Knowledge and associated factors of healthcare workers on measles vaccine and cold chain management at health institutions in Gondar,Ethiopia

Objective:To assess the knowledge of healthcare workers on the measles vaccine and its cold chain management.Method:An institutional-based cross-sectional study was conducted from February 1 to March 30,2022 in Gondar City Administration public health institutions among 165 healthcare workers.Data were collected using a structured questionnaire.In addition,an on-spot observation checklist was used to assess the availability,status and management of the cold chain.A logistic regression model was used to assess the relationship between the outcome and predictor variables.Crude and adjusted odds ratios were calculated with 95%confidence intervals.Results:Overall,87(52.7%;95%CI 44.8%-60.5%)of the healthcare workers had unsatisfactory knowledge regarding the measles vaccine and its cold chain management.One hundred thirty-six(82.4%)healthcare workers correctly mentioned the recommended range of temperature(2-8℃)for measles vaccine storage.Healthcare workers aged 18-29 years(P=0.001)and 30-44 years(P=0.014)were observed as determinants of unsatisfactory knowledge on the measles vaccine and its cold chain management.One hundred and five(63.6%)of the healthcare workers did not correctly mention the type of measles vaccine used in routine immunization.More than one-third(36.4%)of the healthcare workers perceived that the measles vaccine is not safe and could cause measles.Conclusions:More than half of the healthcare workers in the study area had unsatisfactory knowledge on the measles vaccine and its cold chain management.It is necessary to provide technical support and in-service training for healthcare workers to ensure optimal immunization effectiveness.

Characterization of mycobacterium isolates from pulmomary tuberculosis suspected cases visiting Tuberculosis Reference Laboratory at Ethiopian Health and Nutrition Research Institute,Addis Ababa Ethiopia:a cross sectional study

Objective:To characterize mycobaclerium isolates from pulmomary tuberculosis suspected cases visiting National Tuberculosis Reference Laboratory at Ethiopian Health and Nutrition Research Institute,for diagnosis of pulmonary tuberculosis from January 4 to February 22.2010 with total samples of 263.Methods:Sputum specimens were collected and processed:the deposits were cultured.Por culturing Lowenstein Jensen medium(LJ) and Mycobacteria Growth Indicator Tube(BACTEC MGIT 960) were used.Capilia Neo was used for detecting NTM isolates from isolates of BACTEC MGIT960.In Armauer Hansen Research Institute,Addis Ababa Ethiopia,Deletion typing PCR method for species identification(from confirmed Mycobacterium tuberculosis complex(MTBC) isolates by Capilia Neo) uas done.Results:Out of 263 enrolled in the study.124 and 117 ol them were positive for mycobaeterium growth by BACTEC MGIT 960 and 1.1 culture method,respectively.From BACTEC MGIT 960 positive media of 124 isolates.117 were randomly taken to perform Capilia TB Neo lest.From these 7(6%) of them were found to be NTM and 110(94%) were MTBC.From these 110 MTBC isolates,81 of them were randomly taken and run by the deletion typing RD9 PCR method of molecular technique.Out of these 78(96.3%) were found to be species of Mycobacterium tuberculosis and 3(3.7%) were found to be not in the MTBC.Regarding the types of methods of culture media.Mycobacteria Growth Indicator Tube(BACTEC MGIT 960) method was found to have excellent agreement(with kappa value ol 0.78) with the routine method of LJ.Conclusions:Pulmonary tuberculosis suspected cases visiting the National Tuberculosis Reference Laboratory at EHNR1 that were confirmed to be pulmonary tuberculosis are caused by the species of Mycobacterium tuberculosis.hence treatment regimen including pyrazinamide can be applied to the patients as the first choice in the study area in Addis Ababa.Ethiopia.There is indication of the presence of NTM in patients visiting the tuberculosis reference laboratory and this is important because NTM is known lo cause pulmonary disease similar with sign and symptom ol pulmonary tuberculosis but different in treatment.BACTEC MGIT 960 has excellent agreement with LJ media but it has high tendency of having high contamination rale unless a better decontamination method is designed.

Antimicrobial susceptibility patterns of Streptococcus pneumoniae over 6 years at Gondar University Hospital, Northwest Ethiopia

Objective:To assess the magnitude and antimicrobial susceptibility patterns ofStreptococcus pneumoniaeisolates from various clinical specimens.Methods:A record based on retrospectivestudy was conducted at Gondar University Teaching Hospital from September 2007 to January 2012.All patients who visited Gondar University Hospital and provided clinical specimens(body fluids,discharge,swab and blood)for routine bacteriological culturing and antimicrobial susceptibilitytesting were taken for analysis.Clinical specimens were processed for bacterial culture accordingto the standard procedures.Antimicrobial susceptibility test for isolated organisms was doneusing agar disk diffusion method.The data were entered and analyzed using SPSS software version16 package.Results:One hundred and fifty threeStreptococcus pneumoniaewere isolated frompatients who visited Gondar University Teaching Hospital bacteriology laboratory for culture.Majority of the pneumococcal isolates were from inpatients[111(72.5%)],and 74(48.4%)were frombody fluids.Out of the total isolates,93(61%)were found to be resistant to at least one antibioticused for susceptibility testing.Forty eight(43.2%)of the isolates were multi-drug resistant(resistantto two or more drugs).The resistance rate noted for both ciprofloxacin 17(11.1%)and ceftriaxone15(9.8%)were alarming.Conclusions:High proportions of the isolates tend to be increasinglyresistant to the commonly prescribed drugs.The recommended drug of choice like ciprofloxacinand ceftriaxone were found to be less susceptible in the study area.Based on the findings,wetherefore recommend that antimicrobial agents should be inspected for acceptable activity beforethey are prescribed and administered empirically.Further study with a better design and surveyof antimicrobial susceptibility at large scale shoule be performed to draw advanced information.

Ocular manifestation and their associated factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Southern Ethiopia

AIM：To assess the pattern of ocular manifestation and associated factors among human immunodeficiency virus（HIV）/acquired immunodeficiency syndrome（AIDS） patients on highly active antiretroviral therapy（HAART） at Hawassa University Referral Hospital, Southern Ethiopia. METHODS：A cross sectional study was conducted from January 2014 to April 2015. After obtaining informed written consent, 240 adult HIV/AIDS patients on HAART were randomly selected regardless of their ophthalmic symptoms, WHO status or CD4 count. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 20.0 software. RESULTS：The mean duration of HAART was 62.5mo. The prevalence of HIV related ocular manifestation was 14.2%. Seborrheic blepharitis（5%） was the most common ocular manifestation, followed by squamoid conjunctival growth（3.8%）. The rate of ocular manifestation was significantly higher among study participants who had CD4＋ count 〈200 cells/μL（AOR=3.83; 95%CI：1.315-11.153）, low duration of HAART（AOR=3.0; 95%CI：1.305-6.891） and who had primary school education [odds ratio（OR） =2.8; 95%CI：1.105-7.099]. Prevalence of visual impairment and blindness was 10.9% and 5.8%, respectively.CONCLUSION：HAART may be the reason for the decline in the prevalence of ocular manifestation in HIV/AIDS patients in the study area. Ophthalmologic screening of HIV/AIDS patients, especially those with CD4 counts of 〈200/μL cells and in the first five years of HAART followup is recommended to reduce visual impairment and/or blindness.

Malaria helminth co-infections and their contribution for aneamia in febrile patients attending Azzezo health center,Gondar,Northwest Ethiopia:a cross sectional study

Objective:To assess the prevalence of malaria helminth co-infections and their contribution for aneamia in febrile patients attending Azzezo health center,Gondar,Northwest Ethiopia. Methods:A cross section study was conducted among febrile patients attending Azezo health center from February-March 30,2011.Convenient sampling technique was used to select 384 individuals.Both capillary blood and stool were collected.Giemsa stained thick and thin blood film were prepared for identification of Plasmodium species and stool sample was examined by direct wet mount and formalin-ether concentration technique for detection of intestinal helminthes parasites.Haemoglobin concentration was determined using a portable haemoglobin spectrophotometer,Hemocue Hb 201 analyzer.Results:Out of 384 febrile patients examined for malaria parasites,44(11.5%) individuals were positive for malaria parasites,of which Plasmodium vivax accounted for 75.0%(33),Plasmodium falciparum for 20.5%(9| infectious,whereas two person (4.5%) had mixed species infection.Prevalence of malaria was higher in males(28) when compared with prevalence in females(16).More than half(207,53.9%) of study participants had one or more infection.Prevalence was slightly higher in females(109,52.7%) than in males(98,47.3%).About helminths,Ascaris lumbricoides was the predominant isolate(62.1%) followed by hookworms(18.4%). Only 22 participants were co-infected with malaria parasite and helminths and co-infection with Ascaris lumbricoides was predominant(45.0%).The prevalence of anemia was 10.9%and co-infection with Plasmodium and helminth parasites was significantly associated with(P【0.000 1) higher aneamia prevalence compared to individuals without any infection.Conclusions: Prevalence of malaria and soil transmitted helminths is high and the disease is still major health problem in the study area.Hence,simultaneous combat against the two parasitic infections is very crucial to improve health of the affected communities in economically developing countries.

Zoonotic leishmaniasis and control in Ethiopia

Visceral leishmaniasis and cutaneous leishmaniasis are important public health problems in Ethiopian lowland and highland areas respectively. Failure of antimonial drugs to respond in some diffused cutaneous leishmaniasis and HIV/AIDS-leishmaniasis co-infected patients, side effects of these drugs, highly mutilating diagnostic procedures and high health care expense are among the problems associated with leishmaniasis. Control of leishmaniasis requires proper understanding of human parasites transmissions(anthroponotic or zoonotic or both). The aim of this review was to elaborate different ecologies of leishmaniasis based on evidences from previous researches and information from literatures obtained from different sources including PubMed to describe zoonotic leishmaniasis in Ethiopia with possible control methods.Although vectors of leishmaniasis in Ethiopia are not endophelic, night indoor visits of Phlebotomus vectors for possible blood meal on human have been indicated. Thus, application of indoor and domestic residual insecticides spraying, use of insecticide impregnated fine mashed bed net for visceral leishmaniasis, community based manipulation(destruction) and residual insecticide fogging of hyrax-sand fly habitats for cutaneous leishmaniasis are the visible vector and reservoir control methods that can be used for control of these diseases in Ethiopia. Use of repellants during night outdoor activities of people in the endemic areas requires further investigations.

Characteristics of bacterial sepsis among patients with visceral leishmaniasis

Sepsis is one of the major causes and predictors of death in patients with visceral leishmaniasis(VL).Globally,incidence rate of sepsis ranged from 56-91 cases per 100000 people,with a mortality rate of 30%.Incidence of sepsis has been raised due to aging of the population and the higher incidence of immunosuppressive conditions such as HIV.VL and others.The prevalence of sepsis was reported from 4.2%to 32.3%and 14.1%in VL and VL-HIV coinfectcd patients,respectively.The mortality rate of VL patients with sepsis is greater than50%.Factors associated with sepsis in VL patients are immune suppression,pancytopenia.HIV co-infection,age <l year old and >40 years old,indwelling of central venous lines and hospitalization.Although antimicrobial susceptibility patterns were not well reported,both Gram-positive and Gram-negative bacteria were isolated from patients with VL.So far.limited information is available on sepsis in VL.especially in VL-HIV coinfected patients.Therefore,further studies about sepsis prevalence,causative agents and their antibiotic patterns,and associated factors among VL and VL-HIV coinfectcd patients arc necessary.This review provides information about bacterial sepsis in patients with VL.

Prevalence of smear positive pulmonary tuberculosis in Gondar prisoners,North West Ethiopia

Objective:To assess the prevalence and risk factors of smear positive pulmonary tuberculosis among Condar town prisoners.North West Ethiopia.Methods:A cross sectional study was conducted from February to July,2008 in Condar Prison.Prisoners with cough duration of more than two weeks were involved in the study by giving three sputum samples and filling the questionnaires prepared for risk factor assessment.Acid fast staining technique was employed to delect the presence of the Mycobacterium tuberculosis bacilli in the sputum samples.Data was analyzed using SPSS version13 computer software and presented in table.Chi-square test was used to assess associations and a P-value less than 0.05 was taken as significant.Results:A total of 384 prisoners,349 male and 35 females,with a mean age of 33.3 years were involved in the study.The prevalence of smear positive pulmonary tuberculosis among those prisoners with cough duration of more than two wecks was 8.59%.Only the length of imprisonment had a significant association(χ~2= 18.82,P-value【0.0001) with the prevalence of tuberculosis.Conclusions:This study indicated that tuberculosis among prisoners with cough duration of more then two weeks in Gondar prison is very high.Therefore Periodic screening of the prisoners and screening of newly introduced prisoners should be practiced so as to minimise the burden of tuberculosis in prisoners.

Urinary schistosomiasis and malaria associated anemia in Ethiopia

Objective:To assess the prevalence of anemia in children with urinary schistosomiasis,malaria and concurrent infections by the two diseases.Methods:Urine and blood samples were collected from 387 children(216 males and 171 females)to examine urinary schistosomiasis and malaria and to determine hemoglobin concentration at Hassoba and Hassoba Buri village in Amibara woreda,Afar region,Ethiopia.Results:The overall prevalence of urinary schistosomiasis and Plasmodium falciparum malaria was 24.54%and 6.20%respectively.Only 2.84%of children carried concurrent infections of both parasites.There was high percentage of anemic patients(81.81%)in the coinfected cases than in either malaria(33.3%)or schistosomiasis(38.94%)cases.There was significantly low mean hemoglobin concentration in concurrently infected children than non-infected and single infected(P<0.05).The mean hemoglobin concentration between Plasmodium falciparum and S.haematobium infected children showed no significant difference(P>0.05).The level of hemoglobin was negatively correlated with the number of S.haematobium eggs/10 mL urine(r=-0.6)and malaria parasitemia(r=-0.53).Conclusions:The study showed that anemia is higher in concurrently infected children than non-infected and single infected.Furthermore,level of hemoglobin was negatively correlated with the number of S.haematobium eggs and malaria parsitemia.Therefore,examination of hemoglobin status in patients co-infected with malaria and schistosomiasis is important to reduce the risk of anemia and to improve health of the community.

Preliminary study on investigation of zoonotic visceral leishmaniasis in endemic foci of Ethiopia by detecting Leishmania infections in rodents

Objective:To investigate the zoonotic visceral leishmaniasis(ZVL) by identification of the most probable reservoir hosts using parasite isolation and analysis of a possible transmission dynamics of the disease in extra-domestic agricultural fields and rural villages.Methods:Rodents were collected from selected study sites in kala-azar endemic areas based on information for localities of kala-azar cases for screening of Leshmania infections using parasitological,serological and polymerase chain reaction(PCR) from March.2013 to January,2014.Ketamine(Clorketam Veterinary) was used to anaesthesize the rodents according the prescribed dosage(average 2 mg/kg for intra-venous route).The blood obtained using sterile needle was dropped into sterile filter paper and allowed to air dry before sealing in plastic bags.The tissues from liver,spleen and skin were macerated in Locke's solution before transferring them into NNN medium.Blood and touch smears of liver,spleen,skin and bone marrow were prepared for fixing using methanol and staining by Giemsa stain for microscopy.These tissues were also ascd for DNA extractions and PCR amplification of Leishmania infection.Results:A total of 335 rodents(13 species) were analyzed by sampling internal organs.The infection rate by PCR was 11.1%(6/54) for Arvicanthis nilothicas compared to 17.6%(3/17) and 12.5%(2/16) for Acomys cahirinus and Tarera(C) robustus respectively.Almost all the infections were found from bone marrow samples(8/48 or 16.7%) compared with 1/91(1.1%) liver,2/87(2.2%) spleen and 0/87(0%) skin.In all study sites with past human VL cases,rodents and proved vectors shared similar habitats.Conclusions:Leishmania donovani might circulate among different species of rodents in kala-azar endemic lowlands and valleys of Ethiopia by Phlebotamus orientalis and Phlebotomus martini.Detailed studies to substantiate the preliminary data on the possible role of these rodents arc urgently needed.

Incidence of human rabies exposure and associated factors at the Gondar Health Center, Ethiopia: a three-year retrospective study

Background:Rabies is one of the oldest known and most feared human diseases.Epidemiological studies provide basic information about the burden of the disease and underline the importance of prevention and control interventions.However,there have been limited studies conducted regarding the incidence of rabies and associated factors in Ethiopia,in general,and in this study area,in particular.Therefore,the aim of this study was to assess the incidence of human rabies exposure and associated factors at the Gondar Health Center,Ethiopia.Methods:A retrospective cross-sectional study was conducted at the Gondar Health Center where post-exposure prophylaxis(PEP)for rabies was available for the whole population in the North Gondar Zone catchment area.Data of human rabies exposure cases between 2011 and 2013 were collected from the rabies PEP registration book using data abstraction sheets.The data was entered and analyzed using SPSS version 16 statistical software.Result:A total of 261 cases of human rabies exposure were reported to the Gondar Health Center from 2011 to 2013.The sex and age specific distribution showed that the majority of these cases were among males(142/226,62.8%)and children under 15 years of age(87/226,38.5%).A predominant number of cases were observed in individuals from rural areas(161/220,73.2%),and during fall and winter seasons(67/222,30.18%).A significant number of people exposed to rabies(23.2%)came to the health center for PEP two or more weeks after the injury.The incidence of human rabies exposure cases was 4.6,2.61,and 1.27 per 100,000 population in 2011,2012,and 2013,respectively.Being male and living in an urban setting were found to be risk factors for human rabies exposure in 2011.Conclusion:A significant number of human rabies exposure cases were reported to the Gondar Health Center.Being male and living in an urban setting were found to be associated with rabies exposure.A community-based follow-up study is recommended to more accurately estimate the incidence of human rabies exposure.

Multidrug resistant Escherichia coli strains isolated from urine sample,University of Gondar Hospital,Northwest Ethiopia

Objective:To assess multidrug resistant(MDR)Escherichia coli(E.coli)isolates from patients with urinary tract infection.Methods:From February to June 2014,a cross sectional study was conducted among urinary tract infection patients at the University of Gondar Hospital.Culture and disk diffusion method were used for E.coli isolation and to determine the antibiotic susceptibility patterns.Data were entered and analyzed using SPSS version 20.P<0.05 was considered as statistically significant.Results:A total of 112 E.coli isolates were identified and the rate of isolation was higher among female participants(28.7%;P=0.03).Of the isolates,104(92.9%)were MDR E.coli;and the isolates showed high resistance rates towards ampicillin(99%),cotrimoxazole(69%),chloramphenicol(58.7%),gentamycin(56.7%)and ceftazidime(55.8%).However,comparative isolates showed low resistance rates to ciprofloxacin(1%),cefepime(8.7%),and ceftriaxone(11.5%).Moreover,resistance rates of MDR E.coli isolates were significantly higher than non-MDR strains for ceftazidime(55.8%versus 12.5%;P=0.015),and ampicillin(99%versus 87.5%;P=0.018).Conclusions:High prevalence of MDR E.coli isolates was observed in this study.Regular monitoring of antibiotic resistance rates is necessarily required to improve and revise empirical antibiotic therapy protocols.

Smear positive pulmonary tuberculosis among diabetic patients at the Dessie referral hospital, Northeast Ethiopia

Background:Tuberculosis(TB)is an infectious disease which is still a major cause of morbidity and mortality throughout the world.People with diabetes mellitus(DM)have a three times higher risk of developing active TB than people without diabetes.However,there is not enough credible information on the burden of pulmonary tuberculosis(PTB)among DM patients in Ethiopia,in general,and in the city of Dessie,in particular.Therefore,this study aims to determine the prevalence and associated risk factors of smear positive PTB among diabetic patients at a referral hospital in Dessie.Methods:A cross-sectional study was conducted from February 2012 to April 2012.Patient demographic characteristics were collected using a pre-tested standard questionnaire format.Spot-morning-spot sputum specimens were collected from the study participants and examined for acid-fast bacilli using direct microscopy by the Ziehl-Neelsen staining technique.Data was entered and analyzed using the SPSS version 16 statistical software and p-value<0.05 was considered as statistically significant.Results:Out of 225 TB suspected diabetic patients,52%were males and 48%were females.Their ages ranged from 12 to 82 years,with a mean age of 47.2 years.Urban residence(AOR:5.5;95%CI:1.07-28.20),history of TB(AOR:13.4;95%CI:2.74-65.73),contact with TB patients in the family(AOR:9.4;95%CI:1.822-48.50),and long duration of DM(AOR:8.89;95%CI:1.88-58.12)were independently associated with the development of active TB in people living with DM.Conclusions:The prevalence of smear positive PTB was 6.2%in TB suspected diabetic patients,which is higher compared with the general population(0.39%).Patients with a previous history of contact with TB patients,as well as those who had prolonged diabetes,were more prone to have PTB.Therefore,screening of diabetic patients for PTB infection during follow-up is necessary.