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Background. Fetal bowel could pass meconium, a green viscous fluid, before or during labour and most intrauterine passage of meconium is associated with several fetomaternal factors that lead to increased risk of perinatal morbidity and mortality. Given that there is a paucity of data, this study was conducted to assess the proportion and associated factors of meconium-stained amniotic fluid (MSAF) in women who came for labour and delivery service in a tertiary hospital. Methods. A cross-sectional study was conducted from 1 June to 31 August 2018 among 606 labouring mothers at Felege Hiwot Referral Hospital, northwest Ethiopia. Study participants were selected using a systematic random sampling technique. Data were collected using an interviewer-administered pretested questionnaire and data checklist. Factors associated with MSAF were explored using multivariable logistic regression analysis. Results. MSAF occurred in 24.6% (149/606) of pregnancies. Nonreassuring fetal heart rate patterns (Adjusted Odds Ratio [AOR]: 21.9, 95% Confidence interval [95% CI]: 10.96–43.83), postterm pregnancy (AOR: 4.54, 95% CI: 2.24–9.20), duration of labour more than 15 hours (AOR: 2.83, 95% CI: 1.76–4.53), pregnancy-induced hypertension (AOR: 2.43, 95% CI: 1.45–4.05), oligohydramnios (AOR: 2.53, 95% CI: 1.25–5.12), interpregnancy interval less than 2 years (AOR: 2.24, 95% CI: 1.12–4.51), and monthly family income less than 5000 Ethiopian Birr (185 USD) (AOR: 2.03, 95% CI: 1.18–3.51) were significantly associated with MSAF. Conclusions. In this study, the proportion of MSAF was at 24.6% which was higher than a previous report in Ethiopia. Nonreassuring fetal heart rate pattern, postterm pregnancy, duration of labour more than 15 hours, pregnancy-induced hypertension, oligohydramnios, interpregnancy interval less than 2 years, and monthly family income less than 5000 Ethiopian Birr were factors associated with an increased risk for MSAF. Therefore, interventions aimed at detecting MSAF early should consider these factors.

Background. Africa still bears the largest burden of malaria as the majority of infections in the continent are caused by P. falciparum. Artemether-lumefantrine (AL, Coartem®) is the most widely used artemisinin-based combination therapy (ACT), for treating uncomplicated falciparum malaria globally. However, the development of resistance to antimalarial drugs is a major challenge for malaria control. In this review, the efficacy of AL for the treatment of uncomplicated falciparum malaria in Africa was evaluated. Methods. Articles published between January 2015 and July 2019 were systematically searched using comprehensive search strings from PubMed/Medline, SCOPUS, and grey literature from Google Scholar. Interventional studies that followed patients for at least 28 days were included. Two reviewers independently assessed study eligibility, extracted data, and assessed risk of bias. All the included articles were measured to be good quality. While computing the efficacy of AL, polymerase chain reaction (PCR)–corrected cure rate (adequate clinical and parasitological response, ACPR) at day 28 was considered as the main endpoint. Meta-analysis was computed using STATA v 15 to calculate the pooled ACPR. Results. In this review, 39 articles that reported the treatment outcome of 8,320 patients were included. After 28 days of follow-up, the pooled PCR uncorrected and corrected APCR was at 87% (95% CI: 85-90%) and 97.0% (95% CI: 96-98%), respectively. Moreover, the proportion of early treatment failure (ETF) was almost 0%, while most of the included articles reported

Objective Gonorrhea is the second most common sexually transmitted bacterial infection (STI) next to Chlamydia. Untreated cases could results in major complications like pelvic inflammatory disease (PID), ectopic pregnancy, infertility, miscarriage, fetal death and congenital infections. Gonorrhea has been treated with antibiotics for more than eight decades. However, the emergence and spread of antimicrobial resistance (AMR) in gonococcus seriously compromises the management of the disease. The aim of this review was to describe the current developments in the field of azithromycin resistant gonococci. Methods Literatures published in English in the last 10 years were retrieved from PubMed, SCOPUS, Google scholar, Cochrane library and the Google databases using relevant searching terms. Results Gonococcus is capable of using a number of strategies to confer resistance as the bacterium has an extraordinary capacity to alter its genome. So far the accumulated data on the field showed that the world is heading towards a pandemic of extensively drug-resistant (XDR) gonococcus which is now seems to be evolving into a true “superbug”. Hence, in the near future gonorrhea may become untreatable on the international basis unless new drugs become available. An antibiotic resistance in gonococcus has been noted beginning in 1940s against sulfonamides. Since then, resistance has rapidly emerged to penicillins, tetracyclines, macrolides, fluoroquinolones, and cephalosporins. Currently, in most nations, the injectable extended-spectrum cephalosporin (ESC), i.e. ceftriaxone based therapy is the only remaining option for gonorrhea. Based on the WHO and the US-CDC recommendations, countries are increasingly using a combination of cephalosporin and azithromycin for the treatment of gonorrhoea. Azithromycin revolutionized gonoccocal therapy as it shortened treatment time by more than half from 7 to 14 days and improved patient compliance due to high tissue levels and long half-life. However, constantly emerging reports from different parts of the globe showed that N. gonorrhoeae is developing significant level of resistance against azithromycin, and so far more than 33% level of resistance was reported. Two strategies have been commonly implicated in gonococcal resistance against azithromycin: over expression of an efflux pump (due to mutations at mtrR coding region) and decreased antimicrobial affinity (due to mutations in genes encoding the 23S ribosomal subunit). Conclusions With no alternative antimicrobial treatment options for gonorrhoea and only a few new drugs in the development pipeline, it is necessary to monitor drug resistance and optimize treatment regimens regularly. Moreover, investigations for novel drugs should be wired.

Background Cryptococcosis is an opportunistic fungal infection that primarily affects people with advanced HIV/AIDS and is an important cause of morbidity and mortality around the globe. By far the most common presentation of the disease is cryptococcal meningitis (CM), which leads to an estimated 15–20% of all HIV related deaths worldwide, 75% of which are in sub-Saharan Africa. However, to the best of our knowledge there is quite limited reviewed data on the epidemiology of cryptococcal antigenemia in a large HIV-infected population in resource limited settings. Methods Articles published in English irrespective of the time of publication were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. In addition, Google Scholar and Google databases were searched manually for grey literature. Two reviewers independently assessed study eligibility, extracted data, and assessed risk of bias. The pooled prevalence of cryptococcal antigenemia was determined with 95% confidence interval (CI). Results Among 2941 potential citations, we have included 22 studies with a total of 8338 HIV positive individuals. The studies were reported in ten different countries during the year (2007–2018). Most of the articles reported the mean CD4 count of the participants below 100 cells/μl. The pooled prevalence of cryptococcal antigenemia at different CD4 count and ART status was at 8% (95%CI: 6–10%) (ranged between 1.7 and 33%). Body mass index (BMI) 2, CD4 count Conclusions Implementing a targeted screening of HIV patients with low BMI, CD4 count

Livestock production in Ethiopia contributes about 16.5% of the national Gross Domestic Product (GDP), 35.6% of the agricultural GDP, 15% of export earnings, and 30% of agricultural employment. The performance of livestock product marketing was poor in the last decade, despite some improvement in recent years, especially in terms of aggressive policy and strategy on export of livestock and livestock products, indicating that the sector is still underexploited. There is need to promote the market-oriented production of milk export. Knowing the common challenges and opportunities are very much important in designing smart livestock and livestock product marketing systems in the country. The common milk processing products market constraints in Ethiopia include lack of clear milk marketing system, factors of culture and religion, inaccessibility of market and lack of transport, seasonal based demand, lack of effective extension service to use newer technologies and practices, lack of market information, lack of holistic intervention and localized markets. Despite these challenges, there are some golden opportunities that increase the milk demand and to some extent increase milk consumption trend. Hence, the need to review this work was to access literatures available regarding milk processing, status, challenges and opportunities in Ethiopia.

BackgroundGenital infection with certain types of Human papillomavirus (HPV) is a major cause of cervical cancer globally. For early detection of premalignant dysplasia, evidences are coming out on the usefulness of HPV E6/E7 mRNA test as a potential tool compared with cytology and HPV DNA testing. Taking into account shortage of compiled data on this field, the aim of this systematic review was to describe the latest diagnostic performance of HPV E6/E7 mRNA testing to detect high grade cervical lesions (CIN2+) where by histology was taken as a gold standard.MethodsArticles published in English were systematically searched using key words from PubMed/Medline and SCOPUS. In addition, Google Scholar and the Google database were searched manually for grey literature. Two reviewers independently assessed study eligibility, risk of bias and extracted the data. We performed a descriptive presentation of the performance of E6/E7 mRNA test (in terms of sensitivity, specificity, negative and positive predictive values) for the detection of CIN2 + .ResultsOut of 231 applicable citations, we have included 29 articles that included a total of 23,576 study participants (age range, 15–84 years) who had different cervical pathologies. Among the participants who had cervical histology, the proportion of CIN2+ was between 10.6 and 90.6%. Using histology as a gold standard, 11 studies evaluated the PreTect HPV Proofer, 7 studies evaluated the APTIMA HPV assay (Gen-Probe) and 6 studies evaluated the Quantivirus® HPV assay. The diagnostic performance of these three most common mRNA testing tools to detect CIN2+ was; 1) PreTect Proofer; median sensitivity 83%, specificity 73%, PPV 70 and NPV 88.9%. 2) APTIMA assay; median sensitivity 91.4%, specificity 46.2%, PPV 34.3% and NPV 96.3%. 3) Quantivirus®: median sensitivity 86.1%, specificity 54.6%, PPV 54.3% and NPV was at 89.3%. Further, the area under the receiver operating characteristics (AU-ROC) curve varied between 63.8 and 90.9%.ConclusionsThe reported diagnostic accuracy implies that HPV mRNA based tests possess diagnostic relevance to detect CIN2+ and could potentially be considered in areas where there is no histology facility. Further studies including its cost should be considered.

BACKGROUND: Mycobacterium tuberculosis complex (MTBC) and its human host are the most competent organisms with co-evolutionary trajectory. This review determined the phylogeography, clinical phenotype-related genotype and transmission dynamics of MTBC in Africa.METHODS: Spoligotyping and mycobacterial interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) based articles from Africa published in the English language were included. Articles were retrieved from PubMed and Scopus on 12 May 2018.RESULTS: In Africa, respectively 92% and 7% of tuberculosis (TB) cases were caused by M. tuberculosis and M. africanum. Among M. tuberculosis lineages (L), L4 was the predominant, at 67%, followed by L3/Central Asian (CAS; 10%). L7/ETH1 and L5/6/Maf were restricted to the Horn and Western Africa, respectively. L4.6/SIT37, H37Rv like, L4.1.2/Haarlem and H3-Ural were proportionally more frequent among tuberculous lymphadenitis (TBLN) than among pulmonary tuberculosis (PTB) cases. On 24-locus MIRU-VNTR, clustering rate was 31%; the secondary case rate from a single primary source case was 20%.CONCLUSION: Africa in general, and the east-west pole of Africa in particular, harboured a genetically diverse population of MTBC, with characteristics of geographic segregation. Both generalist and specialist genotypes are circulating in the region. L4 is dominant across the continent, while M. bovis is rarely detected as a cause for human TB. The clinical significance of genetic diversity of MTBC in the different geographic and population groups of Africa is not fully understood. Both person-to-person transmission and reactivation mode of TB is significant in Africa. Prevention and control strategies should therefore envisage these two scenarios.

Over 99% of cervical cancer cases are associated with genital infection by certain types of human papillomaviruses (HPVs). To outline optimal vaccination strategies and HPV based cervical cancer screening, synthesized data on the genotype distribution of HPV is fundamental that is otherwise missed in Ethiopia. The aim of this study is to compile the findings on HPV genotyping in Ethiopia. Published articles were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. Further, Google Scholar and the Google databases were also searched manually for grey literature. The included studies in the review employed 859 women (age range 15–85 years) with different kinds of cervical abnormalities. A total of 534 HPV sequences were reported; the proportion of high risk HPVs was varied 80.4–100%. The top five identified genotypes were HPV 16 (45.3%; 95% CI 41.1–49.6%), HPV 52 (9.4%; 95% CI 7.2–12.1%), HPV 18 (8.2%; 95% CI 6.2–10.9%), HPV 58 (6.9%; 95% CI 5.1–9.4%) and HPV 45 (5.2%; 95% CI 3.7–7.5%). The combined prevalence of HPV 16/18 was at 53.6% (95% CI 49.3–57.8%). In this review, HPV 16 in particular, but also HPV 52 and 18, warrant exceptional consideration in vaccination and HPV based screening programs in Ethiopia. To the best of our knowledge, this study represents the first of its kind to establish the genotype distribution of HPV from different kinds of cervical lesions in Ethiopia although it was synthesized out of few studies. Hence, additional nationwide data are needed to strengthen our finding. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13337-019-00527-4) contains supplementary material, which is available to authorized users.

Alene Geteneh,1 Tesfaye Kassa,2 Derbie Alemu,3 Mulugeta Kiros,4 Henok Andualem,4 Admasu Tenna,5 Abebech Tesfaye,6 Dawit Hailu Alemayehu,6 Adane Mihret,6 Rawleigh Howe,6 Andargachew Mulu,6 Wude Mihret6 1Department of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia; 2School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia; 3Department of Medical Laboratory Science, Arba Minch College of Health Science, Arba Minch, Ethiopia; 4Department of Medical Laboratory Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 5School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; 6Armauer Hansen Research Institute, Addis Ababa, EthiopiaCorrespondence: Alene Geteneh Email aleneget@gmail.comIntroduction: Viral meningitis is common in most resource-limited settings, posing a challenge for the management and prognosis of suspected patients. No study has been done on the detection of either viral or viral–bacterial co-infection among presumed pyogenic meningitis cases in Ethiopia. We, therefore, aimed to determine the distribution of cytomegalovirus (CMV) and human enteroviruses (HEVs) among patients with presumptive pyogenic meningitis at University hospitals in Ethiopia.Methods: Viral nucleic acid was extracted from 86 repository CSF samples, which were collected from patients presumptively diagnosed with pyogenic meningitis between 2012 and 2013. PCR was done consecutively to investigate the possible viral etiologic agents of meningitis.Results: HEVs were detected in 11 (12.8%) of the analyzed samples while none of the 86 samples were tested positive for CMV. Viral-bacterial co-infections were found among 4/11 (36.4%) confirmed cases. The majority of the patients (10/11) with HEVs were younger aged ≤ 19 years old.Conclusions: In this study, the magnitude of HEVs was shown to have a significant role in presumed pyogenic meningitis cases. Therefore, we recommend presumed pyogenic meningitis cases to be inspected for viral etiologies and improve meningeal symptoms interpretations.Keywords: pyogenic meningitis, viral meningitis, human enteroviruses, Ethiopia

Background: The perinatal mortality is defined as neonatal deaths of less than seven days of age and fetal deaths after 28 weeks of gestation for developing countries. Perinatal mortality is a worldwide health problem even if variation exists among countries. Despite the presence different studies done on the determinants of perinatal mortality in Ethiopia, there is no comprehensive and currently updated study in this time period in Ethiopia. The objective of this study was to determine the determinants of perinatal mortality in Ethiopia from 2012 up to 2020 time period.Method: The articles were identified through electronic search of reputable databases: Google scholar, PubMed, Cochrane library, MIDLINE, EMBASE and Ovid Maternity and Infant Care Databases. Nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Analysis was done by using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used and a random effect model was also used to estimate the pooled prevalence of perinatal mortality rate. Results: The determinant factors for perinatal mortality were gestational age less than 37weeks , birth weight greater than or equal 2500 gram , had not history of previous abortion, had not history of perinatal death, illiterate maternal education, not using partograph , not vaccinated women about TT vaccine, had not history of obstetric complication ,level of hemoglobin greater than or equal to 11mg/dl ,women who had no prenatal visit ,child birth interval less than two years and non-vertex fetal presentation were significantly associated with perinatal mortality.Conclusion: Government should give especial emphasis for women’s with previous history of abortion, perinatal death and child birth interval less than two years.as well as strengthen all the above associated variables.

Subclinical human cytomegalovirus (HCMV) replication is associated with immune dysfunction in immuno-suppressed antiretroviral therapy (ART) naive HIV infected individuals. No data is documented in Ethiopia so far concerning HCMV co-infection among HIV infected individuals. Hence, this study was aimed at generating data regarding the prevalence of active HCMV infection among treatment-naive HIV-infected individuals from Ethiopia. For this purpose, we enrolled 97 treatment-naive HIV infected study subjects in Addis Ababa from June to December 2018. ELISA and conventional PCR were performed consecutively to detect HCMV specific IgM antibody and HCMV DNA respectively. Of the 97 study subjects, 12 (12.4%) were positive for anti-CMV IgM antibodies but were not confirmed by PCR. With regard to the PCR positivity, 4/97 (4.1%) samples were positive for HCMV DNA. No statically significant associations were found between the dependent and independent variables. The presence of HCMV DNA in the current study highlights the need for a routine laboratory diagnosis for preventing HCMV disease among HIV-infected individuals early. Besides, the use of anti-CMV therapy for these CMV viremic individuals is also recommended as this can reduce the burden of CMV complications and consecutively prolonging the life of HIV infected individuals.

Background Several factors like altitude, age, sex, pregnancy, socioeconomic status, life style and race influence hematological reference interval (RIs), which are critical to support clinical decisions and to interpret laboratory data in research. Currently there are no well-established RIs for cord blood hematological parameters of newborns in Ethiopia. This study aims to generate RIs for umbilical cord blood hematological parameters of newborns from Addis Ababa, Ethiopia. Method A cross-sectional study was conducted from January 1 to March 31, 2019 on healthy, term newborns (37–42 weeks) with normal birth weight born to apparently healthy pregnant mothers who had met the eligibility criteria. From 139 newborns, 2-3ml cord blood was immediately collected from the clumped cord using EDTA tube. The samples were analyzed using Sysmex KX 21 hematology analyzer. Data was entered and the 2.5th and 97.5th percentiles (upper and lower reference limit) were determined using non parametric method by SPSS version 23. The non-parametric independent Mann-Whitney U test (Wilcoxon rank-sum test) was used to compare the distribution of the parameters between genders, modes of deliveries and gestational age. P value less than 0.05 was considered to declare statistical significance. Result The median values and 95 % reference interval for umbilical cord blood hematological parameters of newborns were as follows: WBC = 12.4 [6.6–19.4] x109/L, RBC = 4.51 [3.55–5.52] x1012/L, HGB = 15.8 [12.4–19.7] g/dL, HCT = 45.9[37.9–56.3]%, MCV = 102.1[83.9-111.6] fL, MCH = 35.3 [29.4–39.1] pg, MCHC = 34.3 [32.3–37.4] %, PLT = 236 [146–438] x109/L, LYM = 37.5 [16.6–63.0] %, MXD = 7.9[1.7–15.8] %, NEU = 53.7[30.3–78.4] %, RDW = 15.6[12.0–19.0]%, PDW = 11.0[9.1–15.7]% and MPV = 9.4[8.1–11.8] fL. The current study found no significant difference between genders, except RDW (P = 0.01), and gestational age group, but there was significant difference for WBC (p = 0.007), RBC (p = 0.018) and Absolute NEU (p = 0.001) by delivery type where newborns delivered through caesarean section had lower values for these three parameters compared to those with spontaneous delivery. Conclusions hematological reference intervals in cord blood were established for the first time from healthy newborns of Addis Ababa and its surrounding. The values are applicable for newborns from this area. Larger study throughout the country is warranted.

Introduction:tobacco is the only legal drug that kills many of its users when used exactly as intended by the manufacturers. It is estimated that of the 1.1 billion smokers worldwide, nearly 80% of them live in low and middle-income countries. This trend increases in college and university students with most smokers starting to smoke during adolescent. The aim of this study is to assess cigarette smoking prevalence and associated factors among a select group of college of teachers´ education students. Methods:a cross-sectional study was conducted. Multistage sampling was used to select 605 study participants from across the eight departments of the Injibara College of Teachers´ Education. Each subject was selected by simple random sampling technique after proportional allocation to each class. EpiData version 4.2 was used for data entry and Stata version 14 was used for data cleaning and analysis. Variables with p-value < 0.2 in bi-variable analysis were selected for multi-variable analysis. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported to show the strength of association. Results:the current prevalence of cigarette smoking is 6.8% amongst the Injibara College of Teachers´ Education students. Males [AOR: 2.84 (95% CI: 1.13, 7.14)], divorced marital status [AOR: 7.27 (95% CI: 1.23, 42.85)], food source in hostel [AOR: 11.62 (95% CI 3.23, 41.71)] and exposure to family/other smokers [AOR: 6.17 (95% CI: 2.17, 16.06)] were statistically significant factors for cigarette smoking. Conclusion:the prevalence of cigarette smoking was relatively low. Male, marital status, source of food, and exposure to family/other smokers were identified associated factors. Policy makers and health regulatory body are strongly encouraged to consider this evidence and the associated factors for smoking in their efforts to develop and implement tobacco control laws.

Meningitis is one of the top ten causes of death among Ethiopian infants. Group B streptococcus (GBS) has emerged as a leading cause of meningitis in neonates and young infants, resulting in high mortality. Despite this, there is no report on GBS associated meningitis in Ethiopia where infant meningitis is common. Hence, the aim of this study was to determine the proportion of GBS associated meningitis among Ethiopian infants. PCR was prospectively used to detect GBS in culture-negative cerebrospinal fluid (CSF) samples, which were collected from infants suspected for meningitis, at Tikur Anbessa specialized hospital, Ethiopia, over a one-year period. GBS was detected by PCR in 63.9% of culture-negative CSF samples. Out of the 46 GBS positive infants, 10.9% (n = 5) of them died. The late onset of GBS (LOGBS) disease was noted to have a poor outcome with 3 LOGBS out of 5 GBS positive samples collected from patients with the final outcome of death. PCR was advantageous in the identification of GBS in culture-negative CSF samples. GBS was detected in 64% of the CSF samples from infants with meningitis compared with zero-detection rate by culture.

ObjectiveTo assess the prevalence of food insecurity (FI) and its predictors among lactating mothers in Ataye District, North Shoa Zone, Central Ethiopia.DesignA community-based cross-sectional study design was used.SettingTwo urban and four rural randomly selected kebeles of the Ataye District in Ethiopia.ParticipantsOut of 635 participants, 612 lactating mothers aged 15–49 years participated from February to April 2018. Mothers who lived for at least 6 months and above in the district were included, and mothers who were not able to respond to an interview were excluded. A single lactating mother per household was included. Lactating mothers in the households were selected using a cluster sampling technique. The number of lactating mothers found in each kebele was taken from family folder documentation.Primary outcomeThe prevalence and predictors of food insecurity.ResultsThe prevalence of FI among lactating mothers was 36.8%. No formal education (adjusted OR (AOR) =1.82, 95% CI 1.13 to 2.92), no income-generating activities (AOR=3.39, 95% CI 2.05 to 5.64), no home gardening practice (AOR=5.65, 95% CI 3.51 to 9.08), alcohol use by husbands (AOR=2.02, 95% CI 1.25 to 3.24), low minimum dietary diversity score (AOR=2.94, 95% CI 1.88 to 4.57), less than three frequencies of meals (AOR=3.97, 95% CI 1.65 to 9.54) and three meals only per day (AOR=1.86, 95% CI 1.08 to 3.17) were significant predictors of FI of mothers.ConclusionThe prevalence of FI was high in the study area. No formal education, no income-generating activities, no home gardening practice, alcohol use by husbands, low minimum dietary diversity score, fewer than three frequencies of meals and three meals only per day were independent predictors of FI. Therefore, increasing home gardening, decreasing alcohol intake, increasing dietary diversity and performing income-generating activities are highly recommended to reduce FI.

Introduction Intestinal parasitic infection are a major public health concern affecting both children and adolescents in Ethiopia. The aim of this systematic review and meta-analysis was to determine pooled prevalence and associated factors of intestinal parasitic infection in this target group. Method We systematically retrieved available articles on the prevalence of intestinal parasitic infection following database searches using PubMed, Scopus, Cochrane Library, and Science Direct between March 1 and May 27, 2020. Two authors independently extracted all relevant data using a standardized Microsoft Excel data extraction form. Heterogeneity among included studies was assessed with the Higgins I2 tests. The pooled estimates and associated factors were assessed with a random-effects model using Stata/se Version 14. Result We retrieved 30 eligible articles with a pooled sample size of 14,445 primary school children with response rate of 97.8%. Entamoeba spp (16.11%), Ascaris lumbricoides (13.98%), hookworm (12.51%) and Giardia lamblia (9.98%) are the top causes of intestinal parasitic infection among primary school children in Ethiopia. The pooled prevalence for at least one intestinal parasitic infection was 46.09 (95% CI: 38.50, 53.68). Heterogeneity was assessed by doing subgroup analysis by study province/region. Thus, the highest prevalence of 66.6% (95% CI: 55.5, 77.7) occurred in Tigray region, which was followed by Southern Nations, Nationalities, and Peoples’ Region at 50.8% (95% CI: 33.1, 68.5). No latrine availability (OR = 4.39: 2.50,7.73), no fingernail hygiene (OR = 2.37: 1.67, 3.35), open defecation (OR = 1.67:1.64,4.36), no formal maternal education (OR = 2.02: 1.18,3.47), rural residence (OR = 1.88: 1.46, 2.41), no habit of wearing shoes (OR = 2.66: 1.79, 3.96), non-pipe source of drinking water (OR = 1.99: 1.42,2.76), no regular hand washing practices (OR = 3.45:1.85,6.47), and no habit of washing fruits and vegetables (OR = 1.59:1.01,2.49) were associated with parasitic infection. Conclusions The prevalence of intestinal parasitic infection was high (46%). Attention should be given to promoting personal hygiene, latrine utilization, wearing shoes, avoiding eating raw food, creating awareness for those mothers who lack formal education. Moreover, future research ideally will expand on the topic by conducting research in regions which have no prior research., Author summary Intestinal parasitic infections are distributed virtually with high prevalence rates in many regions, especially in low and middle income countries which intimately linked to age group, poverty and inadequate access to water, sanitation and hygiene. It is now a day’s one of the neglected tropical disease. We had searched different individual studies on intestinal parasitic infections to generate the pooled effect and recommend for the concerned body. We head included 30 different articles with a sample size of 14,445 and we have found a pooled prevalence of 46.09%. This finding indicates the prevalence of parasitic infection was almost near to half. Therefore every concerned body should give emphasize to prevent and control parasitic infection infestation.

This study aimed to assess the diagnostic test accuracy (DTA) of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) serological test methods and the kinetics of antibody positivity. Systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. We included articles evaluating the diagnostic accuracy of serological tests and the kinetics of antibody positivity. MEDLINE through PubMed, Scopus, medRxiv and bioRxiv were sources of articles. Methodological qualities of included articles were appraised using QUADAS-2 while Metandi performs bivariate meta-analysis of DTA using a generalized linear mixed-model approach. Stata 14 and Review Manager 5.3 were used for data analysis. The summary sensitivity/specificity of chemiluminescence immunoassay (CLIA), enzyme-linked immunosorbent assay (ELISA) and lateral flow immunoassay (LFIA) were 92% (95% CI: 86%-95%)/99% (CI: 97%-99%), 86% (CI: 82%-89%)/99% (CI: 98%-100%) and 78% (CI: 71%-83%)/98% (95% CI: 96%-99%), respectively. Moreover, CLIA-based assays produced nearly 100% sensitivity within 11-15 days post-symptom onset (DPSO). Based on antibody type, the sensitivity of ELISA-total antibody, CLIA-IgM/G and CLIA-IgG gauged at 94%, 92% and 92%, respectively. The sensitivity of CLIA-RBD assay reached 96%, while LFIA-S demonstrated the lowest sensitivity, 71% (95% CI: 58%-80%). CLIA assays targeting antibodies against RBD considered the best DTA. The antibody positivity rate increased corresponding with DPSO, but there was some decrement when moving from acute phase to convalescent phase of infection. As immunoglobulin isotope-related DTA was heterogeneous, our data have insufficient evidence to recommend CLIA/ELISA for clinical decision-making, but likely to have comparative advantage over RT-qPCR in certain circumstances and geographic regions.

Background The emergence and spread of antimicrobial resistance (AMR) among uropathogens is increasing, especially in resource limited settings due to a number of reasons. The emergence of drug resistance and particularly the production of Extended Spectrum β-Lactamase (ESBL) by some strains of E. coli and methicillin resistance of Staphylococcus species, limits the choice of antimicrobials in the treatment of urinary tract infection (UTI). However, little is known about the bacteriology of UTI among pregnant women in Hargeisa, SomalilandMethods A cross-sectional study was conducted in the period of 1 Feb to 30 May 2019 among pregnant women at Edna Adan Hospital (EAH), Hargeisa. Following the standard procedure, clean-catch mid-stream urine samples were collected and processed for bacteriological culture. A urine sample was considered positive for significant bacteriuria (SBU) when a single organism was cultured at a concentration of ≥ 105 Colony Forming Units/ml. Antimicrobial sensitivity testing (AST) was done using Kirby-Bauer disc diffusion technique. Ceftazidime (30 µg) and Cefotaxime (30 µg) disks were used for ESBL screening as per CLSI guideline and each ESBL screening positive isolate were phenotypically confirmed by a combination disk test.Results Among 376 study participants, 79 (21.0%) had SBU. Majority at 58(73.4%) of the isolates were Gram-negative. The most predominant isolate was E.coli at 36(45.6%) followed by K. pneumonea 16(20.3%) and S. aureus at 9(11.4%). The proportion of ESBL producing isolates was at 25(32.9%). Gram-negative bacteria showed high level resistance to ampicillin, amoxicillin, cefotaxime, and cephalexin at 87%, 85%, 57%, and 52%, respectively. Previous history of UTI, monthly income, educational status and having dysuria were significantly associated with SBU (p ).Conclusions Most of the isolates were found resistant to the commonly prescribed antimicrobial drugs. Therefore, actions to minimize AMR should be in place to reduce the impact of urinary tract infections among pregnant women. Future large scale study is warranted to find out bacteriological and other factors associated with ESBL producing uropathogenes.

Background.Enterococcithat colonize the intestinal tract of immunocompromised patients are an important cause of nosocomial infections. Data on the prevalence of vancomycin-resistantEnterococci(VRE) and its antimicrobial susceptibility patterns and associated factors are scarce in the present study area. Therefore, this study was conducted aimed at determining the prevalence of VRE colonization among HIV-infected patients attending ART clinic at West Amhara Government Hospitals.Methods. A cross-sectional study was conducted from 1 February 2017 to 31 May 2017. A total of 349 HIV patients were included in the study. A pretested structured questionnaire was used to collect sociodemographic data and possible associated factors for VRE colonization. Identification and confirmation ofEnterococcifrom stool sample was performed based on the standard procedures. Antimicrobial susceptibility testing was done using the Kirby–Bauer disk diffusion method on the Muller–Hinton agar plate as per the standard protocol, and resistance profile of the isolates was determined according to Clinical and Laboratory Standards Institute (CLIS). Data were analyzed using SPSS v23. Descriptive analysis was used to visualize differences within data. Moreover, the stepwise logistic regression model was done to assess factors associated with VRE colonization.Pvalue was set at 0.05 to indicate statistical significance difference.Results. The overall colonization status ofEnterococciwas at 63% (220/349). The VRE colonization was at 17 (7.7% (95% CI: 4.9–12.0)). AmongEnterococcalisolates tested for antimicrobial susceptibility, 142 (64.5%) were found resistant to two or more antibiotics. Antibiotic treatment (for >2 weeks) and history of hospital admission in the last six month were found statistically associated for VRE colonization (AOR = 10.18, (95% CI: 1.9–53.20)) and (AOR = 20.17; (95% CI: 5.22–77.93)), respectively.Conclusions. The observed VRE with multidrug resistance colonization need a periodic surveillance of antimicrobial testing to detect emerging resistance and prevent the spread of further drug resistance.

Background: Tuberculosis and human immunodeficiency virus (TB/HIV) co-infection is an important global public health problem. The consequence of co-infection is multidirectional. The mortality rate of co-infected patients’ comes from many aspects or factors. Identification of these factors is important for planning and for the intervention of care and treatment.Objective: To assess tuberculosis and human immunodeficiency virus co-infected patients’ mortality rate and its predictors in Dire Dawa, Eastern Ethiopia. Method: Institution based retrospective cohort study was employed among 471 randomly selected TB/HIV co-infected patients enrolled from January, 2012 to December, 2016. Relevant variables of data were collected from patients ‘medical cards. The collected data were entered into Epi-data 4.2.0.0 and exported to SPSS version 24 for analysis. Univariate analyses were used to describe the baseline characteristics of the patients. Kaplan Meir curve were used for the comparison of time to recovery among the different groups of patients and Cox model was used to identify independent predictors. Result: A total of 79(16.8%) deaths occurred during the median follow-up period of 685 days. being infected with pulmonary tuberculosis(PTB) [AHR=1.99(95%CI:1.16-3.41)], WHO clinical stage III [AHR=2.88(95%CI:1.56-5.30)], IV[AHR=4.20(95%CI:2.21-8.01)], ambulatory functional status[AHR=4.15(95%CI:1.57-10.98)], bedridden functional status [AHR=6.34(95%CI:2.43-16.59)] and delayed Co-trimoxazole preventive therapy [AHR=2.45(95%CI:1.54-3.91)] were important predictors associated with high mortality rate of TB/HIV co-infected patients. Conclusion: About one to six TB/HIV co-infected persons died in their course of treatment follow-up. Important contributing factors were PTB infection, WHO clinical staging III and IV, ambulatory and bed ridden functional status and delayed Co-trimoxazole preventive therapy.Key words: Dire Dawa, Ethiopia, Retrospective cohort, mortality rate, TB/ HIV co-infection. Funding Statement: No financial support was gained to conduct the study. Declaration of Interests: The authors state that they have no competing interests. Ethics Approval Statement: This study has got ethical approval from Haramaya University College of Health and Medical Sciences, Institutional Health Research Ethical Review Committee (IHRERC). Permission for data collection was also secured from each hospitals and Health Centers.

Acinetobacter baumannii, an opportunistic gram negative bacterium, is known to emerge as a major health threat in Eastern Africa. Clinical isolates exhibit resistance to carbapenems and most or all available antibiotics. This review is intended to present concerns about resistance and therapeutic challenges of multi drug resistance Acinetobacter baumannii in Eastern Africa. Data was obtained from PubMed and Google scholar, and from free goggle access and web Medline for facts about Acinetobacter baumannii and its resistance pattern. Moreover, Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow chart was used to guide the selection of study materials. Total of 98 articles identified, 13 fit the criteria and were included for the final analysis. In East Africa the overall prevalence of Acinetobacter baumannii was 4.95%, while the overall rate of multi drug resistance, carbapenem and pan resistance was 87.3%, 64.8% and 25.2% respectively. Colistin resurges as potential therapeutic options to overcome the lack of new antibiotic treatment of Acinetobacter baumannii. There needs a collaborative effort in researches targeted for Acinetobacter baumannii treatment and respond for call of “Research and Development of new antibiotics” to control its damning impact.

Objective: To determine the etiologic agent, antibiotic susceptibility patterns and possible risk factors among patients who had ear infection. Methods: A cross-sectional study was conducted between February 2014 and June 2014 at the University of Gondar Hospital, Northwest Ethiopia among patients with ear discharge. Data were collected by using a semi-structured questionnaire. Ear discharge was inoculated on blood agar, chocolate agar and MacConkey agar plates. Standard procedures were used for identification of etiologic agents. Antibiotic susceptibility tests were performed on MuellerHinton agar. Data were entered and analyzed by using SPSS version 20 and P < 0.05 was considered statistically significant. Results: Out of 167 patients, 97 (58.1%) were males. The mean age of the study participants was 23.3 years with the age ranging form 4 months to 78 years. Among the 167 study participants with ear discharge, 154 (92.2%) were showed bacterial growth. Gram-negative bacteria were commonly isolated from 100 (58.5%) participants. Of the 167 ear infection cases, 68.9% and 31.1% were from patients with chronic and acute otitis media, respectively. A total of 125 (73.1%) and 46 (24.9%) bacterial isolates were recovered from patients with chronic otitis media and acute otits media, respectively. The most commonly isolated Grampositive bacterium was Staphylococcus aureus [43 (25.1%)]. Among the Gram-negative isolates, Proteus species [43 (25.1%)] were the most common isolate. Age and sex had statically significant association with ear infection (P = 0.013). Multidrug resistances were observed in 100% and 88.4% Gram-positive and Gram-negative bacterial isolates, respectively. Conclusions: The prevalence of Gram-negative bacteria was high. Staphylococcus aureus, Proteus and Pseudomonas species were the most predominant. Alarmingly high rates of multiple drug resistance to majority of the commonly used antimicrobial agents were found. Therefore, treatment of ear infection should be based on culture and susceptibility test.

Background: Childhood underweight is one of the major public health problems in Ethiopia. In Ethiopia, most of the available evidence is related to the general community children, which had different risk and severity levels than orphan children. Even though under-five orphan children have a higher risk of being underweight, they are the most neglected population. Objective: The study aims to determine the prevalence and factors associated with childhood underweight among orphaned preschool children in Southern Ethiopia. Methods: A community-based analytical cross-sectional study was conducted among 367 orphans. The burden of childhood underweight was assessed using World Health Organization standard cutoff points below −2 SD using z-scores. All variables with a p-value of < 0.25 during binary logistic regression analysis were entered into a multivariate logistic regression analysis to identify predictor variables independently associated with underweight at a p-value of 0.05 with 95% CI. Results: In this study, the prevalence of underweight among orphan children was 27.4%. The main factors associated with underweight were female child (adjusted odds ratio (aOR) = 5.29, 95% confidence interval (CI) (2.83–9.92)), adult food as type of first complementary food (aOR = 2.47; 95% CI (1.24–4.94)), food insecurity (aOR = 1.98; 95% CI (1.23–3.21)), and child age from 24–59 months (aOR = 7.19; 95% CI (3.81–13.60)). Conclusion: Childhood underweight is a public health problem in the study area. The sex of a child, type of first complementary food, household food security status, and child age were the major predictors of underweight. Therefore, appropriate dietary interventions, nutrition education, and increased food security status of orphan children are highly recommended.

Background Community acquired pneumonia (CAP) is reported as a common cause of lower respiratory tract infection worldwide. Bacterial pathogens and antimicrobial resistance (AMR) associated with this infection varied between geographical regions. Knowledge of the pathogens in a given area and their up-to-date AMR profile is essential for optimal management of patients. This study was aimed at assessing the type of bacterial isolates and their AMR among CAP adult patients at the Felege Hiwot Referral Hospital (FHRH), Northwest Ethiopia. Methods This cross-sectional study was conducted during 1 April to 30 July 2018. Demographic related data were collected from the study participants using a structured questionnaire. Sputum samples were collected and processed to identify pathogens using the conventional culture and biochemical tests as per the standard procedures. The Kirby Bauer disk diffusion method was implemented for the AMR testing. Descriptive and multivariable analysis was conducted using SPSS version 23. Results Among 414 presumptively diagnosed study participants for CAP, bacterial pathogens were identified from 167 (40.3%) participants. Among these, multidrug resistance (MDR) accounted for 127(76%) of the isolates. The predominant isolates were Streptococcus pneumoniae at 60(35.9%) and Klebsella pneumoniae at 30(18%). Overcrowded living conditions [AOR 1.579 (95%CI: 1.015–2.456)] and alcohol use [AOR 4.043 (95% CI, 2.537–6.443)] were found statistically associated with culture positive sputum. Conclusions The study showed high prevalence of mono- and multi-drug resistant isolates in the study area. Therefore, regular surveillance of the type of isolates and their AMR patterns should be considered. Interventions for reducing community acquired pneumonia should be integrated with lifestyle factors related to household and alcohol use.

Objective Approach to asymptomatic bacteriuria among pregnant women in Ethiopia is mainly based on clinical grounds and urine strip and microscopy tests. On top of this, the treatment is also on an empirical basis which may leads to an increased antimicrobial resistance. The aim of this study was to assess the prevalence, antimicrobial susceptibility profile and associated factors of asymptomatic bacteriuria among pregnant women attending antenatal clinic in Adigrat Hospital, Northern Ethiopia. Results Out of 259 pregnant women included in the study, the prevalence of asymptomatic bacteriuria was at 55 (21.2%). Gram negative bacteria, specifically Escherichia coli were the predominant isolates followed by Klebsiella species and Proteus mirabilis. Of the Gram positive identified bacteria, Staphylococcus aureus was main isolate. Age of the mother (18–25 years old) with [AOR = 8.5, 95% CI (2.2, 32.9)], family income (

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.

Background Data regarding tuberculosis (TB) treatment outcomes, proportion of TB/HIV co-infection and associated factors have been released at different TB treatment facilities in Ethiopia and elsewhere in the world as part of the auditing and surveillance service. However, these data are missing for the TB clinic offering directly observed treatment short-course (DOTs) at Debre Tabor General Hospital (DTGH). Methods The authors analysed the records of 985 TB patients registered at the DTGH from September 2008 to December 2016. Data on patients’ sex, age, type of TB, and treatment outcomes were extracted from the TB treatment registration logbook. The treatment outcome of patients was categorized according to the National TB and Leprosy Control Program guidelines: cured, treatment completed, treatment failed, died, and not evaluated (transferred out and unknown cases). Results Around half of the registered patients were males (516, 52.4%). In terms of TB types, 381 (38.7%), 241 (24.5%), and 363 (36.9%) patients had smear-negative pulmonary TB, smear-positive pulmonary TB, and extra pulmonary TB, respectively. Six hundred and seventy-two patients (90.1%) had successful treatment outcomes (cured and treatment completed), while 74 patients (9.9%) had unsuccessful treatment outcomes (death and treatment failure).TB treatment outcome was not associated with age, sex, type and history of TB, or co-infection with HIV (P > 0.05). The proportion of TB/HIV co-infection was at 24.2%, and these were found to be significantly associated with the age groups of 25–34, 35–44 and ≥65 years:(aOR: 0.44; 95% CI: 0.25–0.8), (aOR: 0.39; 95% CI: 0.20–0.70), (aOR: 4.2; 95% CI: 1.30–12.9), respectively. Conclusions The proportion of patients with successful treatment outcomes was above the World Health Organization target set for Millennium Development Goal of 85% and in line with that of the global milestone target set at > 90% for 2025. Relatively higher proportions of transfer-out cases were recorded in the present study. Similarly, the proportion of TB/HIV co-infection cases was much higher than the national average of 8%.Thus, the health facility under study should develop strategies to record the final treatment outcome of transfer-out cases. In addition, strategies to reduce the burden of TB/HIV co-infection should be strengthened. Electronic supplementary material The online version of this article (10.1186/s40249-018-0395-6) contains supplementary material, which is available to authorized users.

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.Keywords: Malaria, trend analysis, Ethiopia

INTRODUCTION: antimicrobial resistance among bacteria that cause urinary tract infection (UTI) has been increasing since the introduction of chemotherapy. This study was aimed to assess the types of isolates from patients with UTI and to determine their current antimicrobial susceptibility profile.

Background. Microscopic analysis of stained blood smear is the most suitable method of malaria diagnosis. However, gaps were observed among clinical laboratory professionals in microscopic diagnosis of malaria.Methods. A cross-sectional study was conducted in December 2015 among 46 laboratory professionals. Data was collected via on-site assessment and panel testing. The slide panel testing was composed of positive and negative slides. The kappa score was used to estimate the agreement between participants and reference reader.Results. The overall agreement between the study participants and the reference reader in malaria detection was 79% (kappa = 0.62). Participating in refresher training on malaria microscopy (Adjusted Odds Ratio (AOR = 7, CI = 1.5–36.3)) and malaria epidemic investigation (AOR = 4.1 CI = 1.1–14.5) had statistical significant association with detection rate of malaria parasites.Conclusion. Laboratory professionals showed low performance in malaria microscopy. Most of the study participants were graded “in-training” in laboratory diagnosis of malaria.

Background. Urinary tract infection is a major health problem especially in developing countries. Information about bacterial pathogens isolated from urinary tract infection in diabetic patients and their antimicrobial susceptibility patterns is limited in Ethiopia. Therefore, this study aimed at isolating bacterial pathogens and their antimicrobial susceptibility patterns.Methods. A hospital based comparative cross-sectional study was conducted at Debre Tabor. Urine sample was inoculated onto cysteine lysine electrolyte deficient (CLED) medium. Bacterial pathogens were identified using standard bacteriological methods. The data were cleaned and entered into SPSS version 20.Pvalue less than 0.05 is considered statistically significant.Result. A total of 384 study participants were included in the study. Of them, 21 (10.9%) were from diabetics and 9 (4.7%) of them were from nondiabetics. Large proportion of gram positive bacteria at 18 (58.1%) were isolated compared to gram negatives at 13 (41.9%). Gram positive isolates were resistant to cotrimoxazole 10 (58.8%).Conclusion. The isolation rates of bacterial pathogens were higher in diabetic than nondiabetic patients. Bacteriuria was significantly associated with sex and type of diabetes. Multidrug resistance to two or more antibiotics was observed in 56.7% of bacterial isolates. Rational use of antimicrobial agent should be thought of to prevent the emergence of multidrug resistance.

Bacterial blood stream infections (BSIs) are a common cause of morbidity and mortality. Prevailing data on bacterial species causing BSI and their antibiogram are essential for proper management of patients. A retrospective study was conducted on blood culture results that had been processed from March 2013 to January 2015 at Bahir Dar Regional Health Research Laboratory Center. In January 2015, data on age, sex of patients and bacterial isolates with antibiogram were extracted from registration log book. Blood stream causing bacteria were identified according to standard operational procedure for blood culture. Antimicrobial susceptibility tests were performed according to Kirby-Bauer disc diffusion methods. A total of 561 blood specimens were requested for blood culture. Of these, 220 (39.2%, 95% CI: 35.3-43.4%) blood cultures had aerobic bacterial growth. Gram negative bacterial isolates constituted 115 (52.3%) of the isolated bacteria. Staphylococcus aureus 50 (22.7%), coagulase negative staphylococci 35(15.9%), Klebsiella pneumoniae 35 (15.9%), Escherichia coli 19 (8.6%), Pseudomonas aeruginosa 15 (6.8%) and Acinetobacter species 13(5.9%) were the most dominant isolates. Overall, drug resistance for gram positive bacteria were 7 to 61% and for gram negatives 6.9 to 82.6%. Among the gram positive bacteria, high resistance levels were observed against penicillin (61%) and oxacillin (52.9%). The gram negative bacterial isolates showed 66 to 82.6% resistance to ampicillin, ceftriaxone and trimethoprim-sulfamethoxazole. The present study revealed that bacterial blood stream infections linked with high levels of drug resistance would pose a challenge in treatment of patients with BSIs. Hence, blood culture with antibiotic susceptibility tests could play key role for appropriate treatment of patients with bacterial blood stream infection. Key words : Blood culture, Bloodstream infection, antibiogram, Ethiopia

Background : Data on the epidemiology of tuberculosis and its treatment outcomes were incomplete in the study area and this study was done to fill this gap. Methods : Institution based cross sectional study was conducted from January 2011 to December 2014. A total of 949 TB patients who were on treatment in North Eastern Ethiopia, Eastern Amhara region were included. Data was analyzed using SPSS version 20. Frequency, percentages and means were used to present data. To assess the associations of treatment outcomes with sex, age, type of TB and human immunodeficiency virus (HIV), logistic regression was used. Results : The proportion of smear positive and negative pulmonary TB, and extra pulmonary TB were 187/949 (19.7%), 322/949 (33.9%) and 440/949 (46.4%), respectively. Treatment success rate was 853/949 (89.9%). Smear positive pulmonary TB and TB/HIV co-infections were significantly associated with unsuccessful treatment outcome, P≤ 0.002. Conclusion : Extra pulmonary TB was the most prevalent types of TB followed by smear negative pulmonary TB. Treatment success rate was above the WHO target of 85%. The causes for the high proportion of smear negative PTB and EPTB should be further investigated. Special emphasis should be put on smear positive PTB patients and TB/HIV co-infected patients to decrease unsuccessful treatment outcome and TB transmissions. Keywords : Tuberculosis, types of tuberculosis, treatment outcomes, Ethiopia.

Background Tuberculosis (TB) is a global concern for both developing and developed countries. Currently it becomes more complex due to increasing levels of drug resistance and HIV co-infection. Delayed diagnosis and high case load are major factors contributing to continued transmission and failure to the treatment outcome. The study was conducted to determine the profile and treatment outcomes of TB patients at Felege-Hiwot Referral Hospital. Methods We analyzed the records of 1761 TB patients registered for treatment in Felege Hiwot Referral Hospital from July 2010 to June 2015. Data on patients’ socio-demographic characteristics, type of TB, HIV status and treatment outcome were analysed. Descriptive statistics and binary logistic regression models were used to present data. The odds ratio and the 95 % confidence intervals were calculated. A p-value of

Background Tetanus is an acute, often fatal, disease caused by an exotoxin produced by the bacterium Clostridium tetani. It is characterized by generalized rigidity and convulsive spasms of skeletal muscles. Tetanus remains a major public health problem in Ethiopia like other developed nations. The aim of the present study was to assess the clinical profile and outcome of tetanus patients in a referral hospital, Northwest Ethiopia. Methods This is a retrospective cross sectional study in which we collected, compiled and analyzed medical records of patients aged greater than 15 years who were admitted at Felege Hiwot Referral Hospital from Sep 2012 to Sep 2015. Tetanus was diagnosed using clinical observations. Data were entered, cleared, and analyzed using SPSS statistical software package. Results Among 110 tetanus cases 84 (76.4 %) were males. Trauma was the most common antecedent cause. Most of the patients had no history of tetanus toxoid immunization. Aspiration pneumonia at 34.5 % and dysautonomia at 11.8 % were found to be the most frequently observed complications. About 36 (32.7 %) patients were died due to tetanus and the most common immediate cause of death was respiratory failure at (83.3 %). Patients’ area of residence (p = 0.004), type of complications (p = 0.00) and severity of tetanus (p = 0.00) were found statistically associated with the type of treatment outcomes. Conclusions In the study, the case-fatality rate was found to be very high. Therefore, there is a need to universal tetanus immunization and health information dissemination.

Using multi-stage purposive sampling technique, 270 households who owned cattle were selected from three agro-ecologies to assess feed resources potential and to evaluate the nutritional quality majorly used feed resources. Structured questionnaire, field observation and focus group discussion were used to collect detailinformation. Conversion factors were used to quantify each feed recourse yield potential per a year in the district. Ten majorly usedcattle feed sampleswere taken to evaluate their nutritional quality. Collected data were analyzed using SAS version 9.2 software packages. Natural pastures, crop residues, stable grazing and hay were the available feed resources in the study area. The cattle population in the district was estimated 1,520 TLU which required an estimated of 13,871 tons of DM for maintenance per annum. The overall estimated DMYof the feed resources in the district was 366,719 tons per year. By assuming 20% of the feed resources wasted during transportation, storage and feeding, 293,375 tons of DM could be utilized as livestock feed per annum. Major feed resources in the district were grouped under poor quality. In conclusion, the feed resources potential in the district could satisfy the cattle population DM maintenance requirement. However, whether the remaining DMY could satisfy the DM requirement of the entire livestockpopulationin the district needs further investigation. The nutritional quality of feed resources needs improvement through treatment. Moreover, supplementary feeding is needed to satisfy the entire nutrientrequirements of the livestock population in the district.

This manuscript reviews and compares the results of recent greenhouse gas (GHG) emission life-cycle analyses. Specific attention is paid to fossil energy technologies and renewable energy technologies (RETs). It is therefore desirable for GHG emissions under national, regional and international mitigation policies to be accounted for over its entire life-cycle. The results presented here indicate that the most significant GHG avoidance (in absolute terms) can be made from technology substitution. The introduction of advanced fossil fuel technologies can also lead to improvements in life-cycle GHG emissions. Overall, hydro, nuclear, solar and wind energy technologies can produce electricity with the least life-cycle global warming impact. The advantage of using renewable resources for energy production from conventional resources scarcity and power system reliability point of view is too much. Using renewable resources specially wind and solar are becoming common in developing countries for electrifying the remote and rural areas where grid electrification is economically infeasible. This research work shows an investigation that uses a combination of solar and wind energy as hybrid system (HPS) for electrical generation in Dire Dawa. The generated electricity has been utilized for different purposes. The system has also integrated a diesel generator to be more reliable. This system is not linked with conventional energy. The total energy consumption of each household is 29.44 kWh/day. Measurements included the solar radiation intensity, the ambient temperature and the wind speed was collected from national meteorology agency which was collected for 15 years. To simulate the hybrid power system (HPS) HOMER was used. Emissions and renewable energy generation fraction (RF) of total energy consumption are calculated as the main environmental indicator. The net present cost (NPC) and cost of energy (COE) are calculated for economic evaluation. It is found that, for Dire Dawa climates, the optimum results of HPS show a 93.73% reduction of emissions with 99% of renewable energy fraction.

This paper presents the analysis of efficiency improvements of home appliances such as Electrical Stove (Injera Mitad), Electrical Showers, Kerosene Stoves, Charcoal Stoves and Small Electrical Stoves for energy conservation. Most of the existing stoves have been manufactured by small facilities without any regard for energy efficiency standard and safety. It suffers from many shortfalls, such as, poor insulation, lack of temperature regulation, bulkiness and overall poor design that encourages wastage of heat. The energy efficiency of the ordinary electric stove is very low since much of the heat energy is lost through the bottom, its sides, on the top part of the oven and also due to the much delay in the existing Injera baking procedure. The overall efficiency of the electrical shower is affected by the reservoir efficiency and the characteristics of the pipe. Kerosene and charcoal stoves have high heat energy loss due to lack of insulation to their external cover. Therefore, the efficiency of those electrical home appliances can be improved by minimizing the losses through their covers and parts. This can be achieved by selecting appropriate low thermal conductivity materials and insulations.

Background: Honey produced by honeybees ( Apis mellifera ) is one of the ancient traditional medicines used for treatment and prevention of various illnesses. Objective: To assess the antimicrobial potential of honey on some common bacterial pathogen. Methods: This experimental study was conducted in Jimma University, from February 10 – March 14, 2003. The Minimal Inhibitory Concentrations/ MIC and Minimal Bactericidal Concentrations/ MBC of two honey samples on Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella typhi, Shigella shiga, Klebsiella aerogenes, Proteus vulgaris and Proteus mirabilis was investigated by an agar dilution technique. Results: The MIC of honey for 90% of test organism was 6.25% and 7.5% (V/V) for P. aeruginosa . The MBC of honey for 70% of the test organisms was again 6.25% (V/V). The MBC of honey for S. shiga (Standard test organism) and P. aeruginosa (both clinical isolates and control strain) was 7.5% (V/V). Conclusions: Honey produced by honeybees ( Apis mellifera ) has both bacteriostatic and bactericidal activity when tested in vitro. However, Pharmacological standardization and clinical evaluation on the effect of honey are essential before using honey as a preventive and curative measure to common diseases related to the tested bacterial species. [Ethiop.J.Health Dev. 2004;18(2):107-111]

BACKGROUND: Cryptococcosis is one of the common opportunistic fungal infections among HIV infected patients living in Sub-Saharan Africa, including Ethiopia. The magnitude of thedisease 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 IMMYCrAg® 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.

Background Human immunodeficiency virus (HIV) and tuberculosis (TB) are the leading independent global causes of death among patients with infectious diseases. Additionally, due to the shared immune defense mechanisms, they are the leading cause of co-morbidities globally. However, little information was found regarding the proportion of TB/HIV co-infection in the study area. Thus, this study determined the proportion and associated factors of TB/HIV co-infection. Methods All TB patients treated from January/2011 to December/2014 were included in this study. Data were collected from three health centers namely; Kobo, Robit and Gobiye. Data were entered, cleared, and analyzed using SPSS version 20. Frequency, percentage, median and range were used to present the data. To assess the associated factors, logistic regression was employed. Results Of the total 990 TB patients enrolled in the study, 98.2 % were screened for HIV; of these, 24.3 % were co-infected with TB and HIV. The odds of having TB/HIV co-infection were 3.4 times higher among in the age group of 25–45 years compared to older (≥45 years) age TB patients (OR = 3.4; 95 % CI 2–5). Moreover, the odds of having TB/HIV co-infection were 2.8 and 1.7 times higher among smear positive and smear negative patients with pulmonary TB respectively than patients with extra pulmonary TB. Of 236 co-infected patients, 71.2 % took co-trimoxazole preventive therapy and 76.3 % took antiretroviral treatment. Conclusion TB/HIV co-infection is one of the serious public health problems in the study area. Thus, Collaborative TB/HIV activities that reduce the co-morbidities and mortalities should be addressed.

Ear infection linked with frequent antibiotic prescription, hearing impairment, severe disability and death is a public health threat in developing countries. However, there is scarcity of documented data in the study area. Therefore, this study aimed at determining bacterial etiologic agents and their antimicrobial susceptibility patterns among patients of all age groups referred to Bahir Dar Regional Health Research Laboratory Center. Retrospective data recorded on culture and antimicrobial susceptibility profile were retrieved for analysis. Pus swabs from discharging ears collected and processed for aerobic bacteria culture and susceptibility testing. Of the total 368 pus swab samples processed, 296 (80.4 %) were culture positive. Of which, 289 (97.6 %) were bacteria and 7 (2.4 %) were yeast cells. The proportion of ear infection was higher in males (92.7 %) than females (65 %) (P = 0.014). The frequency of ear infection below 21 years of age was 65.2 %. The predominant isolate was Pseudomonas aeruginosa (29.7 %) followed by Staphylococcus aureus (26.3 %) and Proteus spp. (21.9 %). High level of antimicrobial resistance rates were observed for amoxicillin/clavulanic acid, ampicillin and penicillin whereas ciprofloxacin, ceftriaxone, chloramphenicol, cotrimoxazole, gentamicin and amikacin were found effective against the isolated bacteria. Aerobic bacterial otitis media linked with high levels of resistance against amoxicillin/clavulanic acid and ampicillin is major health problem in the study area. Moreover, considerable level of oxacillin resistant S. aureus suggests the diffusion of methicillin resistant S. aureus in the community. Therefore, treatment of otitis media in the study area needs to be guided by antibiotic susceptibility testing of isolates.