Potential human pathogenic bacteria in five hot springs in Eritrea revealed by next generation sequencing

Human pathogens can survive and grow in hot springs. For water quality assessment, Escherichia coli or Enterococci are the main thermotolerant enteric bacteria commonly used to estimate the load of pathogenic bacteria in water. However, most of the environmental bacteria are unculturable thus culture methods may cause bias in detection of most pathogens. Illumina sequencing can provide a more comprehensive and accurate insight into environmental bacterial pathogens, which can be used to develop better risk assessment methods and promote public health awareness. In this study, high-throughput Illumina sequencing was used to identify bacterial pathogens from five hot springs; Maiwooi, Akwar, Garbanabra, Elegedi and Gelti, in Eritrea. Water samples were collected from the five hot springs. Total community DNA was extracted from samples using the phenol-chloroform method. The 16S rRNA gene variable region (V4—V7) of the extracted DNA was amplified and library construction done according to Illumina sequencing protocol. The sequence reads (length >200 bp) from Illumina sequencing libraries ranged from 22,091 sequences in the wet sediment sample from Garbanabra to 155,789 sequences in the mat sample from Elegedi. Taxonomy was assigned to each OTU using BLASTn against a curated database derived from GreenGenes, RDPII, SILVA SSU Reference 119 and NCBI. The proportion of potential pathogens from the water samples was highest in Maiwooi (17.8%), followed by Gelti (16.7%), Akwar (13.6%) and Garbanabra (10.9%). Although the numbers of DNA sequence reads from Illumina sequencing were very high for the Elegedi (104,328), corresponding proportion of potential pathogens very low (3.6%). Most of the potential pathogenic bacterial sequences identified were from Proteobacteria and Firmicutes. Legionella and Clostridium were the most common detected genera with different species. Most of the potential pathogens were detected from the water samples. However, sequences belonging to Clostridium were observed more abundantly from the mat samples. This study employed high-throughput sequencing technologies to determine the presence of pathogenic bacteria in the five hot springs in Eritrea.

Knowledge, attitude and practices: assessing maternal and child health care handbook intervention in Vietnam

BACKGROUND

Maternal and Child Health (MCH) Handbook, an integrated MCH home-based record, was piloted in four provinces of Vietnam (Dien Bien, Hoa Binh, Thanh Hoa and An Giang). The study is aimed at assessing the changes in pregnant women's behavior towards the frequencies of their antenatal care service utilizations and their subsequent breastfeeding practices up to six months of age, through the MCH Handbook intervention. This is because the levels of pregnant women's knowledge, attitude and practices (KAP) towards their antenatal care service utilizations and exclusive breastfeeding practices have been previously neither analyzed nor reported in relation to MCH home-based records in the country.

METHODS

To compare pre-intervention baseline in 2011, post-intervention data were collected in 2013. Structured interviews were conducted with randomly selected 810 mothers of children 6-18 months of age in the four provinces. A focus group discussion among mothers in each of four provinces was conducted.

RESULTS

There was no significant difference in pregnant women's knowledge about the need for ≥3 antenatal care visits between pre- and post-interventions. Yet, the proportion of pregnant women who made ≥3 antenatal care visits in post-intervention was significantly higher than in pre-intervention. Thus, MCH Handbook is likely to have contributed to practicing ≥3 antenatal care visits, by changing their attitude. The proportion of mothers who know the need for exclusive breastfeeding necessary during the initial six months significantly increased between pre- and post-interventions. The proportion of those practicing exclusive breastfeeding significantly increased between pre- and post-interventions, too. Thus, MCH Handbook is likely to have contributed to the increase in both knowledge about and practices of exclusive breastfeeding.

CONCLUSION

The results of study imply that MCH Handbook contributed to the increase in pregnant women's practices of ≥3 antenatal care visits and in their knowledge about and practice of exclusive breastfeeding. While there is room for improvement in the level of its data recording, the study confirmed that MCH Handbook plays a catalytic role in ensuring a continuum of maternal, newborn and child care. Note that this study is the first study that attempted to estimate pregnant women's behavioral changes through MCH Handbook intervention in Vietnam.