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Nega D, Abera A, Gidey B, Mekasha S, Abebe A, Dillu D, Mehari D, Assefa G, Hailu S, Haile M, Etana K, Solomon H, Tesfaye G, Nigatu D, Destaw Z, Tesfaye B, Serda B, Yeshiwondim A, Getachew A, Teka H, Nahusenay H, Abdelmenan S, Reda H, Bekele W, Zewdie A, Tollera G, Assefa A, Tasew G, Woyessa A, Abate E. Baseline malaria prevalence at the targeted pre-elimination districts in Ethiopia. BMC Public Health 2021; 21:1996. [PMID: 34732150 PMCID: PMC8567662 DOI: 10.1186/s12889-021-12036-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/18/2021] [Indexed: 12/05/2022] Open
Abstract
Background Encouraged by the previous success in malaria control and prevention strategies, the Ethiopian ministry of health launched malaria elimination with a stepwise approach by primarily targeting the low-transmission Districts and their adjacent areas/zones in order to shrink the country’s malaria map progressively. Hence, this community survey was conducted to establish baseline malaria information at the preliminary phase of elimination at targeted settings. Methods A community-based cross-sectional survey was conducted at 20 malaria-elimination targeted Districts selected from five Regional states and one city administration in Ethiopia. The GPS-enabled smartphones programmed with Open Data Kit were used to enumerate 9326 study households and collect data from 29,993 residents. CareStart™ Malaria PAN (pLDH) Rapid Diagnostic Tests (RDTs) were used for blood testing at the field level. Armpit digital thermometers were used to measure axillary temperature. Result Overall malaria prevalence by RDTs was 1.17% (339/28973). The prevalence at District levels ranged from 0.0 to 4.7%. The proportion of symptomatic cases (axillary temperature > 37.5oc) in the survey was 9.2% (2760/29993). Among the 2510 symptomatic individuals tested with RDTs, only 3.35% (84/2510) were malaria positive. The 75.2% (255/339) of all malaria positives were asymptomatic. Of the total asymptomatic malaria cases, 10.2% (26/255) were under-five children and 89.8% (229/255) were above 5 years of age. Conclusion The study shows a decrease in malaria prevalence compared to the reports of previous malaria indicator surveys in the country. The finding can be used as a baseline for measuring the achievement of ongoing malaria elimination efforts. Particularly, the high prevalence of asymptomatic individuals (0.88%) in these transmission settings indicates there may be sustaining hidden transmission. Therefore, active case detection with more sensitive diagnostic techniques is suggested to know more real magnitude of residual malaria in the elimination-targeted areas.
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Affiliation(s)
- Desalegn Nega
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Sindew Mekasha
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abnet Abebe
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dereje Dillu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Degu Mehari
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Samuel Hailu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Kebede Etana
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | | | | | - Zelalem Destaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Berhane Tesfaye
- Malaria Control and Elimination Partnership in Africa (MACEPA) at PATH, Addis Ababa, Ethiopia
| | - Belendia Serda
- Malaria Control and Elimination Partnership in Africa (MACEPA) at PATH, Addis Ababa, Ethiopia
| | - Asnakew Yeshiwondim
- Malaria Control and Elimination Partnership in Africa (MACEPA) at PATH, Addis Ababa, Ethiopia
| | - Assefaw Getachew
- Malaria Control and Elimination Partnership in Africa (MACEPA) at PATH, Addis Ababa, Ethiopia
| | - Hiwot Teka
- President's Malaria Initiative (PMI), Addis Ababa, Ethiopia
| | | | | | - Hailemariam Reda
- Clinton Health Access Initiative, Inc. (CHAI), Addis Ababa, Ethiopia
| | - Worku Bekele
- World Health Organization (WHO), Addis Ababa, Ethiopia
| | - Ayele Zewdie
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | | | | | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adugna Woyessa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ebba Abate
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Abate E, Elias D, Getachew A, Alemu S, Diro E, Britton S, Aseffa A, Stendahl O, Schön T. Effects of albendazole on the clinical outcome and immunological responses in helminth co-infected tuberculosis patients: a double blind randomised clinical trial. Int J Parasitol 2014; 45:133-40. [PMID: 25486494 DOI: 10.1016/j.ijpara.2014.09.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 09/15/2014] [Accepted: 09/19/2014] [Indexed: 11/25/2022]
Abstract
Despite several review papers and experimental studies concerning the impact of chronic helminth infection on tuberculosis in recent years, there is a scarcity of data from clinical field studies in highly endemic areas for these diseases. We believe this is the first randomised clinical trial investigating the impact of albendazole treatment on the clinical and immunological outcomes of helminth co-infected tuberculosis patients. A randomised, double-blind, placebo-controlled trial of albendazole (400mg per day for 3 days) in helminth-positive tuberculosis patients was conducted in Gondar, Ethiopia. The primary outcome was clinical improvement (ΔTB score) after 2 months. Among secondary outcomes were changes in the levels of eosinophils, CD4+ T cells, regulatory T cells, IFN-γ, IL-5 and IL-10 after 3 months. A total of 140 helminth co-infected tuberculosis patients were included with an HIV co-infection rate of 22.8%. There was no significant effect on the primary outcome (ΔTB score: 5.6±2.9 for albendazole versus 5.9±2.5 for placebo, P=0.59). The albendazole-treated group showed a decline in eosinophil cells (P=0.001) and IL-10 (P=0.017) after 3 months. In an exploratory analysis after 12 weeks, the albendazole treated group showed a trend towards weight gain compared with the placebo group (11.2±8.5 kg versus 8.2±8.7 kg, P=0.08)). The reductions in eosinophil counts and IL-10 show that asymptomatic helminth infection significantly affects host immunity during tuberculosis and can be effectively reversed by albendazole treatment. The clinical effects of helminth infection on chronic infectious diseases such as tuberculosis merit further characterisation.
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Affiliation(s)
- E Abate
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia; Department of Medical Microbiology, Linköping University, Sweden.
| | - D Elias
- University of Southern Denmark, Institute of Molecular Medicine, Department of Cancer and Inflammation, Odense, Denmark
| | - A Getachew
- Department of Radiology, University of Gondar, Gondar, Ethiopia
| | - S Alemu
- Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
| | - E Diro
- Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
| | - S Britton
- Department of Infectious Diseases, Karolinska Hospital, Stockholm, Sweden
| | - A Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - O Stendahl
- Department of Medical Microbiology, Linköping University, Sweden
| | - T Schön
- Department of Medical Microbiology, Linköping University, Sweden; Department of Clinical Microbiology and Infectious Diseases, Kalmar County Hospital, Kalmar, Sweden
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Reithinger R, Ngondi J, Graves P, Hwang J, Getachew A, Jima D. Risk factors for anemia in children under 6 years of age in Ethiopia: analysis of the data from the cross-sectional Malaria IndicatorSurvey, 2007. Trans R Soc Trop Med Hyg 2013; 107:769-76. [PMID: 24218415 PMCID: PMC10563508 DOI: 10.1093/trstmh/trt096] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Malaria is a leading cause of morbidity in Ethiopia. However, its transmission varies in both space and time, and large areas of the country are hypoendemic and epidemic-prone. The Ethiopia National Malaria Indicator Survey 2007 is a cross-sectional, nationally-representative household survey. The objective of the analyses presented here were to use the survey's data to identify factors associated with anemia presence in children under 6 years of age (U6); specifically, investigate the association between malaria and anemia; and discuss using anemia as a malaria proxy biomarker in the Ethiopian hypo-endemic transmission setting. METHODS The survey sampled 4185 households in 347 enumeration areas ≤2500 m above sea level. Primary outcome was increasing anemia severity in sampled children: no anemia (Hb: ≥11g/dl); mild anemia (Hb: ≥8g/dl and <11g/dl); and moderate-severe anemia (Hb: <8g/dl). Secondary outcomes were positive malaria rapid diagnostic test (RDT) or blood slide microscopy. RESULTS The analysis included 6054 (92.0%) children U6 in 3962 households. The proportion of children with no anemia, mild anemia, and moderate-severe anemia was 63.6%, 31.3%, and 5.1%, respectively. The overall prevalence of anemia (Hb <11g/dl) was 36.4% (95% CI 34.4-38.4). Factors independently associated with reduced relative odds of anemia categories were age (OR=0.7, 95% CI 0.7-0.7) and female sex (OR=0.9, 95% CI 0.8-1.0); malaria RDT positivity was associated with increased relative odds of a more severe anemia category (OR=5.8, 95% CI 3.7-9.2). CONCLUSIONS We conclude that at altitudes ≤2500 m malaria appears to be a significant risk factor for anemia; potentially anemia could be used as a useful proxy biomarker for malaria and its control in Ethiopia.
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Affiliation(s)
- R. Reithinger
- U.S. Agency for International Development, Addis Ababa, Ethiopia
- RTI International, Washington, DC, USA
| | - J.M. Ngondi
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
- RTI International, Dar-es-Salaam, Tanzania
- The Carter Center, Atlanta, GA, USA
| | - P.M. Graves
- The Carter Center, Atlanta, GA, USA
- School of Public Health, Tropical Medicine & Rehabilitation Sciences, James Cook University, Australia
| | - J. Hwang
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Global Health Group, University of California San Francisco, CA, USA
| | - A. Getachew
- Malaria Control and Evaluation Partnership in Africa (MACEPA), PATH, Addis Ababa, Ethiopia
| | - D. Jima
- Federal Ministry of Health, Addis Ababa, Ethiopia
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Schön T, Idh J, Westman A, Elias D, Abate E, Diro E, Moges F, Kassu A, Ayele B, Forslund T, Getachew A, Britton S, Stendahl O, Sundqvist T. Effects of a food supplement rich in arginine in patients with smear positive pulmonary tuberculosis--a randomised trial. Tuberculosis (Edinb) 2011; 91:370-7. [PMID: 21813328 DOI: 10.1016/j.tube.2011.06.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 05/11/2011] [Accepted: 06/08/2011] [Indexed: 11/28/2022]
Abstract
In tuberculosis (TB), the production of nitric oxide (NO) is confirmed but its importance in host defense is debated. Our aim was to investigate whether a food supplement rich in arginine could enhance clinical improvement in TB patients by increased NO production. Smear positive TB patients from Gondar, Ethiopia (n = 180) were randomized to a food supplementation rich in arginine (peanuts, equivalent to 1 g of arginine/day) or with a low arginine content (wheat crackers, locally called daboqolo) during four weeks. The primary outcome was cure rate according to the WHO classification and secondary outcomes were sputum smear conversion, weight gain, sedimentation rate, reduction of cough and chest X-ray improvement as well as levels of NO in urine (uNO) or exhaled air (eNO) at two months. There was no effect of the intervention on the primary outcome (OR 1.44, 95% CI: 0.69-3.0, p = 0.39) or secondary outcomes. In the subgroup analysis according to HIV status, peanut supplemented HIV+/TB patients showed increased cure rate (83.8% (31/37) vs 53.1% (17/32), p < 0.01). A low baseline eNO (<10 ppb) in HIV+/TB patients was associated with a decreased cure rate. We conclude that nutritional supplementation with a food supplement rich in arginine did not have any overall clinical effect. In the subgroup of HIV positive TB patients, it significantly increased the cure rate and as an additional finding in this subgroup, low initial levels of NO in exhaled air were associated with a poor clinical outcome but this needs to be confirmed in further studies.
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Affiliation(s)
- T Schön
- Department of Medical Microbiology, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden.
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Abstract
The overall goal of the FIGO Save the Mothers Fund was to establish basic and comprehensive emergency obstetric care (EmOC) with the specific objectives of increasing the availability and utilization of quality obstetric care as measured by the UN indicators. As a result of this commitment by FIGO, the Ethiopian Society of Obstetricians and Gynecologists (ESOG) launched the Save the Mothers Project (SMP) in West Showa Zone (WSZ), Ethiopia in 1998 to implement and test a demonstration project and evaluate the feasibility and impact of the intervention. The overall objectives matched FIGO's-reducing maternal deaths by promoting the availability, access and utilization of EmOC services for women with complications of pregnancy and childbirth. The intervention package included capacity building as a major activity, and physicians and other service providers from Ambo Hospital, Shenen and Ijaji Health Centers were trained in EmOC. This was intended to combat the high staff turnover in the area. Equipment, materials and supplies were also provided to the demonstration sites to enable them provide basic and comprehensive EmOC services. The interventions, begun in 1999, led to improvements in availability, utilization and met need, which suggests that such an approach may eventually lead to the reduction of maternal deaths. The cesarean section rate for Ambo Hospital increased from 3.7% in 1998 to 17.3% in 2001--an almost six-fold increase. At Ambo Hospital both the total number of deliveries and cases admitted with obstetric complications have increased from baseline. Patients with obstructed labor comprise 39% of all obstetric patients making it the leading cause of hospitalization. Obstetric hemorrhage comes next with 24% of all admissions. The case fatality rate (CFR) (for direct maternal deaths) decreased from 7.2% at baseline, to 4.6% in 2001--showing a definite trend of improvement. Currently, there is 24-h EmOC service at Ambo Hospital where an obstetrician and general medical practitioners with EmOC training are responsible for the service. Shenen and Ijaji health Centers are upgraded in terms of training of staff members, provision of equipment and supplies, and regular supervision so that the community in these areas has access to basic EmOC services. To replicate similar activities, in a setting like ours, EmOC projects have to be low cost to attract decision-makers. The SMP used almost US dollars 100,000 over 3 years to ensure availability of EmOC services for women in WSZ. A favorable political climate such as maintenance of relative peace, and flexibility in adapting to local conditions also contributed to the success of the SMP.
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Affiliation(s)
- T Mekbib
- Population Council, Addis Ababa, Ethiopia.
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Ghebreyesus TA, Witten KH, Getachew A, Haile M, Yohannes M, Lindsay SW, Byass P. Schistosome transmission, water-resource development and altitude in northern Ethiopia. Ann Trop Med Parasitol 2002; 96:489-95. [PMID: 12194709 DOI: 10.1179/000349802125001285] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Schistosomiasis continues to be a major public-health problem, not least in association with water-resource developments. The impact of microdam construction in the northern Ethiopian highlands, in relation to possible increased risks of Schistosoma mansoni infection, has now been assessed. The results of incidence studies, carried out on 473 individuals sampled across eight microdam sites at altitudes of 1800-2225 m above sea level, indicated an overall annual incidence of 0.20 infections/person at risk. A multivariate Poisson regression model showed altitude and sex to be significant risk factors for infection, whereas proximity to a microdam was not significant, except possibly at very high altitudes. It was concluded that altitude was the major factor in this environment and that therefore, at least in terms of public-health planning, microdams should be sited as high as local geography permits.
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Getachew A. Malignant lymphoma in western Ethiopia. East Afr Med J 2001; 78:402-4. [PMID: 11921560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To identify the pattern of malignant lymphoma in western Ethiopia and compare it with similar studies conducted in the region. DESIGN A retrospective study. METHODS A search was made for all histopathologic diagnosis of malignant lymphoma from the files of the department for the years 1988-1999. The pathologic diagnosis of Hodgkin's disease was grouped according to Rye's classification and non-Hodgkin's lymphoma according to the working formulation for clinical usage classification. The results were tabulated and analysed. SETTING The department of pathology of Gondar College of Medical Sciences; the only unit which provides histopathologic services for the region, that includes Amhara and Tigrai region. SUBJECTS All lymphoma cases diagnosed at the department were included. RESULTS A total of 83 cases of lymphoma were diagnosed over a period of 11 years (1988-1999). Their age ranged from four years to 79 years. Twenty one (25.3%) had Hodgkin's diseases, 61(73.5%) non Hodgkin's lymphomas and one (1.2%) unspecified lymphoma. The commonest type of Hodgkin's disease were lymphocyte predominant (38%) and mixed cellularity (33.3%). Nodular sclerosing Hodgkin's disease was diagnosed in only one case. The commonest type of non-Hodgkin's lymphoma was high-grade lymphoma (41.0%) followed by low grade lymphoma (32.8%). Burkitt's lymphoma was diagnosed in four cases. The frequency of Hodgkin's disease was high in the first and second decades while non-Hodgkin's lymphoma showed high frequency in the fifth decade. CONCLUSION This study has shown many similarities in proportion of lymphomas and age and sex distribution of cases. The identified minor differences such as frequencies of histologic patterns of Hodgkin's disease and paucity of Burkitt's lymphoma deserve explanation and invites prospective studies.
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Affiliation(s)
- A Getachew
- Department of Histopathology, College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi
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Ghebreyesus TA, Witten KH, Getachew A, Yohannes AM, Tesfay W, Minass M, Bosman A, Teklehaimanot A. The community-based malaria control programme in Tigray, northern Ethiopia. A review of programme set-up, activities, outcomes and impact. Parassitologia 2000; 42:255-90. [PMID: 11686085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Tigray, the northernmost state of Ethiopia, has a population of 3.5 million, 86% rural, and 56% living in malarious areas. In 1992 a Community-Based Malaria Control Programme was established to provide region-wide and sustained access to early diagnosis and treatment of malaria at the village level. 735 volunteer community health workers (CHWs) serve 2,327 villages with a population of 1.74 million, treating an average of 489,378 patients yearly from 1994 to 1997. Recognition of clinical malaria is similar for CHWs and health staff at clinics where there is no access to microscopy. In 1996 a pilot community-financing scheme of insecticide-treated bednets was well accepted, but re-impregnation rates fell in 1998 because of war-related social upheaval. Indicators from health institutions show a progressive increase in malaria morbidity from 1994 to 1998. Repeated mortality surveys show a 40% reduction in death rates in under-5 children from 1994 to 1996 and a 10% increase from 1996 to 1998. These trends may be related to increased malaria transmission with water resources development, increased seasonal labour migration to malarious lowlands, prolongation of the transmission season with climate changes, and increasing chloroquine resistance throughout Ethiopia. Progressive extension of CHW services to ensure better coverage of women, children, migrant workers and communities near water development projects, change to first-line treatment with sulfadoxine-pyrimethamine, extension of the impregnated bednet initiative, and development of a regional warning system for epidemics should result in a greater impact on morbidity and mortality.
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Ghebreyesus TA, Haile M, Witten KH, Getachew A, Yohannes M, Lindsay SW, Byass P. Household risk factors for malaria among children in the Ethiopian highlands. Trans R Soc Trop Med Hyg 2000; 94:17-21. [PMID: 10748890 DOI: 10.1016/s0035-9203(00)90424-3] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Malaria transmission varies from village to village and even from family to family in the same village. The current study was conducted in northern Ethiopia to identify risk factors responsible for such variations in a hypoendemic highland malaria setting: 2114 children aged < 10 years living in 6 villages situated close to small dams at altitudes from 1775 to 2175 m were monitored. Monthly malaria incidence was determined 4 times over a 1-year period during 1997. Incidence results were then analysed by 14 individual and household factors using Poisson multivariate regression. Among 14 factors analysed, use of irrigated land (rate ratio[RR] = 2.68, 95% CI 1.64-4.38), earth roof (RR = 2.15, 95% CI 1.31-3.52), animals sleeping in the house (RR = 1.92, 95% CI 1.29-2.85), windows (RR = 1.84, 95% CI 1.30-2.63), open eaves (RR = 1.85, 95% CI 1.19-2.88), no separate kitchen (RR = 1.57, 95% CI 1.10-2.23), and 1 sleeping room (RR = 1.52, 95% CI 1.05-2.20), were significantly associated with malaria. The proportion of infection among children exposed to one or no risk factor was 2.1%, increasing with the number of risk factors and reaching 29.4% with 5 or more. Further studies are needed to confirm the importance of particular risk factors, possibly leading to simple health education and control measures that could become part of routine control programmes, implemented with inter-sectoral collaboration.
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Ghebreyesus TA, Haile M, Witten KH, Getachew A, Yohannes AM, Yohannes M, Teklehaimanot HD, Lindsay SW, Byass P. Incidence of malaria among children living near dams in northern Ethiopia: community based incidence survey. BMJ 1999; 319:663-6. [PMID: 10480820 PMCID: PMC28216 DOI: 10.1136/bmj.319.7211.663] [Citation(s) in RCA: 119] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess the impact of construction of microdams on the incidence of malaria in nearby communities in terms of possibly increasing peak incidence and prolonging transmission. DESIGN Four quarterly cycles of malaria incidence surveys, each taking 30 days, undertaken in eight at risk communities close to dams paired with eight control villages at similar altitudes but beyond flight range of mosquitoes. SETTING Tigray region in northern Ethiopia at altitudes of 1800 to 2225 m. SUBJECTS About 7000 children under 10 years living in villages within 3 km of microdams and in control villages 8-10 km distant. MAIN OUTCOME MEASURES Incidence of malaria in both communities. RESULTS Overall incidence of malaria for the villages close to dams was 14.0 episodes/1000 child months at risk compared with 1.9 in the control villages-a sevenfold ratio. Incidence was significantly higher in both communities at altitudes below 1900 m. CONCLUSIONS There is a need for attention to be given to health issues in the implementation of ecological and environmental development programmes, specifically for appropriate malaria control measures to counteract the increased risks near these dams.
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Affiliation(s)
- T A Ghebreyesus
- Tigray Regional Health Bureau, Department of Malaria Control, Mekelle, Ethiopia.
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Ghebreyesus TA, Witten KH, Getachew A, O'Neill K, Bosman A, Teklehaimanot A. Community-based malaria control in Tigray, northern Ethiopia. Parassitologia 1999; 41:367-71. [PMID: 10697885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Community-based control activities have been a major component of the Tigray regional malaria control programme since 1992. A team of 735 volunteer community health workers treat on average 60,000 clinical malaria cases monthly during the high malaria transmission season. Ensuring access for the rural population to early diagnosis and treatment has contributed to a significant decrease in death rate in under-five children at the village level from 1994 to 1996. Mapping and geographic information system (GIS) technologies have been introduced to support planning for control by assessment of community-based coverage. With further development, GIS will be used in stratification, and to assess the impact of water resources development on malaria transmission and intensity.
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Affiliation(s)
- T A Ghebreyesus
- Department for the Control of Malaria, Tigray Health Bureau, Ethiopia
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Getachew A, Tesfahunegn Z. Is fine needle aspiration cytology a useful tool for the diagnosis of tuberculous lymphadenitis? East Afr Med J 1999; 76:260-3. [PMID: 10750505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To study the role of fine needle aspiration cytology (FNAC) in the diagnosis of tuberculous lymphadenitis and find a place for FNAC as laboratory diagnostic method in tuberculosis (TB) control programmes. DESIGN Prospective laboratory study. METHOD Duplicate smears from 127 lymph node aspiration were prepared. Both slides were air-dried. Giemsa stain for cytological examination and Ziehl-Neelsen stain for demonstration of acid fast bacillus(AFB) were used and examined by a pathologist and laboratory technologist respectively. SETTING Tigrai Regional Health Research and Laboratory Centre which is the only unit with microbiological and cytopathological service in the region. SUBJECTS Patients with one or more enlarged lymph nodes who were sent for FNAC were included. RESULTS The AFB positivity among the cytologically diagnosed cases of TB lymphadenitis was 56.77%. If we had used culture media for Mycobacterium spp, the positivity would have probably been higher. The positivity rate varied depending on the type of the aspirate. Caseous aspirate showed a higher positivity rate of 60.47% whereas no AFBs were detected in haemorrhagic aspirates. CONCLUSION This study has demonstrated the usefulness of FNAC in the diagnosis of TB lymphadenitis and the national TB and leprosy control programmes should encompass FNAC as a diagnostic means instead of biopsy which is more invasive and costly.
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Affiliation(s)
- A Getachew
- Department of Pathology, Gondar College of Medical Sciences, Ethiopia
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Getachew A, Demissie M, Gemechu T. Pattern of histopathologic diagnosis of lymph node biopsies in a teaching hospital in Addis Ababa, 1981-1990 G.C. Ethiop Med J 1999; 37:121-7. [PMID: 11957306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
To determine the pattern of diseases that are responsible for lymph node biopsy, a retrospective study was carried out by reviewing daily register and pathologic reports for surgical biopsy specimens for the year 1981-1990 in the Department of Pathology, Medical Faculty, Addis Ababa University. Among 33,924 biopsy specimens 3,396 (10%) were lymph node biopsies (1,378 females, 2018 males). The results showed that 57% were cervical, 15.17% axillary and 8.7% inguinal lymph nodes. The three main causes of lymphadenopathy were tuberculosis (47.8%), reactive lymphadenopathy (26.3%) and malignant lesions (19.8%). In general this study has shown that the majority of lymphadenopathies in patients under 40 years of age are mainly due to tuberculosis and non specific (reactive) lesions and we think this may serve as a basic information for clinicians in their daily activities.
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Affiliation(s)
- A Getachew
- Department of Pathology, Faculty of Medicine, Addis Ababa University, P.O. Box 9086, Addis Ababa
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Ghebreyesus TA, Haile M, Getachew A, Alemayehu T, Witten KH, Medhin A, Yohannes M, Asgedom Y, Ye-ebiyo Y, Lindsay SW, Byass P. Pilot studies on the possible effects on malaria of small-scale irrigation dams in Tigray regional state, Ethiopia. J Public Health Med 1998; 20:238-40. [PMID: 9675750 DOI: 10.1093/oxfordjournals.pubmed.a024754] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Getachew A, Demissie M, Gemechu T. Kaposi's sarcoma diagnosed in the Department of Pathology, Addis Ababa University Medical Faculty: a 15 years retrospective review of biopsy results 1981-1994. Ethiop Med J 1997; 35:53-6. [PMID: 9293147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This is a fifteen years' retrospective analysis of 37 kaposi's sarcoma cases diagnosed in the Department of Pathology, Addis Ababa University Medical Faculty between 1981-1994 G.C.. There were 12 female (32%) and 25 male (66%) patients. The median age was 35 years. There was a marked increase in 1994 when 14 cases (38%) were diagnosed. The most frequent site of the lesion is the lower extremeties followed by lymph nodes. The predominant histologic findings were spindle cell proliferation, vascular proliferation, extravasation and slit spaces. The authors believe that the finding of this study may serve as a base-line data for future studies.
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Affiliation(s)
- A Getachew
- Department of Pathology, Faculty of Medicine, Addis Ababa University
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