RESUMO
BACKGROUND: Nasopharyngeal carriage of bacteria is the main source for transmission of pathogens across individuals and horizontal spread of organisms in the community. It is an important risk factor for the acquisition of community-acquired respiratory tract infection. It is the major public health problem among children. The asymptomatic carriage of nasopharyngeal bacteria is different globally, particularly in Africa, carriage is higher in children and decreases with increasing age, 63.2% in children less than 5 years, 42.6% in children 5-15 years, and 28.0% in adults older than 15 years. OBJECTIVE: The aims of this study was to determine asymptomatic nasopharyngeal bacterial carriage, multi-drug resistance pattern and associated factors among primary school children at Debre Berhan town, North Shewa, Ethiopia. METHODS: Institutional based cross-sectional study was conducted at Debre Berhan town primary schools from February 1 to April 30, 2021. Primarily, the schools were stratified into two strata, public and private primary schools. From a total of sixteen government and fourteen private primary schools, five government and five private schools were selected by using a simple random sampling technique. Socio-demographic variables and potential risk factors were assessed using a structured questionnaire. A total of 384 nasopharyngeal swab samples were collected using sterile swabs aseptically; and inoculated on Blood agar, Chocolate agar, MacConkey agar, and Mannitol salt agar. The colony was characterized to isolate bacteria, and bacterial identification was performed by Gram reaction, hemolysis patterns, colonial characteristics and pigmentation, catalase test, coagulase test, mannitol fermentation test, oxidase test, fermentation of carbohydrates, H2S production, motility, formation of indole, triple sugar iron agar (TSI), citrate utilization, lysine decarboxylase or methyl red vogues proskur utilization, urea hydrolysis and satellitism tests. Antimicrobial sensitivity tests were performed by using modified Kirby-Bauer disk diffusion method. Data were entered into statistical package Epi data 4.0.0.6 and transferred to and analyzed using SPSS software version-23. P value of < 0.05 with Odds ratio (OR) and 95% confidence interval (CIs) was considered as statistically significant. RESULTS: The overall prevalence of nasopharyngeal carriage of bacterial isolate was 35.7% (95% CI 30.7-40.7%). The predominant isolates were Staphylococcus aureus 54.5% followed by coagulase-negative Staphylococcus 35.8%, and Streptococcus pyogens 4.5%. Most bacterial isolates were susceptible to chloramphenicol, ciprofloxacin, gentamycin, nitrofurantoin, azithromycin, ciprofloxacin; and the overall multidrug resistance pattern of isolated bacteria was 62.03% out of 137 bacterial isolates. Numbers of rooms ≤ 2 per house [AOR = 5.88, 95%CI 1.26-27.57], having history of hospitalization [AOR = 4.08, 95%CI 1.45-11.53], passive smoking [AOR = 4.87, 95%CI 1.49-15.97], family size of > 5 members [AOR = 2.17, 95%CI 1.24-3.81], and number of students in the classroom [AOR = 2.35,95%CI 1.37-4.02] were statistically significant associated risk factors for nasopharyngeal bacteria carriage. CONCLUSION: Asymptomatic nasopharyngeal bacteria carriage in children is alarming for community-acquired infection. The overall multidrug resistance was very high. The risk of the carriage was increased with having a history of passive smoking, being in large family size and number of students per class. Longitudinal follow-up studies would be helpful for better understanding the infection risk in bacterial pathogen carriers.
Assuntos
Coagulase , Poluição por Fumaça de Tabaco , Adulto , Humanos , Criança , Pessoa de Meia-Idade , Etiópia/epidemiologia , Estudos Transversais , Ágar , Nasofaringe/microbiologia , Ciprofloxacina , Farmacorresistência Bacteriana Múltipla , Staphylococcus aureus , Instituições Acadêmicas , Testes de Sensibilidade MicrobianaRESUMO
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/farmacologiaRESUMO
BACKGROUND: Multidrug resistance (MDR), extended-spectrum beta-lactamase (ESBL) and carbapenemase-producing Gram-negative bacteria (GNB) has become a public health threat worldwide. This threat is worse in developing countries where there is high infectious disease burden and spread of antimicrobial resistance co-exist. The aim of the present study was, therefore, to assess MDR, ESBL and carbapenemase producing GNB from patients attending three selected referral hospitals in Amhara region. METHODS: A cross-sectional study was conducted from December 2017- April 2018 at the University of Gondar Comprehensive Specialized Hospital, Dessie Referral Hospital and Debre Markos Referral Hospital of Amhara national regional state. A total of 833 study subjects were recruited using a convenient sampling technique. Clinical samples such as blood, urine, stool, wound, abscess, ear discharge, nasal discharge, cervical discharge and body fluid specimens were aseptically collected. Culturing for identification of bacteria and determination of drug susceptibility testing were done following standard microbiological techniques. Selected MDR isolates were phenotypically assessed for ESBL and carbapenemase production. RESULTS: Of the 833 clinical samples cultured for bacterial growth, 141 (16.9%) were positive for GNB. The most common GNB identified were E. coli 46 (32.6%), Klebsiella spp. 38 (26.5%) and Proteus spp. 13 (9.2%). The overall MDR prevalence was 121 (85.8%). Among the total isolates, 137 (97.2%) were resistant to ampicillin followed by cotrimoxazole 115 (81.6%), amoxicillin-clavulanic acid 109 (77.3%), cefixime 99 (70.2%), cefepime 93 (66.0%) and tetracycline 91 (64.5%). The extended-spectrum beta-lactamase producing GNB were 69/124 (55.6%). Of which Klebsiella spp. 19 (15.3%) and E. coli 17 (13.7%) were common ESBL producers. Carbapenemase-producing isolates were 8/51(15.7%). Of which Enterobacter, Klebsiella and E. coli were common carbapenemase producers. CONCLUSION AND RECOMMENDATION: Multi-drug resistance and ESBL producing isolates in the present study were high. E. coli and Klebsiella spp. were the most common ESBL producing GNB. Klebsiella spp., Enterobacter spp., E. coli and Citrobacter spp. were typical carbapenemase-producing isolates. Continuous monitoring, antibiotic stewardship and molecular detection of the gene responsible for drug resistance are important means to reduce the spread of drug-resistant pathogens.
Assuntos
Farmacorresistência Bacteriana Múltipla , Bactérias Gram-Negativas/metabolismo , Encaminhamento e Consulta , beta-Lactamases/metabolismo , Adolescente , Adulto , Antibacterianos/farmacologia , Proteínas de Bactérias , Criança , Pré-Escolar , Estudos Transversais , Farmacorresistência Bacteriana Múltipla/genética , Etiópia/epidemiologia , Feminino , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/genética , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/epidemiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Adulto Jovem , beta-Lactamases/genéticaRESUMO
BACKGROUND: In sub-Saharan Africa, bacterial bloodstream infection is the most common cause of morbidity and mortality. Regular antimicrobial surveillance is required to understand resistance development and to inform clinicians and policymakers on best empiric antibiotic choice, such type of data are scarce in the study area. This study aimed to determine bacterial profiles and their antibiotic susceptibility patterns from patients with suspected septicemia at the University of Gondar comprehensive specialized hospital, northwest Ethiopia, over a six-year period. METHODS: We carried out a six-year (January 2, 2012, to January 1, 2018) retrospective analysis of blood cultures from patients with suspected septicemia. Laboratory report data were used to determine patient demographic, bacterial profiles, and antimicrobial resistance patterns. A total of 2,404 blood cultures were processed during the study period. Data were analyzed using SPSS version 20 software and the results were summarized using tables and graphs. RESULTS: Of the 2,404 blood cultures, 489 (20.7%, [95% CI, 19.2 - 22.3%]) bacteria isolates were obtained. The most common isolates were Staphylococcus aureus (215; 43.2%), followed by Klebsiella spp (67; 13.5%), coagulase-negative staphylococcus (62; 12.4%), Escherichia coli (38; 7.6%), viridans streptococci (25; 5%), Citrobacter spp (17; 3.4%), Enterobacter spp (15; 3%), and Streptococcus pneumoniae (12; 2.4%). Methicillin-resistant S. aureus isolation rate was 21/44 (47.7%). Gram-positive and negative bacteria showed high resistance to older antimicrobials, namely ampicillin, erythromycin, tetracycline, gentamicin, and trimethoprim-sulphamethoxazole. Gram-negative bacteria had a high level of resistance to 3rd generation cephalosporins, but both Gram-positive and negative bacteria were susceptible to ciprofloxacin. CONCLUSIONS: S. aureus, CoNS, S. pneumoniae, Klebsiella spp and E. coli remain the most important bacteria responsible for bloodstream infection in this study. Those pathogens showed a high rate of resistance to old antibiotics. Among the tested antimicrobials, ciprofloxacin was found to be the most effective drug to inhibit the in-vitro growth of both Gram-positive and negative bacteria. Therefore, there is a need for continuous screening of AMR from blood cultures to control the spread of drug resistant isolates in the study area.
Assuntos
Anti-Infecciosos , Staphylococcus aureus Resistente à Meticilina , Sepse , Adulto , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bactérias , Criança , Farmacorresistência Bacteriana , Escherichia coli , Etiópia/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Staphylococcus aureusRESUMO
Background and Aims: Food-borne illness is a public health concern in developing countries because of improper food handling and sanitation practices, irregular medical checkups, lack of clean water supplies, and inadequate education among food handlers. This study investigated the burden of bacterial food-borne illness, antibiotic resistance patterns, and associated factors among food handlers in prison and nonprison food establishment settings. Methods: A cross-sectional study was conducted from August 2022 to January 2023 among asymptomatic food handlers in Shewa Robit town. A total of 384 food handlers participated. Data were collected using structured questionnaires. Stool and hand swab samples were collected and cultivated onto MacConkey agar, xylose-lysine-deoxycholate, Mannitol salt agar, and blood agar, and incubated at 37°C. Bacterial species were identified using biochemical tests and gram staining. Mueller-Hinton agar was used in Kirby Bauer's disk diffusion method. Data were entered and analyzed using SPSS. Descriptive and logistic regression analysis were performed. Results: Fecal and hand carriage rate of bacterial isolates were 106 (27.6%), and 214 (55.7%), respectively. Out of the 102 bacterial isolates, the most common ones from stool samples were Escherichia coli 71 (18.5%), Klebsiella aerogenes 12 (3.1%), and Salmonella spp. 7 (1.8%). Among 214 bacterial isolates, coagulase-negative Staphylococci 115 (29.9%) and Staphylococci aureus 66 (17.3%) were identified from hand swab samples. Hand washing practice after restroom with water (adjusted odds ratio [AOR] = 2; 95% confidence interval [CI]: 1.16-3.45), irregular medical checkups (AOR = 2.49; 95% CI: 1.35-4.59), and did not receive food safety and hygiene training (AOR = 2.33; 95% CI: 1.34-4.05) were statistically significant association with food-borne illness. Conclusions: Foodborne pathogens pose a serious health risk in the study areas. The level of antimicrobial resistance are also concerning. Food handlers should therefore get strict regular health education, medical checkups, and training programs to prevent the spread of infections to the customers.
RESUMO
Hematopoietic stem cell donation is a method used to treat both blood-related and non-blood-related malignancies. Graft-versus-host disease is a potentially life-threatening complication that can occur following a stem cell transplant from a donor. This happens after the transplanted grafts attack the recipient's body as foreign cells, causing significant morbidity and mortality. Clinically, this condition can be classified as acute or chronic based on onset and pathophysiology. This review aims to provide an overview of recent studies on extracorporeal photopheresis as a treatment strategy option for graft-versus-host-diseased patients. It will explain how it treats graft-versus-host disease, summarize its promising effects, and provide future recommendations for its use in treating this illness. Extracorporeal photopheresis is used to treat graft-versus-host disease by collecting and separating white blood cells from the patient. This blood is fractionated into different parts, and white blood cells undergo treatment with 8-methoxy psoralen, a photoactivable drug, before exposure to ultraviolet light A. Lastly, the cells that have been treated are reinfused into the recipient's body. It prompts the programmed cell death of lymphocytes and the engulfment of cellular debris by host antigen-presenting, leading to a subsequent rise in T regulatory cells. However, more experimental and randomized controlled studies are required to identify the best patient selection requirements, environments, and treatment regimens for graft-versus-host disease.
RESUMO
BACKGROUND: Urinary tract infections are common bacterial and fungal infections in humans, occurring both in the community and in immunocompromised patients in healthcare settings. Urinary tract infections have a significant health impact on HIV-infected patients. Nowadays, drug-resistant pathogens are widespread poses a serious clinical risk, and causes urinary tract infection. The common agents of bacteria and fungi that cause urinary tract infection are Escherichia coli followed by Klebsiella pneumonia, Staphylococcus saprophyticus, Enterococcus faecalis, group B streptococcus, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus and Candida. albicans. This study aimed to investigate uro-pathogen, multidrug resistance pattern of bacteria, and associated factors of community-acquired urinary tract infection among HIV-positive patients attending antiretroviral therapy in Dessie comprehensive specialized hospital, Northeast Ethiopia from February 1, 2021, to March 30, 2021. METHODS: An institutional-based cross-sectional study was conducted at Dessie Comprehensive Specialized Hospital. Socio-demographic and clinical data were collected by using structured questionnaires from HIV patients suspected of community-acquired urinary tract infections. About 10 ml of clean-catch midstream urine was collected and inoculated into Blood agar, MacConkey, and Cysteine lactose electrolyte deficient media. Yeasts were identified by using Gram stain, germ tube test, carbohydrate fermentation, assimilation tests, and chromogenic medium. Gram stain and biochemical tests were performed to identify isolates and an antimicrobial susceptibility pattern was performed on disc diffusion techniques. Data were entered and analyzed using SPSS version 25. Both bivariate and multivariable logistic regression analysis was performed and a P value of < 0.05 with an adjusted odds ratio with their 95% confidence interval (CI) was used as statistically significant associations. RESULTS: From the total 346 study participants, 92 (26.6%) were culture positive 75 (81.52%) were bacterial and 17 (18.48%) were fungal pathogens. From a total of 75 bacteria isolates 51(68%) were Gram-negative bacteria and the most commonly isolated bacteria were E. coli 16 (21.33%) followed by K. pneumoniae 11(14.67%) and enterococcus species 10(10.87. Of the 17 fungal isolates of fungi, 8(47.1%) were represented by C. tropicalis. Of the isolated bacteria, 61(81.3%) were resistant to three and above classes of antibiotics (drug classes). About 13 (81.3%) of E. coli, 9(81.8%) of K. pneumoniae, 8(80%) of Enterococcus species, 7 (77.8%) of P. aeruginosa, and CoNs 7(87.5%) were the most frequently exhibited three and above classes of antibiotics (multi-drug resistance). Amikacin and gentamicin were effective against Gram-negative Uro-pathogens. Participants aged>44year, female, being daily labor, being farmer, unable to read and write, patients with CD4 count of ≤ 200 cells/mm3 and CD4 count of 201-350 cells/mm3, who had chronic diabetics, patients having a history of hospitalization and who had urgency of urinations were statistically significant association with significant urinary tract infections. CONCLUSION: The burden of community-acquired urinary tract infections among HIV patients is alarmingly increased. Therefore, behavior change communications might be considered for promoting the health status of HIV patients. Moreover, CD4 level monitoring and therapeutics selection based on microbiological culture are quite advisable for the management of urinary tract infections of HIV patients.
Assuntos
Infecções Comunitárias Adquiridas , Infecções por HIV , Infecções Urinárias , Humanos , Etiópia/epidemiologia , Infecções Urinárias/microbiologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Feminino , Masculino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/complicações , Infecções por HIV/microbiologia , Infecções por HIV/epidemiologia , Adulto , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Pessoa de Meia-Idade , Estudos Transversais , Farmacorresistência Bacteriana Múltipla , Adulto Jovem , Testes de Sensibilidade Microbiana , Antibacterianos/uso terapêutico , Antibacterianos/farmacologia , Hospitais Especializados , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificaçãoRESUMO
Background: The persistent efforts of HIV/AIDS epidemiology remain one of the world's most important community health threats. To avoid becoming an epidemic, UNAIDS has set three 90% fast-track targets for 2020, and Ethiopia has also changed its implementation since 2015. However, the achievement targets in the Amhara region have yet to be evaluated at the end of the programme period. Objective: The aim of this study was to assess the Trends of HIV Infection and Antiretroviral Treatment outcome in Eastern Amhara Regional from 2015 to 2021, Northeast Ethiopia. Methods: A retrospective study was conducted by reviewing the District Health Information System from 2015 to 2021. The collected data includes the trend of HIV testing services, the trend of HIV positivity, the yield of HIV testing approaches, the number of HIV positive patients linked to HIV care and treatment or access to lifelong antiretroviral therapy, viral load testing coverage, and viral suppression. A descriptive statistic and trend analysis were computed. Results: A total of 145,639 people accessed antiretroviral therapy. The trend of HIV test positivity has been declining since 2015, peaking at 0.76% in 2015 and declining to 0.60% in 2020. A high level of positivity was reported in volunteer counselling and testing as compared with provider-initiated testing and counselling services. Following an HIV positive, there was an increase in linkage to HIV care and treatment. High suppression rates of viral load indicate testing coverage grew over time. The viral load monitoring coverage was 70% in 2021, with a viral suppression rate of 94%. Conclusion and Recommendations: The trend in achievement in the first 90s was not consistent with predefined goals (90%). On the other hand, there was good achievement in the second and third goals. Hence, intensified case-finding approaches to HIV testing should be strengthened.
RESUMO
Background and Aims: Intestinal parasites affect the tuberculosis disease outcome by shifting the cell-mediated to humoral immune response and host immune system suppression. However, Mycobacterium tuberculosis (MTB) infection favors the immune escape of parasites. Hence, exploring the rate of intestinal parasitic coinfection with pulmonary tuberculosis (PTB) and its predisposing factors to take better preventive, control, and management measures. Methods: A facility-based cross-sectional study was conducted from September to December 2020 at five health institutions in Hawassa city. A total of 214 PTB patients were diagnosed using the GeneXpert assay and enrolled in this study. Demographic, clinical, and risk factors data were collected using a structured questionnaire. Stool samples were collected using a clean, labeled, and leak-proof stool cup. Stool samples were examined using direct saline microscopy and the formal-ether concentration technique. The data were entered and coded in SPSS software for analysis. Bivariate and multivariate logistic regression were employed to identify the associated risk factors. A p-value less than 0.05 was considered statistically significant. Results: The overall rate of intestinal parasitic-MTB coinfection was 36.9%. The most dominant intestinal parasite was Gardia lamblia (17.8%, 38), followed by Entamoeba histolytica/dispar (9.3%, 20). Intestinal parasitosis coinfection of PTB was associated with being rural resident (adjusted odds ratio [AOR] = 2.42; 95% confidence interval [CI]: 1.23-4.8), not washing of fruits and vegetables before eating [AOR = 4.14; 95% CI: 1.92-9], being at the early stage of anti-TB treatment [AOR = 3; 95% CI: 1.5-6.3] and presence of chronic diseases [AOR = 7; 95% CI: 3.4-14]. Conclusion: The burden of intestinal parasites-MTB coinfection was high. Those who wash fruits and vegetables before eating should be encouraged, early treatment of PTB patients and avoiding the practice of open-field defecation, especially in rural communities, is necessary. The dual effect of coinfection on disease severity and treatment success needs further cohort study.
RESUMO
BACKGROUND: Bacterial urinary tract infection is among the most common community and hospital-acquired infections. Therefore, to know the status of the community and hospital-acquired urinary tract infection, antimicrobial susceptibility patterns, and associated factors among urinary tract infection profiles are essential to physicians and health workers to implement appropriate intervention. METHODS: An institution-based cross-sectional study was conducted among 422 urinary tract infection suspected patients. All isolates were identified by standard microbiological techniques, and their antibiotic susceptibility was done by the Kirby-Bauer disc diffusion method. Data were entered using EpiData version 3.1 and analyzed by SPSS software version 20. P value < 0.05 at 95% CI was considered statistically significant. RESULT: Of 422 urine samples processed, 100 (23.7%) yielded bacterial isolates. About 50(30.7%) and 50(19.3%) were bacterial isolates from the community and hospitalized patients, respectively. E. coli 44/103(42.7%) predominated across the two groups, followed by S. aureus 25/103(24.3%), CONs, 14/103(13.5%), Klebsiella spp. 7/103(6.78), Proteus spp. 3/103(2.91), and Enterococcus spp. 3/103 (2.91%). Pseudomonas spp. 3/103 (2.91), Citrobacter spp. 2/103(1.94%), and Acinetobacter spp. 1/103(0.999), which were isolated from only the hospitalized patients. Meropenem susceptibly was 100% in both study groups and Ampicillin resistance was documented as 83.3% to 100% and 76.9% to 100% in hospitalized and community-acquired samples, respectively. CONCLUSION: This study found a high prevalence of bacterial urinary tract infection in the study area and a high rate of bacterial resistance was observed to most antimicrobial drugs tested. Meropenem and nitrofurantoin were the most active drugs for urinary tract infections. Therefore, expanding routine bacterial culture and identification with antimicrobial susceptibility testing and strengthening regular surveillance systems are essential for appropriate patient care.
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.
RESUMO
BACKGROUND: Although blood transfusion is one of the known therapeutic interventions that cuts across a number of clinical disciplines. It is necessary to test all intending blood donors for HIV infection before donation. The aim of this study was to determine the prevalence of HIV among blood donors at Dessie Blood Bank, Northeast Ethiopia. METHODS: A retrospective study was conducted in Dessie Blood Bank through the year 2008-2012. Sera from blood donors were tested for the detection of Anti HIV by using 4th generation ELISA. Data were abstracted from records and analyzed using Microsoft Excel sheet. RESULTS: From the total of 9384 screened blood samples collected, the prevalence of HIV in blood donors in the blood bank was 5.1% in the five consecutive years but the trend of HIV infection has decreased from 2008(5.2%) to 2012 (2.3%). The age groups 15-24 and 35-44 were the highest prevalence and the age group 45-54 was the lowest prevalence of HIV infection. The prevalence of HIV among female (7.9%) was higher than in male donors (4.4%). The trend of HIV infection was decreasing for both male and female blood donors. CONCLUSION: The prevalence of HIV infections among blood donors is still high in this study setting, and needs constant monitoring to evaluate prevention and control strategies to reduce the burden of transfusion-transmissible HIV infections.
Assuntos
Doadores de Sangue , Transfusão de Sangue , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , HIV-1/isolamento & purificação , Adolescente , Adulto , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Estudos Soroepidemiológicos , Adulto JovemRESUMO
OBJECTIVE: To evaluate the diagnostic performance of CareStart Malaria Pf/Pv Combo test relative to microscopy for the diagnosis of falciparum and vivax malaria in Ethiopia. METHODS: 668 febrile patients visiting two health centers in Wondo Genet, southern Ethiopia, involved in this study in 2008. Giemsa-stained thin and thick blood smears were prepared and microscopically examined under a 100x oil immersion microscope objective for Plasmodium species identification and determination of parasitaemia, respectively. CareStart Malaria Pf/Pv Combo test and Paracheck Pf test were performed as per the manufacturers' instruction. FINDINGS: The diagnostic validity of CareStart Malaria Pf/Pv Combo test for the diagnosis of Plasmodium falciparum were very good with sensitivity of 99.4%, specificity of 98%, positive predictive value of 94.4% and negative predictive value of 99.8%. Sensitivity, specificity, positive predictive value and negative predictive value of the test for the diagnosis of P. vivax were 99.4%, 98.2%, 94.5% and 99.8%, respectively. The diagnostic performance of CareStart Malaria Pf/Pv Combo test is comparable to that of Paracheck Pf test for the diagnosis of P. falciparum (sensitivity 99.4%, specificity 98.2%). CONCLUSION: Although CareStart Malaria Pf/Pv Combo test and Paracheck Pf test have comparable diagnostic performance for the diagnosis of P. falciparum, CareStart Malaria Pf/Pv Combo test has the added advantage of diagnosing P. vivax. Hence, it is preferable to use CareStart Malaria Pf/Pv Combo test for the diagnosis of malaria in areas where microscopy is not accessible and where malaria due to P. falciparum and P. vivax are co-endemic as in Ethiopia.