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Amare GA, Mekonnen GG, Kassa M, Addisu A, Kendie DA, Tegegne B, Abera A, Tadesse D, Getahun S, Wondmagegn YM, Merdekios B, Asres MS, van Griensven J, Van der Auwera G, van Henten S, Pareyn M. First report of cutaneous leishmaniasis caused by Leishmania donovani in Ethiopia. Parasit Vectors 2023; 16:457. [PMID: 38104111 PMCID: PMC10725588 DOI: 10.1186/s13071-023-06057-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 07/19/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Leishmaniasis is a common neglected tropical disease in Ethiopia. Visceral leishmaniasis (VL) caused by Leishmania donovani presents in the lowlands, while cutaneous leishmaniasis (CL) affects people living in the highlands. Although CL is described as being caused by Leishmania aethiopica, there is also evidence of L. tropica and L. major isolated from a patient, sand flies and potential reservoirs. Information on species causing CL in Ethiopia is patchy, and no nation-wide study has ever been done. Understanding which species are causing CL in Ethiopia can have important implications for patient management and disease prevention. METHODS We analyzed stored routine samples and biobanked DNA isolates from previously conducted studies of CL patients from different centers in the north, center and south of Ethiopia. Species typing was performed using ITS-1 PCR with high-resolution melt (HRM) analysis, followed by HSP70 amplicon sequencing on a selection of the samples. Additionally, sociodemographic, clinical and laboratory data of patients were analyzed. RESULTS Of the 226 CL samples collected, the Leishmania species could be determined for 105 (45.5%). Leishmania aethiopica was identified in 101 (96.2%) samples from across the country. In four samples originating from Amhara region, northwestern Ethiopia, L. donovani was identified by ITS-1 HRM PCR, of which two were confirmed with HSP70 sequences. While none of these four patients had symptoms of VL, two originated from known VL endemic areas. CONCLUSIONS The majority of CL was caused by L. aethiopica, but CL due to L. tropica and L. major cannot be ruled out. Our study is the first to our knowledge to demonstrate CL patients caused by L. donovani in Ethiopia. This should spark future research to investigate where, how and to which extent such transmission takes place, how it differs genetically from L. donovani causing VL and whether such patients can be diagnosed and treated successfully with the currently available tools and drugs.
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Affiliation(s)
| | | | | | | | | | | | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | | | | | | | | | | | - Myrthe Pareyn
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
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van Henten S, Pareyn M, Tadesse D, Kassa M, Techane M, Kinfe E, Girma N, Demeke D, Mesay M, Kassa M, Temesgen R, Shewangizaw M, Massebo F, van Griensven J, Wegayehu T, Merdekios B. Community-based treatment of cutaneous leishmaniasis using cryotherapy and miltefosine in Southwest Ethiopia: the way forward? Front Med (Lausanne) 2023; 10:1196063. [PMID: 37886367 PMCID: PMC10598589 DOI: 10.3389/fmed.2023.1196063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
Background Cutaneous leishmaniasis (CL) is a common, yet massively underreported skin morbidity in Ethiopia. Most patients never seek treatment, as this is offered only in specialized treatment centers. Early diagnosis and treatment through decentralization is crucial to decrease transmission and to reach the NTD roadmap goals. However, little information is available on outcomes and challenges of community-based treatment initiatives. Methods A community-based prospective cohort study was conducted in Ochollo. Patients with clinically or microscopy confirmed CL were included. Cryotherapy was (to be) given weekly with at least four sessions for uncomplicated lesions, and miltefosine was given for 4 weeks for complicated lesions. Miltefosine adherence was assessed by counting pill strips. Clinical and patient-reported outcomes (dermatological life quality index and patient-global assessment) were assessed at month 6 (M6). Results A total of 107 patients were included, with a median age of 6 years. Two patients refused, and 15 could not be treated as they were too young (<4 years) for miltefosine. Giving cryotherapy to patients weekly was not feasible due to long wound healing times and required use of topical antibiotics. Only 52.4% of miltefosine patients finished >90% of their tablets by M1. Among 46 patients treated with cryotherapy, 24 (52.2%) were cured at M6, and 9 (19.6%) had substantial improvement. The cure rate was 16/39 (41.0%) for miltefosine with 28.2% (11/39) substantial improvement. Before treatment, more than half (57.8%) of patients reported that CL did not negatively impact their life, which significantly increased to 95.2% at M6. At this time, 61.7% of patients said their lesion was clear, which was 1% before treatment. Conclusion Our study is the first to identify the challenges and opportunities of miltefosine and cryotherapy for community treatment of CL. Although overall cure rates were lower than expected, patient-reported outcomes were generally positive and quite some patients had good improvement.
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Affiliation(s)
- Saskia van Henten
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Myrthe Pareyn
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Dagimawie Tadesse
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mekidim Kassa
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mehret Techane
- Department of Dermatology, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Eyerusalem Kinfe
- Department of Dermatology, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Nigatu Girma
- Department of Biology, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Degnet Demeke
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mebratu Mesay
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mekibib Kassa
- Leishmaniasis Research and Treatment Center, University of Gondar Hospital, Gondar, Ethiopia
| | - Rodas Temesgen
- Department of Internal Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Misgun Shewangizaw
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Fekadu Massebo
- Department of Biology, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Teklu Wegayehu
- Department of Biology, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Behailu Merdekios
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Meles GG, Ayele G, Gutema BT, Kondale M, Zerdo Z, Merdekios B, Tsalla T, Kote M, Baharu A, Bekele A, Gebremeskel F, Shegaze M, Gultie T. Causes and trends of adult mortality in southern Ethiopia: an eight-year follow up database study. BMC Infect Dis 2023; 23:29. [PMID: 36653766 PMCID: PMC9850514 DOI: 10.1186/s12879-023-07988-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Broad and specific causes of adult mortalities are often neglected indicators of wellbeing in low-income countries like Ethiopia due to lack of strong vital statistics. Thus, this database study aimed to assess the causes of adult mortality using demographic surveillance data. METHODS An 8-year (12 September 2009-11 September 2017) surveillance data from the Arba Minch Health and Demographic Surveillance Site was used for this study. Verbal autopsy methods and ICD codes were used to identify the causes of the adult deaths. The collected data were entered to the database by data clerks. We used Microsoft Excel and STATA version 16 software for data cleaning and analysis. Chi-squared test was used to see the significances of the trend analyses. RESULT From the 943 adult deaths from 2009 to 2017 in the Health and Demographic Surveillance Site in southern Ethiopia, more than half of them were females. The specific leading cause of death in the adults were tuberculosis (16.8%), malaria (9.7%), and intestinal infectious diseases (9.6%). Communicable diseases (49.2%, 95% C.I 45.7, 52.7) accounted for about half of the deaths followed by non-communicable diseases (35%, 95% C.I 31.7, 38.4) where both categories showed an increasing trend. CONCLUSION Although pieces of evidences are showing the shift from communicable diseases to non-communicable diseases as the major causes of adult death in developing countries, this study showed that communicable diseases are still the major causes of adult deaths. Efforts and emphasis should be given to control infectious diseases such as tuberculosis and malaria.
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Affiliation(s)
- Gebrekiros Gebremichael Meles
- grid.30820.390000 0001 1539 8988School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Gistane Ayele
- grid.442844.a0000 0000 9126 7261School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Befikadu Tariku Gutema
- grid.442844.a0000 0000 9126 7261School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mekides Kondale
- grid.442844.a0000 0000 9126 7261School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Zerihun Zerdo
- grid.442844.a0000 0000 9126 7261Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Behailu Merdekios
- grid.442844.a0000 0000 9126 7261School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tsegaye Tsalla
- grid.442844.a0000 0000 9126 7261Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mesfin Kote
- grid.442844.a0000 0000 9126 7261School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Alazar Baharu
- grid.442844.a0000 0000 9126 7261Department of Computer Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Alemayehu Bekele
- grid.428935.10000 0000 9552 339XEthiopian Public Health Association, Addis Ababa, Ethiopia
| | - Feleke Gebremeskel
- grid.442844.a0000 0000 9126 7261School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mulugeta Shegaze
- grid.442844.a0000 0000 9126 7261School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia ,grid.27255.370000 0004 1761 1174School of Public Health, Cheeloo College of Medicine, ShandongUniversity, Jinan, Shandong 250012, China
| | - Teklemariam Gultie
- grid.442844.a0000 0000 9126 7261Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Merdekios B, Pareyn M, Tadesse D, Getu S, Admassu B, Girma N, Leirs H, Van Geertruyden JP, van Griensven J. Detection of Cutaneous Leishmaniasis Foci in South Ethiopia. Am J Trop Med Hyg 2021; 105:156-158. [PMID: 33970885 DOI: 10.4269/ajtmh.20-0708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 02/09/2021] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a major public health problem in Ethiopia. The disease is endemic in Ochollo, a village in southern Ethiopia, but there are no reports of CL in the wider area, although it is ecologically very similar. We conducted a rapid assessment survey in the South Ethiopian Rift Valley and found 100 parasitologically confirmed CL cases in 38 villages not reported endemic for CL. Approximately half of the cases were children (57%), and most lesions occurred on the face (78%) and were older than 6 months (77%). Only 2% of the people was aware of the mode of transmission, and 9% sought modern treatment at a hospital. These preliminary data indicate that CL is much more widespread than previously reported and that the disease might have a large psychosocial impact. Hence, this study calls for larger surveys across the Ethiopian highlands. Additionally, health education and treatment capacity need to be implemented.
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Affiliation(s)
- Behailu Merdekios
- 1Department of Public Health, Arba Minch University, Arba Minch, Ethiopia
| | - Myrthe Pareyn
- 2Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium.,3Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dagimawie Tadesse
- 4Department of Medical Laboratory Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Solomon Getu
- 5Department of Haematology, Arba Minch General Hospital, Arba Minch, Ethiopia
| | - Bereket Admassu
- 6School of Medicine, Arba Minch University, Arba Minch, Ethiopia
| | - Nigatu Girma
- 7Biology Department, Arba Minch University, Arba Minch, Ethiopia
| | - Herwig Leirs
- 2Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
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Pareyn M, Rutten A, Merdekios B, Wedegärtner REM, Girma N, Regelbrugge L, Shibru S, Leirs H. High-resolution habitat suitability model for Phlebotomus pedifer, the vector of cutaneous leishmaniasis in southwestern Ethiopia. Parasit Vectors 2020; 13:467. [PMID: 32917242 PMCID: PMC7488460 DOI: 10.1186/s13071-020-04336-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/01/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Phlebotomus pedifer is the vector for Leishmania aethiopica causing cutaneous leishmaniasis (CL) in southwestern Ethiopia. Previous research on the transmission dynamics of CL resulted in recommendations for vector control. In order to target these interventions towards affected areas, a comprehensive understanding of the spatial distribution of P. pedifer at high spatial resolution is required. Therefore, this study determined the environmental predictors that facilitate the distribution of P. pedifer and created a map indicating the areas where conditions are suitable for survival of the vector in southwestern Ethiopia with high spatial resolution. METHODS Phlebotomus pedifer presence points were collected during two entomological surveys. Climate, vegetation and topographic variables were assembled. Climate variables were interpolated with variables derived from high-resolution digital elevation models to generate topoclimatic layers representing the climate conditions in the highlands. A Maximum Entropy model was run with the presence points, predicting variables and background points, which were selected based on a bias file. RESULTS Phlebotomus pedifer was the only captured Phlebotomus species in the study area and was collected at altitudes ranging between 1685 and 2892 m. Model projections indicated areas with suitable conditions in a 'belt' surrounding the high mountain peaks. Model performance was high, with train and test AUC values being 0.93 and 0.90, respectively. A multivariate environmental similarity surface (MESS) analysis showed that the model projection was only slightly extrapolated for some of the variables. The mean annual temperature was the environmental variable, which contributed most to the model predictions (60.0%) followed by the seasonality in rainfall (13.2%). Variables representing steep slopes showed very low importance to model predictions. CONCLUSIONS Our findings indicate that the suitable habitats for P. pedifer correspond well with the altitudes at which CL was reported previously, but the predictions are more widely distributed, in contrast with the description of CL to occur in particular foci. Moreover, we confirm that vector distribution is driven by climate factors, suggesting inclusion of topoclimate in sand fly distribution models. Overall, our model provides a map with a high spatial resolution that can be used to target sand fly control measures in southwestern Ethiopia.
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Affiliation(s)
- Myrthe Pareyn
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Anneleen Rutten
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Behailu Merdekios
- Public Health Department, Arba Minch University, Arba Minch, Ethiopia
| | | | - Nigatu Girma
- Biology Department, Arba Minch University, Arba Minch, Ethiopia
| | - Leo Regelbrugge
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Simon Shibru
- Biology Department, Arba Minch University, Arba Minch, Ethiopia
| | - Herwig Leirs
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
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Pareyn M, Kochora A, Van Rooy L, Eligo N, Vanden Broecke B, Girma N, Merdekios B, Wegayehu T, Maes L, Caljon G, Lindtjørn B, Leirs H, Massebo F. Feeding behavior and activity of Phlebotomus pedifer and potential reservoir hosts of Leishmania aethiopica in southwestern Ethiopia. PLoS Negl Trop Dis 2020; 14:e0007947. [PMID: 32196501 PMCID: PMC7112221 DOI: 10.1371/journal.pntd.0007947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/01/2020] [Accepted: 02/25/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a major public health concern in Ethiopia. However, knowledge about the complex zoonotic transmission cycle is limited, hampering implementation of control strategies. We explored the feeding behavior and activity of the vector (Phlebotomus pedifer) and studied the role of livestock in CL transmission in southwestern Ethiopia. METHODS Blood meal origins of engorged sand flies were determined by sequencing host DNA. A host choice experiment was performed to assess the feeding preference of P. pedifer when humans and hyraxes are equally accessible. Ear and nose biopsies from livestock were screened for the presence of Leishmania parasites. Sand flies were captured indoor and outdoor with human landing catches and CDC light traps to determine at which time and where P. pedifer is mostly active. PRINCIPAL FINDINGS A total of 180 P. pedifer sand flies were found to bite hosts of 12 genera. Humans were the predominant blood meal source indoors (65.9%, p < 0.001), while no significant differences were determined outdoors and in caves. In caves, hyraxes were represented in blood meals equally as humans (45.5% and 42.4%, respectively), but the host choice experiment revealed that sand flies have a significant preference for feeding on hyraxes (p = 0.009). Only a single goat nose biopsy from 412 animal samples was found with Leishmania RNA. We found that P. pedifer is predominantly endophagic (p = 0.003), but occurs both indoors and outdoors. A substantial number of sand flies was active in the early evening, which increased over time reaching its maximum around midnight. CONCLUSION In contrast to earlier suggestions of exclusive zoonotic Leishmania transmission, we propose that there is also human-to-human transmission of CL in southwestern Ethiopia. Livestock does not play a role in CL transmission and combined indoor and outdoor vector control measures at night are required for efficient vector control.
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Affiliation(s)
- Myrthe Pareyn
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
- * E-mail: (MP); (FM)
| | - Abena Kochora
- Biology Department, Arba Minch University, Arba Minch, Ethiopia
| | - Luca Van Rooy
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Nigatu Eligo
- Biology Department, Arba Minch University, Arba Minch, Ethiopia
| | | | - Nigatu Girma
- Biology Department, Arba Minch University, Arba Minch, Ethiopia
| | - Behailu Merdekios
- Public Health Department, Arba Minch University, Arba Minch, Ethiopia
| | - Teklu Wegayehu
- Biology Department, Arba Minch University, Arba Minch, Ethiopia
| | - Louis Maes
- Laboratory of Microbiology, Parasitology and Hygiene, University of Antwerp, Antwerp, Belgium
| | - Guy Caljon
- Laboratory of Microbiology, Parasitology and Hygiene, University of Antwerp, Antwerp, Belgium
| | - Bernt Lindtjørn
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Herwig Leirs
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Fekadu Massebo
- Biology Department, Arba Minch University, Arba Minch, Ethiopia
- * E-mail: (MP); (FM)
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7
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Manilal A, Shewangizaw M, Mama M, Gezmu T, Merdekios B. Methicillin-resistant Staphylococcus aureus colonization in HIV patients of Arba Minch province, Ethiopia: Carriage rates, antibiotic resistance, and biofilm formation. Acta Microbiol Immunol Hung 2019; 66:469-483. [PMID: 31198058 DOI: 10.1556/030.66.2019.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a significant opportunistic pathogen among human immunodeficiency virus (HIV) patients of Ethiopia. This study aimed at delineating the prevalence, antimicrobial resistance, and biofilm-forming potentials of nasally colonized MRSA among HIV patients in the Arba Minch province of Ethiopia. A cross-sectional study was performed in HIV patients who visit anti-retroviral therapy clinic of the Arba Minch Hospital between February and April 2017. Nasal samples were collected and inspected for Staphylococcus following standard procedures. MRSA was identified using cefoxitin disk and antibiotics sensitivity test was performed as per Kirby-Baur disk diffusion method. The formation of biofilm was inspected using both qualitative and quantitative methods. A total of 307 HIV patients were examined. The overall prevalence of S. aureus was found to be 39.7%. The prevalence of MRSA was 20.8%. The rate of nasal colonization of MRSA was relatively higher among females. In bivariate analysis, MRSA colonization was statistically significant in patients with CD4 count ≤350 (p value = 0.002) and co-trimoxazole prophylaxis (p value = 0.003). Concomitant resistance to erythromycin, tetracycline, and co-trimoxazole were 48.4%, 45.3%, and 39.0%, respectively. Invariably, all MRSA isolates were 100% sensitive to vancomycin. Of the 64 MRSA isolates, 18.7% were considered as multidrug-resistant. The rate of biofilm formation was 34.3%. The results revealed a high prevalence rate in the nasal colonization of MRSA in HIV patients.
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Affiliation(s)
- Aseer Manilal
- 1 Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Misgun Shewangizaw
- 2 Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mohammedaman Mama
- 3 Department of Medical Laboratory Science, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Tigist Gezmu
- 1 Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Behailu Merdekios
- 2 Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Ameya G, Manilal A, Merdekios B. In vitro Antibacterial Activity and Phytochemical Analysis of Nicotiana tabacum L. Extracted in Different Organic Solvents. Open Microbiol J 2017; 11:352-359. [PMID: 29399216 PMCID: PMC5759108 DOI: 10.2174/1874285801711010352] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 08/31/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 11/22/2022] Open
Abstract
Background: Controlling infectious disease using medicinal plants is the oldest healthcare known to mankind. Regardless of the enormous advances observed in modern medicine, medicinal plants are still playing vital roles. However, only a small proportion of medicinal plants are examined for bioactive compounds which may vary in different factors. This study aimed to evaluate phytochemical constituent and antimicrobial activities of Nicotiana tabacum L. extracted by different solvents against three set of bacteria. Methods: Nicotiana tabacum L. was collected from the Western Ethiopia and extracted in seven organic solvents. An in-vitro anti-bacterial activity of plant extracts was carried out by agar well diffusion assay against microbial type culture collection of human pathogens, clinical bacterial isolates, and biofilm forming bacteria. Gas Chromatographic and Mass Spectroscopic (GC-MS) analysis was used to determine the phytochemical constituents. Results: Antimicrobial activities of plant extract vary by extraction solvents; and ethyl acetate based extracts showed better antimicrobial activities. Of the experimental organisms, biofilm forming uropathogens were the most sensitive while clinical isolates were quite resistant. Analysis of the active ethyl acetate extract by GC-MS evinced a mixture of five volatile compounds; and Pyridine, 3-(1-methyl-2-pyrrolidinyl)-, (S) was the major compound detected. The overall results of the present study revealed that N. tabacum L extract has high antimicrobial activities against biofilm forming uropathogens. Conclusion: High antimicrobial activity was observed in ethyl acetate extract of N. tabacum against the biofilm forming bacteria whereas the clinically isolated bacteria were the most resistant group. The antibacterial property demonstrated could be due to Pyridine, 3-(1-methyl-2-pyrrolidinyl)-(S) with a broad spectrum of activity.
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Affiliation(s)
- Gemechu Ameya
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Aseer Manilal
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Behailu Merdekios
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Bårnes GK, Kristiansen PA, Beyene D, Workalemahu B, Fissiha P, Merdekios B, Bohlin J, Préziosi MP, Aseffa A, Caugant DA. Prevalence and epidemiology of meningococcal carriage in Southern Ethiopia prior to implementation of MenAfriVac, a conjugate vaccine. BMC Infect Dis 2016; 16:639. [PMID: 27814682 PMCID: PMC5097444 DOI: 10.1186/s12879-016-1975-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 07/13/2016] [Accepted: 10/26/2016] [Indexed: 01/07/2023] Open
Abstract
Background Neisseria meningitidis colonizes humans and transmits mainly by asymptomatic carriage. We sought to determine the prevalence and epidemiology of meningococcal carriage in Ethiopia prior to the introduction of MenAfriVac, a serogroup A meningococcal conjugate vaccine. Methods A cross-sectional meningococcal carriage study was conducted in Arba Minch, southern Ethiopia. A total of 7479 oropharyngeal samples were collected from 1 to 29 year old volunteers, between March and October, 2014. The swabs were cultured for N. meningitidis and Neisseria lactamica in Ethiopia. N. meningitidis isolates were confirmed and characterized by their serogroup, sequence type (ST) and PorA:FetA profile in Norway. Results Overall carriage prevalence was 6.6 %. There was no significant difference in overall carriage between male (6.7 %) and female (6.4 %) participants. Highest carriage prevalence (10.9 %) for females was found in the 15–19 years of age, while prevalence among males was highest (11.3 %) in the 20–24 age group. Non-groupable isolates dominated (76.4 %), followed by serogroups X (14.0 %) and W (5.9 %) isolates. No serogroup A was found. Most non-groupable isolates were ST-192. Serogroup W isolates were assigned to the ST-11 clonal complex, and serogroup X isolates to the ST-181 and ST-41/44 clonal complexes. Overall carriage prevalence of N. lactamica was 28.1 %. Carriage of N. meningitidis and N. lactamica varied depending on age and geographic area, but there was no association between carriage of the two species. Conclusions Epidemic strains of serogroups W and X were circulating in this area of Ethiopia. As no serogroup A was found among the carriage isolates the immediate impact of mass-vaccination with MenAfriVac on transmission of N. meningitidis in this population is expected to be marginal.
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Affiliation(s)
- Guro K Bårnes
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul A Kristiansen
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | | | - Behailu Merdekios
- College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Jon Bohlin
- Department of Methodology Research and Analysis, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Dominique A Caugant
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
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Bårnes GK, Workalemahu B, Kristiansen PA, Beyene D, Merdekios B, Fissiha P, Aseffa A, Caugant DA, Næss LM. Salivary and Serum Antibody Response Against
Neisseria meningitidis
After Vaccination With Conjugate Polysaccharide Vaccines in Ethiopian Volunteers. Scand J Immunol 2016; 84:118-29. [DOI: 10.1111/sji.12451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 05/18/2016] [Indexed: 12/27/2022]
Affiliation(s)
- G. K. Bårnes
- Department of Bacteriology and Immunology Norwegian Institute of Public Health Oslo Norway
- Department of Community Medicine Section of International Community Health University of Oslo Oslo Norway
| | - B. Workalemahu
- Arba Minch College of Health Sciences Arba Minch Ethiopia
| | - P. A. Kristiansen
- Department of Bacteriology and Immunology Norwegian Institute of Public Health Oslo Norway
| | - D. Beyene
- Armauer Hansen Research Institute Addis Ababa Ethiopia
| | - B. Merdekios
- College of Medicine and Health Sciences Arba Minch University Arba Minch Ethiopia
| | - P. Fissiha
- Arba Minch General Hospital Arba Minch Ethiopia
| | - A. Aseffa
- Armauer Hansen Research Institute Addis Ababa Ethiopia
| | - D. A. Caugant
- Department of Bacteriology and Immunology Norwegian Institute of Public Health Oslo Norway
- Department of Community Medicine Section of International Community Health University of Oslo Oslo Norway
| | - L. M. Næss
- Department of Bacteriology and Immunology Norwegian Institute of Public Health Oslo Norway
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11
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Manilal A, Tsalla T, Zerdo Z, Ameya G, Merdekios B, John SE. Evaluating the antibacterial and anticandidal potency of mangrove, Avicennia marina. Asian Pacific Journal of Tropical Disease 2016. [DOI: 10.1016/s2222-1808(15)60999-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Manilal A, Merdekios B, Idhayadhulla A, Muthukumar C, Melkie M. An in vitro antagonistic efficacy validation of Rhizophora mucronata. Asian Pacific Journal of Tropical Disease 2015. [DOI: 10.1016/s2222-1808(14)60622-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Animaw W, Taye W, Merdekios B, Tilahun M, Ayele G. Expanded program of immunization coverage and associated factors among children age 12-23 months in Arba Minch town and Zuria District, Southern Ethiopia, 2013. BMC Public Health 2014; 14:464. [PMID: 24884641 PMCID: PMC4032449 DOI: 10.1186/1471-2458-14-464] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 05/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Immunization averts an estimated 2 to 3 million deaths every year globally. In Ethiopia only quarter of children are fully immunized; the rest are remained at risk for vaccine-preventable mortality. To increase the immunization, its coverage and predictors has to be identified. This study has measured immunization coverage and identified the predictors. METHODS Cross-sectional community based study has been conducted within 630 age 12-23 months children in 15 districts of Arba Minch town and Arba Minch Zuria district, Southern Ethiopia in March 2013. Census was done to identify eligible children. The 2005 world health organization expanded program of immunization cluster sampling method has been used. Data were collected using semi-structured pretested Amharic version questionnaire by interviewing index children's mothers/caretakers, copying from vaccine card and observing BCG vaccine scar. Data were processed using SPSS version 16. Associations between dependent and independent variables has been assessed and presented using three consecutive logistic regression models. RESULT Nearly three fourth (73.2%) of children in Arba Minch Town and Arba Minch Zuria district were fully immunized. The rest 20.3% were partially immunized and 6.5% received no vaccine. Mother education, mothers' perception to accessibility of vaccines, mothers' knowledge to vaccine schedule of their site, place of delivery and living altitude were independent predictors of children immunization status. CONCLUSION Expanded program of immunization (EPI) coverage at Arba Minch town and Arba Minch Zuria district is better than the national immunization coverage but still below the goal. Educating mother, promoting institution delivery could help to maintain and enhance current immunization coverage. More emphasis should be given to the highland areas of the area.
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Affiliation(s)
- Worku Animaw
- Bahir Dar University, College of Medicine and Health Sciences, PO Box 79, Bahir Dar, Ethiopia.
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14
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Abstract
BACKGROUND In Ethiopia, Progress in Reducing Mother-to-Child-Transmission (PMTCT) of human immunodeficiency virus (HIV) is being curtailed by behavioral and cultural factors that continue to put unborn children at risk, and mother-to-child transmission is responsible for more than 90% of HIV infection in children. The objective of this study was to assess PMTCT services by examining knowledge about reducing vertical transmission among pregnant women. METHODS A multistaged sampling institution-based survey was conducted in 113 pregnant women in Arba Minch. Qualitative and quantitative data were obtained. RESULTS Of the 113 respondents, 89.4% were from Arba Minch, 43.4% were at least 25 years of age, 73.4% had formal education at primary level or above, 100% reported acceptance of voluntary counseling and testing, 92.0% were knowledgeable about mother-to-child transmission, and 90.3% were aware of the availability of the PMTCT service in the health facility. Of 74 HIV-positive women in PMTCT, only three (4.1%) had had skilled birth attendants at delivery. There was an unacceptable degree of loss of women from PMTCT. Maternal educational level had a statistical association with income (P < 0.001) and voluntary counseling and testing for pregnant women (P < 0.05). Factors that determined use of PMTCT included culture, socioeconomic status, and fear of stigma and discrimination. CONCLUSION In the area studied, intervention to reduce mother-to-child transmission of HIV is failing to reach its goal. This is an alarming discovery requiring quick reconsideration and strengthening of preventive strategies at all levels.
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Affiliation(s)
- Behailu Merdekios
- College of Medicine and Health Sciences, Arba Minch University, Ethiopia
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