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Abstract Introduction Measles is an extremely contagious viral disease that can be prevented through vaccination. It is caused by the measles virus and presents with symptoms such as high fever, cough, runny nose, conjunctivitis, and a distinctive rash. Complications may include pneumonia, diarrhoea, and neurological issues. The disease spreads through respiratory droplets and continues to pose a significant public health challenge, especially in Africa, despite vaccination efforts. Objective This systematic review and meta-analysis aim to estimate the pooled vaccine effectiveness of measles vaccines among African children, providing insights into immunization program success and informing policy decisions on vaccine distribution and resource allocation. Methods Following PRISMA guidelines, search was conducted in databases including PubMed/Medline, Science Direct, HINARI, Cochrane/Wiley library, Europe PMC, and grey literatures like Google Scholar up to March 2024. Cross-sectional studies assessed measles vaccine effectiveness in African children aged nine months and above were included. Data was extracted using JBI extraction tool and entered into microsoft excel and analysed via STATA version 20.1 using random effect model. Results From 5295 identified articles, 18 met the inclusion criteria, encompassing 26,470 children from 13 African countries. The pooled measles vaccine effectiveness was 68.58%, with significant heterogeneity (I2 = 99.66%, p

Abstract Background Cutaneous leishmaniasis (CL) is a neglected tropical skin disease, caused by the protozoan parasite Leishmania. In Ethiopia, CL is mainly caused by Leishmania aethiopica and can present in different clinical forms. The aim of this study was to assess whether these different forms are associated with differences in parasite genetic and host systemic immune signatures. Methods Here we analysed the whole genome sequence data for 48 clinical parasite isolates and the systemic immune signature from a cohort of CL patients, who were recruited in Nefas Mewcha, Northern Ethiopia, from January 2019 to January 2022. Results Our results show that parasites from CL cases with different presentations in a single Ethiopian setting are from the same genetic population based on a permutation test of genome-wide similarity. Furthermore, a logistic regression test for genome wide association did not identify any individual genetic variants significantly associated with disease presentation. We also measured plasma chemokine and cytokine levels of 129 CL patients presenting with different forms of CL. None of the chemokine [eotaxin, eotaxin-3, interleukin (IL)-8, interferon (IFN)-γ-induced protein-10 (IP-10), monocyte chemoattractant protein (MCP)-1, MCP-4, macrophage-derived chemokines (MDC), macrophage inflammatory protein (MIP)-1α, MIP-1β and thymus- and activation-regulated chemokine (TARC)] or cytokine (IFN-γ, IL-1β, interleukin-2, IL-4, IL-6, IL-10, IL-12p70, IL-13, tumor necrosis factor-α) levels measured were significantly different between the different clinical presentations of CL, as measured by Kruskal–Wallis test. We also compared those with healthy nonendemic controls: our results show a chemokine (IP-10, MCP-1, MCP-4, MDC, MIP-1α, MIP-1β and TARC) but not a cytokine immune signature in patients with CL as compared to healthy nonendemic controls, as measured by Mann-Whitney test. Conclusions The results of our study did not identify a systemic immune signature or parasite genetic factors associated with different clinical presentation of CL. Graphical abstract

The genetic analysis of the Dengue virus circulating in Ethiopia’s Afar region, in 2023, identified three distinct introductions with spatiotemporal clustering linked to genomes from Asia and Italy. These findings are crucial for enhancing prevention and control strategies, reinforcing the necessity to provide sustainable tools for genomic epidemiology in Africa.

Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by Leishmania parasites, that can cause long-term chronic disabilities. The clinical presentation of CL varies in both type and severity. CL presents as three main clinical forms: localised lesions (localised cutaneous leishmaniasis, LCL); mucocutaneous leishmaniasis (MCL) that affects the mucosa of the nose or the mouth; or as disseminated not ulcerating nodules (diffuse cutaneous leishmaniasis, DCL). Here we recruited a cohort of CL patients in a newly established leishmaniasis treatment centre (LTC) in Lay Gayint, Northwest Ethiopia, and collected detailed demographic and clinical data. The results of our study show that more males than females present to the LTC to seek diagnosis and treatment. 70.2% of CL patients presented with LCL and 20.8% with MCL. A small number of patients presented with DCL, recidivans CL (a rare form of CL where new lesions appear on the edges of CL scars) or with a combination of different clinical presentations. The duration of illness varied from 1 month to 180 months. Over a third of CL patients had additional suspected CL cases in their household. Despite the majority of CL patients having heard about CL, only a minority knew about its transmission or that it could be treated. Most CL patients lived in areas where environmental factors known to be associated with the transmission of CL were present. This work highlights that CL is an important public health problem in Lay Gayint and emphasises the urgent need for more CL awareness campaigns, better health education and better disease management practices.

Abstract Cervical cancer is a significant public health concern in Ethiopia. It is mainly caused by persistent infection with the human papillomaviruses. The aim of this study was to assess the relationship between carcinogenic risk of probable, possible and low risk HPV infection and those of cervical intraepithelial neoplasia (CIN) and cervical cancer. A cross sectional study nested from prospective cohort study was conducted in Bahir Dar, northwest Ethiopia. Statistical analyses were performed using SPSSversion 26.0. HPV-16 was associated with a relatively higher risk of CIN II+, (AOR = 15.42; 95% CI 6.81–34.91). In addition, HPV-52, -18, -53 and -58, were significantly associated with an increased risk of CIN II+, (AOR = 7.38 (1.73–31.54), 5.42 (1.61–18.31), 4.08 (1.53–10.87), and 3.17 (1.00–10.03)), respectively. The current study shows high rate of HPV with predominance of HPV-16, -53, -58, -18, -35, and -52. The quadrivalent and nonavalent vaccine had only covered 27.1% and 45% of the circulating HPV genotypes. Ethiopia may need to consider introduction of nonavalent vaccine into the national public health strategy. Polyvalent vaccine which includes the genotypes not covered by existing approved vaccines should be considered.

Abstract Background Schistosoma mansoni causes intestinal schistosomiasis (SCH) in all regions of Ethiopia. Despite many years of mass treatment, the prevalence has not dropped significantly. The reduction of SCH transmission demands the integration of deworming with safe water, sanitation, and hygiene (WASH) activities. Adequate knowledge and a positive attitude towards SCH are critical to practicing those interventions. However, data on the knowledge, attitude, and practice (KAP) level in school and community settings is limited in Ethiopia. Methods School and community-based cross-sectional studies were conducted from February to June 2023 among 634 school-aged children (SAC) and 558 adults. A pre-tested questionnaire was used to collect socio-demographic and KAP data. Records were entered and analyzed using SPSS software version 21. Correct responses for each of the KAP questions were scored as one, while incorrect or ‘I don’t know’ responses were scored as zero. Good knowledge, a positive attitude and good practice were declared if percentage scores were ≥ 80%, ≥ 90% and ≥ 75%, respectively. Results Only 229 (19.2%) respondents, comprising 91 (14.4%) SAC and 138 (24.7%) adults, had ever heard of SCH. Adults, males, and urban residents had higher awareness level compared to their respective counterparts (p

Abstract Introduction Tuberculosis (TB) and intestinal helminths have huge public health importance, and they are geographically overlapped. Data about the burden of intestinal helminth and TB co-infection in these areas are fragmented. In this systematic review and meta-analysis we compile the current literatures and generate pooled prevalence. We also identity factors associated with intestinal helminth co-infection among TB patients. Methods Original articles published in English language up to March 23, 2022 were systematically searched from electronic database (PubMed/Medline, Scopus, Science Direct, Google Scholars and HINARI). The search was done using medical subject heading terms and keywords. Identified articles were exported into the EndNote library. The identified articles were screened using PRISMA flow diagram. Then the methodological quality of included articles was evaluated and rated using the modified version of Newcastle–Ottawa Scale. Data were extracted using Microsoft Excel. Sensitivity analysis and Egger regression test were used for the assessment of heterogeneity and publication bias. Finally the results are presented with a meta-analysis of pooled estimates, forest plots, and tables. The quantitative data were analyzed using Stata version 14. Results From a total of 5457 searched articles, 22 eligible articles were included in the review. The pooled prevalence of helminth co-infection among TB cases was 29.69% (95%CI: 21.10, 38.29). TB patients were found to more frequently harbor one or more intestinal helminths than TB negative individuals (OR = 1.72 (95%CI: 1.20, 2.48)). Among the reported helminths, Schistosoma mansoni and Strongyloides stercoralis had the highest pooled prevalence among TB cases. However, unlike other individual helminths, only Strongyloides stercoralis (OR = 2.67 (95% CI, 1.20–6.76)) had significant association with TB cases compared to TB negatives. BMI was significantly associated with intestinal helminth co-infection among TB patients (OR = 2.75 (95%CI: 1.19, 6.38)). Conclusions Patients with TB have been shown to harbor co-infection with one or more intestinal helminths with considerable proportions when compared with TB-negative individuals. The higher prevalence of helminth infection in TB cases might indicate that co-infection promotes active TB disease. Thus, routine intestinal helminth screening and assessment of their nutritional status is suggested for TB patients.

Abstract Background The serum lipid and immunohematological values of tuberculosis lymphadenitis (TBLN) patients is poorly documented relative to pulmonary tuberculosis (PTB) cases. Therefore, the aim of this study was to investigate the serum lipid and immunohematological values of patients with TBLN in comparison with PTB (PTB) patients. Methods An institution-based comparative cross-sectional study was conducted in Northwest Ethiopia from March to December 2021. The study participants were bacteriologically confirmed PTB (n = 82) and TBLN (n = 94) cases with no known comorbidity and whose ages was greater than 18 years and with no current pregnancy. Independent sample t-test, one-way ANOVA, box plot, and correlation matrix were used to analyze the data. Results The body mass index (BMI), CD4 + T cell count, and high-density lipoprotein-Cholesterol (HDL-C) values were significantly higher among TBLN cases compared with PTB cases. Additionally, the total white blood cell (WBC) count, hemoglobin (Hb), total Cholesterol (CHO) and creatinine (Cr) values were relatively higher among TBLN than PTB (P > 0.05). On the reverse, the platelet count and triacylglycerol (TAG) values were relatively higher among PTB than in TBLN cases. While the mean days of culture positivity were 11.6 days for TBLN, the mean days of culture positivity were 14.0 days for PTB. Anemia and serum lipid values showed no correlation with sputum bacilli load and time to culture positivity. Conclusion Tuberculous lymphadenitis patients were well-endowed with serum lipid, immunological and nutritional status compared with PTB cases. Hence, the high incidence rate of TBLN in Ethiopia could not be explained by low peripheral immunohematological values, malnutrition, Anemia, and dyslipidemia. Further study for identifying the predictors for TBLN in Ethiopia is highly desirable.

Abstract Background Cutaneous leishmaniasis (CL) is a neglected tropical disease that primarily affects the most vulnerable populations. In Ethiopia, where this study took place, CL is an important health problem, however, the incidence of CL is poorly monitored. Objectives This study took place in a recently established CL treatment centre, at Nefas Mewcha Hospital, Lay Gayint. This area was considered to be endemic for CL, however, no cases of CL from Lay Gayint had previously been officially reported to the Amhara Regional Health Bureau. Methods Following a CL awareness campaign, a retrospective data review was performed of patients presenting to this centre between July 2019 and March 2021. Basic demographic and clinical data were collected by a nurse and recorded in the logbook of the CL treatment centre. Results Two hundred and one patients presented for diagnosis and treatment. The age of the patients ranged from 2 to 75 years and 63.2% were males. Most patients were between 10‐ and 19‐years‐old. The majority (79.1%) of the patients presented with localised cutaneous leishmaniasis and 20.9% with mucocutaneous leishmaniasis. 98% of the patients tested positive for Leishmania parasites by microscopy. Conclusions This work underpinned how CL is a major public health problem in the Lay Gayint district. It also shows that raising awareness about CL in the community and providing diagnosis and treatment encouraged patients to travel to seek diagnosis and treatment.

Abstract Biomphalaria snails, namely B. pfeifferi and B. sudanica, are the principal intermediate hosts for Schistosoma mansoni infection in Ethiopia. Epidemiological studies of Biomphalaria snails and their infection status with S. mansoni is vital for public health planning. This study aimed to assess the spatial and seasonal abundance of Biomphalaria snails as well as their infection status with S. mansoni around Lake Tana, northwest Ethiopia. Malacological survey was conducted from January 2021 to December 2021 in ten different collection sites in and around Lake Tana. Snail collection was performed for 20 min from each collection site seasonally (four times in a year) using a standard scoop and handpicking from aquatic vegetation. All collected snails were carefully examined based on their morphological features and all live Biomphalaria snails were subjected to cercariae shedding experiment. Descriptive statistics were used to determine the prevalence of S. mansoni infection and its relationship with snail collection sites and seasons. A total of 3886 freshwater snails were collected from ten collection sites around Lake Tana. Out of the total snails collected, 1606 (41.3%; 95% CI 39.77–42.89%) were Biomphalaria spp. The highest (374) and the lowest numbers (98) of Biomphalaria snails were collected from Shinne River and Qunzela Lakeshore, respectively. Out of the 1375 live Biomphalaria snails, 14.4% (95% CI 12.59–16.37%) snails shed cercariae, but only 4.87% (95% CI 3.79–6.15%) were cercariae of S. mansoni. The infection prevalence of S. mansoni ranged from 10.59% at the Cherechera site to 1.49% at Gumara River. Biomphalaria snail infections with S. mansoni cercariae were observed throughout the season, the highest and the lowest infection rates being in the spring and summer seasons. Significant differences in the prevalence of S. mansoni infection in Biomphalaria snails were observed across study sites and seasons (p

Abstract Background and Aims Pre‐eclampsia (PE) is a pregnancy‐related syndrome that occurs after 20 weeks of pregnancy. The current study was designed to evaluate the determinants of PE in pregnant women following antenatal and delivery services. Methods An institution‐based case‐control study was performed in governmental hospitals of Bahir Dar city. The data were collected using an interview‐administered questionnaire and analyzed by SPSS version 20 software. Bivariate and multivariable logistic regression models were utilized for the analysis of variables. A p

BackgroundTuberculosis (TB), caused by the Mycobacterium tuberculosis complex (MTBC), is a chronic infectious disease with both pulmonary and extrapulmonary forms. This study set out to investigate and compare the genomic diversity and transmission dynamics of Mycobacterium tuberculosis (Mtb) isolates obtained from tuberculous lymphadenitis (TBLN) and pulmonary TB (PTB) cases in Northwest Ethiopia.MethodsA facility-based cross-sectional study was conducted using two groups of samples collected between February 2021 and June 2022 (Group 1) and between June 2020 and June 2022 (Group 2) in Northwest Ethiopia. Deoxyribonucleic acid (DNA) was extracted from 200 heat-inactivated Mtb isolates. Whole-genome sequencing (WGS) was performed from 161 isolates having ≥1 ng DNA/μl using Illumina NovaSeq 6000 technology.ResultsFrom the total 161 isolates sequenced, 146 Mtb isolates were successfully genotyped into three lineages (L) and 18 sub-lineages. The Euro-American (EA, L4) lineage was the prevailing (n = 100; 68.5%) followed by Central Asian (CAS, L3, n = 43; 25.3%) and then L7 (n = 3; 2.05%). The L4.2.2.ETH sub-lineage accounted for 19.9%, while Haarlem estimated at 13.7%. The phylogenetic tree revealed distinct Mtb clusters between PTB and TBLN isolates even though there was no difference at lineages and sub-lineages levels. The clustering rate (CR) and recent transmission index (RTI) for PTB were 30 and 15%, respectively. Similarly, the CR and RTI for TBLN were 31.1 and 18 %, respectively.Conclusion and recommendationsPTB and TBLN isolates showed no Mtb lineages and sub-lineages difference. However, at the threshold of five allelic distances, Mtb isolates obtained from PTB and TBLN form distinct complexes in the phylogenetic tree, which indicates the presence of Mtb genomic variation among the two clinical forms. The high rate of clustering and RTI among TBLN implied that TBLN was likely the result of recent transmission and/or reactivation from short latency. Hence, the high incidence rate of TBLN in the Amhara region could be the result of Mtb genomic diversity and rapid clinical progression from primary infection and/or short latency. To validate this conclusion, a similar community-based study with a large sample size and better sampling technique is highly desirable. Additionally, analysis of genomic variants other than phylogenetic informative regions could give insightful information. Combined analysis of the host and the pathogen genome (GXG) together with environmental (GxGxE) factors could give comprehensive co-evolutionary information.

Abstract Background Strongyloides stercoralis is an intestinal parasite that can cause chronic infection, hyperinfection and/or a dissemination syndrome in humans. The use of techniques targeting ova fails to detect S. stercoralis, as only larvae of the parasite are excreted in faeces. Due to the absence of “Gold” standard diagnostic method for S. stercoralis, there is a paucity of reported data worldwide. Objective This study aimed to evaluate the performance of diagnostic methods of S. stercoralis infection by taking the composite reference as a “Gold” standard. Methods A cross-sectional study was conducted among 844 schoolchildren in Amhara Region, Ethiopia, from April to December 2019. Stool samples were collected and processed with formol-ether concentration technique (FECT), spontaneous tube sedimentation technique (STST), Baermann concentration technique (BCT), agar plate culture (APC) and real-time polymerase chain reaction (RT-PCR). Sensitivity, specificity, positive predictive value, and negative predictive value of each diagnostic method were computed against the composite reference. The agreements of diagnostic methods were evaluated by Kappa value at 95% CI. Results The composite detection rate of S. stercoralis by the five diagnostic methods was 39.0% (329/844). The detection rate of the parasite from stool samples by FECT, STST, BCT, APC and RT-PCR was 2.0% (17/844), 4.0% (34/844), 10.2% (86/844), 10.9% (92/844) and 28.8% (243/844), respectively. The highest detection rate (37.8%; 319/844) of S. stercoralis was recorded by a combination of BCT, APC, and RT-PCR followed by a combination of STST, BCT, APC and RT-PCR (37.3%; 315/844). The sensitivity of FECT, STST, BCT, APC and RT-PCR against the composite reference was 5.2%, 10.3%, 26.4%, 28.0% and 73.9%, respectively. The diagnostic agreements of RT-PCR, APC, BCT, STST and FECT with the composite reference in detection of S. stercoralis were substantial (0.775), fair (0.321), fair (0.305), slight (0.123), and slight (0.062), respectively. Conclusion RT-PCR detected the highest number of S. stercoralis infections. A combination of RT-PCR with APC and/or BCT better detected S. stercoralis from stool samples compared to other combinations or single diagnostic methods. Therefore, RT-PCR and combination of RT-PCR with APC and/or BCT diagnostic methods should be advocated for detection of S. stercoralis infection.

Background: Pre-eclampsia (PE) is a metabolic disorder that adversely affects the lives of mother and their infants. Even though, several studies have been conducted on PE, no effective diagnostic and therapeutic agents were developed so far. Hence, this study was designed to evaluate serum uric acid, blood urea and creatinine levels in the prediction of PE. Methods: A hospital-based case-control study was conducted among pregnant women. A simple random sampling technique was applied to select study participants. The socio-demographic and clinical data were collected using an interview-administered questionnaire. Serum samples were used to determine the maternal uric acid, urea and creatinine levels via an automated chemistry analyzer. Independent sample t-test, Pearson correlation test and receiver operating characteristic (ROC) curve analysis were performed to check the association and diagnostic accuracy of variables to PE. Results: The mean ages (in years) of the case and control groups were 27.98 ± 5.64 and 27.33 ± 4.45, respectively. The mean serum uric acid and blood urea levels were significantly higher in pre-eclamptic women than in normotensive pregnant women (6.27 ± 0.20 vs 4.43 ± 0.15, and 8.50 ± 3.99 vs 5.67 ± 2.19), respectively but the serum creatinine level is non-significantly increased in cases as compared to controls (0.70 ± 0.05 vs 0.50 ± 0.01). The areas under the ROC curve of serum uric acid, creatinine and blood urea levels were 0.785, 0.735 and 0.764 (sensitivity: 69%, 60.7%, 67.9%; specificity: 73.8%, 75%, 71.4%) with the cutoff points of ≥5.25 mg/dL, ≥0.565 mg/dL and ≥6.5 mg/dL, respectively. Conclusion: In this study, we observed a significantly higher concentration of serum uric acid and blood urea values in pre-eclampsia as compared with normotensive pregnant women. Therefore, this suggested that serum uric acid; blood urea and creatinine values can be associated with PE. Moreover, serum uric acid, blood urea and creatinine levels could be carefully utilized as a diagnostic marker for PE, but their inclusion in routine diagnostic test to PE requires large-scale multi-center prospective studies that corroborate our findings.

Background: Human infection with Strongyloides stercoralis and hookworm parasites is usually under reported due to less sensitive diagnostic methods. Agar plate culture (APC) is the most sensitive technique for parasites having larval stage. However, using APC in routine diagnosis is uncommon. This study aimed to determine the detection rate and sensitivity of APC in comparison with formal ether concentration technique (FECT) and spontaneous tube sedimentation techniques (STSTs) for S. stercoralis and hookworm larvae. Methods: Stool samples collected from 844 schoolchildren in Amhara Regional State, northwestern Ethiopia in 2019, transported to nearby health institutions and processed by APC, FECT and STSTs. The prevalence of S. stercoralis and hookworm was computed by descriptive statistics and Chi-square. The diagnostic agreement among the three techniques was evaluated using Kappa value. Results: The overall prevalence of S. stercoralis and hookworm infections by combining the three methods was 13.2% (111/844) and 33.8% (277/844), respectively. Using APC alone, the prevalence of S. stercoralis and hookworm were found to be 10.9% (92/844) and 24.5% (207/844), respectively. Agar plate culture was 5.4 and 2.7 times respectively more sensitive than FECT and STST, with slight and fair agreement in the detection of S. stercoralis. Hookworm diagnostic agreement was moderate between APC and FECT, and APC and STST. The Kappa value between STST and FECT diagnostic methods was substantial. Conclusion: APC has a better detection rate of S stercoralis and hookworm larvae. Therefore, APC can be used as an alternative routine diagnostic method to S. stercoralis and hookworm co-endemic countries.

BackgroundCutaneous leishmaniasis is caused by different protozoan parasites of the genus Leishmania. Leishmania RNA virus (LRV) was identified as the first Leishmania infecting virus in 1998. Different studies showed the presence and role of the LRV in Leishmania parasites causing cutaneous leishmaniasis (CL). However, there is limited data on the pooled prevalence of LRV in Leishmania parasites causing CL. Therefore, the aim of this systematic review and meta-analysis was to determine the pooled prevalence of LRV in Leishmania parasite isolates and/or lesion biopsies in patients with CL from the available literature globally.MethodologyWe retrieved the studies from different electronic databases. The studies were screened and identified based on the inclusion and exclusion criteria. We excluded studies exclusively done in experimental animals and in vitro studies. The review was conducted in line with PRISMA guidelines. The meta-analysis was performed with Stata software version 14 with metan command. The forest plot with random-effect model was used to estimate the pooled prevalence with 95% confidence interval. Inverse variance index (I2) was used to assess the heterogeneity among the included articles.Principal findingsA total of 1215 samples from 25 studies were included. Of these, 40.1% (487/1215) were positive for LRV. The overall pooled prevalence of LRV globally was 37.22% (95% CI: 27.54% - 46.90%). The pooled prevalence of LRV in the New World (NW) and Old World (OW) regions was 34.18% and 45.77%, respectively. Leishmania guyanensis, L. braziliensis, L. major, and L. tropica were the most studied species for the detection of LRV. The prevalence of LRV from Leishmania isolates and lesion biopsies was 42.9% (349/813) and 34.3% (138/402), respectively.ConclusionThis systematic study revealed that there is high prevalence of LRV in Leishmania parasites isolated from patients with CL. More comprehensive studies would be required to investigate the presence of the LRV in other Leishmania species such as L. aethiopica to fully understand the role of LRV in different clinical manifestations and disease pathology presented in CL patients.

Abstract Background Soil-transmitted helminths are more prevalent in tropics and sub-tropics including Ethiopia. Despite their high prevalence, direct saline microscopy with its low sensitivity has been used as a diagnostic method in almost all health facilities in Ethiopia. Alternative diagnostic methods which have higher sensitivity are not yet implemented. Therefore, this study aimed to compare and evaluate the performance of diagnostic methods for soil transmitted helminths. Methods A cross-sectional study among 520 school children was conducted from October to December, 2019 in Amhara National Regional State. The study participants were selected using systematic random sampling technique. Stool samples were processed via formol ether concentration, Kato-Katz, spontaneous tube sedimentation and agar plate culture techniques. Data was entered into Epi-data version 3.1 and analysis was done using SPSS version 20.0. The sensitivity, specificity, and negative predictive value were calculated against the combined result. Strength of agreement of the diagnostic methods was determined by Kappa value. Results The Overall prevalence of soil transmitted helminths was 40.8% using combination of methods. The prevalence 24.4, 22.5, and 32.4%, respectively was recorded by using formol ether concentration, Kato-Katz and spontaneous tube sedimentation. The highest prevalence of hookworm (29.2%) was detected by the agar plate culture. The sensitivity and negative predictive value of formol ether concentration were 57.9 and 78.4%, for Kato-Katz thick smear 55.2 and 76.4%, for spontaneous tube sedimentation were 79.2 and 87.5% to soil transmitted helminths detection, respectively. The sensitivity and negative predictive value of agar plate culture to hookworm detection were 86.4 and 93.5%, respectively. Conclusion Spontaneous tube sedimentation shows higher sensitivity in the detection of soil transmitted helminth infections. Agar plate culture method also indicated better performance for hookworm detection than other methods. Therefore, the employment of spontaneous tube sedimentation technique for routine laboratory and agar plate culture for research purposes will significantly aid in accurate diagnosis of parasitic infections.

BackgroundStrongyloides stercoralis is a parasite that causes strongyloidiasis in humans. It is prevalent in the tropics and sub-tropics where poor sanitation is a common problem. The true prevalence of S. stercoralis in Ethiopia is underestimated due to the lack of a "Gold" standard diagnostic method. Moreover, its prevalence across altitudinal gradient in Amhara Region has not been studied.MethodsA cross-sectional study was conducted among 844 schoolchildren in Amhara Region from April to December 2019. A stool sample was collected from each study participant and processed using formol ether concentration technique (FECT), spontaneous tube sedimentation technique (STST), Baermann concentration technique (BCT), agar plate culture (APC) and real-time polymerase chain reaction (RT-PCR). Data were entered using EpiData and analyzed by SPSS version 23 statistical software. Prevalence of S. stercoralis infection was determined using a single diagnostic technique and combination of techniques. Association of clinical variables with S. stercoralis infection was assessed by logistic regression and independent variables with pResultsPrevalence of soil-transmitted helminths (STHs) and S. mansoni infections was 38.0% and 20.4%, respectively. Among STHs, the prevalence of hookworm infection was 32.8%. Prevalence of S. stercoralis infection was 39.0%, 28.8%, 10.9%, 10.3%, 4.0% and 2.0% by the respective, combinations of the five methods, RT-PCR, APC, BCT, STST and FECT. The highest prevalence rates, 48.2%, 45.0% and 41.1% of S. stercoralis were recorded in the age group of 12-14 years, males and rural dwellers, respectively. Prevalence rates of S. stercoralis infection in highland, semi-highland and lowland areas were 40.4%, 41.8% and 25.9%, respectively. Having abdominal pain (AOR = 2.48; 95% CI:1.65-3.72), cough (AOR = 1.63;95%CI:1.09-2.42), urticaria (AOR = 2.49;95%CI:1.50-4.01) and being malnourished (AOR = 1.44;95%:1.10-2.01) were significantly associated with strongyloidiasis.ConclusionPrevalence of S. stercoralis infection was high and varied across different altitudes in Amhara Region. Some clinical syndromes were found to be significantly associated with S. stercoralis infection. Therefore, proper diagnosis and preventive strategies against S. stercoralis infection are highly recommended to be devised and implemented in Amhara Region.

Background. Soil-transmitted helminths (STHs) are among the most common neglected tropical diseases widely distributed in tropical countries with poor socioeconomic development. Ascaris lumbricoides, Trichuris trichiura, and hookworm are the three major STHs. This study aimed to determine the prevalence of STHs and associated risk factors among schoolchildren in selected primary schools around Lake Tana, Northwestern Ethiopia. Methods. A school-based cross-sectional study was conducted from February to May 2021 involving 337 study participants. A systematic random sampling method was utilized to select the study participants from the selected schools. Data related to sociodemographic characteristics of the study participants and risk factors for STH infections were collected using a pretested questionnaire. Stool samples were collected in sterile plastic containers from each participant and processed using Kato–Katz thick fecal smear and Ritchie’s concentration techniques. The data were analyzed using the Statistical Package for Social Sciences software tool version 23, and factors with a p

Objective: SARS-CoV-2 infection is an ongoing public health emergency of international significance. Considering that there is no specific drug and 100% effective vaccine yet, knowledge, attitude and practices (KAP) toward COVID-19 are crucial to prevent and manage the pandemic. This study aimed to assess knowledge, attitude and practices toward COVID-19 prevention measures of graduate students at a university in northwestern Ethiopia. Methods: A cross-sectional study design was conducted between September to December 2020. A structured questionnaire was used to collect data on socio-demographic characteristics and KAP of 407 randomly selected individuals. The data were exported to SPSS version 23.0, and bivariate and multivariate logistic regressions were used for analyses. Variables with P

Background Schistosomiasis is one of the widely distributed neglected tropical diseases. It is a serious public health problem in sub-Saharan Africa. The disease is highly prevalent and widely distributed in Ethiopia due to suitable environmental factors and human activities. The prevalence and infection intensity varied from locality to locality in the country. This study aimed to assess the prevalence and intensity of S. mansoni infection and associated risk factors among schoolchildren around Lake Tana. Methods A school-based cross-sectional study was conducted among 710 schoolchildren from February to April 2021 in eight selected primary schools around Lake Tana. A questionnaire was used to collect data on socio-demographic information and potential risk factors of S. mansoni infection. After collecting socio-demographic information, students were requested to bring about 2grams of stool specimens for parasitological examination. The collected stool samples were processed using a single Kato-Katz and Ritchie’s concentration techniques. The data were analyzed using SPSS software version 23 and factors with a p-value < 0.05 were considered as statistically significant. Results The overall prevalence of S. mansoni was 34.9% (95% CI: 31.4–38.7) among schoolchildren in the study area. The eggs per gram (EPG) of stool ranged from 24 to 1659 with arithmetic and geometric mean values of 138.1 EPG and 85.1 EPG, respectively. The majority of S. mansoni infections (61.4%) were classified as low infection intensity. Among the different determinant factors being male (AOR = 1.74; 95%CI = 1.233–2.457; P-value = 0.002), bathing habits (AOR = 1.494; 95%CI = 1.013–2.199; P-value = 0.043) and students attending at Qunzela primary school (AOR = 10.545; 95%CI = 3.264–34.067; P-value = 0.001), Alabo primary school (AOR = 3.386; 95%CI = 1.084–10.572; P-value = 0.036) were significantly associated with S. mansoni infection. Conclusion This study revealed that more than one-third of schoolchildren were infected by S. mansoni in the study area. The majority of the infections were classified as low infection intensity. Being male, bathing habits and schools in which students attended were independent explanatory factors for S. mansoni infection. Therefore, integrated control strategies are needed to improve the health conditions of schoolchildren in the study area. Author summary We conducted a school-based cross-sectional study to assess the prevalence and intensity of Schistosoma mansoni infection and associated risk factors. Stool samples were collected from 681 schoolchildren and processed using Kato-Katz and Ritchie’s concentration techniques. Among those students, 238 (34.9%) were infected with S. mansoni. Kato-Katz and Ritchie’s concentration detect 220 (92.4%) and 165 (69.3%) of the total positive cases, respectively. Most of the S. mansoni infections were categorized as low infection intensity based on egg per gram of stool. Among the potential risk factors assessed; being male, bathing habits in open water and schools in which students attended were independent predictors for S. mansoni infection.

Background. Schistosomiasis is one of the neglected tropical diseases causing a serious human health problem in Ethiopia. Praziquantel is the only drug that has been used for the treatment of human schistosomiasis in the country. In line with this, the efficacy of praziquantel has been evaluated in a few interventional studies in the country, but there is a lack in systematically gathered and analyzed information for policymakers. The aim of this systematic review and meta-analysis was to provide a summary of the efficacy of praziquantel for the treatment of human schistosomiasis in Ethiopia. Methods. We conducted a literature search from ScienceDirect, PubMed/Medlin, and Google Scholar databases. A total of 140 articles published in English from 1980 to June 2021 were accessed and 15 of them were eligible for this meta-analysis. The meta-analysis was conducted using Stata 14 software, “metan command.” The heterogeneities among studies were evaluated using I2 test. Results. A total of 140 articles were reviewed, but only 15 of them fulfilled the inclusion criteria. The polled cure rate of 40 mg/kg praziquantel was 89.2% (95% CI: 85.4–93.1) and 93.6% (95% CI: 80.6–106) among Schistosoma mansoni and S. haematobium, respectively. Similarly, the mean egg reduction rates of 40 mg/kg praziquantel were 90.2% and 85% among S. mansoni and S. haematobium infected subjects, respectively. The common adverse events observed after receiving praziquantel include abdominal pain, vomiting, headache, diarrhea, and bloody stool. Conclusion. This systematic review and meta-analysis has indicated that praziquantel is still an appropriate drug for the treatment of human schistosomiasis in Ethiopia.

Background. Malaria is one of the most severe public health problems worldwide. It is a leading cause of suffering, death, and socioeconomic problem, especially in many developing countries like Ethiopia. To introduce appropriate preventive and control measures, assessment of community’s levels of knowledge, attitude, and preventative practices regarding malaria is crucial. This study was aimed at assessing the knowledge, attitude, and practice (KAP) towards malaria and its preventive and control methods among people attending Mekaneeyesus primary hospital, South Gondar, northwestern Ethiopia. Methods. A hospital-based cross-sectional study was conducted from September 2017 to April 2018. A structured questionnaire was administered to collect data on sociodemographic characteristics and KAP of 390 randomly selected individuals. The data collecting tool was pretested before commencing the actual data collection. The data were analyzed using the SPSS version 21 software. P values less than 0.05 were considered statistically significant. Results. The overall prevalence rate of malaria in the study area was 8.5%. Nearly two-third of the participants had good knowledge (63.1%) and positive attitude (62.6%) scores towards malaria while only half of the participants had (50.8%) good practice score towards malaria prevention and control measures. Sex, age category, family monthly income, residence, and occupational and educational status of the participants were significantly associated with knowledge and practice scores (P

Abstract Objective The objective of this study was to investigate the seroprevalence and associated risk factors of syphilis among pregnant women attending antenatal care at Felege Hiwot Referral Hospital, northwest Ethiopia. Result Of the total 384 screened women for syphilis, 10 (2.6%) were found to be seropositive for Treponema pallidum. The odds of infection were about ten times (COR = 9.77, p = 0.002) higher in divorced women than in married women. The likelihood of syphilis was almost three times higher among rural residents compared to urban residents (COR = 3.48, p = 0.079). The likelihood of being infected with syphilis was about five times higher (COR = 5.25, p = 0.018) in women who had prior history of multiple sexual partners. The risk of syphilis was 4.42 (p = 0.071) and 2.67 fold (p = 0.226) greater in women with previous history of abortion and other sexually transmitted diseases (STDs), respectively. It can be concluded that a relatively low seroprevalence of syphilis was observed among the study subjects. Nevertheless, health promotion activity directed at raising the awareness of the community towards the modes of transmission of syphilis and its health impact is important in the prevention of the disease in pregnant women.

IntroductionHypertensive disorder of pregnancy is the second commonest causes of maternal death globally. Different public health studies were conducted on hypertensive disorder of pregnancy which presented inconsistent result. Therefore, this systematic review and meta-analysis was commenced to summarize the findings conducted in several parts of the country and to generate the nationwide representative data on the prevalence and risk factors of hypertensive disorder of pregnancy in Ethiopia.Methods and materialsElectronic databases such as PubMed, Scopus, Google Scholar, Hinari, and African Journals Online were searched for studies published in English up to March, 2020. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and Newcastle-Ottawa Scale were used for data extraction and quality assessment of the included studies. The meta- regression analysis was computed at 95% CI to present the pooled prevalence and risk factors of hypertensive disorder of pregnancy.ResultsThirty four studies were included in this systematic review and meta-analysis. The pooled prevalence of hypertensive disorder of pregnancy and preeclampsia in Ethiopia were 6.82% (95% CI (5.90, 7.74)) and 4.74% (95% CI (3.99, 5.49)) respectively. Maternal age ≥35 years (Adjusted Odds Ratio (AOR): 2.91 (95% CI: 1.60, 5.26)), twin pregnancy (AOR: 3.04 (95% CI: 1.89, 4.87)), previous history of preeclampsia (AOR: 5.36 (95% CI: 3.37, 8.53)), family history of hypertension (AOR: 4.01 (95% CI: 2.65, 6.07)), family history of diabetes mellitus (AOR: 3.07 (95% CI: 1.66, 7.70)), body mass index ≥25 (AOR: 3.92 (95% CI: 1.82, 8.42)), alcohol consumption (AOR: 1.77 (95% CI: 1.11, 2.83)), urinary tract infection (AOR: 4.57 (95% CI: 3.47, 6.02)), lack of nutritional counseling during antenatal period (AOR: 4.87 (95% CI: 3.36, 7.06)), lack of fruits (AOR: 3.49 (95% CI: 2.29, 5.30)), and vegetables consumption (AOR: 2.94 (95% CI: 2.01, 4.31)) were the risk factors of hypertensive disorder of pregnancy in Ethiopia.ConclusionsThe pooled prevalence of hypertensive disorder of pregnancy is relatively higher compared with the previous reports. Maternal age ≥35 years, twin pregnancy, previous history of preeclampsia, family history of hypertension, family history of diabetes mellitus, body mass index ≥25, alcohol consumption, urinary tract infection, lack of fruits and vegetables during pregnancy were risk factors of hypertensive disorder of pregnancy. The governments and stakeholders should work to strengthen the antenatal care practice to include the possible risk factors of hypertensive disorders of pregnancy.

IntroductionSome studies have reported the association between maternal serum lipid profile abnormalities and pre-eclampsia. However, many studies have reported controversial results. Hence, this systematic review and meta-analysis was planned to generate summarized evidence on the association between maternal serum lipid profiles and pre-eclampsia in African women.MethodsFour electronic databases such as; PubMed, Hinari, Google Scholar, and African Journals Online were searched for studies published in English. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and Newcastle-Ottawa Scale were used for data extraction and quality assessment of the included studies. The meta- regression analysis was performed by Stata 14 software. The standardized mean difference (SMD) values of lipid profiles were computed to assess their association with pre-eclampsia at 95% CI.ResultsIn this review a total of 15 observational studies were included. The mean values of triglyceride (TG), total cholesterol (TC), low density lipoprotein- cholesterol (LDL-c) and very low density lipoprotein- cholesterol (VLDL-c) were significantly higher in pre-eclamptic women as compared with normotensive pregnant women (TG = 229.61±88.27 and 147.00 ± 40.47, TC = 221.46 ± 45.90 and 189.67 ± 39.18, LDL = 133.92 ± 38.77 and 112.41 ± 36.08, VLDL = 41.44 ± 19.68 and 26.64 ± 7.87), respectively. The serum high density lipoprotein cholesterol (HDL-c) level was lower, but it is not statistically significant (HDL-c = 51.02 ± 16.01 and 61.80 ± 25.63) in pre-eclamptic women as compared with controls. The pooled standardized mean difference (SMD) of TG, TC, LDL-C and VLDL-C were significantly increased in pre-eclamptic women as compared with normotensive pregnant women with the SMD of (TG = 1.65 (1.10, 2.21), TC = 0.84 (0.40, 1.29), LDL-C = 0.95 (0.46, 1.45) and VLDL-C = 1.27 (0.72, 1.81)) at 95% CI, respectively, but the pooled SMD of HDL-cholesterol was decreased in pre-eclamptic women as compared with normotensive pregnant women (SMD = -0.91 (95% CI: -1.43, -0.39).ConclusionsIn this review, the maternal serum levels of TG, TC, LDL-c and VLDL-c were significantly associated with the risk of preeclampsia. However, HDL- cholesterol was not significantly associated but it was lower in pre-eclamptic women. Further, large scale prospective studies should verify these outcomes and it is recommended that lipid profiles should be included as a routine diagnostic test for pre-eclamptic women.

Background. Schistosomiasis is caused by Schistosoma mansoni and S. haematobium in Africa. These schistosome parasites use freshwater snail intermediate hosts to complete their lifecycle. Varied prevalence rates of these parasites in the snail intermediate hosts were reported from several African countries, but there were no summarized data for policymakers. Therefore, this study was aimed to systematically summarize the prevalence and geographical distribution of S. mansoni and S. haematobium among freshwater snails in Africa. Methods. Literature search was carried out from PubMed, Science Direct, and Scopus which reported the prevalence of S. mansoni and S. haematobium among freshwater snails in Africa. The pooled prevalence was determined using a random-effect model, while heterogeneities between studies were evaluated by I2 test. The meta-analyses were conducted using Stata software, metan command. Results. A total of 273,643 snails were examined for the presence of S. mansoni and S. haematobium cercaria in the eligible studies. The pooled prevalence of schistosome cercaria among freshwater snails was 5.5% (95% CI: 4.9–6.1%). The pooled prevalence of S. mansoni and S. haematobium cercaria was 5.6% (95% CI: 4.9–6.3%) and 5.2% (95% CI: 4.6–5.7%), respectively. The highest pooled prevalence was observed from Nigeria (19.0%; 95% CI: 12.7–25.3%), while the lowest prevalence was reported from Chad (0.05%; 95% CI: 0.03–0.13). Higher prevalence of schistosome cercaria was observed from Bulinus globosus (12.3%; 95% CI: 6.2–18.3%) followed by Biomphalaria sudanica (6.7%; 95% CI: 4.5–9.0%) and Biomphalaria pfeifferi (5.1%; 95% CI: 4.1–6.2%). The pooled prevalence of schistosome cercaria obtained using PCR was 26.7% in contrast to 4.5% obtained by shedding cercariae. Conclusion. This study revealed that nearly 6% of freshwater snails in Africa were infected by either S. haematobium or S. mansoni. The high prevalence of schistosomes among freshwater snails highlights the importance of appropriate snail control strategies in Africa.

Summary: A cross-sectional study involving 408 schoolchildren was performed from November 2013 to February 2014 to assess the prevalence of intestinal helminthic infections and malnutrition among schoolchildren of the Zegie Peninsula, northwestern Ethiopia. A structured questionnaire was used to gather data on the demographic and risk factors associated with intestinal helminthic infections. Stool samples were collected and examined for helminth eggs using the formalin–ether concentration technique. In addition, anthropometric measurements were performed to assess the nutritional status of the schoolchildren. The overall prevalence of intestinal helminthic infections in the study area was 69.1%. Single, double, triple, and quadruple infections were 42.2%, 18.4%, 5.9%, and 0.7%, respectively. The prevalence of hookworm, Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura, Hymenolepis nana, and Strongyloides stercoralis infections were 43.4%, 29.9%, 12.7%, 10%, 4.6%, and 0.7%, respectively. The prevalence of malnutrition in terms of stunting, being underweight, and wasting were 15.3%, 18%, and 27.6%, respectively. However, no significant association was found between intestinal helminthic infections and stunting, being underweight and wasting (p > 0.05). It can be concluded that intestinal helminthic infections, specifically infections due to hookworm and S. mansoni, are important health problems among schoolchildren of the Zegie Peninsula. Keywords: Ethiopia, Intestinal helminthes, Malnutrition, Schoolchildren, Zegie Peninsula

Background: HIV infection continues to pose a serious challenge to global health by predisposing patients to opportunistic infections. A cross-sectional study was conducted from December 2012 to February 2013 to assess the enteric protozoan infection status among individuals living with HIV/AIDS in Felegehiwot Referral Hospital, Bahir Dar, northwest Ethiopia. Methods: Stool specimens from 399 HIV-positive individuals were examined for the presence of trophozoites, cysts, and oocysts using direct wet mount, formol–ether sedimentation and modified Ziehl–Neelsen techniques. In addition, CD4+ T-cell counts were measured to evaluate the immune status of the study subjects. Results: An overall prevalence of 30.6% enteric protozoan infections was recorded. Pre-ART (antiretroviral treatment) individuals were more infected than patients on ART, although this was not statistically significant (p > 0.05). The highest prevalence of enteric protozoan infection was due to Entamoeba histolytica/E. dispar (19.3%), followed by Cryptosporidium spp (5.8%), Giardia lamblia (4.3%), and Isospora belli (1.3%). A CD4+ T-cell count of