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1.
Int J Infect Dis ; 113: 136-147, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34653658

RESUMO

BACKGROUND: Plasmodium falciparum gametocytaemia has been associated with anaemia. The aim of this review was to synthesize available evidence on the comparative effect of dihydroartemisinin-piperaquine (DHA-PQ) and artemether-lumefantrine (AL) on gametocyte clearance and haemoglobin recovery in children with uncomplicated P. falciparum malaria in Africa. METHODS: A systematic literature search was undertaken to identify relevant articles from online databases. The search was performed from August 2020 to 30 April 2021. Extracted data from eligible studies were pooled as risk ratios with 95% confidence intervals (CI). RESULTS: Gametocyte carriage was reduced in both treatment groups, with no significant difference found between the groups. However, on days 28 and 42, a significant increase in serum haemoglobin level from baseline was observed in the DHA-PQ group (standardized mean difference 0.15, 95% CI 0.05-0.26; participants=2715; studies=4; I2=32%, high quality of evidence) compared with the AL group (mean difference 0.35, 95% CI 0.12-0.59; participants=1434; studies=3; I2=35%, high quality of evidence). CONCLUSION: DHA-PQ had a greater impact on haemoglobin recovery than AL on days 28 and 42; this difference was significant.

2.
Infect Drug Resist ; 14: 3599-3608, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34511951

RESUMO

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are hepatotropic viruses whose primary replication occurs in the liver. Despite the significant clinical importance of early screening of hepatitis B and C virus infection in decreasing the hepatotoxicity effect of anti-tuberculosis drugs, screening of hepatitis B and C virus among tuberculosis (TB) patients before treatment has not been practiced in Ethiopia. Thus, this study was conducted to determine the seroprevalence and associated factors of HBV and HCV infections among pulmonary TB (PTB) patients attending health facilities in Gondar, Northwest Ethiopia. Methods: A cross-sectional study was conducted among 145 bacteriologically confirmed PTB patients from January 1 to May 30, 2019. After obtaining a signed informed consent from each participant, data on socio-demographic, clinical, and associated factors were collected using a structured pre-tested questionnaire. Besides, a blood sample was collected to determine HBsAg and HCV antibodies by enzyme linked immune sorbent assay (ELISA). The data were entered and analyzed using SPSS version 21. A Fisher's exact test was used to see the relationship between dependent and independent variables, and a p-value ≤0.05 was considered as statistically significant. Results: Out of the 145 PTB patients screened, 5 (3.4%) patients tested positive for HBsAg, yet none of them were found to be positive for anti-HCV. Besides, the proportion of HIV-positive was 12 (8.3%). History of hospital admission (P= 0.005), tattooing (P= 0.009) and dental extraction (P=0.003) were significantly associated with HBsAg. Conclusion: Although anti-HCV antibodies were not detected, the prevalence of HBV was relatively high in tuberculosis patients. This study highlights the need for the introduction of routine screening of viral hepatitis markers for all TB patients before anti-TB treatment for better management of patients. Likewise, further clinical and epidemiological studies are needed.

3.
Malar J ; 20(1): 340, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384431

RESUMO

BACKGROUND: Emergence of Plasmodium falciparum resistance to artemisinin and its derivatives poses a threat to the global effort to control malaria. The emergence of anti-malarial resistance has become a great public health challenge and continues to be a leading threat to ongoing malaria control efforts. The aim of this review was to synthesize available evidence on the efficacy of dihydroartemisinin-piperaquine (DHA-PQ) compared to artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria among children in Africa. METHODS: A systematic literature search was done to identify relevant articles from online databases PubMed/ MEDLINE, Embase, and Cochrane Central Register of Controlled Trials' database (CENTRAL) for retrieving randomized control trials comparing efficacy of DHA-PQ and AL for treatment of uncomplicated falciparum malaria in African children. The search was performed from August 2020 to April 2021. Using Rev-Man software (V5.4.1), R-studio and Comprehensive Meta-analysis software version 3, the extracted data from eligible studies were pooled as risk ratio (RR) with 95% confidence interval (CI). RESULTS: In this review, 25 studies which involved a total of 13,198 participants were included. PCR-unadjusted treatment failure in children aged between 6 months and 15 years was significantly lower in the DHA-PQ treatment arm on day 28 than that of AL (RR 0.14, 95% CI 0.08-0.26; participants = 1302; studies = 4; I2 = 0%, high quality of evidence). Consistently, the PCR-adjusted treatment failure was significantly lower with DHA-PQ treatment group on day 28 (RR 0.45, 95% CI 0.29-0.68; participants = 8508; studies = 16; I2 = 51%, high quality of evidence) and on day 42 (RR 0.60, 95% CI 0.47-0.78; participants = 5959; studies = 17; I2 = 0%, high quality of evidence). However, the efficacy was ≥ 95% in both treatment groups on day 28. CONCLUSION: From this review, it can be concluded that DHA-PQ reduces new infection and recrudescence on days 28 and 42 more than AL. This may trigger DHA-PQ to become a first-line treatment option.


Assuntos
Antimaláricos/uso terapêutico , Combinação Arteméter e Lumefantrina/uso terapêutico , Artemisininas/uso terapêutico , Malária Falciparum/tratamento farmacológico , Quinolinas/uso terapêutico , Adolescente , África , Antimaláricos/administração & dosagem , Artemisininas/administração & dosagem , Criança , Pré-Escolar , Combinação de Medicamentos , Humanos , Lactente , Reação em Cadeia da Polimerase/normas , Controle de Qualidade , Quinolinas/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Análise de Regressão , Sensibilidade e Especificidade , Fatores de Tempo
4.
Int J Infect Dis ; 106: 421-428, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33794378

RESUMO

BACKGROUND: Pertussis is an acute respiratory tract disease caused by Bordetella pertussis. In 2014, 24.1 million pertussis cases, resulting in 160,700 deaths, were estimated to have occurred worldwide. This study aimed to determine the epidemiology of pertussis among patients with clinically compatible illness who visited selected hospitals in the Amhara Regional State of Ethiopia. METHODS: A cross-sectional study design was used to review pertussis patients with clinically compatible illness. Nasopharyngeal swabs were collected from 515 patients from July 2018 through February 2019. DNA was extracted from all nasopharyngeal swabs and samples were analyzed using real-time (RT-) PCR. Crude and adjusted odds ratios with corresponding 95% confidence intervals were estimated using bivariable and multivariable logistic regression analysis, respectively. RESULTS: The overall prevalence of Bordetella species among the study participants was 156 of 515 (30.3%) [95% CI = 26.4-34.6] as determined by Bordetella RT-PCR, including: 65 (41.7%) B. pertussis, 89 (57.1%) indeterminate B. pertussis, one (0.6%) Bordetella holmesii and one (0.6%) Bordetella parapertussis. CONCLUSIONS: This study found that pertussis is potentially endemic and a common health problem among patients visiting health institutions in the Amhara Regional State of Ethiopia. More data regarding pertussis in Ethiopia could inform development of effective prevention strategies.


Assuntos
Coqueluche/epidemiologia , Adulto , Bordetella pertussis , Estudos Transversais , Testes Diagnósticos de Rotina , Etiópia/epidemiologia , Humanos , Masculino , Prevalência , Reação em Cadeia da Polimerase em Tempo Real/métodos
5.
Ann Clin Microbiol Antimicrob ; 20(1): 26, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879172

RESUMO

BACKGROUND: Antimicrobial-resistant strains of Streptococcus pneumoniae have become one of the greatest challenges to global public health today and inappropriate use of antibiotics and high level of antibiotic use is probably the main factor driving the emergence of resistance worldwide. The aim of this study is, therefore, to assess the antimicrobial resistance profiles and multidrug resistance patterns of S. pneumoniae isolates from patients suspected of pneumococcal infections in Ethiopia. METHODS: A hospital-based prospective study was conducted from January 2018 to December 2019 at Addis Ababa city and Amhara National Region State Referral Hospitals. Antimicrobial resistance tests were performed from isolates of S. pneumoniae that were collected from pediatric and adult patients. Samples (cerebrospinal fluid, blood, sputum, eye discharge, ear discharge, and pleural and peritoneal fluids) from all collection sites were initially cultured on 5% sheep blood agar plates and incubated overnight at 37 °C in a 5% CO2 atmosphere. Streptococcus pneumoniae was identified and confirmed by typical colony morphology, alpha-hemolysis, Gram staining, optochin susceptibility, and bile solubility test. Drug resistance testing was performed using the E-test method according to recommendations of the Clinical and Laboratory Standards Institute. RESULTS: Of the 57 isolates, 17.5% were fully resistant to penicillin. The corresponding value for both cefotaxime and ceftriaxone was 1.8%. Resistance rates to erythromycin, clindamycin, tetracycline, chloramphenicol and trimethoprim-sulfamethoxazole were 59.6%, 17.5%, 38.6%, 17.5 and 24.6%, respectively. Multidrug resistance (MDR) was seen in 33.3% isolates. The most common pattern was co-resistance to penicillin, erythromycin, clindamycin, and tetracycline. CONCLUSIONS: Most S. pneumoniae isolates were susceptible to ceftriaxone and cefotaxime. Penicillin has been used as a drug of choice for treating S. pneumoniae infection. However, antimicrobial resistance including multidrug resistance was observed to several commonly used antibiotics including penicillin. Hence, it is important to periodically monitor the antimicrobial resistance patterns to select empirical treatments for better management of pneumococcal infection.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/efeitos dos fármacos , Cefotaxima/farmacologia , Ceftriaxona/farmacologia , Cloranfenicol/farmacologia , Clindamicina/farmacologia , Eritromicina/farmacologia , Etiópia/epidemiologia , Feminino , Hospitais , Humanos , Masculino , Testes de Sensibilidade Microbiana , Penicilinas/farmacologia , Estudos Prospectivos , Tetraciclina/farmacologia , Combinação Trimetoprima e Sulfametoxazol/farmacologia
6.
Infect Drug Resist ; 14: 787-794, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33688213

RESUMO

Background: In Ethiopia, pneumococcal conjugate vaccine 10 (PCV10) was introduced in 2011 in the national vaccination program. This study was aimed to assess serotype distribution of invasive and non-invasive Streptococcus pneumoniae isolates using whole-genome sequencing. Methods: A hospital-based prospective study was conducted from 2018 to 2019 at Addis Ababa and Amhara region referral hospitals, from all patients. Clinical Samples were collected and initially cultured onto 5% sheep blood agar at 37°C in a 5% CO2 atmosphere. Sequencing was done using the Illumina NextSeq 500 and SeroBA was used to predict serotypes from whole-genome sequencing raw data. Results: Of the 57 S. pneumoniae isolates, there were 32 circulating serotypes. The most common serotypes were 15A/B/C (n=5, 8.8%), 6A (n=4, 7.0%), 10A/F (n=4, 7.0%), 23A (n=4, 7.0%) and 7C (n=3, 5.3%). The serotype coverage of PCV10 and PCV13 were 12.3% and 26.3% respectively. The most common invasive serotypes were 15A/B/C (n=5, 8.8%) and 6A (n=4, 7.0%), and non-invasive serotypes were 23A (n=4, 7.0%) and 10A/F (n=3, 5.3%). The most prevalent serotype obtained from PCV10 eligible children was 3 (n=2, 3.5%). The prevalent serotype obtained from PCV10 non-eligible patients were type 23A (n=4, 7%) and type 6A (n=3, 5.2%). The most common serotypes among children ≤18 years old were 10A/F, 7C, 35A/B, 16F, 19A, 3 and 38. However, the proportions of some non-vaccine serotypes (11A/B and 15A/B/C) were higher in adult patients. Conclusion: In this study a shift in the distribution of non-vaccinated S. pneumoniae serotypes increases in the population, and PCV10 serotype coverage was reduced as compared to PCV13. Therefore, it is important to continue monitoring serotype changes among all patients in addition to assessing the impact and effectiveness brought by vaccines and provides a foundation for prevention strategies and vaccine policies.

7.
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.

8.
BMC Health Serv Res ; 19(1): 240, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31014324

RESUMO

BACKGROUND: Clinical decisions depend on timely laboratory result reporting. The timeliness is commonly expressed in turnaround time and serves as a quality improvement tool to assess the effectiveness and efficiency of the laboratory. According to the International Organization for Standardization (ISO) guidelines, each laboratory shall establish turnaround times for each of its examinations that reflect clinical needs, and shall periodically evaluate whether or not it is meeting the established turnaround times. Therefore, this study aimed to assess the TAT of laboratory results done in the reference laboratories of the Amhara Public Health Institute, Bahir Dar, Ethiopia. METHODS: A retrospective cross sectional study was carried out from 01 January to 31 September 2018. Each patient sample was considered as a study unit. Nine months data were extracted from the sample tracking log and from the Laboratory Information System (LIS) database. Descriptive and summary statistics were calculated using SPSS version 20.0 statistical software. RESULTS: A total of 34,233 patients samples were tested during the study period. Monthly average TAT ranged from 38.6 to 51.3 days for tuberculosis (TB) culture, 5.3 to 42.4 days for exposed infant diagnosis (EID) for HIV, 8.4 to 26 days for HIV 1 viral load, and 1.9 to 3.5 days for TB genexpert tests. Compared with the standard, 76.5% of the viral load, 68.1% of the EID for HIV and 53.8% of the TB genexpert tests had delayed TAT. Repeated reagent stock out, high workload, activities overlapping, and staff turnover were major reasons for the result delays. CONCLUSIONS: There was a delayed turnaround time of laboratory results in APHI. HIV viral load, EID and TB genexpert results were the most affected tests. Workload reduction plan, proper stock management, specific work assignment and trained staff retention are important approaches to minimize the delayed TAT in the setting.


Assuntos
Academias e Institutos , Serviços de Laboratório Clínico/estatística & dados numéricos , Saúde Pública , Testes Sorológicos/normas , Estudos Transversais , Etiópia , Feminino , Humanos , Lactente , Estudos Retrospectivos , Fatores de Tempo
9.
BMC Immunol ; 19(1): 37, 2018 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-30558580

RESUMO

BACKGROUND: The initiation of highly active antiretroviral therapy (HAART) plays a significant role in the clinical management of HIV infected people by preventing morbidity and mortality. This benefit becomes, the most terrible when treatment failure develops. Thus, this research aims to assess the prevalence and associated factors of treatment failure among HIV/AIDS patients on HAART attending University of Gondar Referral Hospital Northwest Ethiopia. RESULTS: Patients on ART with a minimum of 6 months and up to 12 years of treatment were being enrolled. The prevalence of treatment failure, immunological failure and virological failure among people living with HIV/AIDS attending University of Gondar referral hospital were 20.3, 13.2, and 14.7%, respectively. Patients who had no formal education (Adjusted odds ratio (AOR): 3.8; 95% CI, 1.05-13.77), primary level education (AOR: 4.2; 95% CI, 1.16-15.01) and duration on ART < 6 years (AOR: 2.1; 95%CI, 1.12-3.81) were a significant risk factor. However, initial adult regimen D4T +  3TC+ EFV (AOR: 0.025; 95% CI, 0.002-0.36), AZT +3TC + NVP (AOR: 0.07; 95% CI, 0.01-0.71), AZT +  3TC + EFV (AOR: 0.046; 95% CI, 0.004-0.57) andTDF+3TC + EFV (AOR: 0.04; 95% CI, 0.004-0.46) were significantly protective for treatment failure. CONCLUSIONS: Timely and early identification of associated factors and monitoring antiretroviral therapy treatment failure should be done to enhance the benefit and to prevent further complication of the patients. It is preferable to initiate ART using any one of the following ART regimens: AZT +3TC + NVP, AZT + 3TC + EFV and TDF + 3TC + EFV to prevent treatment failure. Since the prevalence of this treatment failure and its associated factor may be different from other ART centers and community in Ethiopia, further national representative institutional based cross-sectional researches are needed across all ART centers of Ethiopia in order to determine the prevalence of treatment failure and its associated factors.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Adolescente , Adulto , Idoso , Linfócitos T CD4-Positivos/efeitos dos fármacos , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Encaminhamento e Consulta , Estudos Retrospectivos , Falha de Tratamento , Carga Viral/efeitos dos fármacos
10.
BMC Res Notes ; 11(1): 781, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30382888

RESUMO

OBJECTIVE: The aim of this study was to assess the magnitude, trend and reasons of rejection among referred specimens through referral network to the Amhara Public Health Institute (APHI) for laboratory testing. RESULTS: A total of 42,923 specimens were received at APHI reference laboratories. Of which, 221 (0.5%) specimens were rejected. CD4, HIV viral load, genexpert and EID specimens' rejection rates were 0.7%, 0.6%, 0.3% and 0.2%, respectively. CD4 specimens were rejected due to wrong package (84.2%) and presence of clots (15.8%). Un-centrifuge (46.9%), hemolysis (19.8%) and use of wrong tube (17.7%) were the main rejection reasons for HIV viral load specimens. Although viral load specimen rejection was improved from 1.8 to 0% up to February/2018, the problem was reoccurred and continued to the end of May (1.3%) and June (0.3%) 2018. Moreover, CD4 specimen rejection (4.3%) was out of the established target in May, and exposed infant diagnosis (EID) specimen rejection became increased since March 2018. Hence, appropriate corrective and preventive actions and close follow up could reduce the problem of specimen referral network.


Assuntos
Coleta de Amostras Sanguíneas/estatística & dados numéricos , Laboratórios/estatística & dados numéricos , Etiópia , Humanos , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos
11.
BMC Clin Pathol ; 18: 4, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29515332

RESUMO

Background: Helicobacter pylori antibody titters fall very slowly even after successful treatment. Therefore, tests detecting H. pylori antibody lack specificity and sensitivity. On the other hand, H. pylori stool antigen tests are reported as an alternative assay because of their reliability and simplicity. However, the comparative performance of H. pylori stool antigen tests for detecting the presence of the bacterium in clinical specimens in the study area is not assessed. Therefore, in this study we evaluated the performance of SD BIOLINE H. pylori Ag rapid test with reference to the commercially available EZ- STEP ELISA and SD BIOLINE H. pylori Ag ELISA tests. Methods: Stool samples were collected to analyse the diagnostic performance of SD BIOLINE H. pylori Ag rapid test kit using SD H. pylori Ag ELISA kit and EZ- STEP ELISA tests as a gold standard. Serum samples were also collected from each patient to test for the presence of H. pylori antibodies using dBest H. pylori Test Disk. Sensitivity, specificity, predictive values and kappa value are assessed. P values < 0.05 were taken statistically significant. Results: Stool and serum samples were collected from 201 dyspeptic patients and analysed. The sensitivity, specificity, positive and negative predictive values of the SD BIOLINE H. pylori Ag rapid test were: 95.6% (95% CI, 88.8-98.8), 92.5% (95%CI, 89-94.1%), 86.7% (95% CI, 80.5-89.6), and 97.6% (95% CI, 993.9-99.3) respectively. Conclusion: The performance of SD BIOLINE H. pylori Ag rapid test was better than the currently available antibody test in study area. Therefore, the SD BIOLINE Ag rapid stool test could replace and be used to diagnose active H. pylori infection before the commencement of therapy among dyspeptic patients.

12.
Int J Microbiol ; 2018: 7510157, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30693035

RESUMO

Background: Enterococci that colonize the intestinal tract of immunocompromised patients are an important cause of nosocomial infections. Data on the prevalence of vancomycin-resistant Enterococci (VRE) and its antimicrobial susceptibility patterns and associated factors are scarce in the present study area. Therefore, this study was conducted aimed at determining the prevalence of VRE colonization among HIV-infected patients attending ART clinic at West Amhara Government Hospitals. Methods: A cross-sectional study was conducted from 1 February 2017 to 31 May 2017. A total of 349 HIV patients were included in the study. A pretested structured questionnaire was used to collect sociodemographic data and possible associated factors for VRE colonization. Identification and confirmation of Enterococci from stool sample was performed based on the standard procedures. Antimicrobial susceptibility testing was done using the Kirby-Bauer disk diffusion method on the Muller-Hinton agar plate as per the standard protocol, and resistance profile of the isolates was determined according to Clinical and Laboratory Standards Institute (CLIS). Data were analyzed using SPSS v23. Descriptive analysis was used to visualize differences within data. Moreover, the stepwise logistic regression model was done to assess factors associated with VRE colonization. P value was set at 0.05 to indicate statistical significance difference. Results: The overall colonization status of Enterococci was at 63% (220/349). The VRE colonization was at 17 (7.7% (95% CI: 4.9-12.0)). Among Enterococcal isolates tested for antimicrobial susceptibility, 142 (64.5%) were found resistant to two or more antibiotics. Antibiotic treatment (for >2 weeks) and history of hospital admission in the last six month were found statistically associated for VRE colonization (AOR = 10.18, (95% CI: 1.9-53.20)) and (AOR = 20.17; (95% CI: 5.22-77.93)), respectively. Conclusions: The observed VRE with multidrug resistance colonization need a periodic surveillance of antimicrobial testing to detect emerging resistance and prevent the spread of further drug resistance.

13.
BMC Public Health ; 15: 15, 2015 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-25605404

RESUMO

BACKGROUND: Universities tend to be highly congregate settings, both in the classroom and in residences, and thus provide special opportunities for large number of persons to be exposed to a person with tuberculosis (TB). Despite the high prevalence of TB in Ethiopia, the TB prevalence and the treatment outcome among students have never been studied. Therefore, this study was aimed at determining the prevalence and treatment outcome of TB among students at University of Gondar from January 2007 to December 2011. METHODS: Data on age, sex, TB type, category, and treatment outcome of students with TB was collected from medical records of University of Gondar Hospital, TB Directly Observed Treatment Short Course (DOTS) clinic. All TB cases diagnosed with smear, culture, and/or radiography were included in the study. RESULTS: During the five year study period in the university, there were an average of 36 students with TB per year out of a mean of 10,036 enrolled students. Smear positive pulmonary TB, smear negative pulmonary TB, and extra pulmonary TB, respectively, were observed in 46 (25.4%), 81 (44.8%) and 54 (29.8%) of the cases. The prevalence of all forms of TB per 100,000 populations in the University ranged from 297.6 in 2009 to 404 in 2011, respectively. The prevalence of TB in the Social Sciences and Humanities Faculty was higher than the one observed in the Medical College. The overall treatment outcome was classified as cured in 36 (19.9%), completed in 91 (50.3%), defaulted in 9 (5%), failed in 3 (1.7%), died in 1 (0.6%), and transferred out in 41 (22.7%) of the cases. Treatment success rate (TSR) among students in University was generally low ranging from 58.1% in 2009 to 82.9% in 2011 with a mean TSR of 70.2%. CONCLUSION: The prevalence of TB is higher in comparison to the national figure among students in University of Gondar. Active surveillance systems could be important to get a clear picture of the TB situation in such settings. Assessing the factors associated with the high prevalence to gear the TB control strategy could also be essential.


Assuntos
Estudantes/estatística & dados numéricos , Tuberculose/epidemiologia , Tuberculose/terapia , Adulto , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Estudos Retrospectivos , Resultado do Tratamento , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/terapia , Universidades , Adulto Jovem
14.
BMC Res Notes ; 6: 534, 2013 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-24330921

RESUMO

BACKGROUND: Human immunodeficiency virus (HIV) pandemic is among the greatest health crises ever faced by humanity. Morbidity and mortality in HIV disease is due to immunosuppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. This study was aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending at Gondar University Hospital. METHODS: Cross sectional study was conducted on 360 adult HIV-infected patients attending antiretroviral therapy clinic from February 2012-April 2012. Patients' OI status was determined through clinical diagnosis and laboratory investigations. CD4 count was determined using flow cytometry technique. Sociodemographic and clinical data were obtained from interview and patients' medical records. Bivariate and multivariate logistic regression analysis was done using SPSS version 16 statistical soft ware and odds ratio was used as the measure of association. P-value less than 0.05 was considered statistically significant for all tests. RESULTS: In this study, 360 HIV-infected patients were included; of whom (n = 216/360, 60%) were females. The majority of patients (n = 153/360, 42.5%) were 25-34 years old with mean age of 35.5+ 8.8 standard deviation. The overall prevalence of OIs was (n = 71/360, 19.7%). Tuberculosis (n = 35/360, 9.72%) followed by oral candidiasis (n = 18/360, 5%) and diarrhea (n = 12/360, 3.3%) were the most frequently observed OIs. CD4 count less than 200/mm3 (OR = 4.933, P < 0.001), World Health Organization (WHO) clinical stage III (OR = 9.418, P < 0.001) and IV (OR = 22.665, P < 0.001) were found to have strong association with acquisition of OIs. CONCLUSIONS: Tuberculosis, oral candidiasis and diarrhea were the leading OIs encountered by HIV-infected patients. CD4 count less than 200/mm3 and advanced WHO clinical stages of the disease were found to be predictors of OIs. Interventions aimed at preventing and treating HIV associated OIs are crucial. Initiation of ART before the CD4 count drops below 350 should be encouraged.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Candidíase Bucal/complicações , Diarreia/complicações , Infecções por HIV/complicações , HIV-1 , Linfócitos T/patologia , Tuberculose Pulmonar/complicações , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Adulto , Contagem de Linfócito CD4 , Candidíase Bucal/epidemiologia , Candidíase Bucal/imunologia , Candidíase Bucal/microbiologia , Estudos Transversais , Diarreia/epidemiologia , Diarreia/imunologia , Diarreia/microbiologia , Etiópia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/imunologia , Infecções por HIV/microbiologia , Hospitais Universitários , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Classe Social , Linfócitos T/imunologia , Linfócitos T/virologia , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/microbiologia
15.
BMC Res Notes ; 6: 283, 2013 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-23875886

RESUMO

BACKGROUND: Bacterial blood stream infection constitutes a significant public health problem and it is an important cause of morbidity and mortality in hospitalized patients. The aim of this study was to assess the prevalence of bacterial isolates from septicemia suspected patients and their antimicrobial susceptibility pattern in Gondar University Hospital. METHODS: This laboratory based retrospective study of 390 blood culture and susceptibility tests was conducted in Bacteriology Laboratory of the University of Gondar Teaching Hospital. The samples were collected and processed following standard microbiological techniques as part of the routine clinical management of the patient. Antibiotic susceptibility testing was done on pure culture isolates employing disc-diffusion method for the commonly used antibiotics. The data were analyzed by using SPSS version 16 and the results were summarized by using tables and graphs. RESULTS: Out of 390 blood culture results, 71 (18.2%) were culture positive. The predominant bacteria isolated from blood culture were Coagulase negative staphylococci 30 (42.3%), followed by S. aureus 17 (23.9%) and Klebiesella spp 9 (12.9%), E. coli 5 (7.0%), Pseudomonas aeroginosa 4 (5.6%) and Salmonella spp. 3 (4.2%). The gram positive and gram negative bacteria constituted 49 (69%) and 22 (31%) of the culture isolates; respectively. The isolates showed high rates of resistance to most antibiotics tested. The range of resistance for Gram positive and Gram negative were from 23.5% - 58.8%, and 20%- 100% respectively. CONCLUSIONS: In the present study most of the pathogens isolated from blood culture showed high rate of resistance to most commonly used antibiotics used to treat bacterial infections. Therefore, rational use of antibiotics should be practiced.


Assuntos
Hospitais Universitários , Testes de Sensibilidade Microbiana , Sepse/microbiologia , Adolescente , Adulto , Bactérias/classificação , Criança , Pré-Escolar , Estudos Transversais , Etiópia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
BMC Res Notes ; 6: 164, 2013 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-23618464

RESUMO

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HBV) infections accounts for substantial proportions of the world wide liver disease. The two hepatotropic virus share common modes of transmission and their co-infection are common. Patients with dual HBV and HCV infection have more severe liver disease and are at increased risk of progression to hepatic cell carcinoma. This study was aimed to assess the prevalence of HBV and HCV among patients attending serology laboratory of Gondar University Teaching Hospital. METHODS: A retrospective study was conducted from January 2007 to December 2011 at serology laboratory of Gondar University Teaching Hospital. Data were cross checked for completeness, entered and analyzed using SPSS version 16 statistical package. RESULTS: From the total of 2,684 clinicaly suspected hepatitis patients, 563 (20.98%) were positive for HBsAg and anti-HCV test. Of all, 14.4% were seropositive for HBV (male= 7.89% female=6.27%) (p-value=0.011) while 12.4% were seropositive for HCV (male =7.6% and female=4.13%) (p-value<0.001). The co-incidence of HBV and HCV were found to be 36 (6.39%) (male=3.9% and female=2.4%) (p-value <0.001). Majority of HBV (30.2%) and HCV (30.7%) infections were detected among age group of 25-34 years old (p-value=0.36) and 15-24 years old (p-value<0.001) respectively. CONCLUSION: The overall prevalence of HBV and HCV is high. Males and younger age groups were more affected. Community awareness about the transmission and prevention of viral hepatitis infection should be strengthened by giving health education and herd immunization.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Hospitais Universitários , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Estudos Soroepidemiológicos
17.
Iran J Kidney Dis ; 7(2): 102-7, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23485533

RESUMO

INTRODUCTION: About 10% to 15% of in-hospital urinary tract infections (UTIs) are due to Candida species, and the prevalence is still increasing. A cross-sectional study was conducted to determine fungal causative agents of UTI in asymptomatic and symptomatic diabetic patients and associated risk factors. MATERIALS AND METHODS: Between May and June 2010, a total of 422 diabetic patients with asymptomatic UTI (n = 387) and symptomatic UTI (n = 35) were investigated for UTI at Gondar University Hospital. Clean-catch midstream urine specimens were collected from each participant. Fungal urine culture and identification were done using standard microbiologic procedure. RESULTS: The age range of the participants was 20 to 84 years (mean, 42.3 years). Significant candiduria was detected in 7.5% and 17.1% of asymptomatic and symptomatic diabetic patients, respectively. The overall prevalence of significant candiduria in both groups was 8.3%. Candida species were isolated in 38 urine samples. Of these, 84.2% were from the asymptomatic diabetic patients and the remaining 15.8% were from the symptomatic patients. The most common species were C albicans (42.0%), C glabrata (34.2%), and C tropicalis (15.8%). Significant candiduria was strongly associated with being female. CONCLUSIONS: The presence of candiduria in diabetic patients should not be neglected. Although C albicans is the organism most often associated with serious fungal infection, other Candida species are also isolated as clinically important opportunistic pathogens in type 2 diabetic patients.


Assuntos
Candida/isolamento & purificação , Candidíase/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Infecções Urinárias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida/classificação , Candidíase/microbiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/microbiologia , Etiópia/epidemiologia , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Infecções Urinárias/microbiologia , Adulto Jovem
18.
BMC Public Health ; 13: 143, 2013 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-23414518

RESUMO

BACKGROUND: Sexually transmitted infections are among the most common causes of illnesses in the world and have far reaching health, social and economic consequences. They are important because of their magnitude, potential complications and interactions with HIV/AIDS. Though the problem may be generally similar to other developing countries, there is scarce information on the incidence and prevalence of sexually transmitted infections in Ethiopia. This study was then aimed to determine the magnitude of sexually transmitted infections among patients visiting a clinic in Gondar town, Northwest Ethiopia. METHODS: Medical records of patients who visited the clinic from January 2011 to December 2011 were reviewed. Sociodemographic and clinical data were extracted using data extraction form. The data were entered and analyzed using SPSS version 16 statistical package. Descriptive statistics and Chi-square tests were carried out. RESULTS: A total of 1071 clients visited the clinic during the study period. Among these, 383 (35.8%) had complained symptoms of sexually transmitted infections. The mean (SD) age of the patients was 26.8 ± 7.4 years. The commonest chief complaints were vaginal discharge (38.4%) and urethral discharge (13.6%). Seventy seven percent of the cases did not bring their sexual partners for treatment. CONCLUSION: There was a high magnitude of STIs in the clinic according to the syndromic approach. However, the actual prevalence of STIs and the associated factors in the community need to be determined through further studies. The results of this study also urge the need for evaluation of the syndromic approach and test for antimicrobial resistance.


Assuntos
Registros Médicos/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Instalações de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
19.
BMC Pediatr ; 13: 7, 2013 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-23311926

RESUMO

BACKGROUND: Parasitic infections have been shown to have deleterious effects on host nutritional status. In addition, although helmintic infection can modulate the host inflammatory response directed against the parasite, a causal association between helminths and allergy remains uncertain. The present study was therefore designed to evaluate the relationship between nutritional status, parasite infection and prevalence of allergy among school children. METHODS: A cross sectional study was performed involving school children in two elementary schools in Gondar, Ethiopia. Nutritional status of these children was determined using anthropometric parameters (weight-for-age, height-for-age and BMI-for-age). Epi-Info software was used to calculate z-scores. Stool samples were examined using standard parasitological procedures. The serum IgE levels were quantified by total IgE ELISA kit following the manufacturer's instruction. RESULT: A total of 405 children (with mean age of 12.09.1 ± 2.54 years) completed a self-administered allergy questionnaire and provided stool samples for analysis. Overall prevalence of underweight, stunting and thinness/wasting was 15.1%, 25.2%, 8.9%, respectively. Of the total, 22.7% were found to be positive for intestinal parasites. The most prevalent intestinal parasite detected was Ascaris lumbricoides (31/405, 7.6%). There was no statistically significant association between prevalence of malnutrition and the prevalence of parasitic infections. Median total serum IgE level was 344 IU/ml (IQR 117-2076, n=80) and 610 IU/ml (143-1833, n=20), respectively, in children without and with intestinal parasite infection (Z=-0.198, P>0.8). The prevalence of self reported allergy among the subset was 8%. IgE concentration was not associated either with the presence of parasitic infection or history of allergy. CONCLUSION: The prevalence of malnutrition, intestinal parasitism and allergy was not negligible in this population. In addition, there was no significant association between the prevalence of allergy and their nutritional status, and parasite infection. Further research prospective observational and intervention studies are required to address the question of causality between nutritional factors, parasites, and allergy.


Assuntos
Helmintíase/complicações , Hipersensibilidade/complicações , Enteropatias Parasitárias/complicações , Desnutrição/complicações , Estado Nutricional , Adolescente , Ancylostomatoidea/imunologia , Ancylostomatoidea/isolamento & purificação , Animais , Anticorpos Anti-Helmínticos/sangue , Ascaris lumbricoides/imunologia , Ascaris lumbricoides/isolamento & purificação , Estatura , Índice de Massa Corporal , Peso Corporal , Criança , Estudos Transversais , Etiópia/epidemiologia , Fezes/parasitologia , Feminino , Helmintíase/sangue , Helmintíase/epidemiologia , Humanos , Hymenolepis nana/imunologia , Hymenolepis nana/isolamento & purificação , Hipersensibilidade/sangue , Hipersensibilidade/epidemiologia , Hipersensibilidade/parasitologia , Imunoglobulina E/sangue , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/epidemiologia , Masculino , Desnutrição/sangue , Desnutrição/epidemiologia , Desnutrição/parasitologia , Prevalência , Inquéritos e Questionários , Trichuris/imunologia , Trichuris/isolamento & purificação
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