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1.
Lipids Health Dis ; 20(1): 129, 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34602073

RESUMO

Mycobacterium tuberculosis (Mtb), the main etiology of tuberculosis (TB), is predominantly an intracellular pathogen that has caused infection, disease and death in humans for centuries. Lipid droplets (LDs) are dynamic intracellular organelles that are found across the evolutionary tree of life. This review is an evaluation of the current state of knowledge regarding Mtb-LD formation and associated Mtb transcriptome directly from sputa.Based on the LD content, Mtb in sputum may be classified into three groups: LD positive, LD negative and LD borderline. However, the clinical and evolutionary importance of each state is not well elaborated. Mounting evidence supports the view that the presence of LD positive Mtb bacilli in sputum is a biomarker of slow growth, low energy state, towards lipid degradation, and drug tolerance. In Mtb, LD may serve as a source of chemical energy, scavenger of toxic compounds, prevent destruction of Mtb through autophagy, delay trafficking of lysosomes towards the phagosome, and contribute to Mtb persistence. It is suggest that LD is a key player in the induction of a spectrum of phenotypic and metabolic states of Mtb in the macrophage, granuloma and extracellular sputum microenvironment. Tuberculosis patients with high proportion of LD positive Mtb in pretreatment sputum was associated with higher rate of poor treatment outcome, indicating that LD may have a clinical application in predicting treatment outcome.The propensity for LD formation among Mtb lineages is largely unknown. The role of LD on Mtb transmission and disease phenotype (pulmonary TB vs extra-pulmonary TB) is not well understood. Thus, further studies are needed to understand the relationships between LD positivity and Mtb lineage, Mtb transmission and clinical types.

2.
Ethiop J Health Sci ; 31(3): 635-644, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34483621

RESUMO

Background: Surgical wound infections (SWI) remain as a major source of postoperative illness that increases the time of hospital stay and health care related costs globally. On top of this, the emergence and spread of drug-resistant pathogens continue to challenge the proper management of surgical wound infections. Methods: A hospital based cross-sectional study was conducted at Felege Hiwot Referral Hospital (FHRH). A total of 165 study participants were included. Socio-demographic data were collected using a pre-tested structured questionnaire. Isolates were identified by conventional bacteriological technique and antimicrobial susceptibility test was performed using the Kirby-Bauer disc diffusion method. Results: Among 165 study participants, 98 (59.4%) were males. The overall prevalence of culture confirmed surgical wound infection was 115 (69.7%). A total of 125 bacteria isolates were identified among which, Staphylococcus aureus was predominant followed by Pseudomonas aeruginosa and Klebsiella species with a proportion of 31 (24.8%), 26 (20.8%) and 17 (13.6%), respectively. Majority (80.8%) of the isolates were found multidrug resistant (MDR). Dirty wound and duration of hospital stay were found significantly associated with culture confirmed surgical wound infections. Conclusions: S. aureus, P. aeruginosa and Klebsiella species were the most common isolates identified from surgical wound sites. Most of these pathogens were found MDR. Therefore, regular surveillance on the types of bacterial isolates and their drug resistance pattern should be considered.


Assuntos
Antibacterianos , Infecção da Ferida Cirúrgica , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Estudos Transversais , Farmacorresistência Bacteriana , Farmacorresistência Bacteriana Múltipla , Etiópia/epidemiologia , Hospitais , Humanos , Masculino , Testes de Sensibilidade Microbiana , Encaminhamento e Consulta , Staphylococcus aureus , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/epidemiologia
3.
Ethiop J Health Sci ; 31(3): 645-652, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34483622

RESUMO

Background: The emergence and spread of antimicrobial resistance (AMR) among uropathogens is increasing, especially in resource limited settings due to a number of reasons. The production of Extended Spectrum ß-Lactamase (ESBL) by some strains of E. coli and methicillin resistant Staphylococcus species, limits the choice of antimicrobials in the treatment of urinary tract infection (UTI) globally. However, little is known about the type of uropathogenes and their current AMR profile among pregnant women in Hargeisa, Somaliland. Methods: Clean-catch mid-stream urine samples were collected and processed for bacteriological culture and antimicrobial sensitivity testing (AST). Ceftazidime (30µg) and Cefotaxime (30µg) disks were used for ESBL screening as per CLSI guideline and each ESBL screening positive isolate were phenotypically confirmed by a combination disk test. Results: Among 376 study participants, 79 (21.0%) had significant bacteriuria (SBU). Majority at 58(73.4%) of the isolates were Gram-negative. The most predominant isolate was E.coli, 36(45.6%) followed by K. pneumonea 16(20.3%) and S. aureus at 9(11.4 %). The proportion of ESBL producing isolates was 25(32.9%). Gram-negatives showed high level resistance to ampicillin, amoxicillin, cefotaxime, and cephalexin at 87%, 85%, 57%, and 52%, respectively. Previous history of UTI, monthly income, educational status and having dysuria were significantly associated with SBU (p<0.05). Conclusion: Relatively high prevalence of uropathogens and an increased level of drug resistance were documented. Therefore, continued surveillance on the type of uropathogens and their AMR pattern is needed to ensure appropriate recommendations for the rational empirical treatment of UTI and for policy input.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Urinárias , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Escherichia coli , Feminino , Hospitais , Humanos , Testes de Sensibilidade Microbiana , Gravidez , Gestantes , Staphylococcus aureus , Infecções Urinárias/tratamento farmacológico , beta-Lactamases
4.
Ethiop J Health Sci ; 31(3): 653-662, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34483623

RESUMO

Background: Tuberculosis and human immunodeficiency virus (HIV) are among the major health problems in Ethiopia. This study assessed the proportion of tuberculosis lymphadenitis (TBLN), HIV infection and their co-infection among TBLN presumptive individuals at the selected hospitals in Northwest Ethiopia. Methods: Institution based cross sectional study was carried out. Data on demographic and clinical variables were collected with standardized questionnaire. Microbiological culture was done on specimen obtained by fine needle aspirates. The HIV status was determined by rapid anti-HIV antibody test. Data was entered and scrutinized using SPSS version 20 statistical packages. A stepwise logistic regression model was used. The result was considered as statistically significant at P<0. 05. Results: A total of 381 lymphadenitis patients were included in the study. The overall prevalence of TBLN and HIV were at 250(65.6%) and 9(2.4%), respectively and their co-infection was at 6(2.4%). Based on the cytological examination, 301(79.0%) of them were diagnosed as TBLN. The age group, (P=0.01) and residency, (P=0.01) were found significantly associated with TBLN. Similarly, unsafe sex was also statistically significant for HIV infection (P=0.007). Conclusion: Tuberculosis lymphadenitis is the leading cause of TB and lymphadenitis in the region. However, TBLN-HIV coinfection was promisingly low. High rate of discrepancy was noticed between cytological and culture results. Hence, the TBLN diagnostic criteria shall pursue revision.


Assuntos
Coinfecção , Infecções por HIV , Linfadenite , Mycobacterium tuberculosis , Tuberculose dos Linfonodos , Coinfecção/epidemiologia , Estudos Transversais , Etiópia/epidemiologia , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Linfadenite/epidemiologia , Linfadenite/etiologia , Tuberculose dos Linfonodos/epidemiologia
5.
Rev Med Virol ; 31(3): e2181, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33152146

RESUMO

This study aimed to assess the diagnostic test accuracy (DTA) of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) serological test methods and the kinetics of antibody positivity. Systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. We included articles evaluating the diagnostic accuracy of serological tests and the kinetics of antibody positivity. MEDLINE through PubMed, Scopus, medRxiv and bioRxiv were sources of articles. Methodological qualities of included articles were appraised using QUADAS-2 while Metandi performs bivariate meta-analysis of DTA using a generalized linear mixed-model approach. Stata 14 and Review Manager 5.3 were used for data analysis. The summary sensitivity/specificity of chemiluminescence immunoassay (CLIA), enzyme-linked immunosorbent assay (ELISA) and lateral flow immunoassay (LFIA) were 92% (95% CI: 86%-95%)/99% (CI: 97%-99%), 86% (CI: 82%-89%)/99% (CI: 98%-100%) and 78% (CI: 71%-83%)/98% (95% CI: 96%-99%), respectively. Moreover, CLIA-based assays produced nearly 100% sensitivity within 11-15 days post-symptom onset (DPSO). Based on antibody type, the sensitivity of ELISA-total antibody, CLIA-IgM/G and CLIA-IgG gauged at 94%, 92% and 92%, respectively. The sensitivity of CLIA-RBD assay reached 96%, while LFIA-S demonstrated the lowest sensitivity, 71% (95% CI: 58%-80%). CLIA assays targeting antibodies against RBD considered the best DTA. The antibody positivity rate increased corresponding with DPSO, but there was some decrement when moving from acute phase to convalescent phase of infection. As immunoglobulin isotope-related DTA was heterogeneous, our data have insufficient evidence to recommend CLIA/ELISA for clinical decision-making, but likely to have comparative advantage over RT-qPCR in certain circumstances and geographic regions.


Assuntos
Teste Sorológico para COVID-19/normas , COVID-19/diagnóstico , Ensaio de Imunoadsorção Enzimática/normas , Citometria de Fluxo/normas , Medições Luminescentes/normas , SARS-CoV-2/patogenicidade , Anticorpos Antivirais/sangue , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/virologia , Teste Sorológico para COVID-19/métodos , Convalescença , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , RNA Viral/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa/normas , SARS-CoV-2/genética , SARS-CoV-2/imunologia , Sensibilidade e Especificidade , Índice de Gravidade de Doença
6.
J Parasitol Res ; 2020: 7371681, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33145101

RESUMO

Background: Africa still bears the largest burden of malaria as the majority of infections in the continent are caused by P. falciparum. Artemether-lumefantrine (AL, Coartem®) is the most widely used artemisinin-based combination therapy (ACT), for treating uncomplicated falciparum malaria globally. However, the development of resistance to antimalarial drugs is a major challenge for malaria control. In this review, the efficacy of AL for the treatment of uncomplicated falciparum malaria in Africa was evaluated. Methods: Articles published between January 2015 and July 2019 were systematically searched using comprehensive search strings from PubMed/Medline, SCOPUS, and grey literature from Google Scholar. Interventional studies that followed patients for at least 28 days were included. Two reviewers independently assessed study eligibility, extracted data, and assessed risk of bias. All the included articles were measured to be good quality. While computing the efficacy of AL, polymerase chain reaction (PCR)-corrected cure rate (adequate clinical and parasitological response, ACPR) at day 28 was considered as the main endpoint. Meta-analysis was computed using STATA v 15 to calculate the pooled ACPR. Results: In this review, 39 articles that reported the treatment outcome of 8,320 patients were included. After 28 days of follow-up, the pooled PCR uncorrected and corrected APCR was at 87% (95% CI: 85-90%) and 97.0% (95% CI: 96-98%), respectively. Moreover, the proportion of early treatment failure (ETF) was almost 0%, while most of the included articles reported <8% late treatment failures. The reinfection and recrudescence rate was less than 10% and 2.6%, respectively, within 28 days. We noted rapid fever and parasite clearance in which greater than 93% and 94% patients were parasite and fever free at day three following AL treatment. Conclusions: This review discovered that despite more than a decade since its introduction, Coartem® remains effective and thus could continue to be the drug of choice for the treatment of uncomplicated falciparum malaria for all age groups in Africa. However, the risk of new emerging resistance for this combination warrants regular monitoring of its efficacy across the continent.

7.
Antimicrob Resist Infect Control ; 9(1): 138, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32811545

RESUMO

OBJECTIVE: Gonorrhea is the second most common sexually transmitted bacterial infection (STI) next to Chlamydia. Untreated cases could results in major complications like pelvic inflammatory disease (PID), ectopic pregnancy, infertility, miscarriage, fetal death and congenital infections. Gonorrhea has been treated with antibiotics for more than eight decades. However, the emergence and spread of antimicrobial resistance (AMR) in gonococcus seriously compromises the management of the disease. The aim of this review was to describe the current developments in the field of azithromycin resistant gonococci. METHODS: Literatures published in English in the last 10 years were retrieved from PubMed, SCOPUS, Google scholar, Cochrane library and the Google databases using relevant searching terms. RESULTS: Gonococcus is capable of using a number of strategies to confer resistance as the bacterium has an extraordinary capacity to alter its genome. So far the accumulated data on the field showed that the world is heading towards a pandemic of extensively drug-resistant (XDR) gonococcus which is now seems to be evolving into a true "superbug". Hence, in the near future gonorrhea may become untreatable on the international basis unless new drugs become available. An antibiotic resistance in gonococcus has been noted beginning in 1940s against sulfonamides. Since then, resistance has rapidly emerged to penicillins, tetracyclines, macrolides, fluoroquinolones, and cephalosporins. Currently, in most nations, the injectable extended-spectrum cephalosporin (ESC), i.e. ceftriaxone based therapy is the only remaining option for gonorrhea. Based on the WHO and the US-CDC recommendations, countries are increasingly using a combination of cephalosporin and azithromycin for the treatment of gonorrhoea. Azithromycin revolutionized gonoccocal therapy as it shortened treatment time by more than half from 7 to 14 days and improved patient compliance due to high tissue levels and long half-life. However, constantly emerging reports from different parts of the globe showed that N. gonorrhoeae is developing significant level of resistance against azithromycin, and so far more than 33% level of resistance was reported. Two strategies have been commonly implicated in gonococcal resistance against azithromycin: over expression of an efflux pump (due to mutations at mtrR coding region) and decreased antimicrobial affinity (due to mutations in genes encoding the 23S ribosomal subunit). CONCLUSIONS: With no alternative antimicrobial treatment options for gonorrhoea and only a few new drugs in the development pipeline, it is necessary to monitor drug resistance and optimize treatment regimens regularly. Moreover, investigations for novel drugs should be wired.

8.
BMC Infect Dis ; 20(1): 407, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32527231

RESUMO

BACKGROUND: Cryptococcosis is an opportunistic fungal infection that primarily affects people with advanced HIV/AIDS and is an important cause of morbidity and mortality around the globe. By far the most common presentation of the disease is cryptococcal meningitis (CM), which leads to an estimated 15-20% of all HIV related deaths worldwide, 75% of which are in sub-Saharan Africa. However, to the best of our knowledge there is quite limited reviewed data on the epidemiology of cryptococcal antigenemia in a large HIV-infected population in resource limited settings. METHODS: Articles published in English irrespective of the time of publication were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. In addition, Google Scholar and Google databases were searched manually for grey literature. Two reviewers independently assessed study eligibility, extracted data, and assessed risk of bias. The pooled prevalence of cryptococcal antigenemia was determined with 95% confidence interval (CI). RESULTS: Among 2941 potential citations, we have included 22 studies with a total of 8338 HIV positive individuals. The studies were reported in ten different countries during the year (2007-2018). Most of the articles reported the mean CD4 count of the participants below 100 cells/µl. The pooled prevalence of cryptococcal antigenemia at different CD4 count and ART status was at 8% (95%CI: 6-10%) (ranged between 1.7 and 33%). Body mass index (BMI) < 18.5 kg/m2, CD4 count < 100 cells, patients presenting with headache and male gender were reported by two or more articles as an important predictors of cryptococcal antigenemia. CONCLUSIONS: Implementing a targeted screening of HIV patients with low BMI, CD4 count < 100 cells, having headache and males; and treatment for asymptomatic cryptococcal disease should be considered. Additional data is needed to better define the epidemiology of cryptococcal antigenemia and its predictors in resource limited settings in order to optimize the prevention, diagnosis, and treatment strategies.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Alocação de Recursos para a Atenção à Saúde , Meningite Criptocócica/diagnóstico , Meningite Criptocócica/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , África ao Sul do Saara/epidemiologia , Humanos , Meningite Criptocócica/tratamento farmacológico , Prevalência , Fatores de Risco
9.
Infect Agent Cancer ; 15: 9, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32047531

RESUMO

Background: Genital infection with certain types of Human papillomavirus (HPV) is a major cause of cervical cancer globally. For early detection of premalignant dysplasia, evidences are coming out on the usefulness of HPV E6/E7 mRNA test as a potential tool compared with cytology and HPV DNA testing. Taking into account shortage of compiled data on this field, the aim of this systematic review was to describe the latest diagnostic performance of HPV E6/E7 mRNA testing to detect high grade cervical lesions (CIN2+) where by histology was taken as a gold standard. Methods: Articles published in English were systematically searched using key words from PubMed/Medline and SCOPUS. In addition, Google Scholar and the Google database were searched manually for grey literature. Two reviewers independently assessed study eligibility, risk of bias and extracted the data. We performed a descriptive presentation of the performance of E6/E7 mRNA test (in terms of sensitivity, specificity, negative and positive predictive values) for the detection of CIN2 + . Results: Out of 231 applicable citations, we have included 29 articles that included a total of 23,576 study participants (age range, 15-84 years) who had different cervical pathologies. Among the participants who had cervical histology, the proportion of CIN2+ was between 10.6 and 90.6%. Using histology as a gold standard, 11 studies evaluated the PreTect HPV Proofer, 7 studies evaluated the APTIMA HPV assay (Gen-Probe) and 6 studies evaluated the Quantivirus® HPV assay. The diagnostic performance of these three most common mRNA testing tools to detect CIN2+ was; 1) PreTect Proofer; median sensitivity 83%, specificity 73%, PPV 70 and NPV 88.9%. 2) APTIMA assay; median sensitivity 91.4%, specificity 46.2%, PPV 34.3% and NPV 96.3%. 3) Quantivirus®: median sensitivity 86.1%, specificity 54.6%, PPV 54.3% and NPV was at 89.3%. Further, the area under the receiver operating characteristics (AU-ROC) curve varied between 63.8 and 90.9%. Conclusions: The reported diagnostic accuracy implies that HPV mRNA based tests possess diagnostic relevance to detect CIN2+ and could potentially be considered in areas where there is no histology facility. Further studies including its cost should be considered.

10.
BMC Res Notes ; 12(1): 568, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31511033

RESUMO

OBJECTIVE: Antimicrobial resistance (AMR) is one of the most serious global public health threats that exert a significant burden in terms of patient morbidity and mortality and financial crises in many developing countries including Ethiopia. Knowledge on the type of predominantly circulating pathogens with their respective AMR profile in a given area is essential for optimal patient care. This study was aimed at assessing the types of bacterial isolates and their AMR profile identified from a range of clinical samples at Debre Markos Referral Hospital, Northwest Ethiopia, over a period of 5 years (2013 to 2017). RESULTS: From the total of 514 different clinical samples processed in the stated time frame, about 240 (46.7%) yield bacterial growth. Majority of the identified bacteria were isolated from stool culture 68 (28.3%) followed by urine 56 (23.3%), ear discharge 54 (22.5%) and wound swabs at 26 (10.8%). Most of the clinical isolates were Gram-negative at 171 (71.25%). The predominant isolate was S. aureus at 41 (17.1%) followed by Salmonella species, 40 (16.7%), Escherichia coli 36 (15%) and Pseudomonas aeruginosa at 26 (11.7%). Generally, the isolates were found resistant at (60-100%) against ampicillin, co-trimoxazole, doxycycline, gentamicin, norfloxacin and tetracycline. Gram-positive isolates were found relatively sensitive to ceftriaxone, erythromycin and vancomycin at (71-84%).


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Infecções Bacterianas/tratamento farmacológico , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Encaminhamento e Consulta , Adolescente , Adulto , Bactérias/classificação , Bactérias/isolamento & purificação , Infecções Bacterianas/microbiologia , Etiópia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana/métodos , Pessoa de Meia-Idade , Adulto Jovem
11.
Tuberculosis (Edinb) ; 118: 101858, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31430694

RESUMO

The molecular epidemiology of Mycobacterium tuberculosis (M. tuberculosis, Mtb) is poorly documented in Ethiopia. The data that exists has not yet been collected in an overview metadata form. Thus, this review summarizes available literature on the genomic diversity, geospatial distribution and transmission patterns of Mtb lineages (L) and sublineages in Ethiopia. Spoligotyping and Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) based articles were identified from MEDLINE via PubMed and Scopus. The last date of article search was done on 12th February 2019. Articles were selected following the PRISMA flow diagram. The proportion of (sub)lineages was summarized at national level and further disaggregated by region. Clustering and recent transmission index (RTI) were determined using metan command and random effect meta-analysis model. The meta-analysis was computed using Stata 14 (Stata Corp. College Station, TX, USA). Among 4371 clinical isolates, 99.5% were Mtb and 0.5% were M. bovis. Proportionally, L4, L3, L1 and L7 made up 62.3%, 21.7%, 7.9% and 3.4% of the total isolates, respectively. Among sublineages, L4.2. ETH/SIT149, L4.10/SIT53, L3. ETH1/SIT25 and L4.6/SIT37 were the leading clustered isolates accounting for 14.4%, 9.7%, 7.2% and 5.5%, respectively. Based on MIRU-VNTR, the rate of clustering was 41% and the secondary case rate from a single source case was estimated at 29%. Clustering and recent transmission index was higher in eastern and southwestern Ethiopia compared with the northwestern part of the country. High level of genetic diversity with a high rate of clustering was noted which collectively mirrored the phenomena of micro-epidemics and super-spreading. The largest set of clustered strains deserves special attention and further characterization using whole genome sequencing (WGS) to better understand the evolution, genomic diversity and transmission dynamics of Mtb.


Assuntos
Mycobacterium tuberculosis/genética , Tuberculose/epidemiologia , Tuberculose/microbiologia , Técnicas de Tipagem Bacteriana/métodos , Viés , Análise por Conglomerados , Etiópia/epidemiologia , Variação Genética , Humanos , Repetições Minissatélites/genética , Mycobacterium tuberculosis/classificação , Filogenia , Tuberculose/transmissão
12.
Virusdisease ; 30(2): 171-179, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31179353

RESUMO

Over 99% of cervical cancer cases are associated with genital infection by certain types of human papillomaviruses (HPVs). To outline optimal vaccination strategies and HPV based cervical cancer screening, synthesized data on the genotype distribution of HPV is fundamental that is otherwise missed in Ethiopia. The aim of this study is to compile the findings on HPV genotyping in Ethiopia. Published articles were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. Further, Google Scholar and the Google databases were also searched manually for grey literature. The included studies in the review employed 859 women (age range 15-85 years) with different kinds of cervical abnormalities. A total of 534 HPV sequences were reported; the proportion of high risk HPVs was varied 80.4-100%. The top five identified genotypes were HPV 16 (45.3%; 95% CI 41.1-49.6%), HPV 52 (9.4%; 95% CI 7.2-12.1%), HPV 18 (8.2%; 95% CI 6.2-10.9%), HPV 58 (6.9%; 95% CI 5.1-9.4%) and HPV 45 (5.2%; 95% CI 3.7-7.5%). The combined prevalence of HPV 16/18 was at 53.6% (95% CI 49.3-57.8%). In this review, HPV 16 in particular, but also HPV 52 and 18, warrant exceptional consideration in vaccination and HPV based screening programs in Ethiopia. To the best of our knowledge, this study represents the first of its kind to establish the genotype distribution of HPV from different kinds of cervical lesions in Ethiopia although it was synthesized out of few studies. Hence, additional nationwide data are needed to strengthen our finding.

13.
Artigo em Inglês | MEDLINE | ID: mdl-31223478

RESUMO

Background: Community acquired pneumonia (CAP) is reported as a common cause of lower respiratory tract infection worldwide. Bacterial pathogens and antimicrobial resistance (AMR) associated with this infection varied between geographical regions. Knowledge of the pathogens in a given area and their up-to-date AMR profile is essential for optimal management of patients. This study was aimed at assessing the type of bacterial isolates and their AMR among CAP adult patients at the Felege Hiwot Referral Hospital (FHRH), Northwest Ethiopia. Methods: This cross-sectional study was conducted during 1 April to 30 July 2018. Demographic related data were collected from the study participants using a structured questionnaire. Sputum samples were collected and processed to identify pathogens using the conventional culture and biochemical tests as per the standard procedures. The Kirby Bauer disk diffusion method was implemented for the AMR testing. Descriptive and multivariable analysis was conducted using SPSS version 23. Results: Among 414 presumptively diagnosed study participants for CAP, bacterial pathogens were identified from 167 (40.3%) participants. Among these, multidrug resistance (MDR) accounted for 127(76%) of the isolates. The predominant isolates were Streptococcus pneumoniae at 60(35.9%) and Klebsella pneumoniae at 30(18%). Overcrowded living conditions [AOR 1.579 (95%CI: 1.015-2.456)] and alcohol use [AOR 4.043 (95% CI, 2.537-6.443)] were found statistically associated with culture positive sputum. Conclusions: The study showed high prevalence of mono- and multi-drug resistant isolates in the study area. Therefore, regular surveillance of the type of isolates and their AMR patterns should be considered. Interventions for reducing community acquired pneumonia should be integrated with lifestyle factors related to household and alcohol use.


Assuntos
Antibacterianos/farmacologia , Bactérias/classificação , Infecções Comunitárias Adquiridas/epidemiologia , Pneumonia/microbiologia , Adulto , Idoso , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Infecções Comunitárias Adquiridas/microbiologia , Estudos Transversais , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Farmacorresistência Bacteriana Múltipla , Etiópia/epidemiologia , Feminino , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Escarro/microbiologia , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação , Adulto Jovem
14.
PLoS One ; 14(4): e0215647, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31002716

RESUMO

INTRODUCTION: Tuberculous lymphadenitis is the most frequent form of extra-pulmonary TB (EPTB) and accounts for a considerable proportion of all EPTB cases. We conducted a systematic review of articles that described the epidemiological features of TBLN in Africa. METHODS: Any article that characterized TBLN cases with respect to demographic, exposure and clinical features were included. Article search was restricted to African countries and those published in English language irrespective of publication year. The articles were retrieved from the electronic database of PubMed, Scopus, Cochrane library and Lens.org. Random effect pooled prevalence with 95% CI was computed based on Dersimonian and Laird method. To stabilize the variance, Freeman-Tukey double arcsine root transformation was done. The data were analyzed using Stata 14. RESULTS: Of the total 833 articles retrieved, twenty-eight articles from 12 African countries fulfilled the eligibility criteria. A total of 6746 TBLN cases were identified. The majority of the cases, 4762 (70.6%) were from Ethiopia. Over 77% and 88% of identified TBLN were cervical in type and naïve to TB drugs. Among the total number of TBLN cases, 53% were female, 68% were in the age range of 15-44 years, 52% had a history of livestock exposure, 46% had a history of consuming raw milk/meat and 24% had history of BCG vaccination. The proportion of TBLN/HIV co-infection was much lower in Ethiopia (21%) than in other African countries (73%) and the overall African estimate (52%). Fever was recorded in 45%, night sweating in 55%, weight loss in 62% and cough for longer than two weeks in 32% of the TBLN cases. CONCLUSIONS: TBLN was more common in females than in males. The high prevalence of TBLN in Ethiopia did not show directional correlation with HIV. Population based prospective studies are warranted to better define the risk factors of TBLN in Africa.


Assuntos
Linfonodos/patologia , Tuberculose dos Linfonodos/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , África/epidemiologia , Animais , Etiópia/epidemiologia , Feminino , Geografia , Humanos , Linfonodos/microbiologia , Masculino , Mycobacterium bovis/isolamento & purificação , Mycobacterium bovis/fisiologia , Mycobacterium tuberculosis/isolamento & purificação , Mycobacterium tuberculosis/fisiologia , Prevalência , Estudos Prospectivos , Tuberculose dos Linfonodos/diagnóstico , Tuberculose dos Linfonodos/microbiologia , Tuberculose Pulmonar/microbiologia , Adulto Jovem
15.
BMC Res Notes ; 11(1): 798, 2018 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-30409208

RESUMO

Following publication of the original article [1], the authors reported that one of the authors' names was spelled incorrectly. In this Correction the incorrect and correct author name are shown. The original publication of this article has been corrected.

16.
BMC Res Notes ; 11(1): 740, 2018 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-30340646

RESUMO

OBJECTIVE: Approach to asymptomatic bacteriuria among pregnant women in Ethiopia is mainly based on clinical grounds and urine strip and microscopy tests. On top of this, the treatment is also on an empirical basis which may leads to an increased antimicrobial resistance. The aim of this study was to assess the prevalence, antimicrobial susceptibility profile and associated factors of asymptomatic bacteriuria among pregnant women attending antenatal clinic in Adigrat Hospital, Northern Ethiopia. RESULTS: Out of 259 pregnant women included in the study, the prevalence of asymptomatic bacteriuria was at 55 (21.2%). Gram negative bacteria, specifically Escherichia coli were the predominant isolates followed by Klebsiella species and Proteus mirabilis. Of the Gram positive identified bacteria, Staphylococcus aureus was main isolate. Age of the mother (18-25 years old) with [AOR = 8.5, 95% CI (2.2, 32.9)], family income (< 1000 ETB) with [AOR = 7.5, 95% CI = (2.4, 23.1)] and gestational period at 1st trimester [AOR = 11.9, 95% CI (4.4, 32.4)] and 2nd trimester [AOR; 5.6, 95% CI (2.0, 15.5%)] were predictors significantly associated with asymptomatic bacteriuria. All Gram negative isolates were found 100% resistance to Ampicllin. Moreover, all Gram positive isolates were found sensitive to Vancomycin at 100%.


Assuntos
Resistência a Ampicilina , Infecções Assintomáticas/epidemiologia , Bacteriúria/epidemiologia , Bacteriúria/microbiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Resistência a Vancomicina , Adolescente , Adulto , Etiópia/epidemiologia , Feminino , Hospitais Gerais , Humanos , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Gravidez , Prevalência , Adulto Jovem
17.
Int J Microbiol ; 2018: 2190787, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30151011

RESUMO

[This corrects the article DOI: 10.1155/2018/6413179.].

18.
Int J Microbiol ; 2018: 6413179, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29861733

RESUMO

Background: The hospital environment is a source of medically important pathogens that are mostly multidrug resistant (MDR) and posing a major therapeutic challenge. The aim of this study was to assess the surface and air bacteriology of selected wards at Felege Hiwot Referral Hospital (FHRH), Northwest Ethiopia. Methods: A cross-sectional study was carried out from 15th February to 30th April 2017. A total of 356 surface and air samples were collected from selected wards using 5% sheep blood agar (Oxoid, UK) and processed at FHRH microbiology laboratory following the standard bacteriological procedures. Pure isolates were tested against the recommended antibiotics using Kirby-Bauer disc diffusion methods, and the susceptibility profile was determined based on Clinical Laboratory Standards Institute (CLSI). Data were entered and analyzed using SPSS version 23 for Windows. Results: Of the total 356 samples processed, 274 were from surfaces and 82 were from air. Among these, 141 (39.6%) showed bacterial growth, yielding a total of 190 isolates. Gram-positive isolates were predominant at 81.6% (n=155), while the gram negatives were at 18.4% (n=35). The main isolates were coagulase negative staphylococci (CoNs), 44%, followed by S. aureus, 37.4%, and Klebsiella species at 11.6%. The bacterial load on surfaces and air was found beyond the standard limits. Besides, the antimicrobial susceptibility profile of the isolates showed that about 75% of the identified isolates were found resistant for two and more antimicrobial agents tested. Conclusions: This study showed high degree of bacterial load that is beyond the standard limits on both surfaces and air samples of the hospital. Furthermore, some 75% of the isolates were found multidrug resistant. Therefore, it is important to evaluate and strengthen the infection prevention practice of the hospital. Moreover, stakeholders should also reinforce actions to decrease the pressure of antimicrobial resistance in the studied area.

19.
BMC Res Notes ; 11(1): 245, 2018 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-29661251

RESUMO

OBJECTIVE: The present cross-sectional study was aimed at determining the magnitude of under diagnosis of intestinal schistosomiasis among patients requested for routine ova/parasite examination at Ayder referral hospital. RESULTS: A total of 280 stool samples were collected and only 5% of the patients were positive for ova of Schistosoma mansoni in the routine direct wet mount microscopy. On the other hand, 12.5% of the patients were positive for ova Schistosoma mansoni when the stool samples were processed by either Kato Kat or formol ether concentration techniques. Moderate test agreement (κ = 0.48) was recorded for wet mount. Formol-ether concentration (κ = 0.89) and Kato-Katz (κ = 0.92) showed excellent agreements with the 'Gold' standard. Direct wet mount technique exhibited the poorest sensitivity (35%) of detection of ova of Schistosoma mansoni. Hence, the Kato-Katz technique should be implemented in parallel with the direct wet mount microscopy for Schistosoma mansoni presumptive patients.


Assuntos
Técnicas de Laboratório Clínico/normas , Fezes/parasitologia , Schistosoma mansoni , Esquistossomose mansoni/diagnóstico , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Técnicas de Laboratório Clínico/métodos , Estudos Transversais , Etiópia , Feminino , Formaldeído , Hospitais/estatística & dados numéricos , Humanos , Masculino , Microscopia/normas , Valor Preditivo dos Testes , Encaminhamento e Consulta , Sensibilidade e Especificidade , Adulto Jovem
20.
Infect Dis Poverty ; 7(1): 16, 2018 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-29482637

RESUMO

BACKGROUND: Data regarding tuberculosis (TB) treatment outcomes, proportion of TB/HIV co-infection and associated factors have been released at different TB treatment facilities in Ethiopia and elsewhere in the world as part of the auditing and surveillance service. However, these data are missing for the TB clinic offering directly observed treatment short-course (DOTs) at Debre Tabor General Hospital (DTGH). METHODS: The authors analysed the records of 985 TB patients registered at the DTGH from September 2008 to December 2016. Data on patients' sex, age, type of TB, and treatment outcomes were extracted from the TB treatment registration logbook. The treatment outcome of patients was categorized according to the National TB and Leprosy Control Program guidelines: cured, treatment completed, treatment failed, died, and not evaluated (transferred out and unknown cases). RESULTS: Around half of the registered patients were males (516, 52.4%). In terms of TB types, 381 (38.7%), 241 (24.5%), and 363 (36.9%) patients had smear-negative pulmonary TB, smear-positive pulmonary TB, and extra pulmonary TB, respectively. Six hundred and seventy-two patients (90.1%) had successful treatment outcomes (cured and treatment completed), while 74 patients (9.9%) had unsuccessful treatment outcomes (death and treatment failure).TB treatment outcome was not associated with age, sex, type and history of TB, or co-infection with HIV (P > 0.05). The proportion of TB/HIV co-infection was at 24.2%, and these were found to be significantly associated with the age groups of 25-34, 35-44 and ≥65 years:(aOR: 0.44; 95% CI: 0.25-0.8), (aOR: 0.39; 95% CI: 0.20-0.70), (aOR: 4.2; 95% CI: 1.30-12.9), respectively. CONCLUSIONS: The proportion of patients with successful treatment outcomes was above the World Health Organization target set for Millennium Development Goal of 85% and in line with that of the global milestone target set at > 90% for 2025. Relatively higher proportions of transfer-out cases were recorded in the present study. Similarly, the proportion of TB/HIV co-infection cases was much higher than the national average of 8%.Thus, the health facility under study should develop strategies to record the final treatment outcome of transfer-out cases. In addition, strategies to reduce the burden of TB/HIV co-infection should be strengthened.


Assuntos
Antituberculosos/uso terapêutico , Terapia Diretamente Observada/estatística & dados numéricos , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Adulto , Idoso , Etiópia/epidemiologia , Feminino , Hospitais Gerais , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Estudos Retrospectivos
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