% CI 1.3-5.1), those with habit of swimming and/or bathing in rivers (AOR = 2.9, 95%CI 1.3-5.1) and involved in irrigation activities (AOR = 2.9, 95% CI 1.0-8.3). Overall, the prevalence of S. mansoni was significantly higher among school children attending Kulit Elementary School compared to those attending the remaining schools (AOR = 12.5, 95%CI 6.2-25.1). CONCLUSION: A wide variation of S. mansoni prevalence was observed among the school children in the different schools. Control interventions better identify and target foci of S. mansoni transmission, instead of targeting the district homogenously.

Prevalence and Intensity of Soil-Transmitted Helminth Infection among Rural Community of Southwest Ethiopia: A Community-Based Study.

BACKGROUND: Helminths are significant contributors to global health problems. Subgroup soil-transmitted helminths are among the listed neglected tropical diseases. The rural inhabitants often suffer from heavy infection, particularly children and pregnant women. OBJECTIVE: The study aimed at determining the magnitude and intensity of soil-transmitted helminth infection and associated risk factors in the study area where the prevalence and intensity of the infection are yet unknown at the community level. METHOD: A community-based cross-sectional study was conducted between April and June 2016 on 377 individuals. Systematic random sampling was utilized to select the households. Lottery method was used for study subject selection in the households. Sociodemographic and risk factor data were collected using a pretested questionnaire. Parasitological tests were processed using Kato-Katz thick smear and duplicate direct wet mount analysis of the stool sample. RESULTS: A total of 377 subjects aged from 2 to 55 years were enrolled in the study, of which 211 were female (56%) and 166 were male (44%). The overall prevalence of soil-transmitted helminths was 265 (70.3%). The females shared more (36.6%, 138) as compared to males (33.7%, 127) at P < 0.05. Of all identified soil-transmitted helminths, Trichuris trichiura was the predominant infectious agent (66.8%, 252) followed by Ascaris lumbricoides (16.4%, 62) and hookworm (14.1%, 53). Gender (AOR: 1.67 (95% CI: 1.034-2.706)), lack of fruit washing before consumption (AOR: 1.7 (95% CI: 1.1-2.6)), open defecation habit (AOR: 1.75 (95% CI: 0.921-3.338)), and drinking untreated water (AOR: 1.994 (95% CI: 1.019-3.90)) were significantly associated with soil-transmitted helminth infection. CONCLUSION: High prevalence of STH infection was still an important health issue of the community even after the implementation of the health extension program. Hence, intervention considering all population of the residents as eligible to deworm and health education are mandatory.