The prevalence of intestinal parasites, undernutrition and their associated risk factors among school-age children in Sekota Town, Northeast Ethiopia: A community-based cross-sectional study

Background and Aims

In developing countries, intestinal parasitic infections and malnutrition are among the most serious health issues affecting school-aged children. They have synergetic consequences. This study aimed to determine the prevalence of intestinal parasites, undernutrition, and their associated risk factors among school-age children.

Methods

A community-based cross-sectional study was conducted from April to June 2021 among school-age children in Sekota Town, Northeast Ethiopia. Households were selected using a systematic random sampling technique. Risk factor variables were collected using pretested questionnaires. Stool samples were collected from study participants and examined using a wet mount, formol-ether concentration, and modified acid-fast techniques. The height and weight of children were also measured using a meter and a standard calibrated balance, respectively. Data were analyzed using SPSS version 26.0 statistical software.

Results

The overall prevalence of intestinal parasites among school-age children was 44.3% (178/402). About seven species of intestinal parasites were identified. The predominant parasite identified was E. histolytica/dispar (11.2%), followed by H. nana (9.2%) and G. lamblia (6.7%). The well as a source of drinking water (adjusted odds ratio [AOR] = 7.93; 95% confidence interval [CI]: 4.38-14.36), habit of open-field defecation (AOR = 7.02; 95% CI: 13.05-12.06), and being undernourished (AOR = 5.67; 95% CI: 2.98-10.79) were independent predictors of intestinal parasitic infections. On the other hand, the overall prevalence of undernutrition was 46.3%. Undernutrition was significantly more likely in children with a dietary diversity score (DDS) of 3 (AOR = 3.73, 95% CI: 2.37-5.88), meal frequency of no more than three times per day (AOR = 2.00, 95% CI: 1.71-2.98), intestinal parasite infection (AOR = 5.25, 95% CI: 3.24-8.52), and no access to school-based feeding (AOR = 3.52, 95% CI: 2.17-7.96).

Conclusion

The prevalence of intestinal parasitic infections and undernutrition was high among school-age children in Sekota Town. The results imply the need for strengthening integrated strategies for the reduction of intestinal parasitic infections and undernutrition.

Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia

Background

Malaria is the leading vector-borne parasitic disease that is causing high morbidity and mortality worldwide. So far huge efforts to control and eliminate malaria are hindered by the occurrence of asymptomatic carriers that are a potential source of infection. Yet, there is a scarcity of data nationally and in the current study area as well. Therefore, this study was aimed to assess the prevalence of asymptomatic malaria in Northeast Ethiopia.

Methods

A community-based cross-sectional study was conducted in 2019 involving a total of 270 study participants recruited via purposive non-probability sampling technique. A structured questionnaire was used to collect data on sociodemographic characteristics, individual and household factors related to asymptomatic malaria. Data were entered in Epi Data 3.1 version and analyzed by using SPSS version 20, and p< 0.05 was considered statistically significant.

Results

The overall prevalence of asymptomatic malaria was 7.0%, with 3.0%, 5.2%, and 12.0%, respectively by Rapid diagnostic tests (RDT), Microscopy and Polymerase chain reaction (PCR). The majority of infections (73.7%) were identified from index households. Previous malaria history (AOR: 4.030, 95% CI: 1.021-15.903), living with index cases (AOR: 3.880, 95% CI: 1.275-11.806) and family size > 6 members (AOR: 4.820, 95% CI: 1.260-18.437) were significant predictors of asymptomatic malaria.

Conclusion

Reactive case detection had identified considerably higher asymptomatic malaria cases in the community. Therefore, active case investigation should be established in the community by tracking the symptomatic cases at the health facilities.

Prevalence of malaria and associated factors among symptomatic pregnant women attending antenatal care at three health centers in north-west Ethiopia

BACKGROUND

Malaria is the disease caused by Plasmodium species and primarily transmitted by the bite of female Anopheles mosquitoes. During pregnancy, malaria causes life threatening outcomes to the mother, the fetus and the new born. Even though, malaria symptomatic pregnant women highly attract mosquitoes and have higher potential of transmitting the disease in communities, most of the previous studies focused on pregnant women with asymptomatic Plasmodium infections. Therefore, the aim of this study was to assess the prevalence of malaria and associated factors among symptomatic pregnant women attending antenatal care at three health centers in northwest Ethiopia.

METHODS

A health facility based cross-sectional study was conducted from February to April, 2021. A total of 312 malaria symptomatic pregnant women were involved from three health centers and enrolled by convenient sampling technique. A questionnaire was used to collect socio demographic and clinical data through face to face interview. Capillary blood samples were collected and used to prepare thin and thick blood smears, which were then stained using 10% Giemsa and examined under light microscope. Logistic regression was used to assess factors associated with malaria. Adjusted odds ratio with 95% confidence interval was calculated and P-value < 0.05 was considered statistically significant.

RESULTS

The prevalence of malaria among symptomatic pregnant women was 20.8% (65/312) of which 12.2% (38/312), 4.8% (15/312) and 3.8% (12/312) were P. falciparum, P. vivax and mixed infections, respectively. Being illiterate (p< 0.001), first trimester (p = 0.036), primigravidae (p<0.001), living far from health center (p<0.001), not sleeping under long lasting insecticide treated nets (p<0.001) and living near irrigation areas (p = 0.006) were significantly associated with prevalence of malaria in malaria symptomatic pregnant women.

CONCLUSIONS

Even though prevalence of malaria is decreasing in the country because of scale-up of intervention and prevention measures, this study showed that, malaria is still the major public health problem among pregnant women. Being illiterate, first trimester, primigravidae, living far from health centers, not sleeping under long lasting insecticide treated nets and living near irrigation areas were factors that increased the prevalence of malaria in malaria symptomatic pregnant women. Therefore, special attention should be given to pregnant women prone to these factors.

Prevalence of Opportunistic Intestinal Parasitic Infections Among HIV/AIDS Patients Before and After Commencement of Antiretroviral Treatment at Felege Hiwot Referral Hospital: A Follow-up Study

Background

Coccidian parasites are opportunistic intestinal parasites that cause diarrhea in immunocompromised individuals. Although the impacts of coccidian infection are significant among HIV/AIDS infected cases, proper diagnosis and management of coccidian infection is limited in sub-Saharan Africa including Ethiopia.

Objective

The aim of this study was to determine the prevalence of coccidian parasitic infections among HIV/AIDS cases before and after commencement of antiretroviral treatment.

Methods

An institution-based longitudinal study was conducted among 304 randomly selected HIV/AIDS cases from February to July 2018 before and after commencement of antiretroviral therapy. A structured questionnaire was used to collect sociodemographic and associated factors data. Stool and blood samples were collected before and three months after treatment. Coccidian detection and CD4⁺ count were conducted via modified acid fast stain technique and fluorescence-activated cell scanning, respectively. Data were entered and analyzed using SPSS version 20. Descriptive statistics were used to compute coccidian prevalence. Logistic regression was used to compute possible association between associated factors and coccidian parasitic infection. Variables with P<0.05 were considered to be statistically significant.

Results

Among 304 HIV/AIDS cases, prevalence of coccidian parasitic infection before and after antiretroviral treatment was 23.4% and 8.9%, respectively. Prevalence of Cryptosporidium spp. (19.7%) and Isospora belli (4.3%) before antiretroviral treatment were higher than Cryptosporidium spp. (7.9%) and Isospora belli (1.0%) after treatment. Drinking unprotected water (AOR: 7.41; 95%CI: 1.64–33.45), poor knowledge of HIV/AIDS and coccidian parasite (AOR: 4.19; 95%CI: 1.69–10.40), and CD4⁺ count below 200 cells/mm³ (AOR: 62.49; 95%CI: 25.32–154.21) were significantly associated with coccidian infection.

Conclusion

Prevalence of coccidian parasites among HIV/AIDS cases decreases after antiretroviral treatment. Drinking unsafe water, limited knowledge of HIV/AIDS and coccidian parasite and low CD4⁺ cell count are factors associated with coccidian infection. Therefore, proper detection and treatment of coccidian parasites among HIV/AIDS cases should be prioritized.

Species Composition, Parous Rate, and Infection Rate of Anopheles Mosquitoes (Diptera: Culicidae) in Bahir Dar City Administration, Northwest Ethiopia

Anopheles mosquitoes are the main vectors of malaria. There is little information on the current entomological aspects of Anopheles mosquitoes in Amhara region of northwestern Ethiopia. Therefore, the aim of this study was to assess the prevailing species composition, parous rate, and infection rate of Anopheles mosquitoes in the Bahir Dar city administration. A community-based cross-sectional study was conducted from January through July 2020. For this, six Centers for Disease Control and Prevention light traps (three traps indoor and three traps outdoor) were used to collect adult female Anopheles mosquitoes. The species were morphologically identified, and the parous and infection rates were determined via dissection of ovaries and salivary gland, respectively. A total of 378 adult female Anopheles mosquitoes comprised of three species (Anopheles d'thali, Anopheles rhodesiensis, and Anopheles gambiae complex) were collected and identified at the study sites. Anopheles rhodesiensis was the predominant species accounting for 90% of all collections at the Zenzelima site, followed by An. gambiae complex (6.5%). In contrast, An. gambiae complex was the predominant species at the Tis Abay site, comprising 94% of captures. The overall parous and infection rates were 35 (62.5%) and 1 (2.9%), respectively.

Parasitic Contamination of Fruits and Vegetables Collected from Local Markets of Bahir Dar City, Northwest Ethiopia

Background

Fruits and vegetables, which are consumed raw, act as potential sources for the spread of various parasitic diseases. The rate of contamination and species of contaminant parasites varies based on climatic, ecological, and human factors. Therefore, local data about the contamination status and predisposing factors augments efforts for successful control of parasitic diseases.

Methods

A cross-sectional study was conducted on fruits and vegetables collected from local markets of Bahir Dar city from February to May 2019. A total of 384 samples were purchased from three randomly selected markets. Data on sociodemographic characteristics of vendors and factors associated with contamination of fruits and vegetables were collected using a structured questionnaire. About 200 g of fruit and vegetable samples were processed for parasites using direct wet mount and modified Zeihl–Neelson staining techniques following standard protocols. All data were analyzed using SPSS version 23.

Results

Among a total of 384 fruit and vegetable samples purchased from 112 vendors, 150 (39.1%) were contaminated with at least one species of parasite. Lettuce (56.4%) and mango (16.7%) were the most and the least commonly contaminated items respectively. Larva of Strongyloides species (13.5%) was the most frequently detected parasite followed by cysts of Entamoeba histolytica/E. dispar (12.8%). Contamination was more common in vegetables than fruits (AOR=2.968, p<0.001). Fruits and vegetables purchased from vendors with untrimmed fingernails (AOR=1.966, p=0.006), directly delivered from farmers (AOR=1.883, p=0.040), displayed in bucket with water (AOR=2.676, p=0.017) and those displayed without washing (AOR=5.511, p<0.001) were significantly associated with parasitic contamination.

Conclusion

The level of parasitic contamination of fruits and vegetables in Bahir Dar city is of public health importance. Hence, the public health sector should create public awareness in order to reduce parasitic transmission via fruits and vegetables.

Magnitude of Intestinal Parasitosis and Associated Factors in Rural School Children, Northwest Ethiopia

Background

Intestinal parasitoses are among the most commonly encountered infections among school children in poor regions of the world. Up to 600 million school children are living in areas where there is high transmission of parasitic worms. Intestinal parasitic infection has been found to have a great effect on nutritional and cognitive status, school absenteeism and dropouts among school age children. This study aimed at determining the prevalence of intestinal parasites infections and associated factors among children in a rural primary school, Northwest Ethiopia.

Methods

A cross-sectional study was conducted in May 2016 among Gob Gob Primary School children. The study participants were provided with labeled stool cups to give stool specimen. The stool samples were processed via direct wet mount and formal-ether concentration techniques. A structured questionnaire was used to collect demographic data and data on factors associated with intestinal parasitic infection through face-to-face interview.

Results

Out of the 273 school children, 84(30.8%) were infected with at least one parasite species. Higher proportion of intestinal parasitic infection was recorded for boys (38.9%), the age group 6-10 years (38.9%), children with untrimmed finger nails (36.4%) and among those whose drinking water was from a stream (56.1%). The predominant species identified were A. lumburicoides 28(33.3%), H. nana 12(14%), E. histolytica/dispar 11(13%), G. lamblia 9(11%), hookworms 7(8.3%), Taenia spp 6(7%), E. vermicularis 6(7%), T. trichuria 4(4.8%) and S. stericoralis 1(1.2%).

Conclusion

This study showed that intestinal parasites were prevalent among the school children in focus. Ascaris lumbricoides was the predominant species.

Magnitude of Cryptococcal Antigenemia among HIV Infected Patients at a Referral Hospital, Northwest Ethiopia

Background

Cryptococcosis is one of the common opportunistic fungal infections among HIV infected patients living in Sub-Saharan Africa, including Ethiopia. The magnitude of the disease at Felege Hiwot Referral Hospital (FHRH) in particular and in Ethiopia at large is not well explored.

Methods

A retrospective document review and analysis was done on records of 137 HIV infected patients who visited FHRH ART clinic from 1 Sep to 30 Dec 2016 and had registered data on their sex, age, CD4 count and cryptococcal antigen screening result. The cryptoccocal antigen (CrAg) detection was done by the IMMY CrAg^® LFA (Cryptococcal Antigen Lateral Flow Assay) kit from patient serum as per the manufacturer's instruction. All data were entered, cleared, and analyzed using SPSS v20. Descriptive data analysis and cross tabulation were done to assess factors associated with cryptococcal antigenemia. Statistical significance was set at p-value less than or equal to 0.05.

Results

More than half of the participants, 54.7% (75/137), included in the study were females. The median age of the participants was 32.0 years (ranged: 8–52 years). The mean CD4 count was 51.8 with SD of 26.3 (range 3–98). All the patients were HIV stage IV. The proportion of positive cryptococal antigen from serum test was at 11.7% (95% CI: 7.3–18.1%). The IMMY CrAg^® LFA result was found statically associated with patient sex (p= 0.045). However, it was not associated with patient age group and the CD4 count (P>0.05)

Conclusions

This study provided baseline data on the magnitude of cryptococcal antigenemia among HIV positive patients that is not touched before in the studied area. The results of the study showed that this opportunistic fungal infection is an important health concern among HIV patients. Further studies with sound design employing adequate sample size should be considered.

Magnitude and associated factors of postpartum morbidity in public health institutions of Debre Markos town, North West Ethiopia

Background

Postpartum maternal morbidity is maternal illness that occurs after one hour of expulsion of placenta up to six weeks of childbirth. Though the true burden of this problem is not well known estimates of WHO, UNICEF and UNFPA showed that 1.4 million women experience acute obstetric morbidity annually. Knowledge of magnitude and predicting factors postpartum morbidity is central to understand the extent of the problem and will help as a cornerstone in designing and implementing better preventive strategies.

Objectives

To assess the magnitude and factors associated with postpartum morbidity in public health institutions in Debre Markos town.

Method

Institutional based cross sectional study was conducted in Debre Markos town public health institutions by reviewing delivery charts, delivery records and reporting log books. Total deliveries in each health institution in the previous year were identified and number of records to be included from each institution was determined by probability proportion to size. Systematic sampling technique was employed to select 308 charts for review. Data was collected by trained midwifes using structured checklist; entered by epi info and analyzed using SPSS 20. To present findings descriptive statistics using frequencies, charts and figures were used accordingly. Finally binary and multiple logistic regressions were performed to identify predicting factors.

Results

The magnitude of postpartum morbidity was found to be 101(32.8%). Divorced/widowed women [AOR = 10.920, 95% CI: (2.168, 54.998)], women who didn’t have ANC follow up [AOR = 3.710, 95% CI: (1.749, 7.870)], abnormal labour [AOR =3.496, 95% CI: (1.69, 7.22)], women delivered by doctor [AOR =0.111, 95% CI: (0.027, 0.454)] and women who were not attended postpartum visit [AOR =0.088, 95% CI: (0.040, 0.194)] were the factors associated with postpartum maternal morbidity.

Conclusion

Maternal morbidity in Debre Markos health institution was found to be major maternal health issue. Being divorced/widowed, absence of ANC visit, intrapartum abnormalities, delivery attended by skilled professionals and no post-partum visit were important predictors of maternal postpartum morbidity.

The Prevalence of Malaria in Tselemti Wereda, North Ethiopia: A Retrospective Study

BACKGROUND

A significant segment of the world's population is at risk of contracting malaria infection at any one time. In Ethiopia, sustained control efforts have been made in the past decade to fight malaria. Yet, it remains as the major cause of morbidity, mortality and socioeconomic problems in the country. The intensified control of malaria can further be augmented by analyzing health facility based malaria data. Hence, the aim of this study was to determine the magnitude of malaria infection in Northwest Ethiopia.

METHODS

A retrospective record review was conducted in Northwest Ethiopia from February-April 2016. All blood film results reported between January 2013 and December 2015 in the seven health centers were extracted and analyzed.

RESULTS

A total of 41,773 patients with chief malaria complaint were screened for malaria in the three years period. The overall prevalence of microscopically confirmed malaria was 28.1%. Males (29.5%) were more affected by malaria than females (26.5%). Malaria was also higher in the age group >15 years (32.6%) followed by 5-15 years (29.3%) and under-five children (20.5%). Plasmodium falciparum, Plasmodium vivax and mixed infections accounted for 58.2%, 35.5% and 6.3%, respectively. The highest prevalence of confirmed malaria cases was observed during spring (35.6%) and summer (25.1%). Higher prevalence of slide positive malaria was recorded in Dima (46.1%), Cherecher (45.3%) and Fyel wuha (35.3%) health centers.

CONCLUSION

Malaria specific outpatient cases were high in the study area. Both plasmodia species were of public health significance in the area with predominance of Plasmodium falciparum.

Incidence of Plasmodium infections and determinant factors among febrile children in a district of Northwest Ethiopia; a cross-sectional study

Background

According to the Ethiopian national malaria indicator survey of 2015, the highest burden of Plasmodia infection resided among the school-age children. Even though several studies revealed various determinant factors of childhood malaria, consistent findings are not reported across the nation and elsewhere. This in turn creates obstacles in implementing exactprevention and control measures in the study area in particular and the country at large.

Objectives

The aim of this study is to determine the incidence of Plasmodium and determinant factors among febrile children in Northwest Ethiopia.

Methods

This cross-sectional study was conducted from April–August 2016. Blood samples were collected from febrile children selected by systematic random sampling. Thin and thick blood films were prepared and stained with Giemsa. Statistical analysis was done via SPSS version 20 statistical software and data were summarized with percentages and frequencies. The bi-variate and multi-variate logistic regressions were used to measure strength of association between Plasmodium infection and determinant factors, and to rule out confounders, respectively.

Result

Among a total of 333 febrile children, 146 (43.8%) were positive for the Plasmodia. The prevalence of plasmodium infection was 47%, 50%, and 40%, among the age groups of 6–8, 9–10 and 11–14 years, respectively. Prevalence of plasmodium among male and female children was 44.2% and 43.5%, respectively. Shorter distance from stagnant water (AOR (adjusted odds ratio) =43, 95% CI (confidence interval):2.8–680.7; P < 0.01), family size (AOR =14.7, 95% CI:(1.4–151.2; P = 0.02), outdoor sleeping (AOR =36.6, 95% CI:2.4–554.2; P < 0.01, irregular bed net use (AOR =21.1, 95% CI:2.9–154.7; P < 0.01), and late bed time (AOR =31.9, 95% CI:2.8–371.3; P < 0.01) showed statistically significant association with plasmodium infection.

Conclusion

The incidence of Plasmodium infection is high among febrile children in the study area. Shorter distance from stagnant water, larger family size, outdoor sleeping, irregular bed net use, and late night sleeping are the major determinant factors for the high incidence of malaria. Therefore, community mobilization and health education should focus on the specific determinant factors of plasmodium infection to alleviate incidence of malaria among the school children.

Five Years Malaria Trend Analysis in Woreta Health Center, Northwest Ethiopia

Background

An estimated 68% of the Ethiopian population, living in 75% of the landmass, is at risk of contracting malaria at any time making it the leading public health problem. The temporal analysis of malaria data could be important to evaluate the performance of malaria prevention programmes. Thus, the aim of this study was to determine the trend of malaria at Woreta Health Center (WHC) over a period of five years.

Methods

We analyzed the records of 8,057 presumptive malaria patients registered in 2012 to 2016. The following patient data were retrieved from laboratory registration logbook for analysis: sex, age, residence, blood film (BF) microscopy result, type of malaria parasite identified, year and month when the patients visited WHC. Logistic regression was employed to assess the association between potential associated factors and positive BF result; p < 0.05 was considered significant.

Results

Among the total presumptive individuals, 4447(55.2%) were females. The prevalence of malaria in each year ranged from 4.1% to 6.7%. The overall prevalence of malaria was 5.4% (95%CI: 4.9%-5.9%). The two most important species of malaria parasite identified were P. falciparum at 233(53.7%) and P. vivax at 184(42.4%). Relatively higher proportions of cases were documented in the months of November, December and June (11.1%, 8.1% and 7.2%, respectively). Patients who visited the health center in the month of December were >4 times more likely to be infected as compared with those who came to the health center in September [AOR: 4.2, 95%CI (2.374-7.560)]. Females were 1.3 times more likely to be infected than males, [AOR: 1.3, 95%CI (1.101-1.638)]. Similarly, patients in the age group above 15 were 1.9 times more likely to be infected than individuals < 5, [AOR: 1.9 95%CI (1.498-2.455), p value 0.000].

Conclusion

In the studied area, malaria remains a major public health challenge. Hence, interventions to decrease the impact of the disease have to be evaluated and strengthened.

Efficacy of single dose albendazole and praziquantel drugs among helminth-infected school children at Rural Bahir Dar, northwest Ethiopia

The resistance of anthelminthic drugs makes helminth control difficult. The aim of our study was to assess the efficacy of single dose albendazole and praziquantel drugs among helminth-infected children. A cross-sectional study was conducted from April to June, 2017. Stool examination was done by the Formol-Ether concentration technique. Students infected with geohelminths and s chistosoma mansoni were treated with a single dose of albendazole and praziquantel, respectively. Post-treatment stool examination was performed after two weeks. The magnitude of parasite infection, percentage of egg count reduction and cure rate following treatment were calculated using descriptive statistics. A total of 409 Sebatamet primary school students were included. The total prevalence of intestinal parasitosis was 58%. The cure rate of albendazole against hookworm was only 76.8%. Praziquantel had a 91.4% cure rate against Schistosoma mansoni. Therefore, periodic evaluation of the efficacy of anthelminthic drugs is required.

Multivariate analysis of factors associated with Schistosoma mansoni and hookworm infection among primary school children in rural Bahir Dar, Northwest Ethiopia

BACKGROUND

Soil-transmitted helminths and Schistosoma mansoni infections are the major causes of morbidity and mortality in Sub-Saharan countries. The highest burden of the disease resides in school-age children. Poor water sanitation and hygiene are believed to be the major contributing factors for the high prevalence. Therefore, the goal of this study was to determine the prevalence of intestinal parasite infections in rural Bahir Dar, Northwest Ethiopia.

METHODS

A cross-sectional study was conducted from April 2017-June 2017 among 409 randomly selected primary school children. A structured questionnaire was used to obtain socio-demographic information and determinant factors through interviewing the students. Stool examination was done by Ritchie's concentration method. The data were entered and analyzed using SPSS version 22. Prevalence of helminthic infections was calculated using descriptive statistics. The association between helminthic infection and determinant factors was determined by Bavarian regression. The confounding effect was checked by multivariate regression at 95% confidence interval. Any association was significant when the p-value was < 0.05.

RESULT

The overall prevalence of intestinal parasite infection was 47.2%.(193/409).. The prevalence of Hookworm species and Schistosoma mansoni was 31.1 and 8.0%, respectively. Co-infection of Hookworm species with Schistosoma mansoni was 5.1% (21/409). The highest prevalence of Schistosoma mansoni was recorded for boys (21%), older children (21.4%) and rural children (17.6%) (P < 0.05). Schistosoma mansoni infection was also higher among children whose household drinking water was sourced from streams/rivers (P < 0.05). The multivariate analysis showed lower odds of Schistosoma mansoni infection for those with no history of bathing (AOR = 3.7, 95% CI: 1.1-12.2; P = 0.034), washing clothes/utensils (AOR = 3.4; 95% CI: 1.2-9.7; P = 0.022), swimming (AOR = 2.8, 95% CI: 1.2-6.9; P = 0.023), and irrigation (AOR = 2.8, 95% CI: 1.3-6.0; P = 0.01). Significantly, higher odds of Hookworm infection was recorded for older children (AOR = 2.3, 95% CI: 1.08-4.89; P = 0.029), boys (AOR = 1.9, 95% CI: 1.12-3.24; P = 0.018), and rural children (AOR = 1.8, 95% CI: 1.04-3.0; P = 0.037). Regular shoe wearing (AOR = 0.29, 95% CI: 0.16-0.50; P = 0.00) is protective for hookworm infection. Higher odds of hookworm infection was also recorded for schoolchildren who had the habit of eating raw vegetables (AOR = 1.2 95% CI: 1.1-1.7 P = 0.011).

CONCLUSION

Hookworm infection and schistosomiasis are prevalent in the school children in rural Bahir Dar in Northwest Ethiopia. Various activities and behaviors of the children were strongly associated with helminthic infection. Hence health education should be delivered regularly to minimize/avoid the risky behaviors and water-based activities. Deworming programs should also be implemented on a regular basis.

Pharyngeal colonization and drug resistance profiles of Morraxella catarrrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae among HIV infected children attending ART Clinic of Felegehiwot Referral Hospital, Ethiopia

Background

Asymptomatic pharyngeal colonization by potential bacteria is the primary reservoir for bacterial species within a population and is considered a prerequisite for development of major childhood diseases such as sinusitis, otitis media, pneumonia, bacteremia, and meningitis. However, there is dearth of data on the colonization and drug resistance pattern of the main bacterial pathogens in the pharynx of HIV infected children in Ethiopia. Therefore, this study determined the pharyngeal colonization and drug resistance profile of bacterial pathogens in HIV infected children attending ART clinic of Felegehiwot Referral Hospital (FHRH), Amhara Region, Ethiopia.

Methods

A hospital based cross-sectional study was conducted from May 2016 to June 2017 at the ART clinic of FHRH. A total of 300 HIV infected children were enrolled in the study. Data on socio-demographic characteristics of the study participants were collected with face-to-face interview and patient—card review using structured questionnaire. Bacterial species were identified using standard bacteriological techniques. Drug susceptibility testing was performed using disk diffusion technique. Chi-square test was done to determine associations among variables.

Results

The median age of the participants was 11 years. Overall, 153 (51%) of children were colonized by respiratory bacteria in their pharynx. Colonization rate was higher in children from mothers who had attained college and above levels of education than others (P = 0.04). It was also higher in children without the sign of malnutrition than others (P = 0.004). The colonization rate of S.aureus, M.catarrhalis, S.pneumoniae and H.influenzae were 88 (29%), 37 (12.3%), 31 (10.3%) and 6 (2%), respectively. S.aureus—M.catarrhalis concurrent colonization was found in 14 (4.7%) of children. Age (P = 0.03), schooling (P = 0.045) and history of running nose (P = 0.043) were significantly associated with S.aureus colonization. Living in urban setting (P = 0.042) and children from mothers with college and above levels of education (P = 0.002) were significantly associated with M.catarrhalis colonization. Majority of the isolates were resistant to penicillin (68.5%) and cotrimoxazole (52.5%).S.aureus isolates were resistant to penicillin (84.1%) and cotrimoxazole (51.1%).M.catarrhalis isolates were resistant to penicillin (94.6%), erythromycin (86.5%)and cotrimoxazole (78.4%). Overall, 99 (59.3%) of the isolates were multi-drug (MDR) resistant. The overall MDR rates among S.aureus, M.catarrhalis and S.pneumoniae isolates were 65.9%, 78.4% and 22.6%, respectively.

Conclusions

Pharyngeal colonization of respiratory bacteria in HIV infected children is a major public health problem. Single and multiple antibiotic resistant is alarmingly high among respiratory colonizers. Therefore, regular screening of HIV infected children for culture and antimicrobial susceptibility testing is recommended to prevent the development of severe opportunistic infections.

Under diagnosis of intestinal schistosomiasis in a referral hospital, North Ethiopia

Objective

The present cross-sectional study was aimed at determining the magnitude of under diagnosis of intestinal schistosomiasis among patients requested for routine ova/parasite examination at Ayder referral hospital.

Results

A total of 280 stool samples were collected and only 5% of the patients were positive for ova of Schistosoma mansoni in the routine direct wet mount microscopy. On the other hand, 12.5% of the patients were positive for ova Schistosoma mansoni when the stool samples were processed by either Kato Kat or formol ether concentration techniques. Moderate test agreement (κ = 0.48) was recorded for wet mount. Formol-ether concentration (κ = 0.89) and Kato-Katz (κ = 0.92) showed excellent agreements with the ‘Gold’ standard. Direct wet mount technique exhibited the poorest sensitivity (35%) of detection of ova of Schistosoma mansoni. Hence, the Kato-Katz technique should be implemented in parallel with the direct wet mount microscopy for Schistosoma mansoni presumptive patients.

Foodborne intestinal protozoan infection and associated factors among patients with watery diarrhea in Northern Ethiopia; a cross-sectional study

BACKGROUND

Intestinal protozoa are parasites transmitted by consumption of contaminated water and food and mainly affect children and elder people and cause considerable health problems. They are the leading causes of outpatient morbidity due to diarrhea in the developing countries. So, assessing water and food source of diarrheal patients and identifying the main associated factors for transmission of protozoan parasitic infections help for effective control measures of protozoan infections. Hence, the current study was aimed at determining the prevalence of foodborne intestinal protozoa infections and associated factors among diarrheic patients in North Ethiopia.

METHODS

A health facility based cross-sectional study was conducted among 223 patients with watery diarrhea in four selected government health facilities in North Ethiopia from November 2016-June 2017. A structured questionnaire was used to collect data on socio-demography of study participants and factors associated with foodborne protozoa infections. The diarrheic stool samples were collected, transported, and processed using direct wet mount, formal-ether concentration and modified ZiehlNeelson staining methods. The data were analyzed using SPSS version 21 and descriptive statistics, bi-variate, and multivariate logistic regressions were computed. P-value < 0.05 at 95% confidence interval was considered statistically significant.

RESULTS

The overall prevalence of foodborne protozoa infection was 101 (45.3%). The predominant protozoa species identified was Entamoeba histolytica/dispar 55 (24.7%), followed by Giardia intestinalis 25 (11.2%) and Cryptosporidium species 5 (2.2%). The highest proportion of protozoa infection was observed among males (23.3%) and the age group 15-24 years (13.5%). Statistically significant associations were observed between foodborne protozoan infection and not using any type of recipe to decontaminate salads and fruits (AOR = 2.64, 95 CI: 1.34-5.19, P = 0.005) and using vinegar as a decontaminant (AOR = 2.83, 95 CI: 1.24-6.48, P = 0.014). Eating out (meals at a restaurant) on the other hand was found to be protective for foodborne protozoan infection (AOR = 0.43, 95 CI: 0.23-0.78, P = 0.006).

CONCLUSION

Our study revealed that foodborne protozoa infections are of public health significance in the study area. Vinegar, which is frequently used as a recipe for decontaminating salads and fruits, is inversely related to foodborne protozoa parasite infection .

Time-frequency analysis of SEMG with special consideration to the interelectrode spacing

The surface electromyogram (SEMG) is a complex, nonstationary signal. The spectrum of the SEMG is dependent on the force of contraction being generated and other factors like muscle fatigue and interelectrode distance (IED). The spectrum of the signal is time variant. This paper reports the experimental research conducted to study the influence of force of muscle contraction and IED on the SEMG signal using time-frequency (T-F) analysis. Two T-F techniques have been used: Wigner-Ville distribution (WVD) and Choi-Williams distribution (CWD). The experiment was conducted with the help of ten healthy volunteers (five males and five females) who performed isometric elbow flexions of the active right arm at 20%, 50%, and 80% of their maximal voluntary contraction. The SEMG signal was recorded using surface electrodes placed at a distance of 18 and 36 mm over biceps brachii muscle. The results indicate that the two distributions were spread out across the frequency range at smaller IED. Further, regardless of the spacing, both distributions displayed increased spectral compression with time at higher contraction level.

Two bioactive pterocarpans from Erythrina burana

Bioactivity-directed fractionation of the CHCl3 extract of the bark of Erythrina burana afforded phaseollidin [1] and cristacarpin [2]. Both 1 and 2 exhibited moderate but selective activity towards DNA repair-deficient yeast mutants, whereas only 1 was found to be cytotoxic. 13C-nmr spectra of both compounds were assigned.