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1.
Proteome Sci ; 18(1): 10, 2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33292280

RESUMO

BACKGROUND: Tuberculosis (TB) is one of the world's most problematic infectious diseases. The pathogen Mycobacterium tuberculosis (Mtb) is contained by the immune system in people with latent TB infection (LTBI). No overt disease symptoms occur. The environmental and internal triggers leading to reactivation of TB are not well understood. Non-tuberculosis Mycobacteria (NTM) can also cause TB-like lung disease. Comparative analysis of blood plasma proteomes from subjects afflicted by these pathologies in an endemic setting may yield new differentiating biomarkers and insights into inflammatory and immunological responses to Mtb and NTM. METHODS: Blood samples from 40 human subjects in a pastoral region of Ethiopia were treated with the ESAT-6/CFP-10 antigen cocktail to stimulate anti-Mtb and anti-NTM immune responses. In addition to those of active TB, LTBI, and NTM cohorts, samples from matched healthy control (HC) subjects were available. Following the generation of sample pools, proteomes were analyzed via LC-MS/MS. These experiments were also performed without antigen stimulation steps. Statistically significant differences using the Z-score method were determined and interpreted in the context of the proteins' functions and their contributions to biological pathways. RESULTS: More than 200 proteins were identified from unstimulated and stimulated plasma samples (UPSs and SPSs, respectively). Thirty-four and 64 proteins were differentially abundant with statistical significance (P < 0.05; Benjamini-Hochberg correction with an FDR < 0.05) comparing UPS and SPS proteomic data of four groups, respectively. Bioinformatics analysis of such proteins via the Gene Ontology Resource was indicative of changes in cellular and metabolic processes, responses to stimuli, and biological regulations. The m7GpppN-mRNA hydrolase was increased in abundance in the LTBI group compared to HC subjects. Charged multivesicular body protein 4a and platelet factor-4 were increased in abundance in NTM as compared to HC and decreased in abundance in NTM as compared to active TB. C-reactive protein, α-1-acid glycoprotein 1, sialic acid-binding Ig-like lectin 16, and vitamin K-dependent protein S were also increased (P < 0.05; fold changes≥2) in SPSs and UPSs comparing active TB with LTBI and NTM cases. These three proteins, connected in a STRING functional network, contribute to the acute phase response and influence blood coagulation. CONCLUSION: Plasma proteomes are different comparing LTBI, TB, NTM and HC cohorts. The changes are augmented following prior blood immune cell stimulation with the ESAT-6/CFP-10 antigen cocktail. The results encourage larger-cohort studies to identify specific biomarkers to diagnose NTM infection, LTBI, and to predict the risk of TB reactivation.

2.
Biochem Insights ; 12: 1178626419875089, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31555049

RESUMO

Aerococcus urinae (Au) and Globicatella sanguinis (Gs) are gram-positive bacteria belonging to the family Aerococcaceae and colonize the human immunocompromised and catheterized urinary tract. We identified both pathogens in polymicrobial urethral catheter biofilms (CBs) with a combination of 16S rDNA sequencing, proteomic analyses, and microbial cultures. Longitudinal sampling of biofilms from serially replaced catheters revealed that each species persisted in the urinary tract of a patient in cohabitation with 1 or more gram-negative uropathogens. The Gs and Au proteomes revealed active glycolytic, heterolactic fermentation, and peptide catabolic energy metabolism pathways in an anaerobic milieu. A few phosphotransferase system (PTS)-based sugar uptake and oligopeptide ABC transport systems were highly expressed, indicating adaptations to the supply of nutrients in urine and from exfoliating squamous epithelial and urothelial cells. Differences in the Au vs Gs metabolisms pertained to citrate lyase and utilization and storage of glycogen (evident only in Gs proteomes) and to the enzyme Xfp that degrades d-xylulose-5'-phosphate and the biosynthetic pathways for 2 protein cofactors, pyridoxal 6'-phosphate and 4'-phosphopantothenate (expressed only in Au proteomes). A predicted ZnuA-like transition metal ion uptake system was identified for Gs while Au expressed 2 LPXTG-anchored surface proteins, one of which had a predicted pilin D adhesion motif. While these proteins may contribute to fitness and virulence in the human host, it cannot be ruled out that Au and Gs fill a niche in polymicrobial biofilms without being the direct cause of injury in urothelial tissues.

3.
J Trop Med ; 2019: 5954313, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30941182

RESUMO

Background: Medical laboratories play essential roles in measurement of analyte in clinical sample for the diagnosis and monitoring of diseases. Thus, data generated from the laboratory have to be reliable for which strict quality assurance is maintained. Objective: To assess the coverage and quality of selected clinical chemistry tests among medical laboratories of health facilities in, Jimma Zone, South West Ethiopia. Methods: A cross-sectional study was conducted at Jimma Zone on health facilities from August 15 to September 15, 2014. Eighty-six health facility laboratories were included in the study. We classified laboratories into laboratories with clinical chemistry service and those without clinical chemistry service clusters and those with clinical chemistry laboratory were again clustered according to their level. Data were collected by direct observation, interview, and proficiency testing (PT). The collected data were analyzed and compared with CLIA PT goal for TEa by considering total allowable error ± 20%, ±10%, ±15%, and ±20 for each analyte, ALT, glucose, creatinine, and total bilirubin, respectively. Result: From total of 86 health facilities with laboratories, 23.3% (n=20) had clinical chemistry service, of which 77.2% results were reported outside of the allowable error limit. Conclusion: According to this study the availability of clinical chemistry test service was very minimal and facilities giving the service do not fulfill the minimum standard for quality; thus clients were either getting wrong clinical decision or misdiagnosed. Therefore, the external and internal quality assessment programs should be reviewed very well. Those laboratories whose report was outside of the allowable error should have to report results with the appropriate reference range so that physicians consider that. Establishment of local clinical chemistry reference range can also minimize the problem.

4.
Artigo em Inglês | MEDLINE | ID: mdl-30534412

RESUMO

Background: Antimicrobial resistance is a global concern of increasing significance. Multidrug resistant tuberculosis (MDR-TB) is spreading worldwide. It is important to monitor trends of antimycobacterial resistance. This is particularly true for high TB burden countries such as Ethiopia where disproportionally less drug sensitivity data are reported from. Methods: The prevalence of drug resistance was assessed with the line probe assay GenoType MTBDRplus in a set of 161 M. tuberculosis strains that were selected from four common lineages and sub-lineages previously identified in Ethiopia. Most of the tested M. tuberculosis isolates had been genotyped by established Spoligotyping and MIRU-VNTR typing methods. Results: The proportion of MDR-TB among the isolates was 3.1%. Mono-resistance was 1.2% to rifampicin and 4.3% to isoniazid, and resistance to either of the two first line drugs was 8.7%. Strains of Lineage 4 had the highest resistance rate (13.6%) followed by Lineage 3 (4.9%). None of the isolates representing Lineages 1 and Lineage 7 were drug resistant. Multidrug resistance among pulmonary TB and TB lymphadenitis clinical isolates was 2.8 and 3.7%, respectively. Drug resistance of strains carrying the most prevalent spoligotype in Ethiopia - SIT149 - was further explored. Stratification by MIRU-VNTR identified one genotype with a high rate of drug resistance against Rifampicin and Isoniazid and circulation of a potential MDR-TB clone is proposed. Conclusion: Although the strain selection was not fully randomized, the overall M. tuberculosis drug resistance rate in this strain set was 8.7% while the rate of MDR was 3.1%. In parallel, we identified a sub-lineage that showed a high rate of resistance to both rifampicin and isoniazid. These resistant strains may belong to a clone of M. tuberculosis that is circulating in the highlands of Ethiopia.

5.
SAGE Open Med ; 6: 2050312118807626, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30397473

RESUMO

Background: Clinical laboratory reference intervals are an important tool to identify abnormal laboratory test results. The generating of hematological parameters reference intervals for local population is very crucial to improve quality of health care, which otherwise may lead to unnecessary expenditure or denying care for the needy. There are no well-established reference intervals for hematological parameters in southwest Ethiopia. Objective: To generate hematological parameters reference intervals for apparently healthy individuals in southwest Ethiopia. Methods: A community-based cross-sectional study was conducted involving 883 individuals from March to May 2017. Four milliliter of blood sample was collected and transported to Jimma University Medical Center Laboratory for hematological analysis and screening tests. A hematological parameters were measured by Sysmex XS-500i hematology analyzer (Sysmex Corporation Kobe, Japan). The data were analyzed by SPSS version 20 statistical software. The non-parametric independent Kruskal-Wallis test and Wilcoxon rank-sum test (Mann-Whitney U test) were used to compare the parameters between age groups and genders. The 97.5 percentile and 2.5 percentile were the upper and lower reference limit for the population. Results: The reference interval of red blood cell, white blood cell, and platelet count in children were 4.99 × 1012/L (4.26-5.99 × 1012/L), 7.04 × 109/L (4.00-11.67 × 109/L), and 324.00 × 109/L (188.00-463.50 × 109/L), respectively. The reference interval of red blood cell, white blood cell, and platelet count in adults was 5.19 × 1012/L (4.08-6.33 × 1012/L), 6.35 × 109/L (3.28-11.22 × 109/L), and 282.00 × 109/L (172.50-415.25 × 109/L), respectively. The reference interval of red blood cell, white blood cell, and platelet count in geriatrics were 5.02 × 1012/L (4.21-5.87 × 1012/L), 6.21 × 109/L (3.33-10.03 × 109/L), and 265.50 × 109/L (165.53-418.80 × 109/L), respectively. Most of the hematological parameters showed significant differences across all age groups. Conclusion: Most of the hematological parameters in this study showed differences from similar studies done in the country. This study provided population-specific hematological reference interval for southwest Ethiopians. Reference intervals should also be established in the other regions of the country.

6.
J Proteome Res ; 17(9): 2917-2924, 2018 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-30114372

RESUMO

The success of shotgun proteomic analysis depends largely on how samples are prepared. Current approaches (such as those that are gel-, solution-, or filter-based), although being extensively employed in the field, are time-consuming and less effective with respect to the repetitive sample processing, recovery, and overall yield. As an alternative, the suspension trapping (S-Trap) filter has been commercially available very recently in the format of a single or 96-well filter plate. In contrast to the conventional filter-aided sample preparation (FASP) approach, which utilizes a molecular weight cut-off (MWCO) membrane as the filter and requires hours of processing before digestion-ready proteins can be obtained, the S-Trap employs a three-dimensional porous material as filter media and traps particulate protein suspensions with the subsequent depletion of interfering substances and in-filter digestion. Due to the large (submicron) pore size, each centrifugation cycle of the S-Trap filter only takes 1 min, which significantly reduces the total processing time from approximately 3 h by FASP to less than 15 min, suggesting an ultrafast sample-preparation approach for shotgun proteomics. Here, we comprehensively evaluate the performance of the individual S-Trap filter and 96-well filter plate in the context of global protein identification and quantitation using whole-cell lysate and clinically relevant sputum samples.


Assuntos
Filtração/métodos , Klebsiella pneumoniae/química , Proteômica/métodos , Manejo de Espécimes/métodos , Escarro/química , Tuberculose Pulmonar/metabolismo , Proteínas de Bactérias , Centrifugação/instrumentação , Centrifugação/métodos , Cromatografia Líquida/instrumentação , Etiópia , Filtração/instrumentação , Interações Hospedeiro-Patógeno , Humanos , Membranas Artificiais , Mycobacterium tuberculosis/crescimento & desenvolvimento , Mycobacterium tuberculosis/patogenicidade , Proteólise , Proteômica/instrumentação , Espectrometria de Massas em Tandem/instrumentação , Tuberculose Pulmonar/microbiologia
7.
Diabetes Metab Syndr ; 12(5): 753-760, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29729979

RESUMO

BACKGROUND: Metabolic syndrome is a multisystem disorder which coined to describe the recognized clustering of metabolic and cardiovascular abnormalities including obesity, hypertension, dyslipidemia, and abnormalities of glucose homeostasis. OBJECTIVE: To assess the prevalence and associated factors of metabolic syndrome among psychiatric patients in Jimma University Specialized Hospital. METHODS: This study was conducted at Jimma University Specialized hospital psychiatric ward from May 15 to July 16, 2015. A cross-sectional study design and consecutive sampling technique were used. A single population proportion formula was used to include a total of 360 psychiatric patients. An interview administered structured questionnaire was used to collect socio-demographic and some clinical data. Anthropometric data were collected based on standard guild line for anthropometric measurement. Five milliliter of venous blood was collected from ante-cubital fossa after overnight fasting for 8 h. Semi-automated clinical chemistry analyzer (Temis Linear) was used for biochemical laboratory analysis. Data analysis was performed by using SPSS version-20 software. Binary and multiple logistic regressions were used to identify the association between dependent and independent variables. P value less than 0.05 was taken as statistically significant association. RESULTS: The prevalence of metabolic syndrome among psychiatric patients was 28.9%. Age greater than 30 years old (AOR: 5.2, CI: 2.3, 11.8, P. value < 0.05); being female (AOR: 7.1, CI: 3.3, 15.2, P. value < 0.05); regularly eating high protein and fat (AOR: 3.3, CI: 1.3, 8.2, P. value < 0.056) were independent determinant variables for high prevalence of metabolic syndrome among diabetic patients in the study area. The other independent variables such as family history of hypertension, chewing chat, Psychotropic drugs, duration of treatment, regularly eating fruits and vegetables had no statistically significant association with metabolic syndrome (P. value > 0.05). CONCLUSION AND RECOMMENDATION: There was high prevalence of metabolic syndrome among the psychiatric patients. Therefore; close assessment, management and treatment of metabolic syndrome among patients with psychiatry problem is essential.


Assuntos
Hospitais Universitários , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/psicologia , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Etiópia/epidemiologia , Exercício Físico/fisiologia , Exercício Físico/psicologia , Comportamento Alimentar/fisiologia , Comportamento Alimentar/psicologia , Feminino , Hospitais Universitários/tendências , Humanos , Masculino , Transtornos Mentais/fisiopatologia , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Relação Cintura-Quadril/psicologia , Relação Cintura-Quadril/tendências , Adulto Jovem
8.
Diabetes Metab Syndr Obes ; 10: 265-271, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28790859

RESUMO

BACKGROUND: Diabetes mellitus is a group of metabolic disorders that are caused by deficiency in insulin secretion or the decreased ability of insulin to act effectively on target tissues, particularly muscle, liver, and fat. As a result of insulin resistance in the target tissues, particularly in the adipocytes, free fatty acid flux is increased, leading to increased lipid synthesis in hepatocytes, which is responsible for diabetic dyslipidemia. OBJECTIVE: The objective of this study was to determine the prevalence and associated factors of dyslipidemia among diabetic patients in Durame General Hospital in Kembata Tembaro zone. METHODS: A cross-sectional study was conducted from September 2015 to April 2016. In total, 224 subjects were involved in the study by using convenient sampling techniques. Face-to-face interview-administered questionnaire was used to collect sociodemographic data and other possible clinical data associated with the prevalence of dyslipidemia. Fasting venous blood specimens were collected to assess serum lipid profiles. Blood pressure (BP), weight, height, and waist circumference were measured. RESULTS: The prevalence of dyslipidemia was 65.6%. Individual lipid abnormality of elevated LDL-C, TC, TG, and reduced HDL-C were identified in 43.8%, 23.7%, 40.6%, and 41.9% of study subjects, respectively. The prevalence of dyslipidemia was significantly associated with high BP, high body mass index, aging, and longer duration of diabetes mellitus. CONCLUSION: High prevalence of dyslipidemia was found among diabetic patients in the study area. Therefore, a compressive mechanism is required to screen, treat, and prevent dyslipidemia.

9.
J Proteomics ; 166: 1-7, 2017 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-28669814

RESUMO

Filter aided sample preparation (FASP) is becoming a central method for proteomic sample cleanup and peptide generation prior to LC-MS analysis. We previously adapted this method to a 96-well filter plate, and applied to prepare protein digests from cell lysate and body fluid samples in a high throughput quantitative manner. While the 96FASP approach is scalable and can handle multiple samples simultaneously, two key advantages compared to single FASP, it is also time-consuming. The centrifugation-based liquid transfer on the filter plate takes 3-5 times longer than single filter. To address this limitation, we now present a quick 96FASP (named q96FASP) approach that, relying on the use of filter membranes with a large MWCO size (~30kDa), significantly reduces centrifugal times. We show that q96FASP allows the generation of protein digests derived from whole cell lysates and body fluids in a quality similar to that of the single FASP method. Processing a sample in multiple wells in parallel, we observed excellent experimental repeatability by label-free quantitation approach. We conclude that the q96FASP approach promises to be a promising cost- and time-effective method for shotgun proteomics and will be particularly useful in large scale biomarker discovery studies. SIGNIFICANCE: High throughput sample processing is of particular interests for quantitative proteomics. The previously developed 96FASP is high throughput and appealing, however it is time-consuming in the context of centrifugation-based liquid transfer (~1.5h per spin). This study presents a truly high throughput sample preparation method based on large cut-off 96-well filter plate, which shortens the spin time to ~20min. To our knowledge, this is the first multi-well method that is entirely comparable with conventional FASP. This study thoroughly examined two types of filter plates and performed side-by-side comparisons with single FASP. Two types of samples, whole cell lysate of a UTI (urinary tract infection)-associated Klebsiella pneumoniae cell and human urine, were tested which demonstrated its capability for quantitative proteomics. The q96FSAP approach makes the filter plate-based approach more appealing for protein biomarker discovery projects, and could be broadly applied to large scale proteomics analysis.


Assuntos
Filtração/métodos , Análise em Microsséries/métodos , Proteômica/métodos , Centrifugação , Humanos , Klebsiella pneumoniae/química , Membranas Artificiais , Proteoma/análise , Manejo de Espécimes/métodos , Fatores de Tempo , Infecções Urinárias/microbiologia , Urina/química
10.
PLoS Pathog ; 13(1): e1006151, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-28129394

RESUMO

Neutrophils have an important role in the antimicrobial defense and resolution of urinary tract infections (UTIs). Our research suggests that a mechanism known as neutrophil extracellular trap (NET) formation is a defense strategy to combat pathogens that have invaded the urinary tract. A set of human urine specimens with very high neutrophil counts had microscopic evidence of cellular aggregation and lysis. Deoxyribonuclease I (DNase) treatment resulted in disaggregation of such structures, release of DNA fragments and a proteome enriched in histones and azurophilic granule effectors whose quantitative composition was similar to that of previously described in vitro-formed NETs. The effector proteins were further enriched in DNA-protein complexes isolated in native PAGE gels. Immunofluorescence microscopy revealed a flattened morphology of neutrophils associated with decondensed chromatin, remnants of granules in the cell periphery, and myeloperoxidase co-localized with extracellular DNA, features consistent with early-phase NETs. Nuclear staining revealed that a considerable fraction of bacterial cells in these structures were dead. The proteomes of two pathogens, Staphylococcus aureus and Escherichia coli, were indicative of adaptive responses to early-phase NETs, specifically the release of virulence factors and arrest of ribosomal protein synthesis. Finally, we discovered patterns of proteolysis consistent with widespread cleavage of proteins by neutrophil elastase, proteinase 3 and cathepsin G and evidence of citrullination in many nuclear proteins.


Assuntos
Armadilhas Extracelulares/imunologia , Infecções Urinárias/imunologia , Western Blotting , Cromatografia Líquida , Humanos , Espectrometria de Massas
11.
PLoS Negl Trop Dis ; 10(2): e0004471, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26900855

RESUMO

BACKGROUND: Rabies is a viral zoonosis that has been described in limited numbers of studies in Ethiopia at large and among pastoralists in particular. This study assessed dog demography, bite wound prevalence and management, potential risk factors of disease transmission and knowledge attitude practice towards rabies among urban dwellers, pastoralists and health workers in Awash, Eastern Ethiopia. METHODOLOGY: Information was collected by means of structured questionnaires and interviews and through medical and official records from the Agricultural and Health bureaus. PRINCIPAL FINDINGS: Respondents totaled 539 (471 urban, 49 pastoralists, 19 medical). Dog(s) were owned in 33% urban and 75.5% pastoralist households respectively. Mean dog number per dog owning household was 1.50 (95%CI: 1.40-1.60) in urban and 2.05 (95%CI: 1.51-2.60) in pastoralists sites. Human Dog Ratio in Metahara was 4.7:1. No bite wounds records were kept in medical facilities, where staff recalled around 100 bites per year, 2/3 being in adults. Over 90% of the respondents claimed knowing rabies but up to 79.2% pastoralist did not know how dogs acquire the disease; 37.3% urban and 23% pastoralist did not know the symptoms of rabies in dogs; 36% urban and 44% pastoralists did not know rabies symptoms in people. Eighty percent of pastoralists did not know that the disease was fatal in people if untreated. Over half (58.7%) of pastoralist respondents go to traditional healers if bitten, despite a health extension worker program in place in the study area. Knowledge gaps were also shown amidst medical staff. CONCLUSIONS: The study highlighted overall poor disease knowledge, severe under-reporting of human rabies cases, lack of record keeping and poor collaboration between the public and animal health sectors and communities in rabies control.


Assuntos
Mordeduras e Picadas/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Raiva/psicologia , Adulto , Animais , Mordeduras e Picadas/epidemiologia , Mordeduras e Picadas/prevenção & controle , Estudos Transversais , Doenças do Cão/epidemiologia , Doenças do Cão/psicologia , Cães , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Raiva/epidemiologia , Raiva/prevenção & controle , Adulto Jovem
12.
Curr Biol ; 25(24): 3260-6, 2015 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-26687624

RESUMO

Colonial medical reports claimed that tuberculosis (TB) was largely unknown in Africa prior to European contact, providing a "virgin soil" for spread of TB in highly susceptible populations previously unexposed to the disease [1, 2]. This is in direct contrast to recent phylogenetic models which support an African origin for TB [3-6]. To address this apparent contradiction, we performed a broad genomic sampling of Mycobacterium tuberculosis in Ethiopia. All members of the M. tuberculosis complex (MTBC) arose from clonal expansion of a single common ancestor [7] with a proposed origin in East Africa [3, 4, 8]. Consistent with this proposal, MTBC lineage 7 is almost exclusively found in that region [9-11]. Although a detailed medical history of Ethiopia supports the view that TB was rare until the 20(th) century [12], over the last century Ethiopia has become a high-burden TB country [13]. Our results provide further support for an African origin for TB, with some genotypes already present on the continent well before European contact. Phylogenetic analyses reveal a pattern of serial introductions of multiple genotypes into Ethiopia in association with human migration and trade. In place of a "virgin soil" fostering the spread of TB in a previously naive population, we propose that increased TB mortality in Africa was driven by the introduction of European strains of M. tuberculosis alongside expansion of selected indigenous strains having biological characteristics that carry a fitness benefit in the urbanized settings of post-colonial Africa.


Assuntos
Mycobacterium tuberculosis/genética , Tuberculose/microbiologia , Etiópia/epidemiologia , Humanos , Metagenômica , Filogenia , Filogeografia , Tuberculose/epidemiologia
13.
BMC Public Health ; 15: 572, 2015 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-26092570

RESUMO

BACKGROUND: The spread of multidrug-resistant tuberculosis (MDR-TB) strains has become a challenge to the global TB control and prevention program. In Ethiopia, particularly in rural areas, information on drug-resistant TB is very limited. In this study, we determined the drug resistance patterns of Mycobacterium tuberculosis (M. tuberculosis) isolates from pulmonary TB patients attending two public hospitals in the East Gojjam zone of northwest Ethiopia. METHODS: A cross-sectional study was conducted between May 2011 and January 2012 using Region of difference-9 (RD9) typing for the identification of species mycobacterium. Drug susceptibility testing (DST) of M. tuberculosis isolates to the first-line drugs: isoniazid, rifampicin, ethambutol and streptomycin was performed by the indirect proportion method on Middle brook 7H10 Agar media. RESULTS: Out of 385 pulmonary TB suspects studied, 124 (32.2%) were culture positive among which 120 were M. tuberculosis strains. Susceptibility testing was performed for 89 isolates. Resistance to at least one drug was 15.58% ([12/77], 95% CI: 7.48-23.68) among newly diagnosed and 50.0% ([6/12], 95% CI: 21.71-78.29) among previously treated cases. Resistance among newly diagnosed patients was most common for streptomycin 5.19% (4/77) and ethambutol 5.19% (4/77) followed by rifampicin 3.89% (3/77). Among retreatment cases, isoniazid resistance was most frequent in which 33.33% (4/12) of the isolates were resistant. MDR prevalence was 1.29% (1/77) for newly diagnosed and 16.67% (2/12) for retreatment cases. In a multivariate logistic regression analysis, age group of 25-34 years (adjusted OR = 4.24; 95% CI: 1.02-17.5; P = 0.046) and previous history of treatment (adjusted OR = 5.42; 95% CI: 1.56-27.49; P = 0.01) were independently associated with anti-TB drug resistance. CONCLUSIONS: In general, the magnitude of anti-TB drug resistance including MDR-TB was comparable to previous studies in other areas of Ethiopia. However, rifampicin resistance was high, which could suggest the potential for a rise in the incidence of MDR. Therefore, re-enforcing TB control programs should be considered by the concerned public health authorities.


Assuntos
Antituberculosos/uso terapêutico , Farmacorresistência Bacteriana Múltipla , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Etambutol/uso terapêutico , Etiópia/epidemiologia , Feminino , Hospitais Públicos , Humanos , Isoniazida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Prevalência , Retratamento/estatística & dados numéricos , Rifampina/uso terapêutico , Medição de Risco , Adulto Jovem
14.
Prev Vet Med ; 120(2): 187-194, 2015 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-25841999

RESUMO

This cross-sectional study investigated the prevalence of brucellosis and bovine tuberculosis (BTB) in local cattle and goat breeds of Oromo and Afar pastoralist communities living in two distinct parts around the Awash National Park. A questionnaire survey was carried out to assess information on husbandry, milk consumption habits, and on knowledge-attitude-practice regarding both diseases. Among a total of 771 animals from all sites tested by comparative intradermal tuberculin test (CIDT) none were BTB reactors with the >4mm cut-off. Using the >2mm cut-off, individual apparent prevalence was 0.9% (95%CI: 0.23-3.56%) in cattle and 0.7% (95%CI: 0.12-3.45%) in goats. Herd prevalence in Oromia and Afar sites was 0% and 66.7% respectively in goats and 16.7% and 50% in cattle. Among the 327 animals tested by enzyme linked immunoassay for brucellosis, 4.8% (95%CI: 1.2-17.1%) of cattle and 22.8% (95%CI: 5.98-29.5%) of goats were reactors. Highest individual prevalence of both diseases was found in Afar settlements with brucellosis being as high as 50%. Respondent ethnicity was the only risk factor for brucellosis positivity in goats in the univariable risk factor analysis. Knowledge about the diseases was poor. Raw goat milk was regularly consumed by women and children, putting them at risk for brucellosis. This study highlighted an increased prevalence gradient of BTB and brucellosis from West to East along the study sites with high brucellosis individual prevalence and abortion rates among Afar settlements in particular.


Assuntos
Brucelose/veterinária , Doenças das Cabras/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Tuberculose/veterinária , Animais , Brucelose/epidemiologia , Brucelose/microbiologia , Brucelose Bovina/epidemiologia , Brucelose Bovina/microbiologia , Bovinos , Etiópia/epidemiologia , Feminino , Doenças das Cabras/microbiologia , Cabras , Masculino , Parques Recreativos , Prevalência , Fatores de Risco , Tuberculose/epidemiologia , Tuberculose/microbiologia , Tuberculose Bovina/epidemiologia , Tuberculose Bovina/microbiologia
15.
BMC Infect Dis ; 15: 112, 2015 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-25886866

RESUMO

BACKGROUND: Ethiopia, a high tuberculosis (TB) burden country, reports one of the highest incidence rates of extra-pulmonary TB dominated by cervical lymphadenitis (TBLN). Infection with Mycobacterium bovis has previously been excluded as the main reason for the high rate of extrapulmonary TB in Ethiopia. METHODS: Here we examined demographic and clinical characteristics of 953 pulmonary (PTB) and 1198 TBLN patients visiting 11 health facilities in distinct geographic areas of Ethiopia. Clinical characteristics were also correlated with genotypes of the causative agent, Mycobacterium tuberculosis. RESULTS: No major patient or bacterial strain factor could be identified as being responsible for the high rate of TBLN, and there was no association with HIV infection. However, analysis of the demographic data of involved patients showed that having regular and direct contact with live animals was more associated with TBLN than with PTB, although no M. bovis was isolated from patients with TBLN. Among PTB patients, those infected with Lineage 4 reported "contact with other TB patient" more often than patients infected with Lineage 3 did (OR = 1.6, CI 95% 1.0-2.7; p = 0.064). High fever, in contrast to low and moderate fever, was significantly associated with Lineage 4 (OR = 2.3; p = 0.024). On the other hand, TBLN cases infected with Lineage 4 tended to get milder symptoms overall for the constitutional symptoms than those infected with Lineage 3. CONCLUSIONS: The study suggests a complex role for multiple interacting factors in the epidemiology of extrapulmonary TB in Ethiopia, including factors that can only be derived from population-based studies, which may prove to be significant for TB control in Ethiopia.


Assuntos
Mycobacterium bovis , Tuberculose/epidemiologia , Zoonoses/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Etiópia/epidemiologia , Feminino , Genótipo , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Instalações de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium bovis/isolamento & purificação , Mycobacterium tuberculosis/isolamento & purificação , Fatores de Risco , Tuberculose/transmissão , Tuberculose/veterinária , Adulto Jovem , Zoonoses/transmissão
16.
J Clin Microbiol ; 53(4): 1301-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25673798

RESUMO

Recent genotyping studies of Mycobacterium tuberculosis in Ethiopia have reported the identification of a new phylogenetically distinct M. tuberculosis lineage, lineage 7. We therefore investigated the genetic diversity and association of specific M. tuberculosis lineages with sociodemographic and clinical parameters among pulmonary TB patients in the Amhara Region, Ethiopia. DNA was isolated from M. tuberculosis-positive sputum specimens (n=240) and analyzed by PCR and 24-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat (MIRU-VNTR) analysis and spoligotyping. Bioinformatic analysis assigned the M. tuberculosis genotypes to global lineages, and associations between patient characteristics and genotype were evaluated using logistic regression analysis. The study revealed a high diversity of modern and premodern M. tuberculosis lineages, among which approximately 25% were not previously reported. Among the M. tuberculosis strains (n=138) assigned to seven subgroups, the largest cluster belonged to the lineage Central Asian (CAS) (n=60; 26.0%), the second largest to lineage 7 (n=36; 15.6%), and the third largest to the lineage Haarlem (n=35; 15.2%). Four sublineages were new in the MIRU-VNTRplus database, designated NW-ETH3, NW-ETH1, NW-ETH2, and NW-ETH4, which included 24 (10.4%), 18 (7.8%), 8 (3.5%), and 5 (2.2%) isolates, respectively. Notably, patient delay in seeking treatment was significantly longer among patients infected with lineage 7 strains (Mann-Whitney test, P<0.008) than in patients infected with CAS strains (adjusted odds ratio [AOR], 4.7; 95% confidence interval [CI], 1.6 to 13.5). Lineage 7 strains also grew more slowly than other M. tuberculosis strains. Cases of Haarlem (OR, 2.8; 95% CI, 1.2 to 6.6) and NW-ETH3 (OR, 2.8; 95% CI, 1.0 to 7.3) infection appeared in defined clusters. Intensified active case finding and contact tracing activities in the study region are needed to expedite diagnosis and treatment of TB.


Assuntos
Diagnóstico Tardio , Genótipo , Mycobacterium tuberculosis/classificação , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/microbiologia , Adulto , Estudos Transversais , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Etiópia/epidemiologia , Feminino , Variação Genética , Humanos , Masculino , Epidemiologia Molecular , Tipagem Molecular , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/crescimento & desenvolvimento , Escarro/microbiologia , Tuberculose Pulmonar/epidemiologia , Virulência
17.
Tuberc Res Treat ; 2014: 753492, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24834351

RESUMO

The study aimed at determining the prevalence and drug resistance patterns of Mycobacterium tuberculosis among new smear positive pulmonary tuberculosis patients visiting TB diagnosis and treatment facilities at selected health facilities in eastern Ethiopia. A cross-sectional study was conducted between October 2011 and May 2013. A total of 408 new adult pulmonary TB patients (≥ 18 years) were enrolled in this study. Three consecutive sputum samples (spot, morning, and spot) were collected from each patient and transported to the Armauer Hansen Research Institute TB laboratory located in Addis Ababa for culture on Lowenstein Jensen slant media. DST was performed on 357 (87.5%) of the patient samples for isoniazid (H), rifampicin (R), ethambutol (E), and streptomycin (S) using the standard proportion method. The rate of resistance to any one drug was 23%. Any resistance to H, S, R, and E was 14%, 11.5%, 2.8%, and 0.3%, respectively. The highest proportion of monoresistance was observed against H (9.5%). MDRTB was detected in 1.1% of the patients. Any drug resistance was associated with HIV infection (COR = 3.7, 95% CI 1.905-7.222) (P = 0.000). Although the prevalence of MDRTB is relatively low in the study area, high prevalence of H resistance is a serious concern demanding close monitoring. Expanding diagnostic capacity for mycobacterial culture and DST is a vital step in this regard.

18.
Ethiop Med J ; Suppl 1: 37-41, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24696987

RESUMO

BACKGROUND: Cutaneous leishmaniasis is endemic to many parts of the world and has re-emerged in a number of endemic countries in recent years. Environmental changes, immune status of the host and treatment failure are the three most important risk factors associated with the re-emerging and spread of Leishmaniasis. Cutaneous leishmaniasis (CL) ranges from localized, self-healing type to the disfiguring mucocutaneous and diffuse cutaneous type. OBJECTIVE: To access the trend of CL patient flow in ALERT Hospital, Addis Ababa, Ethiopia. METHODS: Patients' clinical and laboratory records were collected retrospectively for 1651 leishmaniasis suspected individuals from ALERT Hospital, from January 1, 2007 to December 30, 2010. RESULTS: From the suspected individuals, 234 cases were positive for Leishmania species with Giemsa stain and/or histopathology and confirmed for CL, of whom 30 (12.8%) were diagnosed in 2007, 29 (12.4%) in 2008, 75 (32.1%) in 2009, and 100 (42.7%) were in 2010. CONCLUSIONS AND RECOMMENDATIONS: The overall proportion of cases with leishmaniasis among the suspected cases was 234/1651 (14.2%). The distribution of CL reports was higher for patients coming from Addis Ababa surrounding areas and Oromia region, 96/234 (41.03%) and 71/234 (30.34%), respectively. In general, the trend of leishmaniasis in and around Addis Ababa seems to be increasing, which calls for further detailed epidemiological studies, including vector and reservoir host studies, to help in the prevention and control of the disease.


Assuntos
Leishmania , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Adulto , Idoso , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Hospitais de Isolamento/estatística & dados numéricos , Humanos , Lactente , Leishmania/classificação , Leishmania/isolamento & purificação , Leishmaniose Cutânea/parasitologia , Leishmaniose Cutânea/prevenção & controle , Leishmaniose Cutânea/transmissão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
19.
Int J Mycobacteriol ; 3(2): 132-8, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26786335

RESUMO

BACKGROUND: Tuberculosis (TB) patients co-infected with human immunodeficiency virus (HIV) often lack the classic symptoms of pulmonary tuberculosis, making the diagnosis difficult. Current practices in resource-limited settings often indicate that these co-infected patients are diagnosed when they clinically manifest disease symptoms, resulting in a delayed diagnosis and despite continued transmission. The aim of this study is to determine the prevalence of undiagnosed pulmonary tuberculosis cases through active case finding and including multidrug-resistant TB (MDR-TB) among HIV-infected patients. MATERIALS AND METHODS: A total of 250 HIV-infected patients, aged 18years and above were evaluated in a cross-sectional design between February 2012 and November 2012. Socio-demographic and clinical data were collected using a structured questionnaire. Sputum samples were collected from all participants for acid fast bacilli (AFB) direct smear microscopy and Mycobacteria culture. A PCR-based RD9 deletion and genus typing, as well as first-line anti-TB drug susceptibility testing, was performed for all culture-positive isolates. RESULTS: Following active TB case finding, a total of 15/250 (6%) cases were diagnosed as TB cases, of whom 9/250 (3.6%) were detected by both smear microscopy and culture and the remaining 6/250 (2.4%) only by culture. All the 15 isolates were typed through RD9 typing of which 10 were Mycobacterium tuberculosis species; 1 belonged to Mycobacterium genus and 4 isolates were non-tuberculous mycobacteria. The prevalence of undiagnosed pulmonary TB disease among the study participants was 4.4%, which implies the possibility of identifying even more undiagnosed cases through active case finding. A multivariate logistic regression showed a statistically significant association between the presence of pneumonia infection and the occurrence of TB (OR=4.81, 95% CI (1.08-21.43), p=0.04). In addition, all the isolates were sensitive to all first-line anti-TB drugs, except for streptomycin, seen in only one newly diagnosed TB patient, and MDR-TB was not detected. CONCLUSION: The prevalence of undiagnosed pulmonary TB infection among HIV-infected patients in Gondar was 4.4%. Additionally, the possibility of these undiagnosed TB cases in the community could also pose a risk for the transmission of the disease, particularly among family members. Active screening of known HIV-infected individuals, with at least one TB symptom is recommended, even in persons with opportunistic infections.

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