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Balay G, Abdella K, Kebede W, Tadesse M, Bonsa Z, Mekonnen M, Amare M, Abebe G. Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia. J Clin Tuberc Other Mycobact Dis 2024; 34:100411. [PMID: 38222863 PMCID: PMC10787229 DOI: 10.1016/j.jctube.2023.100411] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
Objective Pyrazinamide (PZA) susceptibility testing is important to develop evidence-based algorithms for case management. We aimed to assess the prevalence of PZA-resistance and its impact on treatment outcomes in previously treated tuberculosis (TB) cases in southwestern Oromia, Ethiopia. Methods A Phenotypic Drug Susceptibility Testing (DST) of PZA with BACTEC MGIT 960 was conducted at the Mycobacteriology Research Center of Jimma University (MRC-JU) from June to November 2021 on sixty-six Mycobacterium tuberculosis complex (MTBC) isolates from previously treated TB cases. SPSS software package version 21 was used. The differences in the proportion of PZA resistance between the groups were compared using the chi squared test. Logistic regression was used to identify the association between PZA resistance and treatment outcomes. Results Among 66 MTBC isolates (49 rifampicin-resistant and 17 rifampicin-sensitive) included in this study, 31.8 % were resistant to PZA. The proportion of PZA resistance was almost three times higher in previously treated TB cases with rifampicin resistance than in rifampicin-sensitive patients (38.8 % vs. 11.8 %, p = 0.039). An unfavorable treatment outcome was documented for 23 % (15/65) of the participants. Patients with PZA resistance were almost four times more likely to have an unfavorable treatment outcome than patients with PZA sensitive (aOR 4.2, 95 % CI: 1.13-15.3). Conclusions The prevalence of PZA resistance was high compared to the pooled PZA resistance estimated worldwide. The majority of TB cases with PZA resistance had an unfavorable treatment outcome. PZA susceptibility testing should be included in the multidrug-resistant TB diagnostic algorithm to improve management of these patients.
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Affiliation(s)
- Getu Balay
- Mycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Kedir Abdella
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Wakjira Kebede
- Mycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mulualem Tadesse
- Mycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Zegeye Bonsa
- Mycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mekidim Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Misikir Amare
- Ethiopian Public Health Institute, National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia
| | - Gemeda Abebe
- Mycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Amankwah S, Adisu M, Gorems K, Abdella K, Kassa T. Assessment of Phage-Mediated Inhibition and Removal of Multidrug-Resistant Pseudomonas aeruginosa Biofilm on Medical Implants. Infect Drug Resist 2022; 15:2797-2811. [PMID: 35668859 PMCID: PMC9166914 DOI: 10.2147/idr.s367460] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/27/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose Despite the growing interest in bacteriophage (phage) usage for the prevention, control, and removal of bacterial biofilms, few scientific data exist on phage applications on medical implant surfaces, while none exists on multiple implants. In this study, we aimed to isolate, biophysically characterize and assess phages as potential antibiofilm agents to inhibit and remove multidrug-resistant (MDR) Pseudomonas aeruginosa biofilm on catheter and endotracheal tube surfaces. Methods The well-identified stored clinical isolates (n = 7) of MDR P. aeruginosa were obtained from Jimma Medical Center. Specific phages were isolated and characterized based on standard protocols. The phages were tested for their antibiofilm effects in preventing colonization and removing preformed biofilms of MDR P. aeruginosa, following phage coating and treatment of catheter and endotracheal tube segments. Results Two P. aeruginosa-specific phages (ΦJHS-PA1139 and ΦSMK-PA1139) were isolated from JMC compound sewage sources. The phages were biophysically characterized as being thermally stable up to 40°C and viable between pH 4.0 and 11.0. The two phages tested against clinical MDR strains of P. aeruginosa showed broad host ranges but not on other tested bacterial species. Both phages reduced MDR bacterial biofilms during the screening step. The phage-coated segments showed 1.2 log10 up to 3.2 log10 inhibition relative to non-coated segments following 6 h coating of segments prior to microbial load exposure. In both phages, 6 h treatment of the segments with 106 PFU/mL yielded 1.0 log10 up to 1.6 log10 reductions for ΦJHS and 1.6 log10 up to 2.4 log10 reductions for ΦSMK. Conclusion Our results suggest that phages have great potential to serve the dual purpose as surface coating agents for preventing MDR bacterial colonization in medical implants and as biofilm removal agents in implant-associated infections.
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Affiliation(s)
- Stephen Amankwah
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
- Accra Medical Centre, Accra, Ghana
| | - Mekonen Adisu
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
- Department of Medical Laboratory Sciences, Wollega University, Nekemte, Ethiopia
| | - Kasahun Gorems
- Microbiology Laboratory of Jimma Medical Center, Jimma, Ethiopia
- St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Kedir Abdella
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Tesfaye Kassa
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
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Umer A, Abdella K, Tekle Y, Debebe A, Manyazewal T, Yuya M, Mohammed H. Community Engagement in the Fight Against COVID-19: Knowledge, Attitude, and Prevention Practices Among Dire Dawa Residents, Eastern Ethiopia. Front Public Health 2021; 9:753867. [PMID: 34917574 PMCID: PMC8669349 DOI: 10.3389/fpubh.2021.753867] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background: There is a global concern that coronavirus disease 2019 (COVID-19) cannot be addressed without the integration and active engagement of communities. We aimed to investigate the knowledge, attitude, and practices (KAP) of the residents in Eastern Ethiopia toward COVID-19. Method: A community-based cross-sectional study was conducted on May 1-30, 2020 among the residents of Dire Dawa, Eastern Ethiopia. Data were collected using a structured questionnaire on the awareness, knowledge, attitudes, and preventive practices toward COVID-19. We used random sampling to select the participants. Data was entered into the statistics and data (STATA) version for data cleaning and analysis. Binary logistic regression models with 95% CI were used to conduct bivariable [crude odds ratio (COR)] and multivariable [adjusted odds ratio (AOR)] analyses. Result: A total of 415 community residents responded to the questionnaire. Of those participants, 52.5% (95% CI 47.7-57) had adequate knowledge, 31.6% (95% CI 27-36) had favorable attitudes, and 49% (95% CI 45-50) had good practice toward the precautionary measures of COVID-19. Adequate knowledge had a significant association with urban residence (AOR = 5, 95% CI 3.1-8.4) and literacy (AOR = 3.1, 95% CI 1.5-6.7). Good preventions practices had a significant association with place of residence (AOR = 4.1, 95% CI 2.3-7.2), literacy (AOR = 2.9, 95% CI: 1,2-7.4), adequate knowledge (AOR = 3.5, 95% CI 2.3-5.8), and favorable attitude (AOR = 2.3, 95% CI 1.4-3.8) about the disease. Conclusion: The overall COVID-19-related KAP was inadequate in the majority of the residents of Dire Dawa that occupy irregular migration flows. These call for robust community-centered behavioral communication strategies that could bridge the gaps and help prevent and control COVID-19 and other future pandemics in their community.
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Affiliation(s)
- Abdurezak Umer
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Kedir Abdella
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yared Tekle
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Addisalem Debebe
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tsegahun Manyazewal
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mohammed Yuya
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Hussen Mohammed
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Amankwah S, Abdella K, Kassa T. Bacterial Biofilm Destruction: A Focused Review On The Recent Use of Phage-Based Strategies With Other Antibiofilm Agents. Nanotechnol Sci Appl 2021; 14:161-177. [PMID: 34548785 PMCID: PMC8449863 DOI: 10.2147/nsa.s325594] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 06/19/2021] [Accepted: 08/20/2021] [Indexed: 12/11/2022] Open
Abstract
Biofilms are bacterial communities that live in association with biotic or abiotic surfaces and enclosed in an extracellular polymeric substance. Their formation on both biotic and abiotic surfaces, including human tissue and medical device surfaces, pose a major threat causing chronic infections. In addition, current antibiotics and antiseptic agents have shown limited ability to completely remove biofilms. In this review, the authors provide an overview on the formation of bacterial biofilms and its characteristics, burden and evolution with phages. Moreover, the most recent possible use of phages and phage-derived enzymes to combat bacteria in biofilm structures is elucidated. From the emerging results, it can be concluded that despite successful use of phages and phage-derived products in destroying biofilms, they are mostly not adequate to eradicate all bacterial cells. Nevertheless, a combined therapy with the use of phages and/or phage-derived products with other antimicrobial agents including antibiotics, nanoparticles, and antimicrobial peptides may be effective approaches to remove biofilms from medical device surfaces and to treat their associated infections in humans.
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Affiliation(s)
- Stephen Amankwah
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Accra Medical Centre, Accra, Ghana
| | - Kedir Abdella
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tesfaye Kassa
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Abebe G, Abdissa K, Abdella K, Tadesse M, Worku A, Ameni G. Spoligotype-based population structure of Mycobacterium tuberculosis in the Jimma Zone, southwest Ethiopia. Microbiologyopen 2018; 8:e00744. [PMID: 30318822 PMCID: PMC6562125 DOI: 10.1002/mbo3.744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 07/23/2018] [Revised: 09/01/2018] [Accepted: 09/10/2018] [Indexed: 12/28/2022] Open
Abstract
Background To understand the population dynamics and propose more effective preventive strategies, defining the population structure of the circulating Mycobacterium tuberculosis strains is important. Methods A total of 177 M. tuberculosis complex isolates from pulmonary tuberculosis (TB) cases in southwest Ethiopia were genotyped by spoligotyping. Of the strains included in this study, 126 were pan‐susceptible strains while the remaining 51 isolates were resistant to one or more first‐line anti‐TB drugs. The genotyping results were compared to the international spoligotyping (SITVIT) database of the Pasteur Institute of Guadeloupe and the newly revised publicly available international multi‐marker database (SITVITWEB/SPOLDB4). An online tool Run TB‐Lineage was also used to predict the major lineages using a conformal Bayesian network analysis. Results The spoligotyping of the 177 isolates resulted in 69 different spoligotype patterns of which 127 (71.8%) were clustered into 19 spoligoclusters (with clustering rate of 61.02%). Each cluster contains 2–29 isolates. Of the isolates with corresponding SIT in SITVIT/SDB4, the predominant strains identified were SIT 37 of the T3 subfamily with 29 isolates followed by SIT 53 of the T1 subfamily with 20 isolates. SIT 777 of the H4 subfamily and SIT 25 of the CAS1_DELHI subfamily each consisting of six isolates were identified. Eighty spoligotype patterns were orphan as they were not recorded in the SITVIT2/SPDB4 database. Further classification of the isolates on the basis of major lineages showed that 82.5% and 14.1% of the isolates belonged to Euro‐American and East African Indian lineages, respectively, while 2.8% of the isolates belonged to Mycobacterium africanum and 0.6% to Indo‐Oceanic. Conclusion The ill‐defined T and H clades were predominant around Jimma. The substantial number of orphans recorded in the study area warrants for additional studies with genotyping methods with better resolution and covering whole areas of southwest Ethiopia. The present study has shown the dominance of ill‐defined T and H clades in the study area. Moreover, a substantial number of isolates were Orphan warranting for additional studies covering the whole geographic area of the southwest Ethiopia and genotypic methods with better resolution.
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Affiliation(s)
- Gemeda Abebe
- Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia
| | - Ketema Abdissa
- Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia
| | - Kedir Abdella
- Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia
| | - Mulualem Tadesse
- Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia
| | - Adane Worku
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Tadesse M, Aragaw D, Dimah B, Efa F, Abdella K, Kebede W, Abdissa K, Abebe G. Drug resistance-conferring mutations in Mycobacterium tuberculosis from pulmonary tuberculosis patients in Southwest Ethiopia. Int J Mycobacteriol 2016; 5:185-91. [PMID: 27242230 DOI: 10.1016/j.ijmyco.2016.02.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 01/22/2016] [Accepted: 02/23/2016] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE/BACKGROUND The nature and frequency of mutations in rifampicin (RIF) and isoniazid (INH) resistant Mycobacterium tuberculosis isolates vary considerably according to geographic locations. However, information regarding specific mutational patterns in Ethiopia remains limited. METHODS A cross-sectional prospective study was carried out among confirmed pulmonary tuberculosis cases in Southwest Ethiopia. Mutations associated with RIF and INH resistances were studied using GenoType MTBDRplus line probe assay in 112 M. tuberculosis isolates. Culture (MGIT960) and identification tests were performed at the Mycobacteriology Research Center of Jimma University, Jimma, Ethiopia. RESULTS Mutations conferring resistance to INH, RIF, and multidrug resistance were detected in 36.6% (41/112), 30.4% (34/112), and 27.7% (31/112) of M. tuberculosis isolates respectively. Among 34 RIF-resistant isolates, 82.4% (28/34) had rpoB gene mutations at S531L, 2.9% (1/34) at H526D, and 14.7% (5/34) had mutations only at wild type probes. Of 41 INH-resistant strains, 87.8% (36/41) had mutations in the katG gene at Ser315Thr1 and 9.8% (4/41) had mutations in the inhA gene at C15T. Mutations in inhA promoter region were strongly associated with INH monoresistance. CONCLUSION A high rate of drug resistance was commonly observed among failure cases. The most frequent gene mutations associated with the resistance to INH and RIF were observed in the codon 315 of the katG gene and codon 531 of the rpoB gene, respectively. Further studies on mutations in different geographic regions using DNA sequencing techniques are warranted to improve the kit by including more specific mutation probes in the kit.
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Affiliation(s)
- Mulualem Tadesse
- Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia; Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
| | - Dossegnaw Aragaw
- Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia; Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Belayneh Dimah
- Jimma University Specialized Hospital, Jimma University, Jimma, Ethiopia
| | - Feyisa Efa
- Jimma University Specialized Hospital, Jimma University, Jimma, Ethiopia
| | - Kedir Abdella
- Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia; Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Wakjira Kebede
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Ketema Abdissa
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Gemeda Abebe
- Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia; Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
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Tadesse M, Abebe G, Abdissa K, Aragaw D, Abdella K, Bekele A, Bezabih M, Apers L, de Jong BC, Rigouts L. GeneXpert MTB/RIF Assay for the Diagnosis of Tuberculous Lymphadenitis on Concentrated Fine Needle Aspirates in High Tuberculosis Burden Settings. PLoS One 2015; 10:e0137471. [PMID: 26366871 PMCID: PMC4569183 DOI: 10.1371/journal.pone.0137471] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [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: 05/01/2015] [Accepted: 08/17/2015] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION The diagnosis of tuberculous lymphadenitis (TBL) remains challenging. The routinely used methods (cytology and smear microscopy) have sub-optimal sensitivity. Recently, WHO recommends GeneXpert to be used as the initial diagnostic test in patients suspected of having extra-pulmonary tuberculosis (EPTB). However, this was a conditional recommendation due to very low-quality evidence available and more studies are needed. In this study we evaluated the performance of Xpert for the diagnosis of TBL on concentrated fine needle aspirates (FNA) in Southwest Ethiopia. METHODS FNA was collected from presumptive TBL cases. Two smears were prepared from each aspirate and processed for cytology and conventional microscopy. The remaining aspirate was treated with N-acetyl-L-cysteine-NaOH and centrifuged for 15minutes at 3000g. The concentrated sediment was used for culture and Xpert test. Capilia TB-Neo test was used to differentiate M. tuberculosis complex (MTBC) from non-tuberculous mycobacteria (NTM). Composite bacteriological methods (culture and/or smear microscopy) were considered as a reference standard. RESULT Out of 143 enrolled suspects, 64.3% (92/143) were confirmed TBL cases by the composite reference standard (CRS). Xpert detected M. tuberculosis complex (MTBC) in 60.1% (86/143) of the presumptive TBL cases. The sensitivity of Xpert compared to CRS was 87.8% [95% CI: 81.0-94.5] and specificity 91.1% [95% CI: 82.8-99.4]. The sensitivity was 27.8% for smear microscopy and 80% for cytology compared to CRS. Cytology showed the lowest specificity (57.8%). Xpert was positive in 4 out of 45 culture- and smear-negative cases. Among 47 cytomorphologically non-TBL cases, 15 were positive on Xpert. More than half of Xpert-positive cases were in the range of very low cut-off threshold values (28 CONCLUSION Xpert test showed a high sensitivity and specificity for the diagnosis of TBL on concentrated FNA samples. In addition, Xpert offered rapid detection of rifampicin-resistant M. tuberculosis strains from lymph node aspirates.
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Affiliation(s)
- Mulualem Tadesse
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
- Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Gemeda Abebe
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
- Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia
| | - Ketema Abdissa
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Dossegnaw Aragaw
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
- Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia
| | - Kedir Abdella
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
- Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia
| | - Alemayehu Bekele
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Mesele Bezabih
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Ludwig Apers
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bouke C. de Jong
- Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Leen Rigouts
- Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
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Abdissa K, Tadesse M, Abdella K, Bekele A, Bezabih M, Abebe G. Diagnostic performance of fluorescent light-emitting diode microscopy for tuberculous lymphadenitis in a high-burden setting. Trop Med Int Health 2015; 20:1543-1548. [PMID: 26250964 DOI: 10.1111/tmi.12585] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/26/2022]
Abstract
OBJECTIVE Diagnosis of tuberculous lymphadenitis using fine-needle aspiration cytology is a simple and safe but low-specificity method, whereas conventional smear microscopy has variable sensitivity due to low bacterial load. We evaluated the diagnostic performance of fluorescent light-emitting diode (LED) microscopy on routinely collected fine-needle aspirates from tuberculous lymphadenitis presumptive cases. METHODS Fine-needle aspirates were collected from patients clinically suspected of having tuberculous lymphadenitis as part of routine diagnosis. Smear preparation was performed from the aspirate and processed for cytology, conventional Ziehl-Neelsen and LED microscopy. The remaining aspirate was processed for culture on Lowenstein-Jensen media. Capilia TB-Neo test was used to differentiate M. tuberculosis complex from non-tuberculous mycobacteria. RESULT A total of 144 tuberculous lymphadenitis presumptive cases were included. 66.7% (96/144) were positive for M. tuberculosis complex on culture. Only one isolate was identified as non-tuberculous mycobacteria. The detection rates of Ziehl-Neelsen and LED microscopy were 18.8% (27/144) and 34% (49/144), respectively. As compared to culture, sensitivity was 25.0% [95% CI: 16.3-33.7] for Ziehl-Neelsen microscopy and 45.8% [95% CI: 35.9-55.8] for LED microscopy. The specificity was 93.8% [95% CI: 86.9-100] for Ziehl-Neelsen microscopy and 89.6% [95% CI: 80.9-98.2] for LED microscopy. LED microscopy showed a statistically significant increase in sensitivity and similar specificity compared to Ziehl-Neelsen microscopy. Mean reading time of positive slides was 2.62 min/slide for Ziehl-Neelsen and 1.60 min/slide for LED microscopy. Cytology showed sensitivity of 82.3% and specificity of 54.2%. LED microscopy detected TB bacilli in 33.3% of cases cytologically classified as suppurative abscess. CONCLUSION The LED microscopy for tuberculous lymphadenitis had significantly higher sensitivity and shorter screening time than Ziehl-Neelsen microscopy. Use of LED microscopy among cases classified as suppurative abscess on fine-needle aspirate cytology improves evidence-based diagnosis of presumptive tuberculous lymphadenitis cases. Moreover, LED microscopy could be considered as an alternative approach in settings where fine-needle aspirate cytology is impractical.
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Affiliation(s)
- Ketema Abdissa
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Mulualem Tadesse
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.,Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia
| | - Kedir Abdella
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.,Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia
| | - Alemayehu Bekele
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Mesele Bezabih
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Gemeda Abebe
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.,Mycobacteriology Research Center, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia
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Abdella K, Abdissa K, Kebede W, Abebe G. Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia. BMC Public Health 2015; 15:599. [PMID: 26135909 PMCID: PMC4489121 DOI: 10.1186/s12889-015-1955-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 06/02/2014] [Accepted: 06/19/2015] [Indexed: 02/05/2023] Open
Abstract
Background Information on the pattern of drug resistant tuberculosis (TB) among re-treatment cases is crucial to develop appropriate control strategies. Therefore, we conducted this study to assess the drug resistance pattern of M. tuberculosis complex (MTBC) isolates and associated factors among re-treatment cases in Jimma area, Southwest Ethiopia. Methods Health facility-based cross-sectional study was conducted between March 2012 and April 2013 in Jimma area, Southwest Ethiopia. We included 79 re-treatment cases selected conveniently. Socio demographic and clinical data were collected using structured questionnaire. Sputum sample processing, mycobacterial culture, isolation and drug susceptibility testing (DST) were done at Mycobacteriology Research Centre (MRC) of Jimma University. All data were registered and entered in to SPSS version 20. Crude odds ratio (COR) and adjusted odds ratios (AOR) were calculated. P-values less than 0.05 were considered statistically significant. Results Seventy-nine re-treatment cases included in the study; 48 (60.8 %) were males. Forty- seven (59.5 %) study participants were from rural area with the mean age of 31.67 ± 10.02 SD. DST results were available for 70 MTBC isolates. Majority (58.6 % (41/70)) isolates were resistant to at least one of the four first line drugs. The prevalence of multidrug-resistant TB (MDR-TB) was 31.4 % (22/70). Place of residence (AOR = 3.44 (95 % CI: 1.12, 10.60), duration of illness (AOR = 3.00 (95 % CI: 1.17, 10.69) and frequency of prior TB therapy (AOR = 2.99, (95 % CI: 1.01, 8.86) were significant factors for any drug resistance. Moreover, history of treatment failure was found to be associated with MDR-TB (AOR = 3.43 (95 % CI: 1.14, 10.28). Conclusion The overall prevalence of MDR-TB among re-treatment cases around Jimma was high. The rate of MDR-TB was higher in patients with the history of anti-TB treatment failure. Timely identification and referral of patients with the history of treatment failure for culture and DST need to be strengthened.
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Affiliation(s)
- Kedir Abdella
- Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia. .,Mycobacteriology Research Centre, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia.
| | - Ketema Abdissa
- Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia.
| | - Wakjira Kebede
- Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia.
| | - Gemeda Abebe
- Department of Medical Laboratory Science and Pathology, College of Health sciences, Jimma University, Jimma, Ethiopia. .,Mycobacteriology Research Centre, Institute of Biotechnology Research, Jimma University, Jimma, Ethiopia.
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Wabe NT, Hussein J, Suleman S, Abdella K. In vitro antifungal susceptibility of Candida albicans isolates from oral cavities of patients infected with human immunodeficiency virus in Ethiopia. Retrovirology 2012. [PMCID: PMC3360346 DOI: 10.1186/1742-4690-9-s1-p44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Wabe N, Hussein J, Suleman S, Abdella K. In vitro antifungal susceptibility of Candida albicans isolates from oral cavities of patients infected with human immunodeficiency virus in Ethiopia. ACTA ACUST UNITED AC 2011. [DOI: 10.5455/jeim.260911.or.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abdella K, Bartolomeos K, Tsegaye F, Bhalla K, Abraham J. Estimates of the burden of injuries in Ethiopia derived from all existing data sources. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bhalla K, Abraham J, Harrison J, Bartolomeos K, Mtonga R, Abdella K. Using mortuary data for estimating urban injury mortality incidence in Africa. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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